| Post Name | Assistant Professor in Cardio Vascular and Thoracic Surgery |
|---|---|
| Department | Medical Education |
| Question Paper Code | 068/2025/OL |
| Category Code | 025/2024 |
| Date of Test | 26 June 2025 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
The muscular shelf in the right ventricle that separates the tricuspid and pulmonary valves is the
Answer
D. Supraventricular crest
2
Hypothermia causes all the following except
Answer
B. Reduced cardiac contractility if in sinus rhytm
3
All of the following are true in zero balance ultrafiltration except
Answer
A. Can remove excess fluid in CPB circuit
4
The following are potential advantages of miniplegia except
Answer
B. Relies on added buffers like tromethamine
5
The following drugs are used in fast-track cardiac surgery except
Answer
D. Pancuronium
6
The starting dose for inhaled nitric oxide is typically
Answer
C. 20 ppm
7
Fresh frozen plasma indicated in
Answer
A. Excessive bleeding with coagulation factor deficiency on ROTEM/TEG
8
Chylothorax after lung resections
Answer
C. are commoner after pneumonectomies
9
The following are true of IABP except
Answer
C. increases systemic after load
10
All are true of cardiac tamponade except
Answer
C. Reduced pulmonary artery diastolic pressures
11
Absolute contraindication for off pump CABG includes all except
Answer
B. Small and calcified coronary arteries
12
In left vebtricular aneurysm, surgical ventricular restoration is indicated in all except
Answer
B. Severe right ventricular dysfunction
13
The following are true regarding negative modified Allen's test
Answer
C. Ulnar artery is not patent
14
The following statements regarding left ventricular aneurysm are true except
Answer
A. There is positive ventricular remodelling
15
In post infarction VSR, which statement is false?
Answer
B. If associated with MR, murmur is heard at the apex with thrill
16
In patient with STEMI, regarding CABG, the following statements are true except
Answer
B. It is the primary reperfusion strategy in uncomplicated cases
17
The following statements regarding post myocardial infarction ventricular septal rupure are true except
Answer
A. The interval between AMI and the onset of VSR is longer in patients treated with thrombolysis
18
In hybrid coronary revascularisation, the following are contraindications, except
Answer
B. Severe calcific ascending aorta
19
In multi detector computed tomography (MDCT), regarding the following statements, i. Had 100% specificity and sensitivity in detecting total occlusion. ii. It does not provide the flow characteristics of the graft. iii. It can identify variations in coronary anatomy than coronary angiography. iv. Graft not visualised on coronary angiography are visualised on MDCT.
Answer
D. All are true
20
In ischemic valvular heart disease, the following are true except;
Answer
C. It is the result of lesions involving papillary muscles, chordae, leaflets and left ventricular free wall
21
Which of the following statements are correct regarding functional anatomy of mitral, aortic and truicuspid valves? i. Type IIIa dysfunction in mitral regurgitation (Carpentier classification) describes restricted leafler motion in systole only. ii. Sino tubular junction is the norrowwest part of the aortic root. iii. Tricuspid valve annulus is saddle shaped and non planar iv. The area corresponding to the anterosepal commissure of tricuspid valve is close to right coronary cusp (RCC) of aortic valve
Answer
B. Only ii and iii
22
With reference to Systolic Anterior Motion (SAM) in mitral valve repair, all statements are true EXCEPT
Answer
D. Substitution with small, rigid or full Annuloplasty ring is effective in managing SAM
23
Identify the INCORRECT cause of LV Rupture/AV dehiscence following Mitral Valve Replacement (MVR)
Answer
C. Chordal sparing mitral valve replacement
24
Which of the following statements is/are correct about combined Aortic and Mitral valve replacement (DVR)? i. In most patients, multivalver disease is rheumatic in origin but manifest in different pathogological conditions. ii. Mortality of simulatneous Aortic and Mitral valve replacement ranged from 6.9 to 9.9%. iii. LV enlargement is a powerful indicator for death late post operatively iv. Lillehei and colleagues were the first to report simultaneous mitral and aortic valve replacement
Answer
B. Only (i, ii and iii)
25
Regarding Annulo aortic ectasia, all statements are true EXCEPT
Answer
D. LV-aortic junction is also usually increased in size
26
Which of the following statement is INCORRECT regarding Bicuspid Aortic valve disease?
Answer
D. Risk of acute ascending aortic dissection is same as tricuspid aortic valve
27
Which is the most common etiologic organism in acute Tricuspid valve endocarditis?
