| Post Name | Assistant Professor in Cardio Vascular and Thoracic Surgery |
|---|---|
| Department | Medical Education |
| Question Paper Code | 086/2026/OL |
| Category Code | 685/2025 |
| Date of Test | 9 May 2026 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
The terminal groove on the right atrium externally corresponds internally with the
Answer
A. crista terminalis
2
The following are true of single atrial cannulation except
Answer
C. drainage is less sensitive to heart positioning
3
Hypothermia exerts its protective eļ¬ects by all except
Answer
B. reduction in high energy phosphate stores
4
The action of mannitol in cardioplegia is to
Answer
D. scavenge oxygen radicals
5
All of the following are features of low cardiac output after cardiac surgery except
Answer
A. wide pulse pressure
6
Rivaroxaban is an oral direct factor Xa inhibitor used for all except
Answer
C. Valvular atrial ļ¬brillation
7
Which of the following is associated with lower stroke rates?
Answer
C. Iimiting rewarming to 35Ā°C
8
Bio membrane mimicry uses a coating of
Answer
B. phosphorylcholine derivative
9
VAC therapy for deep sternal wound infection uses a pressure of
Answer
C. 75 to 125 mm Hg
10
Which of the following will not reduce incidence of ventilator associated pneumonia?
Answer
A. Avoiding head end elevation
11
True statement about right ventricular infarction (RVI) include all of the following EXCEPT
Answer
B. ST segment elevation in lead V4 is commonly present in RVI
12
A 60-year-old man comes to the coronary care unit with severe chest pain. His ECG reveals 2 mm ST segment elevations in leads II, III and AVf. The initial cardiac examination is unremarkable. On the second day a faint late systolic murmur is heard and by third day this murmur has increased to grade 3/6. The patient has mild dyspnoea, and a chest ļ¬lm shows pulmonary vascular redistribution. The most likely explanation of the murmur is:
Answer
C. Infarcted posterior papillary muscle
13
LV aneurysm may develop as a consequence of acute MI. True statement about LV aneurysm EXCEPT
Answer
B. Inferoposterior aneurysms are slightly more common than apical aneurysms
14
The following patients are best treated with coronary artery bypass grafting (CABG)
Answer
C. A 60-year-old man with unstable angina, diabetic, triple vessel disease and an ejection fraction 35 percent
15
Perioperative myocardial infarction occurs following coronary bypass procedure in approximately;
Answer
D. less than 5 percent
16
Which of the following statements about patients treated by placement of an internal mammary artery (IMA) bypass graft at primary CABG is incorrect?
Answer
B. The risk of sternal wound complications is greatly increased if the contralateral IMA is harvested at the time of reoperation
17
Following acute myocardial infarction, ventricular septal defects occur in:
Answer
D. 2% or less
18
Which statement about operative mortality and perioperative incidence of myocardial infarction for elective CABG (X) versus emergency CABG following failed PTCA (Y) is accurate?
Answer
C. The operative mortality and perioperative incidence is higher in X than in Y
19
If blood entering the normal arterial circulation of the heart is 100% saturated with oxygen, oxygen saturation of blood in the coronary sinus can be expected to be approximately:
Answer
D. 35%
20
Which of the following statements about collaterals in the normal coronary circulation is true?
Answer
B. The coronary arterial bed has minimal eļ¬ective collaterals
21
What is the average life expectancy; once a patient develops cardiac failure in Aortic Stenosis?
Answer
C. 1.5 years
22
Which of the following statements is/are correct regarding functional anatomy of mitral, aortic and tricuspid valves? i. Type III a dysfunction in mitral regurgitation (Carpentier classiļ¬cation) describes restricted leaļ¬et motion in systole only. ii. Sino tubular junction is the narrowest part of the aortic root. iii. Tricuspid valve annulus is saddle shaped and non planar iv. The area corresponding to the anteroseptal commissure of tricuspid valve is close to right coronary cusp (RCC) of aortic valve.
