D’25 CVS ANNUAL

Q1. which of the following relieves the pain of angina pectoris sublingually
A. Nitroglycerin
B. Sodium nitrate
C. Glycerin trinitrate

Q2. Anti hypertensive which is used topically to treat Alopecia acreta?

A. Minoxidil
B. Prazosin
C. Hydralazine

Q3.Which ACE inhibitor can be used in hypertensive emergency?

A) Enalapril
B) Lisinopril
C) Captopril

Q4. Which anti hypertensive can cause rebound hypertension on sudden discontinuation?
A. Prazosin
B. Chlorothiazide
C. Clonidine
D. Losartan

Q5.Which coagulation factor falls most rapidly after starting warfarin?

A) Prothrombin
B) Factor VII
C) Factor IX
D) Factor X
E) Factor XI

Q6. Which of the following is caused by ACE inhibitors?

A) Proteinuria
B) Agranulocytosis
C) Hypokalemia
D) Hypertension

Q7. The exact point where QRS meets ST segment is?

A) J point
B) U wave
C) QRS junction

Q8. Which will be given for acute treatment of angina.

A) Nitroglycerin
B) B blockers
 C) Nifedipine

Q9. The antidotes which act by forming new less toxic compounds with poison?
A) Chemical antidotes
B) Physical antidotes
C) Universal antidotes
D) Physiological antidotes

Q10. Which drug improves mortality in STEMI emergency?

A) Nitroglycerin
B) Aspirin
C) Beta blocker
D) Oxygen
E) Anticoagulation with heparin

Q11. Which of the following is gold standard in diagnosing coronary artery disease?
A) Coronary angiography
B) ETT
C) Stress echo

Q12. Which one of the following tests (non-invasive) has the highest sensitivity in detecting
coronary artery disease?
A) CT angiography
B) Cardiac MRI
C) Thallium scan
D) Stress echo

Q13. High dose long term use of hydralazine cause

A) Agranulocytosis
B) Thrombocytopenia
C) Lupus erythematosus
D) Hemolytic anemia
E) Gynaecomastia

Q14. Physical activity in healthy and fit individuals reduces risk of CVD by
a) 100 %
b) 20—30 %
c) 50 %
d) 10%
e) Zero

Q15. Most common cardiomyopathy?

A) Dilated cardiomyopathy
B) Hypertrophic cardiomyopathy
 C) Restrictive cardiomyopathy

Q16. High risk patient for ETT?

A) 3 mmHg decrease in diastolic BP
B) 5 mmHg decrease in systolic BP
C) Upsloping ST depression in leads V2 - V6
D) 2 mm ST depression in inferior leads
E) 1 mm ST elevation in leads V2- V6

Q17. Which of the following has the greatest potential for prevention of CVD?
A) Population strategy
B) High risk strategy
C) Secondary prevention
D) Increase in physical activity
E) Hypertension management

Q18. Associated with congenital heart disease?

A) Rubella infection

Q19. A 28 year old male, known case of hypertrophic obstructive cardiomyopathy presented in
cardiac emergency room with a history of transient loss of consciousness. His elder brother died
at age of 30 years. What will be your definite treatment?
A) Beta blocker
B) Implantable cardioverter defibrillator
C) Dual chamber pacing
D) Reassurance
E) Alcohol Septal Ablation

Q20. A 54 years old male patient presents with Congestive heart failure in emergency. Physical
examination also shows high pressure pulse, notching of ribs on Xray. Which of the following is
the most likely cause
A) Coarctation of Aorta
B) Tricuspid regurgitation
C) Mitral regurgitation
D) Mitral stenosis

Q21. Patient presents with crushing chest pain radiating to left arm. He was given sublingual
nitroglycerin but it didn't improve his condition. If the pain lasts for >20 minutes it is more likely to
be:
A) Myocardial infarction
B) CCF
C) Acute coronary syndrome

Q22. Oligemic lung fields on X ray chest are seen in which of the following?
 A) VSD
B) Tetralogy of fallot
C) ASD
D) Mitral stenosis
E) Tricuspid regurgitation

Q23. What is the most common poison used to commit suicide in industrial areas of Pakistan?
A) Organophosphates
B) Arsenic
C) Barbiturates
D) potassium cyanide
E) Kerosene Oil

Q24. Peripheral cyanosis occurs in which of the following?

