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Diagnosis of Cardiac Problems (GATE - XL)

Description: Diagnosis of Cardiac Problems
Number of Questions: 15
Created by:
Tags: Cardiology Diagnosis of Cardiac Problems Cardiac Disorders GATE Life Science Circulatory System
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A cardiologist observed ST depression in an echocardiogram. It suggests

  1. myocardial infarction

  2. pericarditis

  3. Brugada syndrome

  4. myocardial ischemia


Correct Option: D
Explanation:

ST depression is a sign of myocardial ischemia. It occurs when the heart muscle or myocardium receives insufficient blood flow.

Osborn wave or J wave is an abnormal electrocardiogram finding. Appearance of separate Osborn wave at the J-point is pathognomonic of which of the following?

  1. Tachycardia

  2. Hypokalemia

  3. Hypothermia

  4. Hyperthyroidism


Correct Option: C
Explanation:

The appearance of a separate J wave or Osborn wave at the J point is pathognomonic of hypothermia. In hypothermia, body's core temperature falls and there is a decrease in the heart rate.

Stress tests are performed to assess the heart's ability to respond to external stimuli. A radioisotope dye is injected into the bloodstream in which of the following tests to provide information on the functioning of heart muscle?

  1. Echocardiography

  2. Myocardial perfusion imaging

  3. Harvard step test

  4. Computed tomography


Correct Option: B
Explanation:

Myocardial perfusion imaging is a nuclear stress test in which a radioisotope (Thallium-201 or Technetium-99) is injected into the bloodstream to provide information on the functioning of heart muscles.

Which of the following techniques is specifically used to visualise blood vessels in bony or dense soft tissues?

  1. Digital subtraction angiography

  2. Peripheral angiography

  3. Magnetic resonance angiography

  4. Microangiography


Correct Option: A
Explanation:

Digital subtraction angiography is used to visualise arterial and venous supply to the brain. This is a fluorescence technique to clearly visualise blood vessels in bony or dense soft tissues, like brain.

Cardiac catheterisation is the insertion of a catheter into a chamber or vessel of the heart for diagnostic and interventional purposes. Which of the following techniques is used to visualise the path of the catheter as it enters the heart or the coronary arteries?

  1. Cardioscopy

  2. Fluoroscopy

  3. Pneumoscopy

  4. Arthroscopy


Correct Option: B
Explanation:

Fluoroscopy is a technique to visualise the path of the catheter as it enters the heart or the coronary arteries. The use of fluoroscopy requires radiopaque contrast.

Monitoring and regulation of heart rate is an important requirement for diagnosis and treatment of cardiac patients. Which of the following instruments only stores those periods of heart rhythm that it recognises as irregular?

  1. Holter monitor

  2. Pacemaker

  3. Loop recorder

  4. Cardiac catheter


Correct Option: C
Explanation:

Loop recorder only stores those periods of heart rhythm that it recognises as irregular. An implantable loop recorder is usually given to patients who experience heart-related symptoms such as fainting, light headedness, dizziness, seizure and frequent palpitations.

Angiocardiography is a technique for radiographic examination of the heart chambers, thoracic veins and arteries that exploit the radiocontrast agent. Which of the following radiocontrast agents is used in angiocardiography?

  1. Barium

  2. Thorium dioxide

  3. Iodine

  4. CO2


Correct Option: C
Explanation:

Radiocontrast agents used in angiocardiography contain iodine. Ionic iodine and non-ionic iodine based contrast media are used most commonly due to their solubility and their relatively harmless interaction with the body.

Systolic heart failure occurs when the muscle of the left ventricle loses some of its ability to contract or shorten. Which of the following acts as the best determinant of the severity of systolic heart failure?

  1. End-diastolic volume

  2. End-systolic volume (ESV)

  3. Stroke volume

  4. Ejection fraction


Correct Option: D
Explanation:

Ejection fraction is an important determinant of the severity of systolic heart failure. Ejection fraction is low in patients with systolic congestive heart failure.

Transesophageal echocardiogram (TEE) is an alternative way to perform an echocardiogram. Which of the following is false about TEE?

  1. TEE has a very high sensitivity for locating a blood clot inside the left atrium.

  2. TEE is of limited use for the structures at the back of the heart of adults, such as the left atrial appendage.

  3. TEE may require sedation or general anesthesia.

  4. TEE is very useful during many cardiac surgical procedures, like mitral valve repair.


Correct Option: B
Explanation:

This is false. TEE gives a clearer image of structures that are difficult to view transthoracically because the heart rests directly upon the esophagus, leaving only millimeters that the ultrasound beam has to travel.

Effects of drugs on the heart can be assessed by

  1. cardioversion

  2. vectorcardiography

  3. phonocardiogram

  4. impedance cardiography


Correct Option: C
Explanation:

Phonocardiogram is a technique to assess the effect of drugs on heart by recording the sounds made by the heart in the cardiac cycle.

Which of the following conditions acts as a risk factor for coronary heart disease?

  1. High level of c-reactive protein

  2. High level of homocysteine in the blood

  3. Low level of glycated hemoglobin in the blood

  4. Presence of high density lipoproteins in the blood


Correct Option: B
Explanation:

A high level of homocysteine in the blood makes a person more susceptible to endothelial cell injury which may progress to inflammation in the blood vessels, atherogenesis and to ischemic injury. Hyperhomocysteinemia (high level of homocysteine in the blood) is a possible risk factor for coronary artery disease.

Cardiotocography technique is used for

  1. recording murmurs made by the heart

  2. regulation of heartbeat

  3. recording foetal heartbeat

  4. assessing the structure of the cardiovascular system


Correct Option: C
Explanation:

Cardiotocography technique is used to record foetal heartbeat. This is done to assess foetal well-being.

Which of the following parameters of a 75 year old diabetic person put him on a greater risk of coronary artery disease?

a. Lipoprotein a = 28 mg/dL b. Apolipoprotein A1 = Less than 100 mg/dL c. Apolipoprotein B = Less than 80 mg/dL d. Fibrinogen = More than 300 mg/dL e. N-terminal-pro-B-type natriuretic peptide = Less than 125 pg/m

  1. Only a, b and c

  2. Only a and e

  3. Only b and d

  4. Only c, d and e


Correct Option: C
Explanation:

These parameters put a 75 year old diabetic patient on a greater risk of coronary heart disease. Apo A1 is the major protein of HDL. Desirable level for adults is more than 123 mg/dL. Fibrinogen is a protein found in the blood that encourages blood clotting but high levels are linked to an increased risk for heart attack and vascular disease. Normal levels are less than 300 mg/dL.

Electrocardiography is the process of recording the electrical activity of the heart by using electrodes placed on the skin. Which of the following gels is used to permit electron conduction from skin to wire and then to the electrocardiogram?

  1. Potassium chloride

  2. Cesium chloride

  3. Silver nitrate

  4. Rhodium


Correct Option: A
Explanation:

To permit electron conduction from the skin to the wire and to the electrocardiogram, potassium chloride gel is used.

Ejection fraction, stroke volume and cardiac output lend mathematical structure to the common medical term 'systole'. Which of the following techniques yields these crucial measurements for diagnosis of cardiovascular function?

  1. Cardiac positron emission tomography

  2. Echocardiography

  3. Vectorcardiography

  4. Cardiac ventriculography


Correct Option: D
Explanation:

Cardiac ventriculography yields three crucial measurements for diagnosis of cardiovascular function. They are ejection fraction, stroke volume and cardiac output. They all lend mathematical structure to the common medical term 'systole'. Cardiac ventriculography involves injecting contrast media into the heart's ventricle(s) to measure the volume of blood pumped.

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