lOMoARcPSD|55903010
Madhya Pradesh Medical Science University, Jabalpur
MBBS Second Professional Examination June-2023
Subject- Pharmacology
Paper- I (new scheme)
Maximum Marks :100
Instructions:
a)
b)
Draw diagrams wherever necessary
c)
Answers of Questions and Sub-questions must be written strictly according to serial order of question paper.
MCQ has to be answered in theory answer book
e)
Please write MCQ answer neatly and in serial order with black or blue pen in brackets; for example: - 1. (a) 2. (c)
f)
counted in marks and action will be taken according to UFM rules of university.
g)
Subjective answer should be answered in up to 30 words per marks. For example, if a question having 2 marks should answered in up to 60 marks.
10 x 1 = 10
1. A 26-year-old woman from Banjli village, Ratlam presents to the OPD of General Medicine with progressive fatigability and
diplopia. She is currently receiving neostigmine for treatment and claims good compliance. Physical examination reveals
bilateral ptosis. Infusion of low-dose edrophonium elicits a significant improvement in her muscle strength. Which of the
(a) Increase neostigmine
(b) Add atropine
(c) Administer pralidoxime
(d) Stop neostigmine
temporarily
2. A pack of girl scouts from Madhyapradesh reports to the emergency department after consuming numerous "wild
mushrooms" during a nature walk and camping trip in the outskirts of Shillong, Meghalaya. In order to be sure that they suffer
from excessive cholinergic stimulation from the Inocybe spp. and can be appropriately treated with Atropine, your physical
(a) Mydriasis and increased
(b) Miosis, flushing, dry skin
(c) Dry skin, tachycardia,
(d) Excessive sweating,
and increased heart rate
mental confusion
miosis, difficulty breathing,
and bradycardia
hesitancy, and intermittent urinary flow. Rectal examination revealed a markedly enlarged prostate. Upon reviewing Mr. Jha's
medical record, you also note that his blood pressure was high (160-170/95-100mmHg) during his last several check-ups. He is
not taking any medications. Which of the following drugs would address both of this patient's current problems?
(a) Propranolol
(c) Dopamine
(d) Phenylephrine
4. A 38-year-old man has his blood pressure measured on 3 different occasions in the clinic, yielding values of 145/95, 160/105,
and 150/100. A careful history reveals that he has had a couple of acute gouty attacks in the last 2 years & he is currently
should the physician cautiously AVOID because of his concomitant hyperuricemia?
(a) Captopril
(b) Propranolol
(c) Nifedipine
5. A diuretic which acts in the thick ascending loop of nephron would cause:
(a) Hyporenininemia,
(b) Hypercalcemia,
(c) Hyperglycemia,
Hypermagnesemia, and
hypermagnesemia, and
hyperlipidemia, hypokalemia
hypomagnesemia &
hyperkalemia
and hyperuricemia
preferential vasodilation in
renal vasculature
episode of chest pain and took several tablets of nitroglycerin. His current medications include a daily aspirin for heart attack
prevention, an occasional aspirin for headaches, and occasionally Sildenafil for erectile dysfunction. His blood pressure is
60/30mmHg and his heart rate is 120 beats/min. Which of the following cellular changes is the most likely responsible for the
patient's symptoms?
(b) Gs protein
(c) Cyclic GMP accumulation
(d) Tyrosine kinase activity
phosphorylation
demand, decreased afterload (at high doses), and increased myocardial oxygen delivery by dilating large epicardial arteries.
(a) Beta blocker
(b) Dihydropyridine calcium
(c) Nondihydropyridine
channel blocker
calcium channel blocker
lOMoARcPSD|55903010
8. A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an
his glucose testing apparatus and repeats the test, only to find that the first reading was accurate. He is concerned that his
hypoglycemia did not produce the normal premonitory signs and symptoms. Which of the following medications was MOST
LIKELY prescribed to treat his hypertension?
(a) Prazocin
(c) Hydrochlorthiazide
(d) Captopril
9. A 5-year-old male child with no previous medical history is brought to the Emergency Unit by his mother because he
accidentally ingested a large dose of rat poison (which has Vitamin K epoxide Reductase Inhibitor as an active ingredient). He is
Labs are significant for an elevated PT but a normal aPTT. The patient should be immediately treated with:
(a) Protamine
(b) Flumazenil
(c) Fresh frozen plasma
10. A 58-year-old alcoholic with chronic obstructive lung disease secondary to cigarette smoking is presently receiving
theophylline as a bronchodilator for his lung disease. Serum levels of theophylline are persistently lower than expected for the
prescribed dose. The patient's wife is responsible for administering the medicine each day and states that she has not missed
any doses. Which of the following is the most likely explanation for these laboratory findings?