Answer
A. Pseudomonas aeruginosa
28
Statements regarding Tricuspid valve disease are true EXCEPT
Answer
B. Hemodynamic effects of anatomically moderate TS is equivalent to moderate Mitral Stenosis
29
In Prosthetic Valve Endocarditis (PVE) which of the following statements is/are CORRECT. i. Overall risk of infective endocarditis is 1-5% in the first year after valve replacement ii. If PVE occurs within two months, S. epidermidis is the major offending organism iii. Prognosis and mortality are same as native valve endocarditis iv. Bioprosthetic valves seem less likely to develop endocarditis than mechanical prosthesis
Answer
D. Only (i, ii and iv)
30
The following are the risk factors for persisting Triscuspid Regurgitation (TR) after repair for TR includes all EXCEPT
Answer
C. Right Atrial enlargement
31
In a patient undergoing surgery for left atrial myxoma with severely paroxysmal atrial fibrillation, the most definitive surgical step to reduce arrhythmia recurrence is
Answer
D. Cox MAZE IV via topical radiofrequency ablation
32
The most critical structure to avoid during surgical ablation of atrial return to prevent postoperative sinus node dysfunction is
Answer
C. SA nodal artery from RCA or LCx
33
Which of the following anatomic regions is most commonly targeted in surgical ablation for typical atrial flutter?
Answer
B. Cavotricuspid isthmus
34
In ischemic cardiomyopathy, ectopic arrhythmic foci most often localize to :
Answer
A. Borderzone of infarction
35
In non-penetrating trauma, the earliest ECG finding in myocardial contusion is typically
Answer
C. Nonspecific ST-T changes
36
Cardiac MRI showing a right atrial mass with intense early enhancement and 'sunray' appearance on T1-weighted imaging suggests
Answer
B. Angiosarcoma
37
Which tumor appears as 'sea anemone' on macroscopic examination and very frequently embolizes?
Answer
B. Papillary fibroelastoma
38
Sudden cardiac death in a young adult with a calcified ventricular septal mass is most consistent with
Answer
B. Cardiac fibroma
39
In patient with blunt chest trauma and suspected coronary artery dissection, the most appropriate management is
Answer
A. Emergent PCI
40
The cardia tumor most frequently associated with tuberous sclerosis is
Answer
C. Rhabdomyoma
41
All the following are features of arrhythmogenic right ventricular cardiomyopathy EXCEPT
Answer
D. Caused by molecular alteration in genes encoding lamin A/C protein
42
Features of Takotsubo cardiomyopathy include all EXCEPT
Answer
C. Recurrence of Takotsubo cardiomyopathy is common
43
Which of the following feature is characteristic of restrictive cardiomyopathy?
Answer
B. Impaired ventricular filling with preserved systolic function
44
Which cardiomyopathy is associated with Biventricular thickening with normal cavity size and atrial septal thickening in Cardiac MRI?
Answer
A. Cardiac amyloidosis
45
The most common non-cardiac site of sarcoid involvement is
Answer
A. Lungs
46
The key histological feature of hypertrophic cardiomyopathy is
Answer
A. Myocardial cellular disarray
47
The primary MHC Class II molecules related to solid organ transplantation are all EXCEPT
Answer
C. HLA-DM
48
All of the following are hallmarks of humoral rejection in heart transplantation EXCEPT
Answer
D. Mononuclear inflammatory cell response
49
Most common causes of death during the first year after cardiac transplant are all EXCEPT
Answer
B. Allograft coronary artery disease
50
All the following are common feature of advanced coronary artery disease in transplanted heart EXCEPT
Answer
A. Angina
51
Which of the following finding in X ray chest most reliably correlate with aortic tear in blunt trauma chest?
Answer
B. Loss of aortic knob contour
52
Which of the following statements about acute aortic dissection is true? i. In patients with Type A dissection emergency surgery is the treatment ii. It is reasonable to transfer a patient with Type A dissection and stable haemodynamics to a high volume centre from a low volume centre. iii. It is reasonable to address visceral malperfusion before ascending aorta repair in patients with Type A dissection and mesenteric ischaemia
Answer
D. All of the above (i, ii and iii)
53
Which of the following is true? i. In Marfan Syndrome patients aortic root replacement is indicated if aortic root diameter is > 5 cm ii. In patients with bicuspid aortic valve, aortic root replacement is indicated if aortic root diameter is > 5.5 cm iii. Aortic coarctation is not a risk factor for aortic dissection in Turner's Syndrome
Answer
A. Only i and ii
54
Which one is the preferred material for aorto-renal bypass in children?
