ASSISTANT PROFESSOR (CARDIO VASCULAR AND THORACIC SURGERY -MEDICAL EDUCATION SERVICES

PROVISIONAL ANSWER KEY
Question Paper Code: 3/2021/OL
Category Code: 014/2020
Exam: Assistant Professor in Cardio Vascular and Thoracic Surgery
Date of Test 04-03-2021
Department Medical Education Services
Alphacode A
Question1:-The Inferior Vena Cava (IVC) opening in the diaphragm in adults is at the level of
A:-T10
B:-T8
C:-T12
D:-T6
Correct Answer:- Option-B
Question2:-PAPVC is frequently associated with which type of ASD ?
A:-Septum secondum defect
B:-Septum primum defect
C:-Coronary sinus type
D:-Sinus venosus type
Correct Answer:- Option-D
Question3:-Triangle of Koch is related to all EXCEPT
A:-Tendon of Todaro
B:-Septal leaflet of TV
C:-Inferior Vena Cava
D:-Coronary sinus
Correct Answer:- Option-C
Question4:-In a normal heart all the following veins drains into the left atrium EXCEPT
A:-Right superior pulmonary vein
B:-Anterior cardiac vein
C:-Left inferior pulmonary vein
D:-Right inferior pulmonary vein
Correct Answer:- Option-B
Question5:-Based on which arterial supply of heart determines the dominance of the system ?
A:-Left Anterior descending artery
B:-Left Circumflex artery
C:-Posterior descending artery
D:-Obtuse marginal arteries
Correct Answer:- Option-C
Question6:-In which condition you get pulsus parvus-et-tardus ?
A:-Aortic regurgitation
B:-Tricuspid regurgitation
C:-Mitral regurgitation
D:-Aortic stenosis
Correct Answer:- Option-D
Question7:-In total circulatory arrest, the level of hypothermia achieved is
A:-15 – 18°C
B:-28 to 30°C
C:-32°C
D:-34°C
Correct Answer:- Option-A
Question8:-Following can be branches arising from Left Circumflex EXCEPT
A:-Obtuse marginal arteries
B:-SA nodal artery
C:-Posterior descending artery
D:-Acute marginal artery
Correct Answer:- Option-D
Question9:-Normal mixed venous saturation ranges from
A:-20 – 40%
B:-40 – 60%
C:-60 – 80%
D:-80 – 100%
Correct Answer:- Option-C
Question10:-Normal pulmonary artery wedge pressure ranges from
A:-2-5 mm of Hg
B:-6-12 mm of Hg
C:-13-16 mm of Hg
D:-18-24 mm of Hg
Correct Answer:- Option-B
Question11:-Normal Pulmonary vascular resistance ranges from
A:-55 – 100 dynes/sec/𝑐𝑚5
B:-100 – 155 dynes/sec/𝑐𝑚5
C:-155 – 255 dynes/sec/ 𝑐𝑚5
D:-255 – 300 dynes/sec/ 𝑐𝑚5
Correct Answer:- Option-C
Question12:-Normal Cardiac index ranges from
A:-6 – 8 L/min/ 𝑚2
B:-4 – 6 L/min/ 𝑚2
C:-1.5 – 2 L/min/ 𝑚2
D:-2.5 – 4 L/min/ 𝑚2
Correct Answer:- Option-D
Question13:-Following are CT radiological features of traumatic aortic rupture in majority of cases EXCEPT
A:-Right hemothorax
B:-Aortic intimal flap
C:-Contrast extravasation
D:-Aortic pseudoaneurysm
Correct Answer:- Option-A
Question14:-About MUGA following statements are correct EXCEPT
A:-MUGA scans provide better assessment of left ventricular contractility than echocardiography
B:-Technetium-99 (99Tc) is used to acquire gamma images of patient’s cardiac cycle.
