Madhya Pradesh Medical Science University,
Jabalpur
MBBS Second Professional Examination June-
2023
Subject- Pharmacology
Time: 3:00 Hours
Maximum Marks :100
Instructions:
a) All questions are compulsory
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
(c)
f) 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 be
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.
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.
low-dose edrophonium elicits a significant improvement
in her muscle strength. Which of the following is the best
next step in managing this patient?
(a) Increase neostigmine dosage
(c) Administer pralidoxime
(d) Stop neostigmine temporarily
2. A pack of girl scouts from Madhyapradesh reports to
the emergency department after consuming numerous
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 examination should include
(a) Mydriasis and increased heart rate
(b) Miosis, flushing, dry skin and increased heart rate
(c) Dry skin, tachycardia, mental confusion
(d) Excessive sweating, miosis, difficulty breathing, and
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.
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?
(b) Prazosin
(c) Dopamine
(d) Phenylephrine
4. A 38-year-old man has his blood pressure measured on
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 allopurinol. The decision is
made to treat with a suitable blood pressure-lowering
cautiously AVOID because of his concomitant
hyperuricemia?
(a) Captopril
(b) Propranolol
(d) Hydrochlorthiazide
5. A diuretic which acts in the thick ascending loop of
nephron would cause:
(a) Hyporenininemia, Hypermagnesemia, and Metabolic
(b) Hypercalcemia, hypermagnesemia, and
hyperkalemia
(c) Hyperglycemia, hyperlipidemia, hypokalemia and
hyperuricemia
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
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
responsible for the patient's symptoms?
(a) Receptor downregulation
(b) Gs protein phosphorylation
(c) Cyclic GMP accumulation
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
(a) Beta blocker
(b) Dihydropyridine calcium channel blocker
(c) Nondihydropyridine calcium channel blocker
(d) Nitrate
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
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?
(b) Propranolol
(c) Hydrochlorthiazide
(d) Captopril
9. A 5-year-old male child with no previous medical
because he 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
significant for an elevated PT but a normal aPTT. The
patient should be immediately treated with:
(a) Protamine
(b) Flumazenil
(d) Atropine
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
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
(a) Cirrhosis of the liver
(b) Decreased absorption
(c) Enhanced liver metabolism
(d) Noncompliance
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
pump inhibitors.
effects and advantages of using ACE Inhibitors as
antihypertensive drugs.
PART - B (PHARMACOLOGY) ? 30 MARKS
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
e. Write a short note on drugs for prophylaxis of
migraine.
f. Write a short note on the treatment of stable angina.
PART - C (PHARMACOLOGY) ? 20 MARKS
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.
e. Name two antihypertensive drugs commonly used to
treat eclampsia.
f. Justify why Dextromethorphan is preferred over
codeine as an antitussive.
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
(DVT).
i. Explain clinically important side effects of statins drug
therapy with preventive measures for the same.
j. Enumerate clinical indications of Anticholinergic drugs.
Jabalpur
MBBS Second Professional Examination June-
2023
Subject- Pharmacology
--- Content provided by FirstRanker.com ---
Paper-I (new scheme)Time: 3:00 Hours
Maximum Marks :100
Instructions:
a) All questions are compulsory
--- Content provided by FirstRanker.com ---
b) Draw diagrams wherever necessaryc) 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
--- Content provided by FirstRanker.com ---
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 will be
considered as malpractice, such answers will not be
--- Content provided by FirstRanker.com ---
counted in marks and action will be taken according toUFM 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: 10 10 x 1 = 101. 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.
--- Content provided by FirstRanker.com ---
Physical examination reveals bilateral ptosis. Infusion oflow-dose edrophonium elicits a significant improvement
in her muscle strength. Which of the following is the best
next step in managing this patient?
(a) Increase neostigmine dosage
--- Content provided by FirstRanker.com ---
(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
--- Content provided by FirstRanker.com ---
"wild mushrooms" during a nature walk and camping tripin 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 examination should include
--- Content provided by FirstRanker.com ---
the following signs:(a) Mydriasis and increased heart rate
(b) Miosis, flushing, dry skin and increased heart rate
(c) Dry skin, tachycardia, mental confusion
(d) Excessive sweating, miosis, difficulty breathing, and
--- Content provided by FirstRanker.com ---
bradycardia3. 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.
