24.6.2013(path-CVS,kidney) 47

Question 0

Most important energy source for cardiac myocytes

Answer 0

Fatty acids

Question 1

Dominant coronary artery

Answer 1

Artery which supplies the post 1/3 rd of interventricular septum

It is RCA in majority of individuals

Question 2

Most common cause of right heart failure

Answer 2

Left heart failure

Question 3

Age group affected by RHD

Answer 3

5-15yrs

Question 4

Cross reacting antibodies in RHD are produced against which streptococcal strains

Answer 4

1,3,5,6,18

Question 5

Lab minor criteria for RF

Answer 5

ESR

CRP

Question 6

Supporting evidence of streptococcal infection within last 45 days

Answer 6

Rising ASO titres
Positive throat culture
Rapid antigen test for gpA streptococcus

Question 7

Most common valvular lesion in RHD

Answer 7

MR(acute)

MS(chronic)

Question 8

Most common manifestation of RHD

Answer 8

Arthritis(world)

Carditis(India)

Question 9

RHD features common in males and females

Answer 9

Aortic valve (male)
Mitral valve and chorea(females)

Question 10

Rheumatic fever is more common in which gender

Answer 10

Common in both

Question 11

Sites of subcutaneous nodules in RF

Answer 11

Extensor surfaces of elbow,shin

Occiput

Question 12

Irregular thickening of left atrial wall in RHD due to MR

Answer 12

Maccallum plaques

Question 13

Genetic factors that predispose to RHD

Answer 13

HLA DR3
B cell alloantigen 883
Antibody D 8/17

Question 14

Criteria for recurrence of rheumatic fever in a patient with RHD

Answer 14

Two minor+ evidence of preceding streptococcal infection

Question 15

Feature always associated with carditis

Answer 15

Subcutaneous nodules

Question 16

Late manifestations of RF

Answer 16

Subcutaneous nodules(6weeks)
Rheumatic chorea(3months)

Question 17

Rheumatic Chorea never occurs in

Answer 17

Postpubertal males

Question 18

DOC for Sydenham chorea

Answer 18

Phenobarbitone

Question 19

Triad of Sydenham chorea

Answer 19

Emotional lability
Hypotonia
Uncoordinated movements

Question 20

Indication of IVIG in rheumatic fever

Answer 20

Severe chorea refractory to other treatment

Question 21

PANDAS

Answer 21

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection

Question 22

Major criteria or preceding evidence of streptococcal infection not needed if pt has

Answer 22

Rheumatic chorea

Insidious onset of rheumatic carditis

Question 23

Criterion standard investigation for GAS infection

Answer 23

Throat swab

Question 24

Specific test for detection of GAS infection

Answer 24

RADT | Rapid antigen test for group A streptococcus

Question 25

Rx of rheumatic chorea

Answer 25

Phenobarbitone Haloperidol Chlorpromazine

Question 26

Rheumatic arthritis commonly affects

Answer 26

Large joints (knee,ankle)

Question 27

Which two major criteria manifestations never occur simultaneously

Answer 27

Polyarthritis | Sydenham chorea

Question 28

Residual arthritis in RHD

Answer 28

Jaccoud chronic post rheumatic arthritis

Question 29

Allergic arthritis due to TB

Answer 29

Ponset disease

Question 30

IE vegetations eroding myocardium

Answer 30

Ring abscess

Question 31

Valvular surface commonly affected in LS endocarditis

Answer 31

Undersurface

Question 32

Most common cause of sudden cardiac death

Answer 32

Ventricular fibrillation

Question 33

Percentage of occlusion of coronary vessels when symptoms occur at rest

Answer 33

90%

Question 34

ST changes in prinzmetal angina

Answer 34

Elevation

Question 35

Characteristic histologic feature of reperfusion injury

Answer 35

Contraction band necrosis

Question 36

First sign and symptom of acute MI

Answer 36

Rapid pulse | Dyspnea

Question 37

Order of elevation of cardiac enzymes

Answer 37

Troponins CK MB AST LDH 1

Question 38

Cardiac injury marker that remains elevated for longest time

Answer 38

LDH(2 weeks)

Question 39

Most important troponin

Answer 39

Troponin I

Question 40

CK BB is present in

Answer 40

Brain | Lung

Question 41

Earliest enzyme to rise following MI

Answer 41

Myoglobin

Question 42

LDH isoenzyme more in MI

Answer 42

LDH 1 LDH flip

Question 43

Most common arrythmia after MI

Answer 43

``` Ventricular fibrillation(within 1 hour following MI) Supra ventricular tachycardia(after 1hour following MI) ```

Question 44

Most common site of post MI cardiac rupture

Answer 44

Anterolateral wall

Question 45

Cardiac rupture is most common _________ days after MI

Answer 45

3-7

Question 46

Most common cardiac tumor

Answer 46

Metastasis

Question 47

Site of origin of atrial myxomas

Answer 47

Fossa ovalis

Question 48

Vaso vasorum supplies

Answer 48

Outer half of tunica media and tunica adventitia

Question 49

Endothelial cells are identified by antibodies to

Answer 49

CD31 CD34 vWF

Question 50

Blood flow during diastole is maintained by

Answer 50

Windkessel effect

Question 51

Lp(a) has structural similarity to

Answer 51

Plasminogen

Question 52

Earliest lesion of atherosclerosis

Answer 52

Fatty dot(contains lipid filled foam cells)

Question 53

Lesions of atherosclerosis

Answer 53

