Q.1 Which vessel is most commonly harvested for coronary artery bypass grafting (CABG)?
Radial artery
Saphenous vein
Internal thoracic artery
Ulnar artery
Explanation - The left internal thoracic artery is most commonly used due to its excellent long-term patency compared to saphenous vein grafts.
Correct answer is: Internal thoracic artery
Q.2 Which congenital heart defect is characterized by a 'boot-shaped heart' on chest X-ray?
Tetralogy of Fallot
Transposition of great arteries
Tricuspid atresia
Ventricular septal defect
Explanation - Tetralogy of Fallot produces a boot-shaped heart due to right ventricular hypertrophy and upturned apex.
Correct answer is: Tetralogy of Fallot
Q.3 What is the most common complication after mitral valve replacement?
Bleeding
Prosthetic valve thrombosis
Endocarditis
Arrhythmias
Explanation - Postoperative arrhythmias, especially atrial fibrillation, are the most common complications following mitral valve replacement.
Correct answer is: Arrhythmias
Q.4 Which of the following is a contraindication for lung transplantation?
Cystic fibrosis
Severe pulmonary hypertension
Active malignancy
Pulmonary fibrosis
Explanation - Active malignancy is a contraindication to lung transplantation due to risk of recurrence and immunosuppression complications.
Correct answer is: Active malignancy
Q.5 What is Beck's triad in cardiac tamponade?
Hypotension, distended neck veins, muffled heart sounds
Hypertension, tachycardia, loud heart sounds
Bradycardia, syncope, cyanosis
Hypotension, arrhythmias, clear lung fields
Explanation - Beck's triad describes the clinical findings of cardiac tamponade: hypotension, jugular venous distension, and muffled heart sounds.
Correct answer is: Hypotension, distended neck veins, muffled heart sounds
Q.6 Which suture material is most appropriate for vascular anastomosis in cardiothoracic surgery?
Vicryl
Silk
Prolene
Catgut
Explanation - Prolene (polypropylene) is non-absorbable and preferred for vascular anastomosis due to minimal tissue reactivity.
Correct answer is: Prolene
Q.7 Which condition requires emergency surgical intervention in aortic dissection?
Type B dissection distal to left subclavian artery
Type A dissection involving ascending aorta
Stable intramural hematoma
Chronic dissection with false lumen
Explanation - Type A dissections involving the ascending aorta are surgical emergencies due to risk of rupture and cardiac tamponade.
Correct answer is: Type A dissection involving ascending aorta
Q.8 Which of the following is a risk factor for sternal wound infection after open-heart surgery?
Diabetes mellitus
Young age
Short operative time
Use of absorbable sutures
Explanation - Diabetes is a strong risk factor for sternal wound infections due to impaired wound healing and susceptibility to infection.
Correct answer is: Diabetes mellitus
Q.9 Which maneuver is performed to confirm hemostasis after cardiopulmonary bypass?
Valsalva maneuver
Trendelenburg maneuver
Carotid compression
Pericardial massage
Explanation - The Valsalva maneuver increases intrathoracic pressure and helps detect bleeding sites after bypass.
Correct answer is: Valsalva maneuver
Q.10 Which congenital condition is associated with paradoxical embolism?
Patent ductus arteriosus
Atrial septal defect
Tetralogy of Fallot
Ventricular septal defect
Explanation - ASD allows right-to-left shunting under certain conditions, leading to paradoxical embolism.
Correct answer is: Atrial septal defect
Q.11 Which is the most sensitive investigation for diagnosing pulmonary embolism?
Chest X-ray
CT pulmonary angiography
ECG
D-dimer
Explanation - CT pulmonary angiography is the gold standard and most sensitive diagnostic test for pulmonary embolism.
Correct answer is: CT pulmonary angiography
Q.12 Which heart valve is most commonly affected in infective endocarditis among intravenous drug users?
Aortic valve
Mitral valve
Pulmonic valve
Tricuspid valve
Explanation - The tricuspid valve is most commonly affected due to direct introduction of pathogens into venous circulation.
