FCPS IMM Surgery Cardiothoracic & Vascular Surgery MCQs: High-Yield Practice Questions & Prep

Cardiothoracic & Vascular Surgery is one of the subject blocks in the FCPS IMM Surgery QBank. It covers valve disease, coronary surgery, chest trauma, aortic disease, varicose veins and arterial occlusion. Below is a sample set in the style of the bank, with the reasoning after each answer.

Sample MCQs

1. Which of the following are relative indications for mechanical, as opposed to tissue, valve replacement?

• A) Patient younger than 30 years. ✅
• B) Young female patient who desires children.
• C) An elderly patient.
• D) Tricuspid valve replacement.

Why: Age younger than 30 years is a relative indication for mechanical valves because of an increased incidence of calcification of tissue valves in younger persons.

2. The pectoralis major muscle is available and innervated by the medial and lateral pectoral nerves so named because it describes their relationship to the pectoralis minor

• A) The serratus anterior muscle is available since its absence has no functional significance
• B) There is no serratus posterior muscle
• C) The latissimus dorsi muscle is available and supplied by the thoracodorsal artery 25/28
• D) The latissimus dorsi is innervated by the thoracodorsal nerve with fibers from C6, C7 and C8 ✅

Why: Latissimus dorsi is innervated by the thoracodorsal nerve (C6-C8), making it a useful flap.

3. A 42-year-old woman has noted progressive exercise intolerance and fatigability. Examination discloses an opening snap in the mitral area suggestive of mitral stenosis. The following is/are true:

• A) Critical mitral stenosis is defined as an orifice area reduced to 2 cm2
• B) With a fixed mitral orifice, the change from sinus rhythm to atrial fibrillation has little effect on cardiac output
• C) Mural thrombi and thromboembolism are directly related to the presence of atrial fibrillation ✅
• D) Depressed cardiac output is usually due to depressed myocardial contractility

Why: Normal adults have a 4�6 cm2 mitral orifice and reduction to 2 cm2 is mild stenosis while reduction to 1 cm2 is considered critical mitral stenosis. Even with a fixed orifice, the onset of atrial fibrillation reduces cardiac output by 20%.

4. What is the best initial test for a suspected abdominal aortic aneurysm?

• A) Plain abdominal X-ray
• B) Angiography
• C) Ultrasonography ✅
• D) MRI

Why: USG is the initial screening/diagnostic test; CT confirms and plans repair.

5. Which is the most common primary benign cardiac tumor?

• A) Rhabdomyoma
• B) Myxoma ✅
• C) Fibroma
• D) Lipoma

Why: Atrial myxoma is the commonest primary benign cardiac tumour in adults.

6. Splenic artery aneurysm should be treated if larger than:

• A) 5 mm
• B) 1 cm
• C) 2 cm ✅
• D) 4 cm

Why: Pregnancy, symptoms and size above 2 cm are indications.

7. A neonate is born with a defect in the diaphragm that allows abdominal contents to herniate into the thoracic cavity. What type of hernia is this?

• A) Rolling hernia
• B) Sliding hernia
• C) Mixed hernia
• D) Congenital hernia ✅

Why: Present at birth due to developmental defect.

8. The most important factor that influences the outcome of penetrating cardiac injuries is:

• A) Comminuted tear of a single chamber.
• B) Multiple-chamber injuries.
• C) Coronary artery injury. ✅
• D) Tangential injuries.

Why: Multiple studies in the literature confirm that injuries to the coronary arteries are the most important factor in determining outcome after a penetrating cardiac injury.

9. Operations on the esophagus belong to which surgical specialty?

• A) ENT
• B) Gynecology and Obstetrics
• C) Thoracic surgery ✅
• D) Cardiac surgery

Why: Esophageal surgery is primarily managed by thoracic surgeons.

10. The gold standard for monitoring a re-implanted digit is:

• A) Pulse oximetry ✅
• B) Doppler only
• C) Temperature probe
• D) Capillary refill

Why: Pulse oximetry detects arterial or venous compromise.

How to Study This Block

• Group chest trauma by immediate life-threats and their immediate treatment.
• Know the indications for surgery in each valve lesion.
• Revise peripheral arterial disease, acute limb ischaemia and venous disease together.

Each subject in the QBank can be filtered on its own, so you can drill cardiothoracic & vascular surgery until your accuracy is stable. Confirm the exam format and syllabus against the current CPSP guidelines.

Frequently Asked Questions

Why is this block so large?

Cardiothoracic, thoracic and vascular topics are tested across several question sets, so they form one of the biggest subject groups in the bank.

Do the questions include chest trauma?

Yes. Pneumothorax, haemothorax, flail chest and tamponade are all covered.

Practise With the Full QBank

The FCPS IMM Surgery QBank has a free trial batch in Tutor mode, subject filters and Timed mode. Related: complete exam guide, how to use recalls.