(b) Decreased absorption
(c) Enhanced liver
(d) Noncompliance
metabolism
2 x 20 = 40
a. Classify drugs used for treatment of peptic ulcer and discuss therapeutic uses and adverse effects of proton
pump inhibitors.
b. Classify antihypertensive drugs and discuss adverse effects and advantages of using ACE Inhibitors as
Q3. Brief Answer Questions
6 x 05 = 30
a. Discuss management of Organophosphate poisoning.
b. Discuss Drug-drug Interaction at various Pharmacokinetic & Pharmacodynamic levels.
d. Write a short note on the treatment of angle closure glaucoma.
e. Write a short note on drugs for prophylaxis of migraine.
f. Write a short note on the treatment of stable angina.
Q4. Short Answer Questions
a. Name two parenteral iron preparations.
b. Name two anti-secretary anti-motility drugs for the treatment of diarrhea.
c. Name two common side effects of Amlodipine.
d. Name two potassium-sparing diuretics.
f. Justify why Dextromethorphan is preferred over codeine as an antitussive.
g. Explain why Folic acid alone should not be given in patients with megaloblastic anemia due to vitamin B12
deficiency.
h. Explain why LMW (Low molecular weight heparin) Heparin is preferred to UFH (Unfractionated Heparin) for
i. Explain clinically important side effects of statins drug therapy with preventive measures for the same.
j. Enumerate clinical indications of Anticholinergic drugs.
Madhya Pradesh Medical Science University, Jabalpur
MBBS Second Professional Examination June-2023
Subject- Pharmacology
Paper- I (new scheme)
--- Content provided by FirstRanker.com ---
Time: 3:00 HoursMaximum Marks :100
Instructions:
a)
--- Content provided by FirstRanker.com ---
All questions are compulsoryb)
Draw diagrams wherever necessary
c)
Answers of Questions and Sub-questions must be written strictly according to serial order of question paper.
--- Content provided by FirstRanker.com ---
d)MCQ has to be answered in theory answer book
e)
Please write MCQ answer neatly and in serial order with black or blue pen in brackets; for example: - 1. (a) 2. (c)
f)
--- Content provided by FirstRanker.com ---
MCQ has to be answered only once, any kind of repetition or cutting or erasing or whitener will be considered as malpractice, such answers will not becounted in marks and action will be taken according to UFM rules of university.
g)
Subjective answer should be answered in up to 30 words per marks. For example, if a question having 2 marks should answered in up to 60 marks.
--- Content provided by FirstRanker.com ---
Q1. Total MCQs: 1010 x 1 = 10
1. A 26-year-old woman from Banjli village, Ratlam presents to the OPD of General Medicine with progressive fatigability and
diplopia. She is currently receiving neostigmine for treatment and claims good compliance. Physical examination reveals
bilateral ptosis. Infusion of low-dose edrophonium elicits a significant improvement in her muscle strength. Which of the
--- Content provided by FirstRanker.com ---
following is the best next step in managing this patient?(a) Increase neostigmine
(b) Add atropine
(c) Administer pralidoxime
(d) Stop neostigmine
--- Content provided by FirstRanker.com ---
dosagetemporarily
2. A pack of girl scouts from Madhyapradesh reports to the emergency department after consuming numerous "wild
mushrooms" during a nature walk and camping trip in the outskirts of Shillong, Meghalaya. In order to be sure that they suffer
from excessive cholinergic stimulation from the Inocybe spp. and can be appropriately treated with Atropine, your physical
--- Content provided by FirstRanker.com ---
examination should include the following signs:(a) Mydriasis and increased
(b) Miosis, flushing, dry skin
(c) Dry skin, tachycardia,
(d) Excessive sweating,
--- Content provided by FirstRanker.com ---
heart rateand increased heart rate
mental confusion
miosis, difficulty breathing,
and bradycardia
--- Content provided by FirstRanker.com ---
3. Mr. Santosh Jha is a 66-year-old male who presents to your clinic with a several-month history of straining during urination,hesitancy, and intermittent urinary flow. Rectal examination revealed a markedly enlarged prostate. Upon reviewing Mr. Jha's
medical record, you also note that his blood pressure was high (160-170/95-100mmHg) during his last several check-ups. He is
not taking any medications. Which of the following drugs would address both of this patient's current problems?
(a) Propranolol
--- Content provided by FirstRanker.com ---
(b) Prazosin(c) Dopamine
(d) Phenylephrine
4. A 38-year-old man has his blood pressure measured on 3 different occasions in the clinic, yielding values of 145/95, 160/105,
and 150/100. A careful history reveals that he has had a couple of acute gouty attacks in the last 2 years & he is currently
--- Content provided by FirstRanker.com ---
taking allopurinol. The decision is made to treat with a suitable blood pressure-lowering drug. Which of the following drugsshould the physician cautiously AVOID because of his concomitant hyperuricemia?
