Madhya Pradesh Medical Science University, Jabalpur
MBBS Second Professional Examination June-2023
Subject- Pharmacology
Paper- I (new scheme)
Time: 3:00 Hours
Instructions:
a) Al questions are compulsory
b) Draw diagrams wherever necessary
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)
MCQ has to be answered only once, any kind of repetition or cutting or erasing or whitener wil be considered as malpractice, such answers wil not be
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.
Q1. Total MCQs: 10
10 x 1 = 10
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
fol owing is the best next step in managing this patient?
(a) Increase neostigmine
(c) Administer pralidoxime
(d) Stop neostigmine
dosage
temporarily
mushrooms" during a nature walk and camping trip in the outskirts of Shil ong, 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
examination should include the fol owing signs:
(a) Mydriasis and increased
(c) Dry skin, tachycardia,
(d) Excessive sweating,
heart rate
and increased heart rate
miosis, difficulty breathing,
and bradycardia
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
not taking any medications. Which of the fol owing drugs would address both of this patient's current problems?
(a) Propranolol
(b) Prazosin
(c) Dopamine
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
taking al opurinol. The decision is made to treat with a suitable blood pressure-lowering drug. Which of the fol owing drugs
should the physician cautiously AVOID because of his concomitant hyperuricemia?
(b) Propranolol
(c) Nifedipine
(d) Hydrochlorthiazide
5. A diuretic which acts in the thick ascending loop of nephron would cause:
(b) Hypercalcemia,
(c) Hyperglycemia,
(d) Hypokalemia,
Hypermagnesemia, and
hyperlipidemia, hypokalemia
hypomagnesemia &
Metabolic acidosis
hyperkalemia
preferential vasodilation in
renal vasculature
6. A 50-year-old Caucasian male is brought to the emergency unit with severe dizziness and confusion. He states that he had an
episode of chest pain and took several tablets of nitroglycerin. His current medications include a daily aspirin for heart attack
60/30mmHg and his heart rate is 120 beats/min. Which of the fol owing cel ular changes is the most likely responsible for the
patient's symptoms?
(a) Receptor downregulation
(b) Gs protein
(d) Tyrosine kinase activity
phosphorylation
7. A class of antianginal medications with multiple mechanisms of action that include: decreased preload, decreased oxygen
demand, decreased afterload (at high doses), and increased myocardial oxygen delivery by dilating large epicardial arteries.
(b) Dihydropyridine calcium
(c) Nondihydropyridine
(d) Nitrate
channel blocker
8. A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an
antihypertensive agent. Three days later, he measures his blood glucose at home and finds that it is 53 mg/dL. He recalibrates
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 fol owing medications was MOST
(a) Prazocin
(b) Propranolol
(c) Hydrochlorthiazide
(d) Captopril
accidentally ingested a large dose of rat poison (which has Vitamin K epoxide Reductase Inhibitor as an active ingredient). He is
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
(c) Fresh frozen plasma
(d) Atropine
10. A 58-year-old alcoholic with chronic obstructive lung disease secondary to cigarette smoking is presently receiving
theophyl ine as a bronchodilator for his lung disease. Serum levels of theophyl ine are persistently lower than expected for the
any doses. Which of the fol owing is the most likely explanation for these laboratory findings?
(a) Cirrhosis of the liver
(b) Decreased absorption
(c) Enhanced liver
metabolism
Q2. Long Answer Questions
2 x 20 = 40
a. Classify drugs used for treatment of peptic ulcer and discuss therapeutic uses and adverse effects of proton
b. Classify antihypertensive drugs and discuss adverse effects and advantages of using ACE Inhibitors as
antihypertensive drugs.
Q3. Brief Answer Questions
6 x 05 = 30
b. Discuss Drug-drug Interaction at various Pharmacokinetic & Pharmacodynamic levels.
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.
Q4. Short Answer Questions
10 x 2 = 20
a. Name two parenteral iron preparations.
b. Name two anti-secretary anti-motility drugs for the treatment of diarrhea.
d. Name two potassium-sparing diuretics.
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
h. Explain why LMW (Low molecular weight heparin) Heparin is preferred to UFH (Unfractionated Heparin) for
treatment and maintenance of Deep Vein Thrombosis (DVT).
i. Explain clinical y important side effects of statins drug therapy with preventive measures for the same.
j. Enumerate clinical indications of Anticholinergic drugs.
MBBS Second Professional Examination June-2023
Subject- Pharmacology
Paper- I (new scheme)
Time: 3:00 Hours
--- Content provided by FirstRanker.com ---
Maximum Marks :100Instructions:
a) Al questions are compulsory
b) Draw diagrams wherever necessary
--- Content provided by FirstRanker.com ---
c) Answers of Questions and Sub-questions must be written strictly according to serial order of question paper.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)
MCQ has to be answered only once, any kind of repetition or cutting or erasing or whitener wil be considered as malpractice, such answers wil not be
--- Content provided by FirstRanker.com ---
counted in marks and action wil 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.
Q1. Total MCQs: 10
10 x 1 = 10
--- Content provided by FirstRanker.com ---
1. A 26-year-old woman from Banjli vil age, Ratlam presents to the OPD of General Medicine with progressive fatigability anddiplopia. 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
fol owing is the best next step in managing this patient?
