CVS-II MODULAR TEST - 22

1. A female body is ready for performing autopsy, Ideal incision will be:
a. I-shaped
b. Modified Y-shaped.
c. U-shaped
d. Y-shaped

2. A 46-year-old man with essential hypertension has a resting BP of 160/110 mmHg and was given
Amlodipine. After a couple of weeks his BP falls to 130/80mmhg. Which mechanism of action is
more likely associated with Amlodipine?
a. Alpha adrenergic antagonist
b. Angiotensin converting enzyme inhibitor
c. Beta adrenergic blocker
d. Calcium channel blocker

3. The most likely criterion for the diagnosis of systemic Hypertensive heart disease is:
a. Left atrial hypertrophy
b. Left ventricular hypertrophy
c. Right ventricular hypertrophy

4. Autopsy findings in a 65-year-old male who had sudden death, revealed right internal carotid artery
plaque with superimposed thrombus. Plaque revealed foam cells and abundant necrotic lipid core.
Which of the following is a not a pathogenetic mechanism for this condition?
a. Accumulation of HDL in the wall
b. Endothelial injury and dysfunction
c. Monocyte adhesion followed by formation of foam cells
d. Smooth muscle proliferation

5. Pulmonary hypertension due to primary lung parenchymal or vascular disorders results in:
a. Arrythmias
b. Calcific aortic stenosis
c. Congestive heart failure
d. Cor pulmonale
6. A newborn was brought in Pediatric emergency. The baby’s face turned cyanotic on crying &
feeding. His X-Ray chest exhibited enlarged boot shaped heart, while echocardiography revealed
ventricular septal defect, overriding of aorta & right ventricular hypertrophy. Which one of the
following is the most likely diagnosis?
a. Coarctation of aorta
b. Cor Pulmonale
c. Patent ductus arteriosus
d. Tetralogy of Fallot

7. A 03-year-old child presented in the medical OPD with blistering edema of the hands and feet.
Physical examination revealed conjunctival and oral erythema with cervical lymph node
enlargement. Radiological scan revealed 6mm coronary artery aneurysm. The most likely
diagnosis is:
a. Churg-Strauss syndrome
b. Kawasaki disease
c. Microscopic polyangiitis
d. Takayasu arteritis

8. A drug that is useful in angina but cause constipation and pedal edema as its adverse effects is?
a. Atenolol
b. Diltiazem
c. Hydralazine
d. Isosorbide di nitrate

9. Most characteristic feature of elapids snakes envenomation:

a. Bleeding manifestation
b. Cardio toxicity
c. Neuro – paralytic symptoms
d. Rhabdomyolysis

10. Angiotensin converting enzyme inhibitor (ACE) are associated with which of the following
metabolic disturbance?
a. Hyperkalemia
b. Hypernatremia
c. Hypokalemia
d. Hyponatremia

11. The most common organism for infective endocarditis is:

a. Enterococcus
b. Staphylococcus aureus
c. Staphylococcus epidermidis
d. Staphylococcus viridians
12. A 52-year-old male, cigarette smoker for 20 years was diagnosed as having Abdominal Aortic
Aneurysm (AAA). Choose one of the most common site for the development of this aneurysm.
a. Above the renal arteries
b. At the level of porta hepatis
c. Below the renal arteries
d. Just below the diaphragm

13. Clinical criteria for diagnosis of infective endocarditis include?

a. Two major, or one major with three minor, or five minors.
b. One major with two minors, or six minors.
c. One positive blood culture
d. One major with one minor, or four minors.