A) Low cardiac output
B) Congenital heart diseases (right to left shunt)
C) Lung disease

Q25. A case of heart failure. Has hypokalemia and hypomagnesemia. Which of the following
drugs is contraindicated?
A) Digoxin
B) Spironolactone

Q26. Sustained and forceful apex beat?

A) Aortic stenosis

Q27. A 54 year old female presented in ER with shortness of breath since 4 months, and is
unable to perform her daily activities. She has a history of hyperlipidemia, diabetes, and three
vessel disease since about 4 years. On examination, bilateral crepitations/crackles are present
in lungs. What is diagnosis of her condition?
A) Myocarditis
B) Endocarditis
C) Left heart failure
D) Right heart failure

Q28. A patient presents with angina pectoris. Which of the following cells will sustain the initial
injury due to this arterial disease?
A. Endothelial cells
B. Monocytes
C. Neutrophils
D. Platelets

Q29. Most cardiac specific test?

A) Troponins I and T
 B) CK-MB

Q30. About lidocaine?

A) Increases action potential duration
B) Prolong PR interval
C) Reduces abnormal automaticity
D) Reduces refractory period
E) Increases contractility

Q31. Regarding ideal homicidal drug:

A) Easily administered orally
B) Cheap
C) Tasteless and odorless
D) Resemble disease
E) Rapid in action0 ugh

Q32. At which costal cartilage level Aortic Valve is present (not the murmur but the actual
valve)?
A) right 2nd
B) Left 3rd (ref. Brs anatomy)
C) Right 4
D) Left 4
E) Left 5

Q33. Dysfunction in restrictive cardiomyopathy?

A) Diastolic dysfunction
B) Systolic dysfunction 0

Q35. A proff asks his students to code all the data that is being collected. This will result in:
A) Fast data analysis
B) Reduces efficiency
C) Delayed data entry
D) Errors
E) Increased efficiency

Q36. Christenson's saying is for:

A. Oxalic acid
B. Caustic soda
C. Carbolic acid
D. Nitric acid
E. Caustic Potash

Q37. Which brings bias in research questionnaire

A) Leading questions
 B) Open ended questions
C) sensitive questions
D) Skip pattern in question

Q38. Which reduces risk of CVD

A) Polyunsaturated vegetable oil
B) Saturated fats
C) Animal fat
D) Butter

Q39. About screening questions in research

A) Minimize sample size
B) Diagnosis of disease
C) Manage time efficiently
D) Exclude out certain individuals

Q40. SA node is present in wall of

A) Right atrium
B) Right ventricle
C)Left atrium
D) Left ventricle
E)Aorta

Q41. A researcher wants to know the number of old and new cases of TB in a year in Karachi.
Which study design is suitable
A) Cross sectional
B) Cohort
C) Quasi experimental
D) Case control

Q42. Process by which one activates and sustains thoughts, behavior and emotion to works
towards his goal
A) Self perception
B) Self awareness
C) Self regulation
D) Self ideas
E) Self esteem

Q43. Which factor influences self regulation ?