C:-RWMA can be detected at rest and under stress
D:-Defects observed during stress are indicative of areas of ventricular scar
Correct Answer:- Option-D
Question15:-Structures commonly compressed in Thoracic outlet syndrome are all EXCEPT
A:-Subclavian artery
B:-Subclavian vein
C:-Phrenic nerve
D:-Brachial plexus
Correct Answer:- Option-C
Question16:-Indications for Emergency Room Thoracotomy are all EXCEPT
A:-Unresponsive hypotension (SBP < 60 mm Hg) B:-Blunt thoracic injuries with no previously witnessed cardiac activity C:-Traumatic arrest with previously witnessed cardiac activity (pre-or-in-hospital) following penetrating thoracic injuries D:-Persistent hypotension (SBP < 60 mm Hg) with diagnosed cardiac tamponade, air embolism Correct Answer:- Option-B Question17:-Trauma score in a case of blunt cardiac injury causing valvular insufficiency is A:-1 B:-2 C:-4 D:-5 Correct Answer:- Option-C Question18:-Absolute contraindications of VATS in Thoracic Trauma includes all EXCEPT A:-Treatment for ongoing thoracic hemorrhage B:-Suspected cardiac injury C:-Suspected great vessel injury D:-Inability to tolerate single lung ventilation Correct Answer:- Option-A Question19:-Benign lung tumor of epithelial origin is A:-Hamartoma B:-Fibroma C:-Benign endobronchial fibrous histiocytoma D:-Pleomorphic adenoma Correct Answer:- Option-D Question20:-Alveolitic Interstial lung disease is seen in A:-Wegeners granulomatosis B:-Churg strauss syndrome C:-Goodpastures syndrome D:-Sarcoidosis Correct Answer:- Option-C Question21:-Selection criteria for lung volume reduction surgery include all EXCEPT A:-Bronchiectasis B:-Cessation of tobacco use for more than 6 month C:-Marked emphysema D:-Marked airflow obstruction Correct Answer:- Option-A Question22:-Indications of lung transplant include all EXCEPT A:-COPD with cor pulmonale B:-Severe PAH with MODS C:-Cystic fibrosis D:-Idiopathic pulmonary fibrosis Correct Answer:- Option-B Question23:-7 �ℎ station of lymph node for staging non small cell Carcinoma of lung is A:-Subaortic node B:-Subcarinal node C:-Para aortic node D:-Pulmonary ligament node Correct Answer:- Option-B Question24:-Which describes the thoraco abdominal aortic aneurysm repair ? A:-DeBakey classification B:-Stanford classification C:-Rastelli classification D:-Crawford classification Correct Answer:- Option-D Question25:-Adamkiewicz artery is A:-Largest artery supplying esophagus B:-First arterial branch arising from aorta C:-Largest radicular artery supplying spinal cord D:-Main arterial supply of diaphragm Correct Answer:- Option-C Question26:-Closed mitral commissurotomy is most commonly performed through A:-Clamshell incision B:-Left Anterolateral thoracotomy C:-Left Posterolateral thoracotomy D:-Median Sternotomy Correct Answer:- Option-B Question27:-Surgery involving replacement of aortic root with pulmonary autograft is A:-DeBakey operation B:-Bendall procedure C:-Rastelli operation D:-Ross procedure Correct Answer:- Option-D Question28:-Life long oral anticoagulants is advised to all except A:-Mechanical prosthetic valve replacement B:-AVR with OnX valve C:-MVR with bioprosthetic valve D:-DVT with recurrent thromboembolic episodes Correct Answer:- Option-C Question29:-The class I recommendations for aortic valve replacement in patients with AS are all EXCEPT A:-Patients with moderate AS who are undergoing cardiac surgery for another indication B:-Symptomatic patients with severe AS C:-Patients with severe AS undergoing concomitant coronary artery bypass graft surgery, heat valve surgery or aortic surgery D:-Patients with severe AS and left ventricular systolic dysfunction (ejection fraction < 50%) Correct Answer:- Option-A Question30:-Nicks Nunez is an aortic root enlargement technique which involves