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Signature of the Invigilator Exam Centre Code

Seal & Signature of theExam Centre Superintendent

MCC-001

00207

POST GRADUATE DIPLOMA IN CLINICALCARDIOLOGY (PGDCC)

Term-End Examination

December, 2009

MCC-001 : FUNDAMENTALS OF CARDIO-VASCULAR SYSTEM-I

Time : 2 hours Maximum Marks : 60

Note :

(i)

There will he multiple choice type of questions in this examination which are to answered in

OMR Answer Sheets.

All questions are compulsory.

Each question will have four options and only one of them is correct. Answers have to he marked infigures in the appropriate rectangular boxes corresponding to what is the correct answer and then

blacken the circle for the same number in that column by using HB or lead pencil and not by ball pen

in OMR Answer Sheets.

If any candidate marks more than one option, it will he taken as the wrong answer and no marks willbe awarded for this.

Erase completely any error or unintended marks.

There will be 60 questions in this paper and earl question carries equal marks:

There will he no negative marking for wrong answers.

(viii) No candidate shall leave the examination hall at least for one hour after the commencement of theexamination.

MCC-001

1 P.T.O.

FALSETRUE

TRUE I FALSE

TRUE FALSE

1. Leads V7 and V8 are occasionally used to detect :

Infero posterior MI TRUE FALSE

Anterolateral MI TRUE FALSE

High lateral MI TRUE FALSE

Posterolateral Ml TRUE FALSE

PR segment represents

Duration of atrioventricular conduction TRUE FALSE

Duration of intra atrial conduction FALSE1TRUE

Duration of His-Purkinje conduction TRUE FALSE

Duration of intra ventricular conduction TRUE FALSE

3. Attenuation of respiratory sinus arrhythmia (heart rate variability) can be seen in all except

Ageing TRUE FALSE

Diabetes mellitus TRUE FALSE

CHF TRUE FALSE]

Pericarditis TRUE 'FALSE

4. 55 yr. old man presents with 2 hours of central crushing chest pain. His ECG is as shownbelow. He :

will not benefit from thrombolysis

is more likely to have AV block

is likely to have occlusion of left Anterior Descending artery.

will have severe hypokinesia/akinesia of Lateral wall on the

echocardiogram. TRUE FALSE

HI VaVFaVLaVR

MCC-001 2

5. This ECG is typical of

Hypercalcemia TRUE FALSE

Hypocalcemia TRUE FALSE

Hypokalemia TRUE FALSE

Hyperkalemia I TRUE FALSE

6. Prominent 'a' wave in the JVP is seen in all except

A-V dissociation TRUE FALSE

Tricuspid Regurgitation TRUE FALSE

Pulmonic stenosis TRUE FALSE

PAH TRUE FALSE

7. BP differential of >10 mm Hg can be associated with all except

Subclavian artery stenosis TRUE FALSE

Supra valvular AS TRUE FALSE

Co A TRUE FALSE

Type III Aortic Dissection TRUE FALSE

8. At above anaerobic threshold

Muscle switches to anaerobic metabolism as additional energy source.

TRUE FALSE

Minute ventilation decreases relative to respiratory oxygen uptake TRUE FALSE

Oxygen is consumed in excess of CO 2 produced TRUE FALSE

CO2 production is proportional to oxygen consumption TRUE FALSE

MCC-001 3

P.T.O.

(TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE'

TRUE FALSJ

TRUE FALSE

TRUE FALSE

TRUE FALSE

9. Following exercise parameters are associated with adverse prognosis except

Duration of symptom-limiting exercise 5-7 METS

Failure to increase systolic BP 120 mm Hg

ST depression 2mm starting at < 5 METS

Sustained VT

10. A Treadmill score

—11 indicate high risk

> +5 indicates worse prognosis

Works better in women than men

Does not add independent prognostic information to that provided

by LV ejection fraction

11. Corrigan Pulse is found in

Severe AS

Severe AR

Severe MR

Severe MS

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

12. Loud Si is heard in all except

MS

TS

Hyperkinetic states

First degree Av block

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

13. Pansystolic murmur is heard in all except

VSD

Chronic MR

Chronic TR

Severe AS

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

MCC-001 4

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

14. Continuous murmur is heard in

PDA with PAH

VSD

PS

Pulmonary Artery branch stenosis

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

15. Murmur associated with the following condition increases in intensity with Valsalvamaneauvre

AS

AR

HOCM

MS

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

16. Loud P2 is heard in

PS

PR

PAH

Normal adolescents

17. All are signs of severe MS except

Long holodiastolic murmur

Loud S1

Short A2-OS interval

Loud P2

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

18. Cardiomegaly in an adult on a standard PA chest radiograph is present if CT ratio is

more than 0.65

more than 0.50

more than 0.55

more than 0.60

TRUE

TRUE

TRUE

TRUE

FALSE

FALSE

FALSE

FALSE

5 P.T.O.MCC-001

TRUE FALSE

TRUE !FALSE!