(a) Increase neostigmine
--- Content provided by FirstRanker.com ---
(b) Add atropine(c) Administer pralidoxime
(d) Stop neostigmine
dosage
temporarily
--- Content provided by FirstRanker.com ---
2. A pack of girl scouts from Madhyapradesh reports to the emergency department after consuming numerous "wildmushrooms" during a nature walk and camping trip in the outskirts of Shil ong, 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
examination should include the fol owing signs:
(a) Mydriasis and increased
--- Content provided by FirstRanker.com ---
(b) Miosis, flushing, dry skin(c) Dry skin, tachycardia,
(d) Excessive sweating,
heart rate
and increased heart rate
--- Content provided by FirstRanker.com ---
mental confusionmiosis, difficulty breathing,
and bradycardia
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
--- Content provided by FirstRanker.com ---
medical record, you also note that his blood pressure was high (160-170/95-100mmHg) during his last several check-ups. He isnot taking any medications. Which of the fol owing drugs would address both of this patient's current problems?
(a) Propranolol
(b) Prazosin
(c) Dopamine
--- Content provided by FirstRanker.com ---
(d) Phenylephrine4. 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
taking al opurinol. The decision is made to treat with a suitable blood pressure-lowering drug. Which of the fol owing drugs
should the physician cautiously AVOID because of his concomitant hyperuricemia?
--- Content provided by FirstRanker.com ---
(a) Captopril(b) Propranolol
(c) Nifedipine
(d) Hydrochlorthiazide
5. A diuretic which acts in the thick ascending loop of nephron would cause:
--- Content provided by FirstRanker.com ---
(a) Hyporenininemia,(b) Hypercalcemia,
(c) Hyperglycemia,
(d) Hypokalemia,
Hypermagnesemia, and
--- Content provided by FirstRanker.com ---
hypermagnesemia, andhyperlipidemia, hypokalemia
hypomagnesemia &
Metabolic acidosis
hyperkalemia
--- Content provided by FirstRanker.com ---
and hyperuricemiapreferential vasodilation in
renal vasculature
6. A 50-year-old Caucasian male is brought to the emergency unit with severe dizziness and confusion. He states that he had an
episode of chest pain and took several tablets of nitroglycerin. His current medications include a daily aspirin for heart attack
--- Content provided by FirstRanker.com ---
prevention, an occasional aspirin for headaches, and occasionally Sildenafil for erectile dysfunction. His blood pressure is60/30mmHg and his heart rate is 120 beats/min. Which of the fol owing cel ular changes is the most likely responsible for the
patient's symptoms?
(a) Receptor downregulation
(b) Gs protein
--- Content provided by FirstRanker.com ---
(c) Cyclic GMP accumulation(d) Tyrosine kinase activity
phosphorylation
7. A class of antianginal medications with multiple mechanisms of action that include: decreased preload, decreased oxygen
demand, decreased afterload (at high doses), and increased myocardial oxygen delivery by dilating large epicardial arteries.
--- Content provided by FirstRanker.com ---
(a) Beta blocker(b) Dihydropyridine calcium
(c) Nondihydropyridine
(d) Nitrate
channel blocker
--- Content provided by FirstRanker.com ---
calcium channel blocker8. A 43-year-old, insulin-dependent diabetic patient is diagnosed with hypertension and begins therapy with an
antihypertensive agent. Three days later, he measures his blood glucose at home and finds that it is 53 mg/dL. He recalibrates
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 fol owing medications was MOST
--- Content provided by FirstRanker.com ---
LIKELY prescribed to treat his hypertension?(a) Prazocin
(b) Propranolol
(c) Hydrochlorthiazide
(d) Captopril
--- Content provided by FirstRanker.com ---
9. A 5-year-old male child with no previous medical history is brought to the Emergency Unit by his mother because heaccidentally ingested a large dose of rat poison (which has Vitamin K epoxide Reductase Inhibitor as an active ingredient). He is
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
--- Content provided by FirstRanker.com ---
(b) Flumazenil(c) Fresh frozen plasma
(d) Atropine
10. A 58-year-old alcoholic with chronic obstructive lung disease secondary to cigarette smoking is presently receiving
theophyl ine as a bronchodilator for his lung disease. Serum levels of theophyl ine are persistently lower than expected for the
--- Content provided by FirstRanker.com ---
prescribed dose. The patient's wife is responsible for administering the medicine each day and states that she has not missedany doses. Which of the fol owing is the most likely explanation for these laboratory findings?
(a) Cirrhosis of the liver
(b) Decreased absorption
(c) Enhanced liver
--- Content provided by FirstRanker.com ---
(d) Noncompliancemetabolism
Q2. Long Answer Questions
2 x 20 = 40
a. Classify drugs used for treatment of peptic ulcer and discuss therapeutic uses and adverse effects of proton
--- Content provided by FirstRanker.com ---
pump inhibitors.b. Classify antihypertensive drugs and discuss adverse effects and advantages of using ACE Inhibitors as
antihypertensive drugs.
Q3. Brief Answer Questions
6 x 05 = 30
--- Content provided by FirstRanker.com ---
a. Discuss management of Organophosphate poisoning.b. Discuss Drug-drug Interaction at various Pharmacokinetic & Pharmacodynamic levels.
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.
--- Content provided by FirstRanker.com ---
f. Write a short note on the treatment of stable angina.Q4. Short Answer Questions
10 x 2 = 20
a. Name two parenteral iron preparations.
b. Name two anti-secretary anti-motility drugs for the treatment of diarrhea.
--- Content provided by FirstRanker.com ---
c. Name two common side effects of Amlodipine.d. Name two potassium-sparing diuretics.
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
--- Content provided by FirstRanker.com ---
deficiency.h. Explain why LMW (Low molecular weight heparin) Heparin is preferred to UFH (Unfractionated Heparin) for
treatment and maintenance of Deep Vein Thrombosis (DVT).
i. Explain clinical y important side effects of statins drug therapy with preventive measures for the same.
j. Enumerate clinical indications of Anticholinergic drugs.
--- Content provided by FirstRanker.com ---