(a) Captopril
(b) Propranolol
(c) Nifedipine
--- Content provided by FirstRanker.com ---
(d) Hydrochlorthiazide5. A diuretic which acts in the thick ascending loop of nephron would cause:
(a) Hyporenininemia,
(b) Hypercalcemia,
(c) Hyperglycemia,
--- Content provided by FirstRanker.com ---
(d) Hypokalemia,Hypermagnesemia, and
hypermagnesemia, and
hyperlipidemia, hypokalemia
hypomagnesemia &
--- Content provided by FirstRanker.com ---
Metabolic acidosishyperkalemia
and hyperuricemia
preferential vasodilation in
renal vasculature
--- Content provided by FirstRanker.com ---
6. A 50-year-old Caucasian male is brought to the emergency unit with severe dizziness and confusion. He states that he had anepisode of chest pain and took several tablets of nitroglycerin. His current medications include a daily aspirin for heart attack
prevention, an occasional aspirin for headaches, and occasionally Sildenafil for erectile dysfunction. His blood pressure is
60/30mmHg and his heart rate is 120 beats/min. Which of the following cellular changes is the most likely responsible for the
patient's symptoms?
--- Content provided by FirstRanker.com ---
(a) Receptor downregulation(b) Gs protein
(c) Cyclic GMP accumulation
(d) Tyrosine kinase activity
phosphorylation
--- Content provided by FirstRanker.com ---
7. A class of antianginal medications with multiple mechanisms of action that include: decreased preload, decreased oxygendemand, decreased afterload (at high doses), and increased myocardial oxygen delivery by dilating large epicardial arteries.
(a) Beta blocker
(b) Dihydropyridine calcium
(c) Nondihydropyridine
--- Content provided by FirstRanker.com ---
(d) Nitratechannel blocker
calcium channel blocker
lOMoARcPSD|55903010
8. A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an
--- Content provided by FirstRanker.com ---
antihypertensive agent. Three days later, he measures his blood glucose at home and finds that it is 53 mg/dL. He recalibrateshis glucose testing apparatus and repeats the test, only to find that the first reading was accurate. He is concerned that his
hypoglycemia did not produce the normal premonitory signs and symptoms. Which of the following medications was MOST
LIKELY prescribed to treat his hypertension?
(a) Prazocin
--- Content provided by FirstRanker.com ---
(b) Propranolol(c) Hydrochlorthiazide
(d) Captopril
9. A 5-year-old male child with no previous medical history is brought to the Emergency Unit by his mother because he
accidentally ingested a large dose of rat poison (which has Vitamin K epoxide Reductase Inhibitor as an active ingredient). He is
--- Content provided by FirstRanker.com ---
conscious but appears quite agitated. On physical exam, he is found to have a blood pressure of 110/70 and a heart rate of 90.Labs are significant for an elevated PT but a normal aPTT. The patient should be immediately treated with:
(a) Protamine
(b) Flumazenil
(c) Fresh frozen plasma
--- Content provided by FirstRanker.com ---
(d) Atropine10. A 58-year-old alcoholic with chronic obstructive lung disease secondary to cigarette smoking is presently receiving
theophylline as a bronchodilator for his lung disease. Serum levels of theophylline are persistently lower than expected for the
prescribed dose. The patient's wife is responsible for administering the medicine each day and states that she has not missed
any doses. Which of the following is the most likely explanation for these laboratory findings?
--- Content provided by FirstRanker.com ---
(a) Cirrhosis of the liver(b) Decreased absorption
(c) Enhanced liver
(d) Noncompliance
metabolism
--- Content provided by FirstRanker.com ---
Q2. Long Answer Questions2 x 20 = 40
a. Classify drugs used for treatment of peptic ulcer and discuss therapeutic uses and adverse effects of proton
pump inhibitors.
b. Classify antihypertensive drugs and discuss adverse effects and advantages of using ACE Inhibitors as
--- Content provided by FirstRanker.com ---
antihypertensive drugs.Q3. Brief Answer Questions
6 x 05 = 30
a. Discuss management of Organophosphate poisoning.
b. Discuss Drug-drug Interaction at various Pharmacokinetic & Pharmacodynamic levels.
--- Content provided by FirstRanker.com ---
c. Discuss pharmacotherapy for Status Asthmaticus.d. Write a short note on the treatment of angle closure glaucoma.
e. Write a short note on drugs for prophylaxis of migraine.
f. Write a short note on the treatment of stable angina.
Q4. Short Answer Questions
--- Content provided by FirstRanker.com ---
10 x 2 = 20a. Name two parenteral iron preparations.
b. Name two anti-secretary anti-motility drugs for the treatment of diarrhea.
c. Name two common side effects of Amlodipine.
d. Name two potassium-sparing diuretics.
--- Content provided by FirstRanker.com ---
e. Name two antihypertensive drugs commonly used to treat eclampsia.f. Justify why Dextromethorphan is preferred over codeine as an antitussive.
g. Explain why Folic acid alone should not be given in patients with megaloblastic anemia due to vitamin B12
deficiency.
h. Explain why LMW (Low molecular weight heparin) Heparin is preferred to UFH (Unfractionated Heparin) for
--- Content provided by FirstRanker.com ---
treatment and maintenance of Deep Vein Thrombosis (DVT).i. Explain clinically important side effects of statins drug therapy with preventive measures for the same.
j. Enumerate clinical indications of Anticholinergic drugs.