2019 Scheme
Q.P. Code: 211001
Reg. no.: .....................
Second Professional MBBS Degree Regular/Supplementary Examinations
December 2024
(General Pharmacology, ANS, CNS, CVS, Blood, Diuretics, Autacoids, Respiratory System)
Time: 3 Hours
Total Marks: 100
Answer all questions to the point neatly and legibly ? Do not leave any blank pages between answers ?
Answer all parts of a single question together ? Leave sufficient space between answers
Draw table/diagrams/flow charts wherever necessary
1. Multiple Choice Questions
(1x20=20)
two writing sheets (ie Page No. 3 & 4) only
Question Numbers (i) ? (v) are Single Response Type
i. Norepinephrine lacks the following action:
a) Bronchodilatation
c) Reduced blood flow to kidney
d) Rise in blood pressure
ii. The ability of a drug to cause fetal abnormalities when administered to a pregnant lady is
referred to as:
b) Idiosyncrasy
c) Pharmacogenetics
d) Teratogenicity
iii. Heparin overdosage is treated with:
b) Epsilon aminocaproic acid
c) Protamine sulfate
d) Tranexamic acid
iv. The factor which does not govern the volume of distribution of a drug is
b) First pass metabolism
c) Congestive cardiac failure
d) Plasma protein binding
v. The following opioid is contraindicated in myocardial infarction as an analgesic due to its
a) Morphine
b) Pethidine
c) Fentanyl
d) Pentazocine
the answers appropriately.
vi. The following are the examples of idiosyncrasy:
1. Chloramphenicol producing aplastic anemia
2. Aspirin producing gastric irritation
4. Atypical pseudocholinesterase resulting in succinylcholine apnea
a) 1 & 3
b) 2 & 4
c) 1 & 4
vii. Toxicities of atropine include the following:
1. Bradycardia
2. Dry mouth
3. Miosis
a) 1 & 2
b) 2 & 3
c) 1 & 3
d) 2 & 4
1. It is a potassium sparing diuretic
2. It can cause gynecomastia and impotence
3. It acts on the thick ascending limb of Loop of Henle
4. It is combined with lisinopril to counteract hypokalemia
b) 1 & 4
c) 2 & 4
d) 1 & 3
ix. The following statements concerning the use of lithium in the management of bipolar
1. Excessive intake of sodium chloride enhances the toxicity of lithium
2. Lithium alleviates the manic phase of bipolar disorder in 24 hours
3. Lithium dosage may need to be reduced in patients taking diuretics
4. Lithium has narrow margin of safety and requires therapeutic drug monitoring
b) 2 & 3
c) 3 & 4
d) 2 & 4
(PTO)
x. Select the CORRECT statement regarding protein binding of drugs:
1. Protein bound drug is not available for action.
2. Highly plasma protein bound drugs tend to have high volume of distribution.
3. Highly protein bound drugs are generally long acting.
4. Basic drugs are generally bound to albumin.
b) 2 & 3
c) 3 & 4
d) 1 & 3
Question Numbers (xi) ? (xv) are based on case scenarios. Read the statements and mark
A 35-year-old woman with a history of heavy menstrual periods presents with fatigue and
dizziness. Blood tests confirm iron deficiency anemia.
xi. The following statements about iron kinetics is FALSE:
a) Ferric form of iron is better absorbed than ferrous form
c) Excess iron is stored as ferritin
d) Iron is transported with the help of transferrin
xii. All of the following are adverse effects of oral iron therapy EXCEPT:
a) Nausea and vomiting
c) Diarrhoea
d) Acute kidney injury
xiii. Due to her intolerance, the physician decides to initiate parenteral iron therapy to restore her
iron levels effectively. The following iron preparation may be used in her by intravenous
a) Ferrous gluconate
b) Ferrous fumarate
c) Ferric ammonium citrate
d) Ferric carboxymaltose
a) Physician's assessment based on amount of the blood lost
b) Using the formula based on body weight and haemoglobin deficit
c) Based on the time available for the restoration of haemoglobin levels
d) Start with a low dose and titrate upwards over two weeks
a) Fresh frozen plasma
b) Erythropoietin
c) Desferrioxamine
d) Folinic acid
Answer these questions by selecting the appropriate options given below.
xvi. Assertion (A): Nitroglycerine is administered by sublingual route in acute attack of angina
pectoris.
Reason (R): Nitroglycerine has high oral bioavailability
b) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
d) A is false, but R is true
xvii. Assertion (A): Neostigmine and its congeners are the first line drugs used to restore muscle
Reason (R): They improve muscle contraction by allowing acetylcholine released from
prejunctional endings to accumulate and act on the nicotinic receptors over a wider area.
a) Both A and R are true, and R is the correct explanation of A
b) Both A and R are true, and R is not the correct explanation of A
d) A is false, but R is true
xviii. Assertion (A): Lignocaine is one of the preferred drugs in paroxysmal supraventricular
tachycardia.