A) Self awareness (knowledge)
B) Self perception
C) Gratification
D) Communication
E) Low motivatiom
Q44. 50 year old obese female traveling from the USA. She complains of sudden onset of
breathlessness
A) Pulmonary embolism

Q45. A child was admitted to the ER due to ? She had high BP in upper extremities and low BP
in the legs. Imaging showed scalloped ribs. What could be the possible diagnosis?
A) Coarctation of aorta
B) ASD
C) VSD

Q46. What Is the most common disease associated with congenital heart disease?
A) Down Syndrome
B) Digeorge Syndrome
C) Noonan's
D) William syndrome

Q47. Which study design would not need permission from ethical board?
A) Systematic Review
B) Cross sectional
C) Case study
D) Cohort study

Q48. A researcher will be following COVID-19 patients men and women to find the long term
complications of COVID. What type of study is this?
A) Cohort
B) Case control

Q49. An elderly person with hypertension was being giving hydrathiazide? 50 mg but it no
longer helped in reducing Blood pressure. He was given another medicine, spontaneous sys BP
fall was seen. What was the medication?
A) Captopril
B) Amlodipine
C) Atenolol
D) Alpha methyl dopa
E) Losartan

Q50. Which is most commonly associated with ventricular septal defect ?

A) Tetralogy of Fallot
B) Truncus Arteriosis
C) ASD

Q51. What condition encompasses VSD, pulmonary stenosis, dextroposition of aorta and right
ventricle hypertrophy?
 A) TOF

Q52. A patient presented with a fixed split S2 sound? What could be the diagnosis?
A) Pulmonary stenosis
B) Atrial Septal Defect

Q53. A child on screening was found to have a defect at the limbus of foramen ovale. What
could be the possible structure involved?
A) ASD+Ostium primum
B) Atrial Septal Defect+Ostium secundum

Q54. Activated charcoal for adult quantity?

a. 2-4 gms
b. 300-400 grams
c. 50-100 grams
d. 1 kg

Q55. Which ASD is associated with AV valve abnormalities?

A) Septum primum defect
B) Septum secondum defect

Q56. Sign of 3 seen in

A) Coarctation of aorta
B) Tetralogy of Fallot

Q57. Waxing Waning Machine like murmur

A. Patent ductus arteriosus
B. Total anomalous venous return

Q58. "Continuous" Murmur was the buzz word, with a long case about a child given.
A. Patent ductus arteriosus
B. Aortic stenosis

Q59. What murmur is seen in aortic stenosis?

A) Diamond shaped systolic Crescendo decrescendo murmur
B) Decrescendo murmur

Q60. Brown stomach folds and hardened esophagus?

A. Oxalic acid
B. Carbolic acid

Q61. Gastric lavage ABSOLUTELY contraindicated in?

A. 6-8 hours after poison
B. Volatile poison
 C. Sulfuric acid poison
D. Carbolic acid poison
E. Strychnine poison

62) A 53 year old obese came to opd with complaints of recurrent chest pain .He has
experienced similar chest pains for the past few years. He also experiences cramps while
walking.his sugar level is 170 mg/dl. Cholesterol level of 358 mg/dl. His ecg and cardiac
markers are normal. What is the underlying pathology of this condition ?
A) Atherosclerosis of Coronary artery

Q63) Wide fixed splitting of S2 is heard in;

A) Atrial Septal Defect
B) VSD
C) PDA

64) A case about a man. Artery in the interventricular septum occluded. Branch of left coronary
artery.
● Anterior interventricular artery
● Posterior interventricular artery

65) A child had repeated infections and pneumonia since birth. O/E a systolic murmur is heard
at left 4th intercostal space and bilateral ventricular hypertrophy is found on imaging. What is
the likely diagnosis?
a. Pulmonic stenosis
b. Ventricular septal defect
c. ToF

66) Acute cor pulmonale has:

a. Right ventricular dilatation with hypertrophy Answer??
b. Right ventricular dilatation without hypertrophy
c. Right ventricular dilatation with fibrosis

Q67 recommended exercise for preventing cVd :

a. 10 minutes for 5 days/week
b. 20 minutes for 5 days/week
c. 30 minutes for 5 days/week
d. 50 minutes for 5 days/week
e. 60 minutes for 5 days/week

Q68) idiosyncrasy refers to;

