Rasamayi May 2013 Special Double Dhamaka (Venkat & Murali)

some photos of Venkat's karaoke - prof k venkateswara rao anesthesia HOD who is retiring may 31st.

HAMSA - Cardiology MCQs - 1-5-2013 & 8-5-2013

HAMSA – Andhra Medical College – 
Learning Session – I – 2013 

(email - hamsaamc@rediffmail.com) 
The first Learning Session of HAMSA for this academic year was held on 1st May 2013. Sessions included
- an Inauguration by Principal i/c Dr SV Kumar & Suptdt Dr M Madhusudhana Babu - also present were Vice Principal Dr NN Raju & Surgeon Dr M Raja Gopal
- Cardiology MCQs from Dept of Cardiology - (a little bit difficult paper i guess)
- Basics of Chest Xray - by Indrasena Reddy 2k9
- Interpreting Chest Xrays - Dr UmaMaheswara Rao (Radiology Assoc Prof)

(among those who gave their answer sheets of the Cardiology MCQs for correction & scoring,
highest score was 28 to Ram Manohar & second to Mahati 22 - both 2k9 - 
2 others got 22 - Viswanath & Vyshnavi - but they gave their scripts late and missed the prizes!)

HAMSA executive -
Coordinators - Indrasena Reddy & Abhijna - 2k9 
Secretary - Neeharika
Treasurer - Venkat Arjun 
--------------------------------------------

8th May 2013 saw

- MCQs on Fractures, their discussion by Prof Uday Kumar & Dr Ashok.
- Acute Rheumatic Fever - presented by Mr K Thrinadh 2k9
- Mitral Stenosis  - by Prof P  Ramana Rao Cardiology.

- prizes will be sponosored by Orthopedics dept & Dr Uday Kumar 
- Ram Manohar & Swaroop (2k9) stood first with 30 each out of 50.
- Keerti (2k9) scored 27 but didn't mark the answers properly!!!!! (the mock OMR sheets)

those were photos of 1st May session. here are some photos of 8th May sessions.

CARDIOLOGY  MCQS 

MCQs on Cardiology – 45Q - 20min. 

1.  NYHA classification useful for grading :

a. Dyspnoea     b. Fatigue         c. Palpitation    d. All of the above

2. Common side effect of Calcium channel blockers is

a. Angioedema         b. Cough                      c. Pedal edema               d. Hypokalemia           e. all

3.  All are true regarding Atrial Fibrillation EXCEPT  :

a. Pulse deficit >10      b. Absent ‘a’ wave in JVP       c. On exertion A.fib decreases
d.Irregularly irregular pulse

4. Following antihypertensives are avoided in pregnancy EXCEPT

a. Ramipril       b. Atenolol       c. Losartan       d. Hydralazine 

5.  1 peak in systole & 1 peak in diastole is seen in following type of pulse :

a. P.bisferens   b. P.dicroticus  c. P.bigeminus d. P.alternans

6. endocarditis prophylaxis is indicated in all  except

   a) Fallot’s Tetralogy              b) d-TGA         c) Eisenmenger’s  Syndrome   d) VSD

7. coarctation of aorta is characterised by all except

  a) bicuspid aortic valve          b) circle of willis aneurysm     c) seen in Down syndrome  d) seen in Turner syndrome

8.  Which is one of the following is a not a correct match :

a.  Austin flint murmur – AR   b. Graham Steel murmur – PAH with PR

c. Carey coombs murmur –Infective endocarditis          d. Lutembachers syndrome –  ASD + MS

9.  Pressure overload is not characterized by :

a. Heaving apex        b. Fast , ill sustained parasternal impulse             c. S4    d.  LVH on ECG 

10. QT prolongation is seen in all except  
A. Hypothermia           B. Digitalis toxicity      C. Hypocalcemia         D. Romano Ward syndrome

11. Drug of choice in SVT
A. Adenosine               B. Propranolol                         C. Verapamil               D. Digoxin

 12. In a patient with wide complex tachycardia, the following suggest VT in ECG   EXCEPT

a. AV dissociation       b. Fusion beats                         c. Typical RBBB          d. Capture  beats

13. Prominent atrial enlargement and diastolic dysfunction are features of

a. Restrictive Cardiomyopathy b. Hypertrophic cardiomyopathy 

c. Ischemic Cardiomyopathy   d. Dilated Cardiomyopathy

14. Direct rennin inhibitor

a. Minoxidil                 b. clonidine                  c. Aliskerin                  d. Cilnidipine

15. Coxsackie viral myocarditis can lead to

a. defect in actin ./myosin        b. mutation of SCN5A gene & arrhythmia

c. cleavage of dystrophin in sarcolemma & LV dysfunction  d. channelopathy

16. Antihypertensive drug in a 48 year male diabetic hypertensive with EF of 40%. Creatinine 0.8 is

a. Nifedipine Retard    b. Enalapril      c. Atenolol       d. Hydrochlorthiazide e. Nifedipine plain  

17. Constant PR interval is seen in : 
a. First degree block b. Second degree – mobitz type I block c. Atrial  fibrillation D. Third degree block 

18. Takayasu’s arteritis –

a. Panarteritis               b. affects young males > females        c. also called pseudocoarctation

d. mainly causes lower limb arteritis & claudication                e. all are true

19. LA myxoma is associated with the following EXCEPT
a. LV outflow tract obstruction                        b. Tumor plop              c. NAME & LAMB syndrome

d. clubbing, fever, Raynaud’s phenomenon & raised ESR

20. murmur increasing with  valsalva maneuvre -  

a) mitral stenosis          b) VSD            c) HOCM         d) aortic  stenosis.

