2016-05-26

@marimphil wrote:

post you queries/ high yielding facts / doubtful MCQs here,,,
regards

ques 1) all of the following drugs reduce hs-CRP except?
a) niacin
b) statins
c) aspirin
d) fibrates

please post questions here...
we will solve them with explanations

its all about pgdcc course... quacks creating course run by ignopen universuty.... to cheat poor public in rural areas... people who done ug from china ,russia etc r joining in this course...without any basic knowledge, labelling them selves as cardiologist and cheating public...they r spoiling our names...spoiling whole cardiology speciality..its high time to stop this course..else its a crime.. we should join together and file case.. all real cardiologists are interested in this....report

ques 2) Each of the following statements regarding high-sensitivity C-reactive protein (hsCRP) is true EXCEPT:
A Statins reduce hsCRP in a manner directly related to their low-density lipoprotein–lowering effect
B An hsCRP level > 3 mg/L in a patient with unstable angina is associated with an increased risk of recurrent coronary events
C An elevated level of hsCRP is predictive of the onset of type 2 diabetes mellitus
D Statin therapy has been shown to reduce cardiovascular events in apparently healthy individuals with elevated hsCRP even if the baseline LDL-C is <130 mg/dL
E The cardiovascular benefit of aspirin therapy appears to be greatest in patients with elevated hsCRP levels

A (Braunwald, pp. 922-926)
C-reactive protein (CRP), a circulating member of the pentraxin family, plays an important role in innate immunity. It is formed primarily in the liver but is also elaborated from coronary arteries, especially atherosclerotic intima. Levels of CRP are elevated in inflammatory states and may directly affect vascular vulnerability, thereby promoting atherosclerosis. Multiple epidemiologic studies have demonstrated that CRP levels measured by high-sensitivity assays (hsCRP) are strongly and independently associated with myocardial infarction, stroke, peripheral arterial disease, and sudden death.[1] hsCRP levels can be classified as low (<1 mg/L), intermediate (1 to 3 mg/L), or high (>3 mg/L). In patients with acute coronary events, high hsCRP levels are associated with worse outcomes, including increased mortality.[2]

An elevated level of hsCRP also predicts the onset of type 2 diabetes, perhaps because it correlates with insulin sensitivity, endothelial dysfunction, and hypofibrinolysis. Many medications lower hsCRP levels, in particular statins, fibrates, and niacin. Statin therapy reduces hsCRP levels largely unrelated to the low-density lipoprotein–lowering effect.[3] Furthermore, statin therapy has been shown to benefit patients with relatively normal LDL, if the hsCRP is elevated. In the JUPITER trial, rosuvastatin resulted in a 44% reduction in vascular events in apparently healthy individuals with baseline LDL < 130 mg/dL and hsCRP > 2 mg/L.[4]

Aspirin does not directly lower hsCRP levels but appears to have the greatest cardiovascular benefit in patients with elevated baseline hsCRP levels.

ques 3) Thiazide diuretics can contribute to each of the following metabolic effects EXCEPT:
A Hypomagnesemia
B Hypouricemia
C Hypercalcemia
D Hypercholesterolemia
E Hyponatremia

Thiazide diuretics are the most frequently prescribed first-line agents for the treatment of hypertension. They have a number of important side effects. The most common metabolic disturbance is hypokalemia; the serum potassium level falls an average 0.7 mmol/L after institution of 50 mg/d of hydrochlorothiazide, and 0.4 mmol/L with 25 mg/d, but there is almost no decline with 12.5 mg/d.[1] Hypomagnesemia is usually mild but may prevent the restoration of an intracellular deficit of potassium; therefore, it should be corrected.

Hyperuricemia is present in one third of untreated hypertensive persons, and it develops in another third during therapy with thiazides. This is likely a result of increased proximal tubular reabsorption of urate.[1] Thiazides may increase the total blood cholesterol in a dose-related fashion. Low-density lipoproteins and triglycerides also increase. There may also be a rise in serum calcium (usually < 0.5 mg/dL) on thiazide therapy, which is probably secondary to increased proximal tubular reabsorption. Hyponatremia may occur with thiazide therapy, especially in the elderly.

segment with most delayed activation of contraction in non ischemic DCMP with LBBB = posterobasal segment

segment with most delayed activation of contraction in ischemic DCMP with LBBB = inferior wall

warfarin level is increased by:- 1. phenobarb 2. allopurinol 3. rifampicin 4. Sucralfate

non cardiac surgery in >40 yr male increase risk except:- 1. ccs2 angina 2. s3 3. ami<3mth 4. vpc>5/hr in preop ecg

stridor+dyspnea:- 1. left aortic arch+abrrent right subclavian 2. right aortic arch+abrrent right subclavian 3. right aortic arch with mirror image 4. double aortic arch

combined peripheral +central cyanosis without dysnea:- 1. methhemoglobinemia 2. co poisoning 3. cyanide pisoning

cardiac dyspnea all except:- 1. dec frc 2. dec vc 3. dec dLco 4. dec compliance

Fetal death seen in all except:- 1. Ebstein 2. Psvt 3. Tga 4. Chb

Least voltage required in cardioversion for:- 1. Vt 2. Vf 3. Atrial flutter 4. Sinus tachycardia

