Q1. Which coronary arterial vessels are most susceptible to ischaemia?
✅ Answer: b) Epicardial arterial vessels
Epicardial vessels are the most susceptible to coronary artery disease. Intramyocardial vessels are the least susceptible.
Epicardial vessels are the most susceptible to coronary artery disease. Intramyocardial vessels are the least susceptible.
Q2. What is not true about left dominant coronary circulation?
✅ Answer: a) It is seen in 20% of the population
90% of the people have right dominant coronary system (RCA ends as PDA). Left dominant: LCX supplies PDA. LCX arises from LMCA, gives marginal branches, and ends as obtuse marginal artery. Rarely (0.5%) LCX arises from the right coronary sinus.
90% of the people have right dominant coronary system (RCA ends as PDA). Left dominant: LCX supplies PDA. LCX arises from LMCA, gives marginal branches, and ends as obtuse marginal artery. Rarely (0.5%) LCX arises from the right coronary sinus.
Q3. Which of the following is not an indication for Coronary artery Bypass grafting (CABG)?
✅ Answer: d) Double vessel disease with patent LAD
Indications for CABG: - LMCA stenosis >60% - LAD or LCA stenosis >70% - Two/three vessel disease with LVEF <50% - Two/three vessel disease with proximal LAD stenosis.
Indications for CABG: - LMCA stenosis >60% - LAD or LCA stenosis >70% - Two/three vessel disease with LVEF <50% - Two/three vessel disease with proximal LAD stenosis.
Q4. Which is not a pathological stage in mitral stenosis?
✅ Answer: d) Fixation of valve alone with free subvalvular system
Progressive pathological stages: commissural fusion, chordal shortening, calcification. Fixation involves both valve and subvalvular system. Suitability for valvuloplasty, commissurotomy, or replacement depends on pathology. (Ref: Schwartz Surgery 8th ed, p.663)
Progressive pathological stages: commissural fusion, chordal shortening, calcification. Fixation involves both valve and subvalvular system. Suitability for valvuloplasty, commissurotomy, or replacement depends on pathology. (Ref: Schwartz Surgery 8th ed, p.663)
Q5. Which of the following change does not occur in mitral stenosis?
✅ Answer: c) Ventricular hypertrophy
The stenosed mitral valve protects the LV from volume/pressure overload. Hence no LV hypertrophy occurs.
The stenosed mitral valve protects the LV from volume/pressure overload. Hence no LV hypertrophy occurs.
Q6. Most common congenital anomaly associated with coarctation of aorta is:
✅ Answer: c) Bicuspid aortic valve
All anomalies can be seen with coarctation, but bicuspid aortic valve is most common (25–40% cases).
All anomalies can be seen with coarctation, but bicuspid aortic valve is most common (25–40% cases).
Q7. Which one of the following is not a clinical feature of coarctation of aorta?
✅ Answer: a) Hypotension
Coarctation = narrowing distal to L subclavian artery → hypertension (not hypotension). Collaterals via intercostals & internal mammary arteries → rib notching, precordial pulsation. Femoral pulse = low volume, delayed (radio-femoral delay).
Coarctation = narrowing distal to L subclavian artery → hypertension (not hypotension). Collaterals via intercostals & internal mammary arteries → rib notching, precordial pulsation. Femoral pulse = low volume, delayed (radio-femoral delay).