Download VNSGU MBBS 2106000102020101 Pharmacology Paper I FebruaryMarch2024 Question Paper

Examination February-March 2024

SECOND MBBS

PHARMACOLOGY ( PAPER - I ) - LEVEL 2

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[Time: Three Hours]

[Max. Marks: 100]

Instructions:

1. Fill up strictly the following details on your answer book
   1. Name of the Examination : SECOND MBBS
   2. Name of the Subject : PHARMACOLOGY ( PAPER - I ) - LEVEL 2

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   3. Subject Code No : 2106000102020101
2. Sketch neat and labelled diagram wherever necessary.
3. Figures to the right indicate full marks of the question.
4. All questions are compulsory.

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5. Answers should be precise and to the point.
6. Give examples and figures if needed.
7. First 20 mins have been allotted to solve multiple choice questions.

SECTION - I

Q.1 Multiple choice questions (MCQs) [1*20=20]

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(Each question carries one mark and is no negative marking.)

1. Alkaline diuresis is done for treatment of poisoning due to:
   1. Morphine
   2. Amphetamine
   3. Phenobarbitone
   4. Atropine

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2. Which of the following statements best describes an 'orphan drug'?
   1. It is a drug which acts on orphanin receptors
   2. It is a very cheap drug
   3. It is a drug which has no therapeutic use
   4. It is a drug required for treatment or prevention of a rare disease

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3. A newborn baby was born with phocomelia. It results due to which drug taken by mother during pregnancy?
   1. Tetracycline
   2. Thalidomide
   3. Alcohol
   4. Phenytoin

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4. In which of the following phases of clinical trials, healthy normal human volunteers participate:
   1. Phase-I
   2. Phase-II
   3. Phase-III
   4. Phase-IV

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5. Major neurotransmitter released at ganglion of the sympathetic division of the autonomic nervous system is:
   1. Adrenaline
   2. Noradrenaline
   3. Dopamine
   4. Acetylcholine

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6. Botulinum toxin produces skeletal muscle paralysis by
   1. Enhancing release of norepinephrine
   2. Inhibiting release of acetylcholine
   3. Direct damage to nerve endings
   4. Producing hemolysis

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7. A patient was given pilocarpine. All of the following can be the features seen in him except:
   1. Sweating
   2. Salivation
   3. Miosis
   4. Cycloplegia

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8. Exogenous adrenaline is metabolized by:
   1. AChE
   2. COMT
   3. Decarboxylase
   4. Acetyl transferase

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9. Most common dose limiting adverse effect of colchicine is:
   1. Sedation
   2. Kidney damage
   3. Diarrhea
   4. Muscle paralysis

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10. Which of the following is a DMARD?
    1. Deferoxamine
    2. Penicillamine
    3. Succimer
    4. Dimercaprol

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11. Which prostaglandin helps in cervical ripening?
    1. PGI2
    2. PGF2
    3. PGE2
    4. PGD2

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12. Which of the following compounds acts as a benzodiazepine antagonist?
    1. Flumazenil
    2. Naloxone
    3. Furazolidone
    4. Naltrexone

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13. Which of the following has highest potential to cause metabolic syndrome?
    1. Clozapine
    2. Risperidone
    3. Quetiapine
    4. Aripiprazole

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14. The rationale for using ethanol in methanol poisoning is that it:
    1. Antagonizes the actions of methanol
    2. Stimulates the metabolism of methanol and reduces its blood level
    3. Inhibits the metabolism of methanol and generation of toxic metabolite
    4. Replenishes the folate stores depleted by methanol

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15. Antihistaminics used for motion sickness is:
    1. Cetirizine
    2. Meclizine
    3. Diphenhydramine
    4. Fexofenadine

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16. Tachyphylaxis is seen after use of
    1. Tamoxifen
    2. Morphine
    3. Ephedrine
    4. Chlorpromazine

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17. Omalizumab is indicated for which of the following conditions?
    1. Multiple myeloma
    2. Gout
    3. Bronchial asthma
    4. Rheumatoid arthritis

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18. Time for peak plasma concentration (Tmax) indicates:
    1. The rate of elimination
    2. The rate of absorption
    3. The duration of effect
    4. The intensity of effect

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19. Which of the following undergoes Hoffmann's elimination?
    1. Atracurium
    2. Pancuronium
    3. Mivacurium
    4. Vecuronium

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20. Therapeutic drug monitoring is desirable for
    1. Diazepam
    2. Paracetamol
    3. Digoxin
    4. Nitrous oxide

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Q.2 Answer in short [any five]: [3*5=15]

1. Enumerate parenteral routes of drug administration. Enlist the advantages of intravenous route.
2. Write a note on plasma protein binding of drugs.
3. Define therapeutic index. Explain with the help of diagram.

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4. Explain the pharmacological basis for the use of prostaglandin analogues in glaucoma.
5. Classify a blockers. Why prazosin is given at bed time?
6. Explain why succinyl choline produces prolonged apnoea in some patients.

Q.3 Write answers in details [any three]: [5*3=15]

1. Discuss drug antagonism. Compare and contrast competitive and noncompetitive antagonists.

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2. Enumerate various factors affecting action of a drug. Describe any three in detail.
3. Classify sympathomimetic agents. Write a note on dopamine and dobutamine.
4. Classify ? blockers. Describe uses of ? blockers.

Q.4 Case based questions: [10*1=10]

A 30 years old male farmer was spraying insecticides in his farm. He developed profuse sweating, lacrimation, excess salivation, labored breathing & pinpoint pupil. He was brought to emergency room. His pulse rate was 50/minute and blood pressure was 90/60 mm Hg.

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1. Which may be the culprit agent? Enumerate the agents which cause actions as seen in the above case. [1+2]
2. Explain how the agent will cause the above sign and symptoms in the patient. [3]
3. Which specific antidotes will you give to this patient. Explain the pharmacological basis of use of these antidotes. [1+3]

SECTION - II

Q5 Answer in short [any five]: [3*5=15]

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1. Write a note on antitussive agents.
2. Discuss briefly the importance of three different doses of aspirin in therapeutics.
3. Compare and contrast first generation antihistaminics and second generation antihistaminics.
4. Explain why adrenaline is added to local anesthetics.
5. Enumerate the uses and contraindications of morphine.

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6. Describe the management of paracetamol poisoning.

Q6 Write answers in details [any three]: [5*3=15]

1. Classify drugs used in asthma. Mention pharmacotherapy for status asthamaticus.
2. Enumerate drugs used for treatment of epilepsy. Describe mechanism of action and adverse effects of Phenytoin.
3. Classify drugs used in treatment of migraine. Mention pharmacotherapy for an acute attack of migraine.

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4. Classify antidepressants. Describe the toxic effects of tricyclic antidepressants.

Q7 Case based questions: [10*1=10]

A 60-year-old man came to OPD of GMC Surat with progressive worsening of tremors in hand for past 1 year. He noticed that it was harder to walk. He was walking in shuffling gait, his face was expressionless, pin rolling tremor was found in his hands and cogwheel rigidity was found. He was diagnosed as a case of Parkinson's disease and was prescribed Levodopa and Carbidopa combination.

1. Why levodopa is used for treatment of parkinsonism and not dopamine in this case? [1]
2. Explain the rationale for combining carbidopa with levodopa. [3]

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3. Describe the adverse effects of levodopa and carbidopa combination that you will observe at the initiation of therapy in this patient? [3]
4. After prolonged treatment with this combination (5 years) what changes in response will you see? How will you manage these changes, if needed at all? [3]

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