14. Carboluria is suggestive of poisoning with:

a. Acid of sugar
b. Engraver’s acid.
c. Muriatic acid
d. Phenol

15. Throwing of any corrosive on any part of body out of jealousy or revenge is:
a. Acid rush
b. Itlaf-e-salahiyat-e-udw
c. Itlaf-e-udw
d. Vitriolage

16. For the diagnosis of rheumatic fever, one of the following criteria should meet:
a. One major and one minor
b. One major and two minor
c. One major only
d. Two major and one minor

17. The following congenital heart defect is not manifested as Left-to-right shunt:
a. Atrial septal defect
b. Atrio-ventricular septal defect
c. Patent ductus arteriosus
d. Transposition of great arteries

18. Most useful drug for relief of chest pain for angina on exertion is:
a. Beta-blocker
b. Calcium channel blocker
c. Oral nitrates
d. Sublingual nitrate
19. An 18-year-old male was brought to ER with complaints of arrhythmias and migratory polyarthritis.
Clinical examination and investigation showed presence of cardiac murmurs, cardiac hypertrophy
and dilation and mitral stenosis. Endomyocardial biopsy of heart shows Aschoff bodies. What is
the most likely diagnosis?
a. Dengue fever
b. Infective Endocarditis
c. Rheumatic fever
d. Rheumatoid valvulitis

20. A 65-year-old female presented with cough and breathlessness. Initially dyspnea occurred on
exertion which lasted for many years, for which she did not take any medication. There was
progressive worsening of dyspnea and now it occurred even at rest. The most characteristic
finding seen in the lungs in this condition is
a. Epithelioid granulomas
b. Hemosiderin laden macrophages
c. Nutmeg appearance
d. Pulmonary fibrosis

21. An antihypertensive drug that is used in hypertension but due to postural hypotension as its side
effect, is not used frequently. Which of the following drug is it?
a. Hydralazine
b. Methyldopa
c. Prazosin
d. Propranolol

22. The murmur present on auscultation in a patient with aortic stenosis is:
a. Easy diastolic murmur
b. Ejection systolic murmur
c. Mild diastolic murmur
d. Pansystolic murmur

23. After the completion of Autopsy by a senior experienced medico-legal officer, cause of death not
found, it is:
a. Incomplete autopsy
b. Negative autopsy
c. Obscure autopsy
d. Second autopsy

24. A 40 year old patient came to hospital in emergency with complaints of shortness of breath and
chest pain on exertion. His BP was 180/110 mmHg. What will be best combination treatment?
a. Ace inhibitors + diuretics
b. Nitrate + diuretics and Ca++ channel blocker
c. Vasodilator+ Angiotensin II Receptor Blockers (ARB)
d. α and β adrenergic blockers
25. A 30 years old term gravida presented in the Gynae OPD, with complaints of difficulty in walking.
On physical examination, she had extremely painful swollen peripheries and prominent vessels of
both the legs. History reveals that she has developed the symptoms during the last trimester. The
most likely reason of her complaints is:
a. Capillary Hemangioma
b. Raynaud Phenomenon
c. Thrombophlebitis
d. Varicose veins

26. Poisonous snakes have:

a. Large head scales
b. Long fangs
c. Non-compressed tail
d. Small belly

27. In a patient with rheumatic fever which of the following is one of the major criteria?
a. Fever
b. Increase CRP
c. Migratory polyarthritis
d. Sore throat

28. A 56-year-old obese and hypertensive man presented to the emergency with crushing chest pain
radiating to the left arm, rapid pulse, profuse sweating, nausea and vomiting for half an hour. The
blood levels of which one of the following serum marker is most likely diagnostic of myocardial
infarction in this patient?
a. C-reactive proteins
b. Fibrinogen
c. Prothrombin
d. Troponins T and I

29. Chronic alcoholism is associated with:

a. Dilated cardiomyopathy
b. Hypertensive obstructive cardiomyopathy (HOCM)
c. Infiltrative cardiomyopathy
d. Restrictive cardiomyopathy

30. The role of beta-blocker for the prophylaxis of angina is probably due to the mechanism:
a. Block exercise induced tachycardia
b. Decreased ventricular ejection
c. Decreased ventricular volume
d. Increase cardiac output
31. Life style modification and diet modification play an important part in prevention of cardiovascular
diseases. Which one of the following set of nutrients with moderate physical activity can play an
important part in prevention of cardiovascular diseases?
a. Low potassium, along with good amount of calcium and magnesium.
b. Low sodium, high potassium and low saturated fat.
c. Low sodium, high potassium and low unsaturated fat.
d. Low sodium, low potassium and low-fat diet.