Answer
B. Only (ii & iii)
23
Indications for Ross procedure includes all EXCEPT
Answer
D. Connective tissue disorders aļ¬ecting Aortic root
24
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 eļ¬ective in managing SAM
25
In patients with Tricuspid Regurgitation secondary to Mitral valve disease, Tricuspid Annuloplasty is generally performed if Tricuspid annulus diameter is
Answer
B. > 35 mm
26
Regarding Annulo aortic ectasia, all statements are true EXCEPT.
Answer
D. LV- aortic junction is also usually increased in size
27
Who has ļ¬rst reported simultaneous Aortic and Mitral valve replacement with mechanical prosthesis?
Answer
C. Cart Wright and colleagues
28
Choose the CORRECT statement /Statements about Mitral Regurgitation from Ischemic heart disease. (i) Papillary muscle dysfunction is the most common cause for severe MR in acute MI (ii) In patients with papillary muscle rupture; 75% of rupture occurs in Anterior papillary muscle. (iii) Papillary muscle rupture occurs typically 2 to 7 days after acute infarction. (iv) First successful surgical correction of papillary muscle rupture was reported by Austen and colleagues.
Answer
B. Only (i, iii & iv)
29
Which is the most common etiologic organism in acute Tricuspid valve endocarditis?
Answer
A. Pseudomonas aeruginosa
30
Which is the most common congenital heart disease in adults?
Answer
C. Bicuspid Aortic valve
31
A patent on VVI pacing develops hypothension and syncope despite adequate rate. What is the mechanism by which VVI pacing can cause hypotension?
Answer
B. Loss of AV dynchrosony with atrial contraction against closed AV valve
32
Which condition predisposes to spontaneous complete heart block due to bundle elongation?
Answer
B. AV discordance
33
Sinus node dysfunction after A.SO is mainly due to
Answer
D. Ischemia from sinus nodal artery injury
34
A: Congenital comple heart block (CHB) may present despite normal anatomy R : Progressive ļ¬brosis of conduction pathways may develop over time
Answer
B. Both A and R are true, R doesn't explain A
35
The most common cause of sudden death in complete heart block (CHB) is
Answer
D. Ventricular asystole
36
In cardiac tamponade due to trauma A. Hypotension may be absent in early traumates cardiac tamponade. R. Rapid accumulation of pericaredial blood limits compensatory pericadial stretch
Answer
C. Both A and R are true, R doesn't explain A
37
A blunt trauma patient with persistent arrhythmias and elevated troponin but hemodynamically stable. Which is the best management strategy?
Answer
C. Observation with monitoring
38
A 35 year old symptomates patient with HOCM has, Ā· L VOT gradient of 80 mm of HG Ā· Sever septal hypertrophy Ā· Moderate MR due to systolie anterior motion (SAM) of mitral valve Surgeon performs an adequate septal mycetomy. However, intra operative TEE still shows signiļ¬cant LVOT gradient and MR. What is the most appropriate next step?
Answer
C. Address abnormal mitral sub valvular apparatus
39
Which maneuver MOST increases. LVOT obstruction in HOCM (Hypeetrophic obstractive cardimyopathy)
Answer
C. Valsalva strain reļ¬ex
40
In a post mycetomy HOCM patient is hypotensive gradient shoots up and severe SAM on TEE. Inotropic support kept is 6 mg/kg/mt of dobutamine what all thing would you not do out of following four choices?
Answer
A. Stop dobutamine start adrenaline
41
The hallmark hemodynamic feature of dilated cardiomyopathy is
Answer
C. Reduced ejection fraction with ventricular dilatation
42
The classic ECG ļ¬nding in Arrhythmogenic Right Ventricular Cardiomyopathy is
Answer
A. Epsilon wave
43
Hyper acute rejection is primarily mediated by
Answer
B. Preformed antibodies
44
Acute cellular rejection is mainly mediated by
Answer
D. T lymphocytes
45
Harlequin syndrome in VA-ECMO refers to
Answer
B. Upper body hypoxia due to mixing of ļ¬ows
46
Which of the following feature is characteristic of restrictive cardiomyopathy?
