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Exam: 2004 FMGE exam
Subject: Medicine
Topic: Atrial septal defect
Q 123. All of the following are true about ASD except:
A. Right atrial hypertrophy
B. Left atrial hypertrophy
C. Right ventricular hypertrophy
D. Pulmonary hypertension
Ans. B
Atrial septal defect (ASD) is a form of congenital heart defect that enables blood flow between two compartments of the heart called the left and right atria. Normally, the right and left atria are separated by a septum called the interatrial septum. If this septum is defective or absent, then oxygen-rich blood can flow directly from the left side of the heart to mix with the oxygen-poor blood in the right side of the heart, or vice versa.
This can lead to lower-than-normal oxygen levels in the arterial blood that supplies the brain, organs, and tissues. However, an ASD may not produce noticeable signs or symptoms, especially if the defect is small.
A "shunt" is the presence of a net flow of blood through the defect, either from left to right or right to left. The amount of shunting present, if any, determines the hemodynamic significance of the ASD . A "right-to-left-shunt" typically poses the more dangerous scenario.
Kumar, Vinay (2007). Robbins Basic Pathology (8th ed. ed.). Philadelphia: Saunders/Elsevier. p. 384. ISBN 1416029737.
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Exam: 2004 FMGE exam
Subject: Medicine
Topic: Echocardiography
Q 121. A 26 years old asymptomatic woman is found to have arrhythmias and a systolic murmur associated with midsystolic ? . Which investigation would you use:
A. Electrophysiological testing
B. CT scan
C. Echocardiography
D. Angiography
Ans. C
Echocardiogram, often referred to cardiac echo or simply an echo is a sonogram of the heart. Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.
Echocardiography has become routinely used in the diagnosis, management, and follow-up of patients with any suspected or known heart diseases.
This test is done to evaluate the valves and chambers of the heart in a noninvasive way. The echocardiogram allows doctors to diagnose, evaluate, and monitor:
Abnormal heart valves
Atrial fibrillation
Congenital heart disease
Damage to the heart muscle in patients who have had heart attacks
Heart murmurs
Infection in the sac around the heart (pericarditis)
Infection on or around the heart valves (infectious endocarditis)
Pulmonary hypertension
The pumping function of the heart for people with heart failure
The source of a blood clot after a stroke or TIA
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Exam: 2004 FMGE exam
Subject: Medicine
Topic: Echocardiography

Q 121. A 26 years old asymptomatic woman is found to have arrhythmias and a systolic murmur associated with midsystolic ? . Which investigation would you use:

A. Electrophysiological testing
B. CT scan
C. Echocardiography
D. Angiography

complete set of solved exam MCQs for FMGE are available at http://indiaqbank.com/
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Exam: 2004 FMGE exam
Subject: Medicine
Topic: acute inferior wall MI

Q 120. In a patient of acute inferior wall MI. Best modality of treatment is:

A. IV fluids
B. Digoxin
C. Diuretics
D. Vasodilators

Ans. A

Inferior wall MI causes Rt. heart failure and leads to shock, therefore the best treatment is such a case is through i.v. fluids.

Severe hypotension or other signs of shock are ominous and must be treated aggressively with IV fluids and sometimes vasopressors

Hypotension may be due to decreased ventricular filling or loss of contractile force secondary to massive MI. Marked hypotension (eg, systolic BP < 90 mm Hg) with tachycardia and symptoms of end-organ hypoperfusion (reduced urine output, mental confusion, diaphoresis, cold extremities) is termed cardiogenic shock.

For hypotension due to hypovolemia, cautious fluid replacement with 0.9% saline is usually possible without left heart overload (excessive rise in left atrial pressure). However, sometimes LV function is so compromised that adequate fluid replacement sharply increases pulmonary artery occlusion pressure to levels associated with pulmonary edema (> 25 mm Hg). If left atrial pressure is high, hypotension is probably due to LV failure, and if diuretics are ineffective, inotropic therapy or circulatory support may be required.

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Q 119. ABG analysis of a patient on ventilator shows decreased pCO2, normal pO2, pH 7.5. Diagnosis is:

A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis

Ans. C

Arterial blood gas analysis provides information on the following:
1] Oxygenation of blood through gas exchange in the lungs. 2] Carbon dioxide (CO2) elimination through respiration. 3] Acid-base balance or imbalance in extra-cellular fluid (ECF).

Is the disturbance respiratory or metabolic? What is the relationship between the direction of change in the pH and the direction of change in the PaCO2? In primary respiratory disorders, the pH and PaCO2 change in opposite directions; in metabolic disorders the pH and PaCO2 change in the same direction.

In Acidosis (Respiratory) pH ↓ (decreases) PaCO2 ↑ (Increased)

In Acidosis (Metabolic) pH ↓(decreases) PaCO2 ↓(decreases)

In Alkalosis (Respiratory) pH ↑ (Increased) PaCO2 ↓(decreases)

In Alkalosis (Metabolic) pH ↑ (Increased) PaCO2 ↑ (Increased)

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Exam: 2004 FMGE exam
Subject: Medicine
Topic: ABG analysis
Q 118. An ABG analysis shows: pH 7.2, raised pCO2, decreased HCO3. Diagnosis is:
A. Respiratory acidosis
B. Compensated metabolic acidosis
C. Respiratory and metabolic acidosis
D. Respiratory alkalosis
Ans. C
Arterial blood gas analysis provides information on the following:
1] Oxygenation of blood through gas exchange in the lungs. 2] Carbon dioxide (CO2) elimination through respiration. 3] Acid-base balance or imbalance in extra-cellular fluid (ECF).
Remember: an acidosis or alkalosis may be present even if the pH is in the normal range (7.35 – 7.45)
You will need to check the PaCO2, HCO3- and anion gap
Is the disturbance respiratory or metabolic? What is the relationship between the direction of change in the pH and the direction of change in the PaCO2? In primary respiratory disorders, the pH and PaCO2 change in opposite directions; in metabolic disorders the pH and PaCO2 change in the same direction.
In Acidosis (Respiratory) pH ↓ (decreases) PaCO2 ↑ (Increased)
In Acidosis (Metabolic) pH ↓(decreases) PaCO2 ↓(decreases)
In Alkalosis (Respiratory) pH ↑ (Increased) PaCO2 ↓(decreases)
In Alkalosis (Metabolic) pH ↑ (Increased) PaCO2 ↑ (Increased)
complete set of solved exam MCQs for FMGE are available at http://indiaqbank.com/
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Bharat IndiaQBank

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Exam: 2004 FMGE exam
Subject: Medicine
Topic: Atrial septal defect
Q 123. All of the following are true about ASD except:
A. Right atrial hypertrophy
B. Left atrial hypertrophy
C. Right ventricular hypertrophy
D. Pulmonary hypertension
complete set of solved exam MCQs for FMGE are available at http://indiaqbank.com/
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Exam: 2004 FMGE exam
Subject: Medicine
Topic: acute inferior wall MI

Q 120. In a patient of acute inferior wall MI. Best modality of treatment is:

A. IV fluids
B. Digoxin
C. Diuretics
D. Vasodilators

complete set of solved exam MCQs for FMGE are available at http://indiaqbank.com/
1
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Bharat IndiaQBank

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Exam: 2004 FMGE exam
Subject: Medicine
Topic:

Q 119. ABG analysis of a patient on ventilator shows decreased pCO2, normal pO2, pH 7.5. Diagnosis is:

A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis

complete set of solved exam MCQs for FMGE are available at http://indiaqbank.com/
1
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