Cardiovascular and Thoracic Surgery Questions and Answers

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Cardiovascular and Thoracic Surgery Questions and Answers

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Questions and Answers on Cardiovascular and Thoracic Surgery

1. Lutembatcher syndrome is
(1) Congenital mitral stenosis + O.S.— ASD
(2) Rheumatic mitral stenosis + O.S. – ASD
(3) Rheumatic mitral stenosis + O.P. — ASD
(4) Congenital mitral stenosis + O.P. — ASD

2. Which is not a major John’s criteria ?
(1) Arthritis
(2) Arthralgia
(3) Chorea
(4) Carditis

3. An aneurysm of the sinus of Valsalva usually arises from
(1) Right aortic sinus
(2) Left aortic sinus
(3) Non-coronary sinus
(4) Pulmonary outflow

4. The type of involvement of the heart in rheumatic fever is
(1) Fibrinous Pericarditis
(2) Myocarditis
(3) Endocarditis
(4) Pancarditis

5. Which is not an indication for surgery in prosthetic valve endocarditis ?
(1) Fungal P.V.E.
(2) Valvular dysfunction or dehiscence
(3) New onset of heart block
(4) Size of vegetation of less than 1.5cm

6. Which of these methods are used to classify the severity of cardiovascular disease ?
(1) NYHA
(2) CCS
(3) SAS
(4) All of the above

7. All of these factors increase the embolic potential in rheumatic mitral valve disease except
(1) Atrial fibrillation
(2) Size of L.A.
(3) Decreased LVEF
(4) Severity of disease

8. Mechanism of exertional syncope in a patient of Aortic stenosis
(1) Fall of S.V.R.
(2) Failure of forearm vasoconstriction during leg exercise.
(3) Cardiac output fails to rise due to severe fixed obstruction.
(4) All of the above.

9. Which is not a degenerative cause of chornic M.R. ?
(1) S.L.E.
(2) Euler’s Danlos syndrome
(3) Marfan’s syndrome
(4) Mitral valve prolapse

10. Drug of choice of mitral valve prolapse syndrome with palpitations and chest pain Is
(1) Beta-blockers
(2) Diuretics
(3) ACE inhibitors
(4) Digoxin

11. On 2-D echo, which quantitative indice does not suggest severe mitral regurgitation ?
(1) Regurgitant fraction > 50%
(2) E.R.O. > 40%
(3) Regurgitant volume > 60 ml
(4) Vena contracta width

12. The most common complication of MS. is
(1) A.F.
(2) LE
(3) Systemic embolism
(4) Pulmonary oedema

13. Which is not a physical finding of M.S. ?
(1) Loud S1
(2) Soft S2
(3) Opening snap
(4) Diastolic rumble

14. Abnormal left ventricular ejection fraction in patients of aortic stenosis can be the result of
(1) Reduced intrinsic myocardial function.
(2) Reduced preload.
(3) A preload-afterload mismatch.
(4) All of the above.

15. Surgical management of HOCM as left ventricular myectomy and myotomy is also known as
(1) Morrow procedure
(2) Nick’s procedure
(3) Konno-Rastan procedure
(4) Mustard procedure

16. Aortoventriculoplasty seems the procedure of choice for
(1) Tunnel stenosis.
(2) Hypoplastic annulus.
(3) Stenosis secondary to previously implanted small aortic valve prosthesis.
(4) All of the above.

17. Most common combination of rheumatic valvular disease is
(1) M.S. C aortic valve disease
(2) MR. C aortic valve disease
(3) M.S. CTS.
(4) MS.CA.S.CT.S.

18. Which syndrome is associated with valvar pulmonary atenosis ?
(1) Rubella syndrome
(2) Noonan’s syndrome
(3) Williams syndrome
(4) All of the above

19. The height of the R wave in V1 in mm multiplied by __________ is predictive of right ventricular peak systolic pressure.
(1) 3
(2) 4
(3) 5
(4) 6

20. After balloon pulmonary valvuloplasty in patients of P.S., restenosis is defined as gradient of ___________ mm Hg or more.
(1) 30
(2) 40
(3) 50
(4) 60

Practice Set MCQs
Quiz Questions and Answers

21. Functional tricuspid regurgitation because of annular dilatation is common beyond the critical annular diameter of more than
(1) 21 mm/m2
(2) 23 mm/m2
(3) 25 mm/m2
(4) 27 mm/m2

22. These are the factors favouring P.T.M.C. in a patient of mitral stenosis except
(1) Advanced age
(2) Severe Pulmonary hypertension
(3) Pregnancy
(4) Severe sub-valvular lesions

23. Which one of the following is not a bileaflet mechanical prostheses ?
(1) St. Jude Medical Mechanical heart valve.
(2) ATS Medical open pivot mechanical heart valve.
(3) On-X prosthetic heart valve.
(4) Omnicarbon Cardiac valve prosthesis.