Answer
A. Impaired ventricular ļ¬lling with preserved systolic function
47
The normal amount of pericardial ļ¬uid is
Answer
B. 10 - 50 mL
48
The characteristic ECG ļ¬nding in acute pericarditis is
Answer
D. Diļ¬use ST elevation with PR depression
49
Beckās triad in cardiac tamponade includes
Answer
C. Hypotension, jugular venous distension, muļ¬ed heart sounds
50
Kussmaulās sign refers to
Answer
B. Increase in JVP on inspiration
51
Which of the following statements are correct about acute aortic dissection? (i) Hypertension is the major risk factor for acute aortic dissection (ii) Type B aortic dissection requires urgent surgical intervention. (iii) Intravenous beta-blockers are the ļ¬rst- line medical management in reducing aortic wall stress in acute aortic dissection. (iv) Cobweb sign is used to identify the true lumen.
Answer
B. Only (i & iii)
52
Which of the following statement about traumatic aortic disruption is false?
Answer
C. More than 8 cm widening of the mediastinurn in X ray Chest is diagnostic of aortic disruption
53
Retrograde propagation of a Type A aortic dissection can lead to the following complications except:
Answer
C. Stroke
54
The type of Thoraco-abdominal aortic aneurysm that extends from left subclavian artery down to infra renal aorta as per Crawford classiļ¬cation is
Answer
B. Extent II
55
Which of the following statements about spinal cord protection is correct in Thoraco-abdominal aortic aneurysm surgery? (i) Keep CSF ļ¬uid pressure above 15 cm of H2O (ii) temporary renal bypass helps to reduce paraplegia. (iii) Maintaining adequate distal perfusion utilizing left atrio-femoral bypass is useful (iv) Re-implantation of the lower utercostal arteries are useful to prevent spinal schernia.
Answer
D. Only (iii & iv)
56
The primary pathological mechanism of a penetrating aortic ulcer is
Answer
A. Ulceration of atherosclerotic plaque
57
A 45-year-old man with prior pulmonary embolism presents with progressive exertional dysponea. Echo shows PA pressure of 40 mm Hg. CT pulomary angiography is inconclusive. What is the best next step?
Answer
C. Ventilation perfusion scan
58
A 48-year-old lady presents with sudden onset of hypotension, tachycardia, and breathlessness, Echo shows McConnellās sign with RV dilatation. Patient is not stable enough to shift for a CT scan. The best management strategy will be:
Answer
D. Immetiate systemic thrombolysis
59
Which haemodynamic proļ¬le is most consistent with massive pulmonary embolism?
Answer
B. Low cardiac output, high pulmonary vascular resistance
60
Which of the following radiological sign suggests pulmonary artery sarcoma?
Answer
A. Wall eclipsing sign
61
The Eustachian valve in the heart is related to
Answer
C. Inferior Venacava
62
Double aortic arch is due to failure of regression of
Answer
B. Right fourth aortic arch
63
Ductal closure occurs in neonates due to
Answer
C. Both 1 & 2
64
In Sinus venosus ASD,Warden Procedure consists of
Answer
D. All of the above
65
The pathophysiology of isolated Cor Triatriatum sinistrum is similar to
Answer
B. Mitral valve disease
66
The success of Fontan operation is NOT related to
Answer
C. Left Ventricular hypertrophy
67
In Carpentierās classiļ¬cation of Mitral regurgitation, mitral leaļ¬et motion is enhanced in
Answer
B. Type 2
68
DiGeorge syndrome includes
Answer
D. All of the above
69
Regarding PH stat strategy,which is NOT true
Answer
D. In infants and children,Alfa stat strategy is preferred
70
Myocardial infaction in children is caused by
Answer
D. All of the above
71
A 45-year-old man undergoes ascending aorta replacement and is discharged uneventfully 2 weeks after surgery. The patient visits the follow-up OPD after 1 month and complains of progressive breathlessness for 2 days. Prior to breathlessness, there is a history of vigorous coughing due to an upper respiratory viral infection. The HRCT chest shows left sided pneumothorax. What is the next best step in the management of this patient?