A:-A vertical incision through the commissure between the left coronary and the noncoronary cusp and extending down in the interleaflet triangle B:-A vertical incision through the middle of the noncoronary sinus extending through the annulus and into the anterior leaflet of the mitral valve C:-A vertical aortotomy is extended into the right coronary sinus left of the right coronary artery, through the aortic annulus near the commissure between the right and left coronary cusps and into the interventricular septum D:-Anterior root enlargement technique Correct Answer:- Option-A Question31:-Wilkins score is to assess disease of A:-Aortic valve B:-Mitral valve C:-Pulmonary valve D:-Tricuspid valve Correct Answer:- Option-B Question32:-In Carpentier's functional classification of Mitral regurgitation, Type II will have the following pathophysiological changes A:-Restricted leaflet motion (systole only), Papillary muscle displacement, Ischemic cardiomyopathy B:-Restricted leaflet motion (systole and diastole), Leaflet thickening or retraction, Rheumatic disease C:-Normal leaflet motion, Annular dilation, ischemic cardiomyopathy D:-Increased leaflet motion above annular plane (leaflet prolapse), Chordal elongation or rupture, Degenerative diseases/Infective endocarditis Correct Answer:- Option-D Question33:-Closed mitral valvotomy can be done in all the following condition EXCEPT A:-Presence of commissural calcification B:-Pliable valve cusps C:-Absence of LA clot D:-Minimal or no subvalvular fusion Correct Answer:- Option-A Question34:-Following are not Selection Criteria for Lung Metastasectomy EXCEPT A:-Presence of extrathoracic metastases B:-Can perform a complete resection of the metastases C:-Significant comorbidity that would preclude surgery D:-Alternative therapy that is superior to surgery available Correct Answer:- Option-B Question35:-Hernia associated with defected development of pleuroperitoneal membrane is A:-Bochdalek hernia B:-Hiatus hernia C:-Morgagni hernia D:-Pericardial hernia Correct Answer:- Option-A Question36:-Most common type of Esophageal Atresia (EA) is A:-EA with distal Tracheo Esophageal Fistula (TEF) B:-H type TEF C:-EA with proximal TEF D:-EA with double TEF Correct Answer:- Option-C Question37:-Benign esophageal tumor arising from submucosa is A:-Squamous papilloma B:-Retention cyst C:-Fibroma D:-Leiomyoma Correct Answer:- Option-C Question38:-Following are techniques of esophagectomy EXCEPT A:-Nissens procedure B:-Ivor Lewis procedure C:-Mckeown's procedure D:-Oringer's procedure Correct Answer:- Option-A Question39:-Most common systemic disease associated with thymoma is A:-Hypogammaglobulinemia B:-Myesthenia Gravis C:-SLE D:-Sjogren's syndrome Correct Answer:- Option-B Question40:-Posterior mediastinal neurogenic tumor arising from sympathetic ganglia is A:-Neuroblastoma B:-Neurofibroma C:-Neurosarcoma D:-Paraganglioma Correct Answer:- Option-A Question41:-End Diastolic Pressure Volume Relationship (EDPVR) is affected by all EXCEPT A:-Myocardial passive stiffness B:-Myocyte relaxation C:-Atrial suction D:-Pericardium Correct Answer:- Option-C Question42:-Benefits of CABG compared to PTCA are all EXCEPT A:-Quicker recovery from initial procedure B:-Fewer subsequent procedures and hospitalizations C:-More complete initial revascularization D:-Established benefit in left main coronary disease Correct Answer:- Option-A Question43:-Cangrelor is A:-Cox 1 inhibitor B:-P2Y12 inhibitor C:-Cox 2 inhibitor D:-Protease activated receptor 1 inhibitor Correct Answer:- Option-B Question44:-Abciximab is A:-Glycoprotein inhibitor B:-Cox 2 inhibitor C:-P2Y12 inhibitor D:-Protease activated receptor 1 inhibitor Correct Answer:- Option-A Question45:-Which drug causes no change in low doses in