Reason (R): Lignocaine is a blocker of inactivated Na+ channels more than that of open
potential duration.
a) Both A and R are true, and R is the correct explanation of A
b) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
(PTO)
xix. Assertion (A): Levodopa is combined with carbidopa.
Reason (R): Levodopa-carbidopa combination reduces involuntary movements and postural
hypotension.
b) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
d) A is false, but R is true
xx. Assertion (A): Codeine is the preferred antitussive in asthmatics and patients with
Reason (R): Codeine is an opium alkaloid and suppresses cough center.
a) Both A and R are true, and R is the correct explanation of A
b) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
Long Essays: (2x10=20)
2. A 62-year-old male presents with exertional dyspnea and pedal edema. There is no significant
medical or family history. Physical examination showed the presence of elevated jugular
venous pulse and mild hepatomegaly. Echocardiography showed an ejection fraction of 35%
a) Name two drug groups, with two examples for each, which are likely to slow down the
disease progression in this patient.
b) Explain their mechanism of action in heart failure.
c) Which drug would be suitable to relieve the congestive symptoms in this patient.
d) Explain the role of phosphodiesterase 3 inhibitors in heart failure. (2+4+2+2)
3. A 60-year-old male with a history of hypertension and diabetes presents to the emergency
department with crushing chest pain radiating to his left arm, suggestive of acute myocardial
infarction (AMI). He is anxious, and his pain is rated as 9/10. The patient is stabilized with
a) Mention the analgesic of choice in this patient with route of administration and
pharmacological basis for the same.
b) Mention two adverse effects of the same along with the involved receptor.
c) Enumerate two other uses of the preferred analgesic.
with route of administration.
(4+2+2+2)
Short Essays: (6x6=36)
4. Define bioavailability. What are the factors that affect bioavailability of drugs (1+5)
Write the mechanism of action of all three groups. (3+3)
6. Name three drug groups with two examples each used in treatment of Rheumatoid arthritis.
Briefly describe DMARD
(3+3)
differences between unfractionated heparin and low molecular weight heparins. (1+2+3)
8. Compare and contrast: chlorpromazine and risperidone. (3+3)
9. Mention four groups of antiasthmatic drugs giving two examples each. How will you treat a
case of acute severe exacerbation of bronchial asthma.
Short Answers: (6x4=24)
10. Enumerate four factors that modify drug action giving suitable examples for each.
11. Mention four atropine substitutes with respective clinical indications for the same.
12. Explain the pharmacological basis for using diuretics in hypertension with an example.
(3+1)
13. Mention four prostaglandin analogs and their respective clinical indications.
14. Enumerate four objectives of preanesthetic medications along with the drugs used for
achieving the same.
**********************
Q.P. Code: 211001
Reg. no.: .....................
Second Professional MBBS Degree Regular/Supplementary Examinations
December 2024
--- Content provided by FirstRanker.com ---
Pharmacology - Paper I(General Pharmacology, ANS, CNS, CVS, Blood, Diuretics, Autacoids, Respiratory System)
Time: 3 Hours
Total Marks: 100
Answer all questions to the point neatly and legibly ? Do not leave any blank pages between answers ?
--- Content provided by FirstRanker.com ---
Indicate the question number correctly for the answer in the margin spaceAnswer all parts of a single question together ? Leave sufficient space between answers
Draw table/diagrams/flow charts wherever necessary
1. Multiple Choice Questions
(1x20=20)
--- Content provided by FirstRanker.com ---
The Answers to MCQ questions (Q.No. i to Q.No. xx) shall be written continuously on the firsttwo writing sheets (ie Page No. 3 & 4) only
Question Numbers (i) ? (v) are Single Response Type
i. Norepinephrine lacks the following action:
a) Bronchodilatation
--- Content provided by FirstRanker.com ---
b) Intestinal relaxationc) Reduced blood flow to kidney
d) Rise in blood pressure
ii. The ability of a drug to cause fetal abnormalities when administered to a pregnant lady is
referred to as:
--- Content provided by FirstRanker.com ---
a) Iatrogenicityb) Idiosyncrasy
c) Pharmacogenetics
d) Teratogenicity
iii. Heparin overdosage is treated with:
--- Content provided by FirstRanker.com ---
a) Phytonadioneb) Epsilon aminocaproic acid
c) Protamine sulfate
d) Tranexamic acid
iv. The factor which does not govern the volume of distribution of a drug is
--- Content provided by FirstRanker.com ---
a) Lipid: water partition coefficient ratiob) First pass metabolism
c) Congestive cardiac failure
d) Plasma protein binding
v. The following opioid is contraindicated in myocardial infarction as an analgesic due to its
--- Content provided by FirstRanker.com ---
sympathomimetic properties:a) Morphine
b) Pethidine
c) Fentanyl
d) Pentazocine
--- Content provided by FirstRanker.com ---
Question Numbers (vi) ? (x) are Multiple Response Type. Read the statements and markthe answers appropriately.