Answer
D. Hypogastric artery
55
Which of the following statements are true about CSF drainage in thoraco-abdominal aortic surgery? i. CSF drainage helps to prevent paraplegia by improving spinal cord perfusion pressure ii. CSF drainage can be continued for 72 hours after Thoraco-abdominal-aortic surgery iii. CSF drainage should not be combined with left atrio-femoral bypass
Answer
A. Only i and ii
56
McConnell's sign is an enchocardiography finding in
Answer
D. Pulmonary embolism
57
Following statements about pulmonary artery aneurysms are true except
Answer
D. Dissection and rupture of pulmonary artery aneurysms is not reported
58
The commonest primary malignant tumour of the pulmonary artery is
Answer
C. Sarcoma
59
Which of the following congenital heart disease is most commonly diagnosed in adulthood
Answer
C. Atrial septal defect
60
A 25 year old man presented with new onset seizure disorder. His CVS examination revealed ejection systolic murmur in left parasternal border, single S2 with no cardiomergaly or cyanosis. CT brain showed features suggestive of brain abscess. The most probable diagnosis in relation to CVS in this patient is
Answer
C. Tetralogy of Fallot
61
The following are true of Scimitar syndrome except
Answer
A. symptoms are not related to the degree of left to right shunt from the anomalous vein
62
In atrioventricular canal defects there is
Answer
C. Loss of normal wedged position of the aortic valve between the AV valves
63
Ventricular septal defect classification that is commonly used was
Answer
D. developed by Soto and modified by Van Pragh
64
All of the following are potential univentricular lesions except
Answer
B. Balanced AV canal defects
65
In pulmonary atresia with severe right ventricular hypoplasia
Answer
B. RVOT infundibular cavity is absent
66
The modified Blalock Taussig Thomas shunt was developed and named by
Answer
B. Marc de Leval
67
Which of the following are not part of stage one palliation of hyperplastic left heart syndrome
Answer
C. SVC to PA shunt
68
Which of the following is not used in neonatal correction of Ebstein malformation?
Answer
A. Cone repair
69
The commonest cause of acute failure of arterial switch operation is
Answer
D. Coronary artery obstruction
70
All are common in ALCAPA except
Answer
C. Right axis deviation on ECG
71
What is the most critical factor influencing chest wall stability after resection of a primary chest wall tumor?
Answer
B. Location of the defect
72
In right upper sleeve lobectomy, which technique is used to match the caliber of the right main bronchus to the bronchus intermedius?
Answer
C. Posterior wall telescoping of bronchus intermedius
73
Which of the following findings best indicates a trapped lung, contraindicating decortication in malignant pleural effusion?
Answer
D. Non-expanding lung on post-thoracentesis imaging
74
In surgical decision-making for symptomatic adult diaphragmatic eventration, which of the following intraoperative findings best distinguishes true eventration from chronic paralysis?
Answer
A. Thinned but contractile diaphragm fibers
75
A 55-year-old male undergoes resection of a high-grade chondrosarcoma involving the anterior second to fifth ribs with full-thickness involvement. You plan rigid reconstruction. Which reconstructive choice would provide the best combination of structural support and infection control in this oncologic setting?
Answer
D. Titanium plating with soft tissue flap
76
A 32-year-old patient with a posterior mediastinal mass presents with Horner's syndrome. The most likely tumor is
Answer
B. Ganglioneuroma
77
A patient with post-intubation tracheal stenosis at 3 cm below vocal cords undergoes segmental resection. Intraoperatively, the tension across anastomosis is high despite neck flexion. What additional maneuver is justified?
Answer
C. Suprahyoid laryngeal release
78
A patient develops chylothorax after left pneumonectomy. Initial conservative measure fail. Thoracic duct ligation is planned. Where is the most reliable site for ligation?
Answer
A. Above diaphragm on right side
79
In delayed presentation (> 24 hours) of spontaneous esophaeal perforation with contained leak and minimal sepsis, which is the preferred management stragegy?
Answer
D. Endoscopic clipping or stenting with nasogatric decompression
80
A 58-year-old chronic smoker presents with shoulder pain, Horner's syndrome and weakness of intrinsic hand muscles. Imaging reveals a superior sulcus tumor with vertebral body erosion but no distant metastases. Next best step?