Liver cirrhosis presnts with all except:- 1. Pph 2. Hemoptysis 3. Hypoxemia 4. Av fistula

Anticoagulation not required in :- 1. Heart mate 2. Abiocor 3. Novacor

Usa-least common risk :- 1. Lv dysfunction 2. Tropt 3. Prolonged chest pain 4. New onset

Bnp all true except:- 1. Increase co 2. Sympathetic inhibition 3. Less arrythmogenic than dobutamine 4. Concentration>4.1 mg/ml

Conduction system development begins in fetus at:- 1. 4th wk 2. 8th wk 3. 3rd wk 4. 20th

Intracoronary thrombus can be caused by all except:- 1. Aspirin 2. Ticlopidine 3. Abciximab 4. Clopidogrel

All of the following are used for postoperative af prophylaxis except;- 1. Over drive pacing 2. Betablockers 3. Amiodarone 4. Sotalol

All are non-coronary causes of st depression during tmt except:- 1. Excessive exercise 2. Long qt syndrome 3. Glucose overload 4. Wpw syndrome

Asymmetrical septal hypertrophy seen in the following conditions except:- 1. Iwmi 2. Anteroseptal mi 3. Posterior wall mi 4. Hocm

Regular pulse with changing pulse volume:- 1. Chb 2. 2:1 av block 3. Chb with af 4. Atrial based pacemaker (AAI) for severe sinus bradycardia

Identify the conditions with the highest cardiac output and the widest difference in av oxygen content:- 1. Systemic av fistula 2. High altitude dwellers 3. Severe anemia 4. Maximal exercise

Which of the following events occurs farthest from aortic component of second heart sound? 1. Physiological third heart sound 2. Third heart sound of lv systolic dysfunction 3. Tumour plop of lv myxoma 4. Pericardial knock of constrictive pericarditis

Which of the following is not a predictor os sudden death in an otherwise healthy individual with no structural heart disease or metabolic dearrangement? 1. Pr interval=0.36 s 2. Qtc=0.245 s 3. Qtc=0.580 s 4. Epsilon wave in right precordial leads

Prolonged hv interval is associated with greater likelihood of developing :- 1. Rbbb 2. Lbbb 3. Bifascicular block 4. Trifasciclar block

Prevalance of htn in urban india:- 1. 10-15% 2. 10-20% 3. 20-40% 4. 40-50%

Anatomy of heart true all except:- 1. Both MV/TV are in vertical axis to septum 2. Ventricles are inferior and left to their respective atria

Zoonotic viral disease not uncommon in india all except:- 1. Marburg 2. Nipah 3. Hanta 4. West nile

Av shunt of skin:- 1. Not sensitive to circulating epinephrine 2. Depends on metabolic need 3. Respond to autoregulation 4. Cholinergic

TMT, ECG changes get obscured by all except:- 1. Digoxin 2. Paced rhythm 3. Mvp with st-t changes 4. Vpc with st-t changes

Most common arrythmia after in post operative tof:- 1. Vt 2. At 3. Af 4. Jt

least cardioversion ..decide urself
in braunwald
a fl 50,, vt 20-50
but I think sinus tachy me not req

I am a new comer here. I am currently doing MD med from MMC chennai. can you pl suggest me
are there any question banks available ?
apart from braunwald , what other books to prepare for exam?
any idea about the clinical cases kept in exam?

TOF murmur is decreased by all except

A) VALSALVA phase 4

B) large VSD

C) less overriding of aorta

i came across this question in one of the online mock test. It was a AIIMS MAY 2008 QUESTION it seems. They hav given the answer as B) LARGE VSD.
If so then the question should be TOF murmur is decreased by which one among the following? CORRECT ME IF I'M WRONG.

asked in diff papers..none of 3 mentioned option given ans anywere..4th option given in mcq books is amyl nitrate and it decreases tof murmer

Large VSD decreases TOF Murmur..rest of the options increase the murmur...you are right,...question framing is wrong

cHARACTERSTIC OF DIGOXIN TOXICITY ALL EXCEPT-
1. Bidirectional VT
2. PAT with block
3. ventricular bigeminy
4. Regularization of VT

ques) digoxin levels can be increased with all except?
1) hypokalemia
2) cardiac amyloidosis
3) myxedema
4) phenytoin

i am doing my md 1st year .i am also preparing for cardio entrance. my query is= can i also appear for dip nb medicine part 2 along with my md(medicine) exam.
i have cleared my dip nb part 1 way too long ie more that 2 years. please do reply. i had some seniors who did like this but i dont have their contact address now.

Topic : DM cardiology preparation
Try mddmonline for previous dm from AIIMS PGI JAYADEVA SCTMIST GB PANT RML WB KERALA fully solved with explanation from BRAUNWALD ....arranged chapter wise ....mock test check where u stand?

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