Systemic Vascular Resistance (SVR) and Pulmonary Artery Wedge Pressure (PAWR) but increases both in higher doses ? A:-Adrenaline B:-Dopamine C:-Noradreanaline D:-Milrinone Correct Answer:- Option-B Question46:-Following are valve sparing ascending aortic or aortic root repair procedures EXCEPT A:-Supra Coronary Ascending Aortic Replacement B:-David's procedure C:-Yacoub's procedure D:-Bendall's procedure Correct Answer:- Option-D Question47:-Major criteria of Cardiovascular system seen in Marfan Syndrome is A:-Mitral Valve Prolapse B:-Dilatation of Pulmonary Artery C:-Aortic Root Dilatation D:-Dilatation or Dissection of Descending Aorta Correct Answer:- Option-C Question48:-Following Thoracic Endovascular Aortic Repair (TEVAR), Type IV endoleak is due to A:-Graft wall porosity B:-Attachment site leak C:-Branch leak D:-Graft defect Correct Answer:- Option-A Question49:-Clinical grading system for Peripheral Occlusive Vascular Disease (POVD) is A:-POCAS scale B:-Rutherford scale C:-Wilkins score D:-Euro score Correct Answer:- Option-B Question50:-All are sutureless valves EXCEPT A:-Perimount valve B:-3f Enable valve C:-Perceval S valve D:-Intuity valve Correct Answer:- Option-A Question51:-Stentless valve is A:-Epic valve B:-Perceval S valve C:-Trifecta valve D:-Prima plus valve Correct Answer:- Option-D Question52:-De Vega annuloplasty is done for the repair of A:-Aortic valve B:-Mitral valve C:-Tricuspid valve D:-Pulmonary valve Correct Answer:- Option-C Question53:-Modified Duke criteria is for the diagnosis of A:-Rheumatic heart disease B:-Infective endocarditis C:-Degenerative valvular heart disease D:-Valvular insufficiency Correct Answer:- Option-B Question54:-Implantable Cardioverter Defibrillator (ICD) therapy is contraindicated in all EXCEPT A:-Patient with LVEF < 35% due to prior MI, more than 40 days post MI, NYHA - class II B:-Acute MI with severe electrolyte imbalance C:-Patient with terminal illness and life expectancy less than 12 months D:-Patient with severe psychiatric disorder Correct Answer:- Option-B Question55:-Contour 3D ring is used for the repair of A:-Aortic regurgitation B:-Mitral regurgitation C:-Tricuspid regurgitation D:-Pulmonary regurgiation Correct Answer:- Option-C Question56:-SYNTAX study compares A:-Mechanical valve Vs Bioprosthetic valve B:-Total arterial revascularization Vs Arterio venous revascualarization C:-OPCAB Vs on pump CABG D:-CABG VS PCI Correct Answer:- Option-D Question57:-Following Mechanical circulatory support device can be placed percutaneously EXCEPT A:-IABP B:-ECMO C:-LVAD D:-Impella Correct Answer:- Option-C Question58:-About SynCardia following statement is/are correct. Choose the correct option (i) Right ventricular assist device (ii) Left ventricular assist device (iii) Biventricular assist device A:-Only (ii) is correct B:-Only (i) is correct C:-Only (iii) is correct D:-None is corrrect Correct Answer:- Option-C Question59:-Most common cause of heart failure requiring heart transplantion is A:-Congenital heart disease B:-Cardiomyopathy C:-Coronary artery disease D:-Valvular heart disease Correct Answer:- Option-B Question60:-Surgically placed mechanical circulatory support devices are the following EXCEPT A:-Abiomed BVS 5000 B:-Tandem heart C:-CentriMag D:-Thoratec heartmate XVE Correct Answer:- Option-B Question61:-Most common malignant sarcoma of heart is A:-Angiosarcoma B:-Rhabdomyosarcoma C:-Malignant mesothelioma D:-Fibrosarcoma Correct Answer:- Option-A Question62:-Development of heart completes by A:-7 weeks B:-10 weeks C:-12 weeks D:-15 weeks Correct Answer:- Option-B Question63:-For survival after birth, patency of ductus arteriosus dependent congenital heart diseases are all EXCEPT A:-Pulmonary atresia B:-PAPVC C:-Hypoplastic left