``` 1 fatty dot 2 fatty streak 3 intermediate lesion 4 atheroma lesion 5 fibroatheroma 6 complicated lesion ```

Question 54

Most common site of atherosclerotic aneurysm in body

Answer 54

Abdominal aorta

Question 55

Common cause of ascending aorta aneurysm

Answer 55

Hypertension

Question 56

Tuberculous aneurysms affect

Answer 56

Thoracic aorta

Question 57

Ehlers danlos syndrome

Answer 57

Defect in collagen type III

Question 58

Loeys dietz syndrome

Answer 58

Aneurysms due to defect in elastin and collagen I and III

Question 59

Subtype of HCV that causes acute infection

Answer 59

HCV 3

Question 60

Subtype of HCV that responds to Rx well

Answer 60

HCV 2

Question 61

Subtype of HCV that is commonly associated with chronic infection

Answer 61

HCV D

Question 62

Color changes in Raynaud

Answer 62

1. White 2. Blue 3. Red

Question 63

Commonest cause of secondary Raynaud

Answer 63

Systemic sclerosis

Question 64

Fingers commonly affected by Raynaud attacks

Answer 64

Index and middle finger Thumb is least sensitive

Question 65

Onset of buerger disease

Answer 65

Before age 35yrs

Question 66

Strawberry gums

Answer 66

Wegener

Question 67

Cystic hygroma

Answer 67

Cavernous lymphangioma | Non encapsulated

Question 68

Stages of kaposi sarcoma

Answer 68

Patch Plaque Nodular

Question 69

Lymphadenopathy is present in which types of kaposi sarcoma

Answer 69

African/endemic Epidemic/AIDS associated Immunosuppression associated

Question 70

Visceral involvement is seen in which type of kaposi sarcoma

Answer 70

Immunosuppression associated and epidemic form

Question 71

Only skin affected in which form of kaposi

Answer 71

European/classical form/chronic

Question 72

Most common site of hemangiopericytoma

Answer 72

Pelvic retroperitoneum | Lower limbs

Question 73

Arrangement of capillaries in hemangiopericytoma

Answer 73

Fish hook pattern Demonstrated by silver stain

Question 74

Commonest cardiac manifestation of carcinoid syndrome

Answer 74

Tricuspid regurgitation

Question 75

Hyperlipoproteinemias not associated with CAD

Answer 75

Type I and V

Question 76

Mode of inheritance of Barlow syndrome

Answer 76

Autosomal dominant

Question 77

Aschoff bodies show

Answer 77

Anitschkow cells Giant cells Fibrinoid necrosis

Question 78

Hyperplastic arteriosclerosis is seen in

Answer 78

Kidney Intestine Gall bladder Pancreas Not found in heart

Question 79

Wegener disease involves

Answer 79

Eyes Skin HEART lungs

Question 80

Pathognomonic feature of acute rheumatic fever

Answer 80

Aschoff nodules

Question 81

Most common cause of myocarditis

Answer 81

Viral myocarditis due to coxsackie A and B

Question 82

Most common helminthic disease associated with myocarditis

Answer 82

Trichinosis

Question 83

Autoimmune causes of myocarditis

Answer 83

RF polymyositis SLE

Question 84

Bacteria causing myocarditis

Answer 84

``` C.psittaci C.diphtheriae Lyme disease Rickettsia typhi Meningococcus ```

Question 85

Protozoa causing myocarditis

Answer 85

Toxoplasma | Trypanosoma cruzi

Question 86

Calcification of aortic valve is seen in

Answer 86

Syphilis

Question 87

Metastasis to heart is commonly from

Answer 87

Ca lung and breast Melanomas Leukemia Lymphoma

Question 88

Naxos syndrome

Answer 88

Arrythmogenic right ventricular cardiomyopathy | Thickening of palms and soles

Question 89

Naxos syndrome is due to

Answer 89

Plakoglobin gene

Question 90

Microscopic appearance of rhabdomyoma

Answer 90

Spider cells

Question 91

Mutation in HOCM

Answer 91

Myosin beta chain

Question 92

Gold standard investigation for chronic mesenteric ischemia

Answer 92

Angiography Mesenteric duplex ultrasonography is non invasive

Question 93

Most common cause of death during acute rheumatic fever

Answer 93

Myocarditis

Question 94

Factors involved in atherogenesis

Answer 94

PDGF is mitogenic and chemotactic for smooth muscle cells TGF B is chemotactic for SMC Key cell-platelets

Question 95

Pericarditis following MI

Answer 95

Early(2-4 days) reaction to transmural necrosis | Late onset-dressler syndrome