Correct answer is: Tricuspid valve
Q.13 What is the most common indication for lung transplantation in adults?
Pulmonary hypertension
Pulmonary fibrosis
COPD
Sarcoidosis
Explanation - COPD is the leading indication for adult lung transplantation, followed by pulmonary fibrosis and cystic fibrosis.
Correct answer is: COPD
Q.14 Which of the following best describes the Fontan procedure?
Systemic venous return is directed to pulmonary arteries without a ventricle
Right atrium is connected directly to left ventricle
Pulmonary artery connected to aorta
Left atrium connected to right atrium
Explanation - The Fontan procedure diverts systemic venous blood directly to pulmonary circulation, bypassing a subpulmonary ventricle.
Correct answer is: Systemic venous return is directed to pulmonary arteries without a ventricle
Q.15 What is the most common cause of death following lung resection surgery?
Infection
Pulmonary embolism
Bronchopleural fistula
Respiratory failure
Explanation - Respiratory failure is the leading cause of postoperative mortality after lung resections.
Correct answer is: Respiratory failure
Q.16 Which imaging is preferred for diagnosing coarctation of the aorta in adults?
Echocardiography
CT angiography
Chest X-ray
MRI angiography
Explanation - CT angiography provides detailed anatomical information, making it the preferred modality in adults.
Correct answer is: CT angiography
Q.17 Which surgical approach is most commonly used for mitral valve repair?
Right thoracotomy
Median sternotomy
Left thoracotomy
Subxiphoid approach
Explanation - Median sternotomy provides optimal exposure and remains the most common approach for mitral valve repair.
Correct answer is: Median sternotomy
Q.18 What is the most common indication for surgical closure of a patent ductus arteriosus (PDA) in adults?
Endocarditis prevention
Congestive heart failure
Cyanosis
Arrhythmias
Explanation - In adults, surgical PDA closure is mainly indicated to prevent infective endocarditis.
Correct answer is: Endocarditis prevention
Q.19 Which coronary artery supplies the majority of the interventricular septum?
Right coronary artery
Left anterior descending artery
Left circumflex artery
Posterior descending artery
Explanation - The LAD supplies the anterior two-thirds of the interventricular septum.
Correct answer is: Left anterior descending artery
Q.20 Which heart valve is most commonly repaired rather than replaced?
Aortic valve
Mitral valve
Tricuspid valve
Pulmonic valve
Explanation - The mitral valve is most commonly repaired due to better outcomes compared to replacement.
Correct answer is: Mitral valve
Q.21 Which syndrome is associated with thoracic aortic aneurysm and dissection?
Marfan syndrome
Down syndrome
Turner syndrome
Noonan syndrome
Explanation - Marfan syndrome predisposes to thoracic aortic aneurysms and dissections due to connective tissue weakness.
Correct answer is: Marfan syndrome
Q.22 What is the most serious complication of blunt cardiac trauma?
Arrhythmias
Cardiac tamponade
Myocardial contusion
Pericarditis
Explanation - Cardiac tamponade is life-threatening and the most serious complication of blunt cardiac trauma.
Correct answer is: Cardiac tamponade
Q.23 Which pulmonary condition is most commonly treated with bullectomy?
Asthma
Emphysema
Pulmonary fibrosis
Bronchiectasis
Explanation - Bullectomy is performed in patients with giant bullous emphysema to relieve compression of normal lung tissue.
Correct answer is: Emphysema
Q.24 Which test is best for assessing myocardial viability before CABG?
Stress echocardiography
Coronary angiography
Cardiac MRI with contrast
CT angiography
Explanation - Cardiac MRI with late gadolinium enhancement is highly sensitive for assessing myocardial viability.
Correct answer is: Cardiac MRI with contrast
Q.25 Which structure is most at risk of injury during mitral valve surgery?
Coronary sinus
Circumflex artery
Aortic root
Pulmonary veins
Explanation - The circumflex artery runs close to the mitral annulus and is at risk during mitral valve procedures.
Correct answer is: Circumflex artery