heart syndrome D:-TGA Correct Answer:- Option-B Question64:-Long term mechanical circulatory support device are all EXCEPT A:-Thoratec intracorporeal VAD B:-Jarwick 2000 C:-Micromed DeBakey D:-Impella Correct Answer:- Option-D Question65:-Post tricuspid acyanotic congenital heart disease is A:-Patent ductus arteriosus B:-Ostium primum ASD C:-Ostium secondum ASD D:-PAPVC Correct Answer:- Option-A Question66:-3 �� generation mechanical circulatory support devices are all EXCEPT A:-Heartmate II B:-Heartware HVAD C:-Dura heart D:-Synergy Correct Answer:- Option-A Question67:-Grade 4 murmur is A:-Extremely loud and can be heart even if only edge of stethoscope is in contact with skin B:-Moderately loud with no thrill C:-Faint but can be heard easily D:-Loud with palpable thrill Correct Answer:- Option-D Question68:-Cyanotic congenital heart disease with low pulmonary blood flow and no PAH is A:-Hypoplastic left heart syndrome B:-TAPVC C:-Truncus arteriosus D:-Ebstein anomaly Correct Answer:- Option-D Question69:-Rib notching in chest X-ray is seen in A:-ASD B:-CoA C:-TOF D:-TGA Correct Answer:- Option-B Question70:-Left superior vena cava is due to persistence of A:-Right posterior cardinal vein B:-Left anterior cardinal vein C:-Left common cardinal vein D:-Left posterior cardinal vein Correct Answer:- Option-B Question71:-Seen in Scimitar syndrome is A:-Hypoplastic right inferior PV and right lung B:-Hypoplastic left superior pulmonary vein and left lung C:-Hypoplastic right pulmonary artery and right lung D:-Hypoplastic left pulmonary artery and left lung Correct Answer:- Option-C Question72:-Type 2 TAPVC is A:-Cardiac type B:-Supracardiac type C:-Infracardiac type D:-Mixed type Correct Answer:- Option-A Question73:-ASD due to endocardial cushion defect is A:-Ostium primum ASD B:-Ostium secondum ASD C:-Sinus venosus ASD D:-Coronary sinus type ASD Correct Answer:- Option-A Question74:-Children with which chromosomal abnormality will have most congenital cardiovascular malformation ? A:-Trisomy 13 B:-Trisomy 18 C:-Trisomy 21 D:-DiGeorge syndrome Correct Answer:- Option-B Question75:-According to Kirklins classification Type I Ventricular Septal Defect is A:-Muscular VSD B:-Perimembaranous VSD C:-Inlet or AV canal VSD D:-Supracristal infundibular VSD Correct Answer:- Option-D Question76:-Gerbode defect is A:-Interatrial defect B:-Interventricular defect C:-Defect between LV and RA D:-Defect between RV and LA Correct Answer:- Option-C Question77:-Regarding indications for surgical closure of VSD, which statement is correct i. Refractory heart failure ii. Development of AR iii. Asymptomatic older children with Qp/Qs greater than 2 : 1 A:-Only i and ii is correct B:-Only ii and iii is correct C:-Only i and iii is correct D:-All i, ii, iii is correct Correct Answer:- Option-D Question78:-Rastelli classification is for A:-Complete AV canal defect B:-Transposition of great arteries C:-TAPVC D:-Hypoplastic left heart syndrome Correct Answer:- Option-A Question79:-Gibson murmur is seen in A:-Congenital aortic stenosis B:-PDA C:-VSD D:-Ebstein anomaly Correct Answer:- Option-B Question80:-Cap of Zinn in Chest X-ray is seen in A:-PDA B:-TGA C:-TAPVC D:-VSD Correct Answer:- Option-A Question81:-Regarding aortopulmonary window, most common type is due to A:-Proximal defect B:-Distal defect C:-Confluent defect D:-Intermediate type defect Correct Answer:- Option-A Question82:-The type of Aneurysm of Sinus of Valsalva, which is most commonly associated with VSD is ? A:-Type IV B:-Type III C:-Type II D:-Type I Correct Answer:- Option-D Question83:-RVOT obstruction can be due to all the following EXCEPT A:-Pulmonary valve stenosis B:-Infundibular stenosis C:-Double chambered right ventricle D:-Tricuspid atresia Correct