--- Content provided by FirstRanker.com ---
Upon reviewing Mr. Jha's medical record, you also notethat 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?
--- Content provided by FirstRanker.com ---
(a) Propranolol(b) Prazosin
(c) Dopamine
(d) Phenylephrine
4. A 38-year-old man has his blood pressure measured on
--- Content provided by FirstRanker.com ---
3 different occasions in the clinic, yielding values of145/95, 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 allopurinol. The decision is
made to treat with a suitable blood pressure-lowering
--- Content provided by FirstRanker.com ---
drug. Which of the following drugs should the physiciancautiously AVOID because of his concomitant
hyperuricemia?
(a) Captopril
(b) Propranolol
--- Content provided by FirstRanker.com ---
(c) Nifedipine(d) Hydrochlorthiazide
5. A diuretic which acts in the thick ascending loop of
nephron would cause:
(a) Hyporenininemia, Hypermagnesemia, and Metabolic
--- Content provided by FirstRanker.com ---
acidosis(b) Hypercalcemia, hypermagnesemia, and
hyperkalemia
(c) Hyperglycemia, hyperlipidemia, hypokalemia and
hyperuricemia
--- Content provided by FirstRanker.com ---
(d) Hypokalemia, hypomagnesemia & preferentialvasodilation 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
--- Content provided by FirstRanker.com ---
several tablets of nitroglycerin. His current medicationsinclude 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
--- Content provided by FirstRanker.com ---
the following cellular changes is the most likelyresponsible for the patient's symptoms?
(a) Receptor downregulation
(b) Gs protein phosphorylation
(c) Cyclic GMP accumulation
--- Content provided by FirstRanker.com ---
(d) Tyrosine kinase activity7. 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
--- Content provided by FirstRanker.com ---
dilating large epicardial arteries.(a) Beta blocker
(b) Dihydropyridine calcium channel blocker
(c) Nondihydropyridine calcium channel blocker
(d) Nitrate
--- Content provided by FirstRanker.com ---
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
--- Content provided by FirstRanker.com ---
test, only to find that the first reading was accurate. He isconcerned 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?
--- Content provided by FirstRanker.com ---
(a) Prazocin(b) Propranolol
(c) Hydrochlorthiazide
(d) Captopril
9. A 5-year-old male child with no previous medical
--- Content provided by FirstRanker.com ---
history is brought to the Emergency Unit by his motherbecause he 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
--- Content provided by FirstRanker.com ---
pressure of 110/70 and a heart rate of 90. Labs aresignificant for an elevated PT but a normal aPTT. The
patient should be immediately treated with:
(a) Protamine
(b) Flumazenil
--- Content provided by FirstRanker.com ---
(c) Fresh frozen plasma(d) Atropine
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
--- Content provided by FirstRanker.com ---
disease. Serum levels of theophylline are persistentlylower 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
--- Content provided by FirstRanker.com ---
laboratory findings?(a) Cirrhosis of the liver
(b) Decreased absorption
(c) Enhanced liver metabolism
(d) Noncompliance
--- Content provided by FirstRanker.com ---
PART - A (PHARMACOLOGY) ? 40 MARKSQ2. 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
pump inhibitors.
--- Content provided by FirstRanker.com ---
b. Classify antihypertensive drugs and discuss adverseeffects and advantages of using ACE Inhibitors as
antihypertensive drugs.
PART - B (PHARMACOLOGY) ? 30 MARKS
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
--- Content provided by FirstRanker.com ---
glaucoma.e. Write a short note on drugs for prophylaxis of
migraine.
f. Write a short note on the treatment of stable angina.
PART - C (PHARMACOLOGY) ? 20 MARKS
--- Content provided by FirstRanker.com ---
Q4. Short Answer Questions 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.
--- Content provided by FirstRanker.com ---
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.
--- Content provided by FirstRanker.com ---
g. Explain why Folic acid alone should not be given inpatients 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.
--- Content provided by FirstRanker.com ---
***Document Outline
--- Content provided by FirstRanker.com ---