Answer
A. Intercostal drainage tube followed by VATS in case of prolonged pleural air leaks
72
All of the following ļ¬ndings in various investiganons indicate a descending thoracic aortic injury EXCEPT
Answer
D. Loss of imaging in the distal aortic arch on TEE
73
Which structure is located in the anterior mediastinum?
Answer
B. Thymus
74
All of the following muscles are involved in expiration EXCEPT
Answer
A. External intercostals
75
Below is the image of a hysteresis loop during mechanical ventilation. What does the arrow denote?
Answer
A. Overdistension of alveoli
76
Preterm neonates often develop respiratory insuļ¬ciency due to a lack of pulmonary surfactant. This surfactant is primarily made up of
Answer
D. Dipalmitoylphosphatidylcholine
77
A 26-year-old male develops chylothorax after cardiac surgery. Which of the following criteria can be used to conļ¬rm the diagnosis?
Answer
A. Triglyceride levels> 110 mg/dL
78
A 28-year-old, postpartum female develops respiratory distress, hypotension and hypoxia, and is put on mechanical ventilation 24 h after delivery. Which of the following investigations may help in the diagnosis of pulmonary embolism in this patient?
Answer
D. D dimer levels
79
Delivery of oxygen is calculated as DOā = [(1.34 Ć [Hb] Ć SaOā) + (PaOā Ć 0.0031)] Ć cardiac output. The numerical 0.0031 is the solubility coefficient of oxygen in the blood. Its unit is
Answer
A. mL Oā/dL/mm Hg
80
A 6-year-old child develops right diaphragmatic palsy after corrective cardiac surgery. Which of the following nerves must have been injured?
Answer
A. Right Phrenic nerve
81
A patient with a history of severe retching and vomiting suddenly develops acute chest pain, dyspnea and subcutaneous emphysema. What is the most likely diagnosis?
Answer
C. Esophageal rupture
82
In delayed presentation (>24 hours) of spontaneous esophageal perforation with contained leak and minimal sepsis, which is the preferred management strategy?
Answer
D. Endoscopic clipping or stenting with nasogastric decompression
83
A 58-year-old chronic smoker presents with shoulder pain Hornerās 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
A. Chemoradiotherapy followed by surgery
84
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 ļ¬exion. What additional maneuver is Justiļ¬ed?
Answer
C. Suprahyoid laryngeal release
85
A solitary pulmonary nodule is discovered incidentally on a chest CT scan in an asymptomatic 60-year-old former smoker. What is the most appropriate next step in management?
Answer
C. Positron Emission Tomography (PET) scan and/or biopsy
86
Chronic lung allograft dysfunction (CLAD) most commonly presents as:
Answer
B. Bronchiolitis obliterans syndrome
87
Ex vivo lung perfusion (EVLP) primarily helps in:
Answer
B. Expanding donor pool
88
Which sign is speciļ¬c for diaphragmatic rupture on CT thorax?
Answer
B. Collar sign
89
Which is the best diagnostic tool for mediastinal staging in lung cancer?
Answer
C. EBUS-TBNA
90
A 32-year-old male presents after a high-speed deceleration injury. He is hemodynamically stable. Chest CT angiography shows a focal outpouching at the aortic isthmus with surrounding mediastinal hematoma. No active extravasation is seen. What is the most appropriate management?
Answer
B. Endovascular stent grafting (TEVAR)
91
Which of the following anatomical criteria is generally considered unsuitable for a standard infrarenal endovascular aneurysm repair (EVAR) using most commercially available oļ¬-the-shelf stent grafts?
Answer
B. A proximal neck angulation of 75 degrees
92
The Nellix Endo Vascular Aneurysm Sealing (EVAS) system represents a signiļ¬cant shift from traditional stent-grafting by focusing on āsac sealing.ā What is the primary mechanism by which this system prevents Type II endoleaks?