vi. The following are the examples of idiosyncrasy:
1. Chloramphenicol producing aplastic anemia
2. Aspirin producing gastric irritation
--- Content provided by FirstRanker.com ---
3. INH producing hepatotoxicity4. Atypical pseudocholinesterase resulting in succinylcholine apnea
a) 1 & 3
b) 2 & 4
c) 1 & 4
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d) 2 & 3vii. Toxicities of atropine include the following:
1. Bradycardia
2. Dry mouth
3. Miosis
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4. Psychotic behaviora) 1 & 2
b) 2 & 3
c) 1 & 3
d) 2 & 4
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viii. The following statements about spironolactone are true:1. It is a potassium sparing diuretic
2. It can cause gynecomastia and impotence
3. It acts on the thick ascending limb of Loop of Henle
4. It is combined with lisinopril to counteract hypokalemia
--- Content provided by FirstRanker.com ---
a) 1 & 2b) 1 & 4
c) 2 & 4
d) 1 & 3
ix. The following statements concerning the use of lithium in the management of bipolar
--- Content provided by FirstRanker.com ---
affective disorder is TRUE:1. Excessive intake of sodium chloride enhances the toxicity of lithium
2. Lithium alleviates the manic phase of bipolar disorder in 24 hours
3. Lithium dosage may need to be reduced in patients taking diuretics
4. Lithium has narrow margin of safety and requires therapeutic drug monitoring
--- Content provided by FirstRanker.com ---
a) 1 & 3b) 2 & 3
c) 3 & 4
d) 2 & 4
(PTO)
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x. Select the CORRECT statement regarding protein binding of drugs:
1. Protein bound drug is not available for action.
2. Highly plasma protein bound drugs tend to have high volume of distribution.
3. Highly protein bound drugs are generally long acting.
4. Basic drugs are generally bound to albumin.
--- Content provided by FirstRanker.com ---
a) 1 & 2b) 2 & 3
c) 3 & 4
d) 1 & 3
Question Numbers (xi) ? (xv) are based on case scenarios. Read the statements and mark
--- Content provided by FirstRanker.com ---
the answers appropriately.A 35-year-old woman with a history of heavy menstrual periods presents with fatigue and
dizziness. Blood tests confirm iron deficiency anemia.
xi. The following statements about iron kinetics is FALSE:
a) Ferric form of iron is better absorbed than ferrous form
--- Content provided by FirstRanker.com ---
b) Ascorbic acid increases iron absorptionc) Excess iron is stored as ferritin
d) Iron is transported with the help of transferrin
xii. All of the following are adverse effects of oral iron therapy EXCEPT:
a) Nausea and vomiting
--- Content provided by FirstRanker.com ---
b) Constipationc) Diarrhoea
d) Acute kidney injury
xiii. Due to her intolerance, the physician decides to initiate parenteral iron therapy to restore her
iron levels effectively. The following iron preparation may be used in her by intravenous
--- Content provided by FirstRanker.com ---
route:a) Ferrous gluconate
b) Ferrous fumarate
c) Ferric ammonium citrate
d) Ferric carboxymaltose
--- Content provided by FirstRanker.com ---
xiv. The guide for calculating the dose of parenteral iron is:a) Physician's assessment based on amount of the blood lost
b) Using the formula based on body weight and haemoglobin deficit
c) Based on the time available for the restoration of haemoglobin levels
d) Start with a low dose and titrate upwards over two weeks
--- Content provided by FirstRanker.com ---
xv. Suppose this lady develops acute iron poisoning, the therapy which can be given is:a) Fresh frozen plasma
b) Erythropoietin
c) Desferrioxamine
d) Folinic acid
--- Content provided by FirstRanker.com ---
Question numbers (xvi) ? (xx) consists of two statements ? Assertion (A) and Reason (R).Answer these questions by selecting the appropriate options given below.
xvi. Assertion (A): Nitroglycerine is administered by sublingual route in acute attack of angina
pectoris.