A) Side effects in some people by a
small dose with drugs which are within safety margin (answer)
B) Side effects of any substance
C) Side effect by prolong use of drug
69) Aspirin causes increased bleeding time by which mechanism
1. Inhibit thromboxane a2 from platelet
2. Inhibit prostacyclin endothelial cells
3. Inhibits clotting factors

Q70) Acid neutralization in stomach with which of the following is contraindicated in H2SO4
poisoning:
A) Sodium bicarbonate
B) Milk of Magnesia
C) Limewater
D) Aluminum hydroxide

Q71 During treatment of MI, which of the following is an adverse side effect of fibrinolytic
therapy?
a. Formation of antiplatelet antibodies
b. Acute hemorrhagic stroke

Q72 A child has been cyanotic since birth. He has pulmonary edema and shortness of breath
but no signs of Congestive Cardiac Failure are found. Which of the following abnormality would
be have?
a. Clubbing
b. Peritibial edema
c. Increased bp
d. Severe anemia

Q73 decreasing triglycerides by inhibit having hepatic secretion of VLDL and suppressing
synthesis of VLDL by;
A) Nicotinic acid
B) Fluvastatin

Q74 A case of beta thalassemia, having several blood transfusions develops cardiomyopathy
due to
A) Hemochromatosis
B) Dilated cardiomyopathy
C) Restrictive cardiomyopathy
D) Blood transfusion

Q75 A person after antihypertensive therapy has developed dry cough, which of the following
has this side effect;
A) Captopril

Q76 A person works in a marble factory, he's exposed to dust and complains about cough and
SOB, This is commonly due to;
 A) Silicosis
B) Pneumoconiosis
C) Bagassis

Q77 In which condition is BNP not increased

A)constrictive pericarditis
B)dilated
C)hypertrophic
D)restrictive

Q78 The duration of PR interval is

A. 0.22
B. 0.20p

Q.79 A 40 year old man presented to the outpatient department with complaints of
breathlessness and fatigue. He received radiation to mediastinum for Hodgkin's Lymphoma 5
years ago. Now, he developed cardiomyopathy. What type of cardiomyopathy developed in this
patient?
A) Restrictive Cardiomyopathy
B) Hypertrophic cardiomyopathy
C) Dilated cardiomyopathy
D) Hemochromatosis induced cardiomyopathy
E) Myocarditis due to viral infections

Q80. Which requires anticoagulant

a. Bioprosthetic valve replacement
b. Mechanical valve replacement

Q81. In mitral stenosis

a. Turbulent flow produces the characteristic low pitched mid diastolic murmur
b. Patient remain asymptomatic until stenosis is less than 2 cm2
c. Antibiotic prophylaxis against infective endocarditis is given to all patients with rheumatic
MS
d. Mitral balloon valvotomy can be safely done in patients with heavily calcified mitral valve

82. Regarding diastolic murmurs

A. Long mid diastolic rumble is characteristic of severe MS

83. Most common indication for CABG surgery

A. Multivessel disease
B. 20% or greater stenosis of RCA
C. 50% or less than 50% stenosis of LCA
D. Valvular defects
84. Which vasculitis involves aorta?
A. Takayasu disease

85. A patient comes to the clinic who has history of taking liquids for suicide purpose. On
examination, his pulse rate is 92 per minute, blood pressure is 120/70 mmHg. He also has
ulceration around the mouth and tongue. His chest is full of crepts and has severely disturbed
breathing. Most appropriate treatment would be:
A. Airway, breathing and circulation establishment
B. Mouthwash and antacids
C. Inject morphine
D. BP maintenance

86. A 25 year old man complains of sharp pain which increases on lying and is relieved with
sitting. Diagnosis:
A. Pericarditis
B. STEMI
C. COPD

87. Modifiable risk factor for the prevention of CVD?

A. Obesity
B. Gender
C. Genetics
D. Age
E. Family history

88. MOA of nitrates?

A. Activates cGMP

89. Man with a history of smoking. Which vasculitis?

A) Berger w