21. Normal mitral valve  area –

    a) 1-2 cm2  b) 0.5 -1 cm2  c) 4-6 cm2       d) 2-4 cm2.

22. Severe  Aortic Stenosis is characterised  by  all  EXCEPT

   a) Single S2  b) Paradoxial splitting of S2 c) Ejection Click  4)LVS4

23. Radiofrequency Ablation is done for the following EXCEPT : 
a. VT               B. SVT             C. WPW syndrome      D. VF               E. Atrial tachycardia 

24. In acute sMI, which enzyme is raised in 4 to 6 hours and decreases in 3 to 4 days ?
a. SGOT           B. LDH            C. CPK            D. SGPT 

25. Following are true regarding peripartum cardiomyopathy EXCEPT

a. younger maternal age, single fetus,  Primigravida,  and absence of preeclampsia are risk factors

b. usually occurs in last trimester of pregnancy or first 6 months after delivery

c. cabergoline can be tried in treatment                       

d. absence of pre-existing cardiac disease is necessary for diagnosis

26) Complex congenital heart diseases include all except

   a) Ebstein’s anomaly            b) double outlet ventricle         c)truncus arteriosus      d) ostium primum ASD

27. In MI following are used except  

a. Fibrinolytics b. Platelet inhibitor      c. Plasminogen activator inhibitor        d. Anti  thrombotics.

28. Commonest tumor of heart

a. myxoma       b. sarcoma       c. secondaries              d. mesothelioma

29. What is diagnostic of fresh MI in ECG ?
A. QT interval prolongation     B. P mitrale      C. ST segment elevation          D. ST segment  depression.

30. Digitoxicity can manifest as all EXCEPT

a. bradycardia              b. unconsciousness      c. vomiting       d. tachycardia

31. Biomarker elevated in Heart failure

a.  LDH            b. Troponin T              c. B Natriuretic Peptide                        d. HS CRP

32. A young male came with exertional dyspnea and occasional angina. His father died suddenly at 40 yrs age. He has a rough systolic murmur at the left sternal border increasing on standing. In him, the following are true  EXCEPT

a. Systolic anterior motion of Mitral valve on echo     b. Valsalva maneuver will reduce the murmur

c. Beta blocker & verapamil are helpful                      d. alcohol septal ablation is a treatment option

33) Acute severe Mitral regurgitation is characterised  by all except                   

a)severe symptoms      b) classical Pan systolic murmur          c) LVS3           d) normal sized heart.

34)Ebstein’s anomaly  has all except  

    a) normotensive TR         b) hypoplastic RV            c) hypertrophic  RV     d)WPW syndrome

35. Myocardial isoenzyme of CK which is specific for myocardial infarction ?
A. CK-BB        B. CK-MB       C. CK-MM       D. ALL OF THE ABOVE

36. All are true regarding aortic dissection EXCEPT

a. Distal dissection is more dangerous and must always undergo immediate surgery 

b. Pregnancy, Hypetension & cystic medial necrosis are risk factors

c. Stanford classification A & B helps to stratify cases           

d. IV  propranolol + Nitroprusside or IV labetalol are helpful             e. Hydralazine is contraindicated

37. FIBROUS SCAR in MI is well established by 
A. 8 weeks B. 8 years C. 4 weeks D. 4 days 

38)Radiological features of left ventricular failure are all except

  a)kerly B lines       b)Cardiomegaly           c)oligemic lung fields d) increased flow in upper lobe veins.

39) which of the following valve is most anterior?

   a) pulmonary valve               b) aortic valve            c) tricupsid valve               d) mitral valve

40. Commonest toxin causing chronic dilated cardiomyopathy is

a.       Nicotine           b. Lead                 c. Alcohol                    d. Mercury  

41. Correct statements regarding aortic aneurysm in Marfan’s include the following EXCEPT

a. beta blockers delay enlargement of aneurysm        b. cystic medial necrosis of proximal aorta

c. defect in type III procollagen                       d. surgery if aneurysm is >5.5-6 cm or enlarging by >1cm/yr.

42. cardiac output is determined by

a. Preload         b. Afterload                 c. Contractility                   d. all the above

43. A  lady with previous history of Ca. Cervix, recently treated, came with 1day h/o acute dspnea and mild pedal edema. Xray shows cardiomegaly and clear lung fields. In her,

a. you would suspect Acute MI             b. you would order an ECG                

c. You would suspect tamponade        d. you would plan for thrombolysis

44. A 50 year diabtetic woman has come with retrosternal chest pain for 3 hours, and sweating and two syncopal attacks. Her Pulse is 36, regular, BP 90/60. ECG shows ST elevation in L2 L3 aVF & AV dissociation. Treatment would include the following EXCEPT

a. streptokinase     b. Atorvastatin      c. Aspirin        d. Metoprolol           e. temporary pacing

45. The following can lead to Lt heart failure / Pulmonary edema EXCEPT

a. Hypertension        b. Pericardial effusion      c. Cardiomyopathy            d. Mitral /Aortic valve disease 

____________________ 

links to answers discussed - audio recording

answers to q 1 to 10 - listen here -  http://www.mediafire.com/?2mrhmyfd2a2hrgy
answers to q 11 to 20 -   listen here - http://www.mediafire.com/?38txx7gbk9s3y43
answers to q 21 to 35 - listen here - http://www.mediafire.com/?be8yurmepdyhb6c

Answers - 
1d 2c 3c 4d 5b              6d 7c 8c 9b 10b          11a 12c 13a 14c 15c
16b 17a 18a 19a 20c    21c 22c 23d 24c 25a   26d 27c 28c 29c 30b
31c 32b 33b 34c 35b   36a 37a 38c 39a 40c    41c 42d 43c 44d 45b 
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