24. Which one of the following is not a stentless bioprostheses ?
(1) Medtronic freestyle Aortic bioprosthesis .
(2) The Edward Prima plus bioprosthesis.
(3) Toronto SPV valve.
(4) Medtronic mosaic porcine bioprosthesis.

25. The treatment of choice for infective endocarditis and mixed valvular or aortic root pathology in patients who cannot tolerate anticoagulation is
(1) Stentless bioprosthesis.
(2) Carpentier-Edwards pericardial bioprosthesis.
(3) Meditronic mosaic porcine bioprosthesis.
(4) Allografts

26. How much % of left I.T. As (LIMA) to L.A.D. anastamosis grafting are patent 10-20 yrs after surgery ?
(1) More than 95 %
(2) 90-95%
(3) 85-90%
(4) 80-85%

27. Coronary endarterectomy is most commonly needed in which coronary artery disease ?
(1) R.C.A.
(2) L.A.D.
(3) L.Cx.
(4) P.D.A.

28. Which of the following investigation is not used to distinguish myocardial scar from ischemia ?
(1) M.R.I.
(2) P.E.T.
(3) T.M.T.
(4) Thallium Scintigraphy

29. Unstable angina is defined as the angina occurs at rest for more than
(1) 10 mins
(2) 15 mins
(3) 20 mins
(4) 30 mins

30. V.S.D. occurs within week _______ of an myocardial infarction.
(1) 1st
(2) 2nd
(3) 3rd
(4) 4th

31. Haemodynamic stability during manipulation of heart during OPCABG surgery can be preserved by following maneuvers.
(1) Trendelenburg position.
(2) Opening of right pleural space.
(3) Pacing to prevent prolonged bradycardia.
(4) Hypovoluemia and hypothermia.

32. Which of the following is not a type of stress testing in CAD patients ?
(1) T.M.T.
(2) Myocardial perfusion imaging
(3) Exercise radionuclide angiography
(4) 2-D echocardiography

33. For distal anastomoses during CABG, venotomy should be __________ % larger than arteriotomy.
(1) 10-20%
(2) 20-30%
(3) 30-40%
(4) should be equal

34. In hybrid MIDCAB approach, which venel should be bypassed ?
(1) L.A.D.
(2) R.C.A.
(3) O.M.
(4) P.D.A.

35. Who popularize the use of autologous saphenous vein graft in C.A.B.G. ?
(1) Sabiston
(2) Favaloro
(3) Kolesov
(4) Kirklin

36. To relieve spasm of Radial or internal mammary artery during CABG, we wrap the graft with moistened sponge with paparerine in the concentration of
(1) 20 mg/20 ml
(2) 20 mg/100 ml
(3) 20 mg/500 ml
(4) 20 mg/1000 ml

37. Radial grafts should not be used to graft coronaries with less than stenosis because of low patency.
(1) 50%
(2) 70%
(3) 80%
(4) 90%

38. Arterial grafts for CABG are all except
(1) Internal mammary graft
(2) Right Gastroepiploic artery
(3) Left Gastroepiploic artery
(4) Radial artery

39. Stress testing should be done after how much time of surgery (CABG) to obtain a baseline and to prescribe an appropriate cardiac rehabilitation programme ?
(1) 6 weeks to 3 months
(2) 3 months to 6 months
(3) 6 months to 9 months
(4) 9 months to 12 months

40. Coronary spasm is the mechanism of rest pain in
(1) Unstable angina
(2) Prinzmetal angina
(3) Myocardial infarction
(4) Emotion induced angina

41. Cause of painless myocardial infarction are all except
(1) Diabetic patients
(2) Elderly patients with dementia
(3) In pulmonary oedema
(4) ACE inhibitor therapy

42. Postprandial angina occurs within __________ of a meal.
(1) 15 minutes
(2) 30 minutes
(3) 45 minutes
(4) 60 minutes

43. A patient of C.A.D. can perform an activity requiring 2-5 MFTS. What is the functional CCS classification of this patient ?
(1) Class I
(2) Class I
(3) Class III
(4) Class IV

44. Indication for C.A.B.G. in CAD patients (Asymptomatic) is
(1) Chronic stable angina with left main stenosis > 50%.
(2) Left main equivalent.
(3) T.V.D. with LVEF < 50%.
(4) All of the above.

45. Cardiac surgery (CABG) is preferred in a patient with Syntax Score of
(1) More than 10
(2) More than 14
(3) More than 18
(4) More than 22