TRUE • FALSE

LTRUE FALSE

TRUE FALSE

TRUE FALSE]

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

FIRUE FALSE

19. On a frontal projection

RA

SVC

Ascending aorta

RV

CID heart border is formed by all of the following except

20. RA enlargement on a chest X-Ray is seen in all except

Ebstein anomaly

Tricuspid atresia

Chronic severe TR

RA myxoma

21. Cardiac index is

heart rate x stroke volume

heart rate • x end systolic volume per body surface area

heart rate x stroke volume per body surface area

heart rate x end systolic volume

22. Ejection Fraction is the ratio of

Stroke volume to end systolic volume TRUE 1FALSE

Stroke volume to end diastolic volume TRUE FALSE

Stroke volume x heart rate rTRUE FALSE

Stroke volume x mean systolic blood pressure TRUE FALSE

23. Dyskinesis is defined as

Reduced systolic shortening TRUE FALSE

Systolic elongation/ bulging TRUE FALSE

Absent systolic shortening TRUE] FALSE1

Increased systolic shortening TRUE FALSE

MCC-001 6

26. Resting Transmembrane potential in AV Nodal cell is

— 40 to — 50

—50 to — 60

— 60 to — 70

— 70 to — 80

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE I FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

24. Afterload is determined by all except

Aortic Pressure

Ventricular volume

Heart rate

Wall thickness

25. Left coronary Artery arises from the

Left aortic cusp

Right aortic cusp

Non coronary cusp

Aortic Arch directly

TRUE FALSE'

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

LTRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

27. The upstroke (Phase 0) of cardiac action potential is due to

Increase in membrane conductance to Na-1"

Decrease in membrane conductance to Na +

Increase in membrane conductance to Ca2+

Decrease in membrane conductance to K+

28. Triggered activity

Is the property of a fiber to initiate an impulse spontaneously

Is initiated by after depolarizations

Does not require preceding impulse or series of impulses

Is the commonest mechanism of arrhythmogenesis

TRUE FALSE

TRUE FALSE

TRUE FALSE

LTRUE FALSE

7 P.T.O.MCC-001

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE]

TRUE FALSE

TRUE FALSE

TRUE FALSE,

TRUE FALSE]

TRUE FALSE

TRUE FALSE

TRUE I FALSE

TRUE FALSE

TRUE FALSE

29. The primitive straight cardiac tube is formed in the

First month of gestation

Second month of gestation

Third month of gestation

Fourth month of gestation

30. Following are formed from the endocardial cushions except

Inferior IAS

Superior IVS

Portions of septal leaflet of tricuspid and mitral valves

Superior IAS

31. Following is true about tricuspid valve

Septal leaflet is the largest

Inserted more apically than mitral valve

Three leaflets occupy an Anterior, Posterior and Superior positions

Leaflets are supported by anterolateral and posteromedial papillary

muscles

TRUE FALSJ

TRUE FALSE1

TRUE FALSE

TRUE FALSE]

32. Morphological Right ventricle is

Elliptical

Rectangular

Triangular

Circular

MCC-001 8

33. By definition, ascending aorta is proximal to the

Origin of ® subclavian artery TRUE FALSE

Origin of ® common carotid artery TRUE FALSE

Origin of CD common carotid artery TRUE FALSE

Origin of Innominate Artery TRUE FALSE,

34. All of the following occur with the first inspiration at birth except

Fall in pulmonary vascular resistance TRUE FALSE

Fall in PA pressure TRUE FALSE

Rise in systemic vascular resistance TRUE FALSE

Fall in LA pressure FALSATRUE

35. In full term infants, ductus arteriosus is functionally closed

within 10-15 hours

within 24 hours

within 3 days

within 3 weeks

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

36. Endogenous substances produced by endothelial cells causing vasodilatation include all except

Prostacyclin TRUE FALSE

Endothelin F—TRUE 'FALSE

Endothelium derived hyper polarizing factor TRU1 FALSE

Nitric oxide TRUE FALSE

9 P.T.O.MCC-001

37. All of the following are functions of vascular endothelium in a health y adult except

Fibrinolysis TRUE FALSE'

Vasoconstriction TRUE FALSE

Anti inflammatory TRUE FALSE

Anti proliferative TRUE FALSE

38. All are true of Actin except

Consists of a double helix TRUE FALSE

Constitutes of thin filament TRUI:j FALSE

Contains ATP are activity TRUE FALSE

Combines reversibly with myosis in presence of ATP and Ca24- TRUE FALSE

39. Tick the incorrect response. Afterload is

Load that opposes shortening

Tension developed in the ventricular wall during ejection

Determined by aortic pressure, volume and thickness of the

ventricular cavity

higher in a normal sized ventricle than a dilated ventricle

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUEJFALSE

40. Starling's law of the heart states that within limits

(1) force of ventricular contraction depends on the end diastolic length ofcardiac muscle