Reason (R): Nitroglycerine has high oral bioavailability
--- Content provided by FirstRanker.com ---
a) Both A and R are true, and R is the correct explanation of Ab) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
d) A is false, but R is true
xvii. Assertion (A): Neostigmine and its congeners are the first line drugs used to restore muscle
--- Content provided by FirstRanker.com ---
strength in myasthenia gravis.Reason (R): They improve muscle contraction by allowing acetylcholine released from
prejunctional endings to accumulate and act on the nicotinic receptors over a wider area.
a) Both A and R are true, and R is the correct explanation of A
b) Both A and R are true, and R is not the correct explanation of A
--- Content provided by FirstRanker.com ---
c) A is true, but R is falsed) A is false, but R is true
xviii. Assertion (A): Lignocaine is one of the preferred drugs in paroxysmal supraventricular
tachycardia.
Reason (R): Lignocaine is a blocker of inactivated Na+ channels more than that of open
--- Content provided by FirstRanker.com ---
state. It is relatively selective for partially depolarized cells and those with longer actionpotential duration.
a) Both A and R are true, and R is the correct explanation of A
b) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
--- Content provided by FirstRanker.com ---
d) A is false, but R is true(PTO)
xix. Assertion (A): Levodopa is combined with carbidopa.
Reason (R): Levodopa-carbidopa combination reduces involuntary movements and postural
hypotension.
--- Content provided by FirstRanker.com ---
a) Both A and R are true, and R is the correct explanation of Ab) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
d) A is false, but R is true
xx. Assertion (A): Codeine is the preferred antitussive in asthmatics and patients with
--- Content provided by FirstRanker.com ---
diminished respiratory reserve.Reason (R): Codeine is an opium alkaloid and suppresses cough center.
a) Both A and R are true, and R is the correct explanation of A
b) Both A and R are true, and R is not the correct explanation of A
c) A is true, but R is false
--- Content provided by FirstRanker.com ---
d) A is false, but R is trueLong Essays: (2x10=20)
2. A 62-year-old male presents with exertional dyspnea and pedal edema. There is no significant
medical or family history. Physical examination showed the presence of elevated jugular
venous pulse and mild hepatomegaly. Echocardiography showed an ejection fraction of 35%
--- Content provided by FirstRanker.com ---
(normal >50%), suggestive of heart failure.a) Name two drug groups, with two examples for each, which are likely to slow down the
disease progression in this patient.
b) Explain their mechanism of action in heart failure.
c) Which drug would be suitable to relieve the congestive symptoms in this patient.
--- Content provided by FirstRanker.com ---
Explain.d) Explain the role of phosphodiesterase 3 inhibitors in heart failure. (2+4+2+2)
3. A 60-year-old male with a history of hypertension and diabetes presents to the emergency
department with crushing chest pain radiating to his left arm, suggestive of acute myocardial
infarction (AMI). He is anxious, and his pain is rated as 9/10. The patient is stabilized with
--- Content provided by FirstRanker.com ---
oxygen and other supportive measures but his chest pain persists.a) Mention the analgesic of choice in this patient with route of administration and
pharmacological basis for the same.
b) Mention two adverse effects of the same along with the involved receptor.
c) Enumerate two other uses of the preferred analgesic.
--- Content provided by FirstRanker.com ---
d) Mention two antagonists that can be used in case the patient encounters overdosagewith route of administration.
(4+2+2+2)
Short Essays: (6x6=36)
4. Define bioavailability. What are the factors that affect bioavailability of drugs (1+5)
--- Content provided by FirstRanker.com ---
5. Enumerate three drug groups with two examples each for treating chronic simple glaucoma.Write the mechanism of action of all three groups. (3+3)
6. Name three drug groups with two examples each used in treatment of Rheumatoid arthritis.
Briefly describe DMARD
(3+3)
--- Content provided by FirstRanker.com ---
7. Mention two low molecular weight heparins. Explain their mechanism of action. What are thedifferences between unfractionated heparin and low molecular weight heparins. (1+2+3)
8. Compare and contrast: chlorpromazine and risperidone. (3+3)
9. Mention four groups of antiasthmatic drugs giving two examples each. How will you treat a
case of acute severe exacerbation of bronchial asthma.
--- Content provided by FirstRanker.com ---
(4+2)Short Answers: (6x4=24)
10. Enumerate four factors that modify drug action giving suitable examples for each.
11. Mention four atropine substitutes with respective clinical indications for the same.
12. Explain the pharmacological basis for using diuretics in hypertension with an example.
--- Content provided by FirstRanker.com ---
Mention two antihypertensives used in pregnancy.(3+1)
13. Mention four prostaglandin analogs and their respective clinical indications.
14. Enumerate four objectives of preanesthetic medications along with the drugs used for
achieving the same.
--- Content provided by FirstRanker.com ---
15. Describe the role of autonomy, beneficence and justice as guiding principles in patient care.**********************