32. Gold standard investigation to diagnose aortic regurgitation is:

a. ECG
b. Echocardiography
c. MRI chest
d. X-ray chest P/A view

33. A 23-year-old male suffered head injury due to road traffic accident, after few hours his intracranial
pressure was raised. He was given infusion of diuretics to reduce the intracranial pressure, which
one of the following diuretics is indicated for decreasing intracranial pressure?
a. Eplerenone.
b. Furosemide.
c. Mannitol.
d. Metolazone.

34. Collection of specimens at autopsy, their preservation and dispatch to appropriate laboratories
while maintaining optimum temperatures is:
a. Autopsy Protocol
b. Chain of command
c. Chain of evidence
d. Evidentiary Protocol

35. Most important auscultatory finding in a patient with mitral stenosis is:
a. Ejection systolic murmur
b. Loud S2
c. Loud S3
d. Mid diastolic murmur

36. Which of the following adverse effects is less common when an angiotensin receptor blocker is
used instead of an ACEI (angiotensin converting enzyme inhibitor)?
a. Altered sense of taste
b. Dry cough
c. Fetal malformations
d. Hyperkalemia
37. The first line drug in the treatment of acute and chronic heart failure:
a. Atenolol
b. Diltiazem
c. Furosemide
d. Metoprolol
38. Which of the following patterns of infarction is seen in the myocardium after the occlusion of
epicardial vessel?
a. Transmural infarction
b. Subendocardial infarction
c. Multifocal infarction
d. Reperfusion modified infarct
39. Tissue collected for histopathology examination are preserved in:
a. 10% formalin
b. Saturated solution of common salt
c. solution of sodium citrate
d. Spirit
40. A 50-year-old man, known hypertensive, was taking β-blocker. His BP was 140/100.To control his
BP he needed another drug. What could be best combination?
a. β -blocker + captopril
b. β -blocker + nifedipine
c. β -blocker + digoxin
d. β -blocker + diltiazem

EMQ 1
a. Myocardial infarction f. Tricuspid regurgitation
b. Right sided heart failure g. Pericardial tamponade
c. Left sided heat failure h. Infective endocarditis
d. Mitral stenosis i. Angina
e. Mitral regurgitation j. Rheumatic fever

41. An I.V drug abuser was having high grade fever and shortness of breath along with hemoptysis for
last 7 days. On auscultation he has diastolic murmur at left 4th intercostal space, he has?
42. A 45-year-old male, known case of hypertension developed shortness of breath for 2weeks. On
auscultation crepts are audible at the base of chest
43. After Myocardial infarction recovery, a 65-year-old male got sudden shortness of breath and
repeated angina on exertion. On examination he has pansystolic murmur. He has most likely
developed?
44. A 65-year-old male was having central chest pain for last 7 days on exertion but relieve on rest.
Doctor suggests him nitro glycine sublingual when he felt pain. His symptoms suggest he has?
45. A 35-year-old female having childhood history of rheumatic fever developed progressive history of
chest pain and on and off shortness of breath. She is likely to develop?
 EMQ 2
a. Medico-legal autopsy f. Negative autopsy
b. Hydrocyanic acid g. Sulphuric acid
c. Mini autopsy h. Elapid snake
d. Viper snake i. Therapeutic artefacts
e. Postmortem artefacts j. Incomplete autopsy.

46. Only a localized incision given on the affected obvious injured part by the medico-legal officer
without opening the other cavities.
47. Autopsy done by medico-legal officer who was performing autopsy for the first time and declare
no cause of death.
48. Any change caused or feature introduced in a body after death. They had to wrong interpretation in
number of cases.
49. A body received in a mortuary, time since death calculated about 12 hours. Body emitting a bitter
almond smell. Diagnosis?
50. A case of snake poisoning presenting with giddiness, lethargy, muscular weakness and spreading
paralysis. Type of snake?