Answer
B. Total obliteration of the aneurysm sac using polymer-ļ¬lled āendobagsā
93
A 68-year-old diabetic patient with Chronic Limb-Threatening Ischemia (CLTI) and a non-healing heel ulcer undergoes a successful endovascular revascularization of the posterior tibial artery. Post-procedurally, a 99mTc-tetrofosmin SPECT/CT perfusion study is performed. According to recent clinical evidence regarding the prognostic value of SPECT/CT in this setting, which of the following is the most signiļ¬cant clinical utility of this modality?
Answer
C. It can quantify regional microvascular perfusion within speciļ¬c angiosomes to predict 12-month amputation-free survival
94
62-year-old male presents 48 hours after the sudden onset of coldness and numbness in his left leg. He has a history of a femoropopliteal bypass with a prosthetic graft 2 years ago. Imaging conļ¬rms acute prosthetic graft thrombosis (Rutherford Category IIa). Catheter-directed thrombolysis (CDT) is initiated. Which of the following statements regarding the use of pharmacological agents and outcomes in this scenario is most accurate according to current evidence?
Answer
C. Fibrinogen levels should be monitored every 6ā12 hours, and thrombolysis should typically be suspended if levels drop below 100ā150 mg/dL
95
In the context of quality improvement and value-based healthcare, which of the following has bees identiļ¬ed as the most common āpreventableā cause for 30-day unplanned readmission following major lower extremity bypass surgery?
Answer
B. Surgical site infections (SSI) and wound complications
96
In light of the recently reported 5-year outcomes from the PARTNER 3 and Evolut Low Risk trials comparing Transcatheter Aortic Valve Implantation (TAVI) to Surgical Aortic Valve Replacement (SAVR) in low-risk patients, which of the following statements regarding long-term clinical outcomes is most accurate?
Answer
C. While early beneļ¬ts in rehospitalization and stroke are attenuated over time, TAVI maintains a signiļ¬cantly lower risk of new-onset atrial ļ¬brillation and life-threatening bleeding compared to SAVR at 5 years
97
A 65-year-old male with a history of atrial ļ¬brillation presents with sudden onset of severe right leg pain and ācoldnessā for 4 hours. On examination, the limb is pale with minimal sensory loss limited to the toes. He has no motor weakness. Bedside Doppler examination reveals inaudible arterial signals at the pedal level but audible venous signals. According to the Rutherford classiļ¬cation for acute limb ischemia, what is the most appropriate management category and recommended time frame for revascularization?
Answer
B. Category IIa (Marginally Threatened); Revascularization is urgent and should ideally occur within 6-24 hours
98
A 54-year-old female presents with acute dyspnoea and pleuritic chest pain. Her heart rate is 108 bpm and her systolic blood pressure (SBP) is 105 mmHg. CT Pulmonary Angiography (CTPA) conļ¬rms a saddle pulmonary embolus with a right ventricle-to-left ventricle (RV/LV) ratio of 1 .2. Her troponin I is elevated. According to the latest 2024ā2026 expert consensus and the clinical framework established by trials like PEITHO-3 and HI-PEITHO,which of the following is the most appropriate management strategy?
Answer
B. Initiation of therapeutic anticoagulation (e.g., LMWH) and close monitoring for hemodynamic decompensation
99
70-year-old diabetic patient presents with a 2 cm deep ulcer over the ļ¬rst metatarsal head and mild cellulitis. Non-invasive studies reveal an Ankle-Brachial Index (ABI) of 0.45 and a Toe Pressure of 35 mm Hg. According to the WIfI Classiļ¬cation System and the Global Vascular Guidelines (GVG), which of the following best describes this patientās clinical status and the recommended management strategy?
Answer
B. WIfI Stage 3 or 4 (High Risk); The risk of amputation at 1 year is high, and early revascularization is strongly recommended
100
A 22-year-old female presents with a progressive, pulsatile swelling of the right mid-thigh associated with overlying skin warmth and a palpable thrill. MRI/MRA demonstrates a complex network of dilated vessels with early venous ļ¬lling. According to the ISSVA Classiļ¬cation and the Schobinger Staging System, which of the following is the most appropriate management for this lesion?
Answer
C. Targeted embolization of the nidus using absolute alcohol or liquid embolic agents (e.g., Onyx), followed by surgical excision if necessary
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