Answer
B. Chemoradiotherapy followed by surgery
81
All of the following statements are correct regarding pectus excavatum except
Answer
C. The manubrium, first and second costal cartilages are typically involved
82
Which of the following statements about chest wall tumour are correct? i. Homer Wright Rossettes are diagnostic of Malignant Fibrous Histiocytoma ii. Chondrosareomas are the most common primary malignant tumours iii. Askin tumour most commonly seen in children and young adults iv. Surgical resection with chest wall reconstruction is the standard of care
Answer
B. ii, iii, iv
83
All of the following statements regarding post pneumonectomy Bronchopleural fistule are correct except
Answer
A. Left side is commoner than right
84
Regarding neoplasms of trachea, which of the following statement is correct
Answer
C. Submucosal spread is seen in Adenoid cystic carcinoma
85
Which of the following statements regarding oesophageal perforation are correct? i. Thoracic perforations are commoner than cervical ii. Boerhaave's syndrome involves left lower oesophages near oesophagogastric junction iii. Mid oesophageal perforations are best approached from left thoracotomy iv. The most common cause of oesophageal perforation is iatrogenic
Answer
C. i, ii, iv
86
In TNM staging of Lung Cancer (9th edition); which of the following comes under metastasis?
Answer
B. Pleural nodule
87
The most common lobe of lung affected by congenital lobar emphysema is
Answer
A. Left upper lobe
88
With regards to diaphragmatic openings for visceral structures and their vertebral levels, match the following. i. Aorta x. ii. IVC (Inferior Venacava) y. iii. Oesophagus z.
Answer
D. i-z, ii-y, iii-x
89
All of the following statements regarding pulmonary sequestration are true except
Answer
D. Extralobar type is commoner than intralober type
90
A 50 year old man (smoker) is diagnosed as having a Solitary Pulmonery Nodule (SPN) without extrathoracic dissemination. The appropriate management would be
Answer
B. Proceed with pulmonary resection after evaluating fitness
91
Atropy (wasting) of the hand muscles, along with electrophysiological abnormalities on nerve conduction studies, attributed to chronic compression of the brachial plexus nerve roots by a cervical rib or anomalous fibrous band at the level of the thoracic outlet is known by
Answer
A. Gilliat-Sumner Hand
92
All about Tunica intima is true except
Answer
D. Houses various cell types, including fibroblasts, progenitor cells and immune cells such as macrophages, T cells, B cells, and dendritic cells
93
Facts about the use of Color coded Doppler Ultrasound (CUS) for detection of recurrent deep vein Thrombosis are true except
Answer
B. Features of acute and chronic Deep Vein Thrombosis are easily distinguished by routine ultrasound doppler scanning
94
Popliteal artery entrapment syndrome-False statement is
Answer
D. Typically suspected when an elderly sedentary adult female complains of leg pain
95
Regarding management of Peripheral Arterial Disease (PAD) following are true (2024 guidelines Guideline for the Management of Lower Extremity Peripheral Artery Disease) Except
Answer
C. The combination of full-intensity oral anticoagulation and dual antiplatelet therapy, known as "triple therapy", is not associated with an increased risk of bleeding complications
96
Regarding Acenocoumarol (Acitrom) action and metabolism all are true except
Answer
B. Protein bound (98.7%r) mainly to Globulin
97
Regarding development of Aortic arch following statements are correct i. First aortic archregresses except for a very small part that gives risk to the maxillary artery ii. Right Fourth aortic arch is the genesis of the proximal part of the right subclavian artery iii. Second aortic archregresses completely and very early in the development
Answer
A. i and ii
98
The following are true about the management of Renal Artery Stenosis (RAS) except
Answer
D. 50% diameter or larger stenosis with a mean trans-lesion gradient mroe than 20 mm Hg
99
In chronic Thoracic and thoracoabdominal aneurysm following are true except
Answer
D. Statin therapy has been associated with decreased long-term mortality in patients with thoracicaorticaneurysms compared to abdominal aortic aneurysm
100
Correct statement about endoleaks are i. Type I endoleak occurs when there is a gap between the graft and the vessel wall at seal zones. Typically requires urgent attention due to high risk of sac enlargement and rupture ii. Type II endoleak results when there is presistent blood flow in the aneurysm sac from small side branches coming off the aorta. This is the most common type of endoleak iii. A Type III endoleak results from a defect or misalignment between the components of endografts iv. A Type IV endoleak occurs soon after some EVAR procedures due to the porosity of certain graft materials v. A Type V endoleak, is thought to occur when increased graft permeability allows pressure to be transmitted through the aneurysm sac, affecting the native aortic wall
Answer
C. i, ii, iii, iv and v
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