TRUE FALSE

(2) force of ventricular contraction depends on end systolic length ofcardiac muscle

TRUE FALSE

Stroke volume varies inversely with preload

TRUE FALSE

Stroke volume varies directly with the afterload

TRUE FALSE

MCC-001 10

41. ST segment elevation is seen in all except

Acute MI TRUE !FALSE

Acute pericarditis TRUE FALSE

Prinzmetal angina TRUE FALSE

Endocarditis TRUE FALSE

42. ECG changes of hyperkalaemia include all except

Tented T waves TRUE I FALSE

QT prolongation TRUE FALSE

wide QRS TRUEJFALSE

Prolonged PR TRUE FALSE

43. Low voltage QRS complexes are seen in the ECG in all except

Hyperthyroidism TRUE FALSE]

Pericardial effusion FALSEITRUE

Obesity TRUE FALSE

Myocarditis TRUE FALSE

44. Non coronary causes of ST segment depression include all except

Digitalis use TRUE FALSE

LVH TRUE FALSE

Severe aortic stenosis FALSE1TRUE

Hyperkalaemia TRUE FALSE]

MCC-001 11

P.T.O.

TRUE FALSE

TRUE FALSE

TRUE FALSE

LTRUE FALSE

TRUE FALSE

45. Sensitivity of an exercise ECG is defined as

Percentage of patients with CAD who have an abnormal result

Percentage of patients without CAD who have a normal result

Percentage of patients with an abnormal result who have CAD

Percentage of patients with a normal result who do not have CAD

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

46. Drugs used to treat an acute attack of PSVT include all except

Adenosine

Diltiazem

Amiodarone

Verapamil

47. Risk factors for developing Atrial fibrillation include all except

Mitral valve disease TRUE

Hypertension TRUE

Heart failure TRUE

Diabetes mellitus TRUE

FALSE I

FALSE

FALSE

FALSE

48. Cardiogenic shock is characterized by all except

Raised pulmonary capillary wedge pressure TRUE FALSE

Normal cardiac output TRUE FALSE

Raised systemic vascular resistance TRUE I FALSE

Low venous oxygen saturation TRUE FALSE

MCC-001 12

FALSETRUE

TRUE FALSE

FALSETRUE

TRUE FALSE

49. Vasoconstrictors that are increased in most forms of shock include all except

Vasopressin

Angiotensin II

Prostacyclin

Endothelin 1

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

50. Systolic hypertension with wide pulse pressure is seen in all except

AV fistula

Hypothyroidism

fever

PDA

51. Most common congenital cardiovascular cause of hypertension is

Aortic stenosis

Coarctation of aorta

Aortic regurgitation

PDA

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

52. SA node dysfunction can be seen in all except :

Hypothyroidism

Decreased intracranial pressure

Sleep Apnoea

Hypothermia

TRUE FALSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

MCC-001 13 P.T.O.

TRUE FALSEI

TRUE FALSE

TRUE FALSE

TRUE I FA LS___]

TRUE FALSE

TRUE I FALSE

TRUE IFALSE1

TRUE FALSE

53. Conduction through AV node is improved by all of the following except

Exercise

Atropine

Isoprenaline

Carotid massage

TRUE FALSE

TRUE FALSE I

TRUE FALSE

TRUE FALSE

54. Dobutamine stress echocardiography would be preferred over exercise for diagnosis CAD inpatients with

Paced rhythm

RVH

RBBB

First degree AV block

55. Palpable presystolic impulse

Corresponds to S4

Corresponds to S3

Occurs in severe MR

Occurs in HOCM with AF

56. Most common cause of a mid systolic murmur in an adult is

PS

AS

HOCM

ASD

57. Carey Coombs murmur is clinically associated with

Rupture of AML

AML Prolapse

Severe PAH

Acute Rheumatic mitral valvulitids

TRUE FALSE]

TRUETFAL§I;

TRUE FALSE

TRUE FALSE

TRUE FA LSE

TRUE FALSE

TRUE FALSE

TRUE FALSE

MCC-001 14

58. Loud P2 suggests

Severe valvular PS TRUE FALSE

Severe infundibular PS rTRUT:IFALSE

Tetralogy of Fallot TRUE FFALSEl

Pulmonary Arterial hypertension TRUE FALSE

59. Diastolic dysfunction of the LV can be measured by all except

Cardiac catheterization TRUE 'FALSE

Cardiac MRI TRUE FALSE

Doppler Echocardiography TRUE FALSE

PET scan TRUE FALSE

60. During physical exercise

Heart rate remains unchanged TRUE FALSE

Arterial diastolic pressure increases [TRUE FALSE

LV ejection period increases TRUE FALSE I

Pulse pressure increases TRUE FALSE

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