Answer:- Option-D Question84:-Type A interrupted aortic arch is A:-Between left common carotid artery and left subclavian artery B:-Distal to left subclavian artery C:-Between innominate artery and left common carotid artery D:-Proximal to innominate artery Correct Answer:- Option-A Question85:-Cyanotic spell in Tetrology of Fallot (TOF) is due to atrial tachycardia was proposed by A:-Wood's theory B:-Kothari's thoery C:-Morgan's theory D:-Young's theory Correct Answer:- Option-D Question86:-Type IV Aneurysm of Sinus of Valsalva ruptures into A:-Pulmonary Artery B:-Right Ventricle C:-Right Atrium D:-Both RA and RV Correct Answer:- Option-C Question87:-Sub valvular LVOT obstruction is due to A:-Dysplastic aortic valve B:-Hypertrophic obstructive cardiomyopathy C:-Interrupted aortic arch D:-Coarctation of aorta Correct Answer:- Option-B Question88:-Following indices are considered for prediction of success of Intra Cardiac Repair in TOF EXCEPT A:-Goldman risk index B:-Nakata index C:-McGoon index D:-Z score Correct Answer:- Option-A Question89:-Advantage of Balloon pulmonary valvotomy are all EXCEPT A:-Substantial increase in 𝑂2 saturation B:-Helps in growth of pulmonary valve annulus and pulmonary artery C:-The need of transannular patch is reduced by 80% D:-In TOF it acts as a safe bridge to surgery Correct Answer:- Option-C Question90:-Palliative procedure augmenting pulmonary blood flow in TOF are all EXCEPT A:-Modified Blalock Taussig shunt B:-Intracardiac repair C:-Waterston shunt D:-Balloon pulmonary valvotomy Correct Answer:- Option-B Question91:-Taussig Bing anomaly is A:-DORV with sub aortic VSD B:-DORV with sub pulmonary VSD C:-DORV with non committed VSD D:-DORV with doubly committed VSD Correct Answer:- Option-B Question92:-Arterial switch operation for dTGA is A:-Jatene operation B:-Senning operation C:-Mustard operation D:-Rastelli operation Correct Answer:- Option-A Question93:-Indication for IABP insertion includes all the following EXCEPT A:-Cardiogenic shock B:-Severe aortic regurgitation C:-Perioperative refractory ischaemia D:-Post operative poor cardiac output refractory to ionotropic support Correct Answer:- Option-B Question94:-Norwood procedure is done for A:-Tricuspid atresia B:-dTGA C:-Hypoplastic left heart syndrome D:-DORV Correct Answer:- Option-C Question95:-Closed mitral valvotomy is done using A:-Codmann's ventricular dilator B:-Modified Hegar's dilator C:-Pratt's dilator D:-Tubb's dilator Correct Answer:- Option-D Question96:-Conduits most commonly used for CABG are all EXCEPT A:-Left internal mammary artery B:-Intercostal vein C:-Long saphenous vein D:-Radial artery Correct Answer:- Option-B Question97:-Type I Cor triatriatum is A:-Accessory atrial chamber receives part of PV and connected to LA B:-Accessory atrial chamber receives all PV and does not communicate with LA C:-Accessory atrial chamber receives all PV and communicates with LA D:-Accessory atrial chamber receives part of PV and connected to RA Correct Answer:- Option-C Question98:-Hammock valve causes A:-Left ventricular inflow obstruction B:-Left ventricular outflow obstruction C:-Right ventricular inflow obstruction D:-Right ventricular outflow obstruction Correct Answer:- Option-A Question99:-The type of Tricuspid atresia associated with Truncus Arteriosus is A:-Type I B:-Type II C:-Type III D:-Type IV Correct Answer:- Option-D Question100:-Based on Carpentiers classification, Type C Ebsteins anomaly is A:-Almost complete atrialization of RV except for a small infundibular portion B:-Atrialized portion of RV is large but anterior is freely mobile C:-Mild displacement of proximal attachment of septal and posterior leaflets D:-Anterior leaflet mobility is limited, RVOT is severely obstructed Correct Answer:- Option-D