1224 E427
Second Year MBBS Examination
II MBBS Pharmacology Paper 2
Time: 3 hours
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Max Marks: 100Instructions:
1. Answer to the points.
2. Figure to the right indicates marks.
3. Use separate answer books for each
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section.4. Draw diagrams wherever necessary.
5. Write legibly.
Section 1
1. Answer any one
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(10)a) What is antibiotic stewardship
program (ASP). Discuss WHO
AWaRe classification of Antibiotics
Enumerate the Goals of ASPs.
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b) Classify Antimicrobials (3+4+3=10)interferine with_protein_synthesis.
Describe mechanism of action,
Indications and Adverse effects of
Oxazolidinones.
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2. Answer Any Two of the following(2x6=12) (12)
a) A hospital X, extensively used
vancomycin for Surgical prophylaxis
of wound infection. The antibiogram
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of the institution depicts emergence ofVancomycin resistant Staph, aureus
and Enterococcus. What is Drug
resistance. Explain types and causes
of the phenomena.
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b) A 40 Years old female leukemiapatient was undergoing
Chemotherapy with antineoplastic
drugs. During treatment she
developed systemic infection. A white
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vaginal discharge was observed.After obtaining appropriate
specimens, empirical antibiotic
therapy was started but no
improvement was observed.
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Additionally, she developed sorethroat with white plaques in her
pharynx. Blood and urine culture grew
out Candida albicans. At this point.
What is the best course of action.
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What is the mechanism of action andadverse effects of the medication you
choose.
c) A 30 Years old sexually active
female has 4 one week of a moderate
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vaginal discharge having a afcefishyaodor. She has no complaints of
vaginal pruritus or burning. On
examination the discharge appears
gray, homogenous and malodorous. A
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diagnosis of bacterial vagnosis ismade. Prescribe appropriate
treatment for this lady. What is the
mechanism of action of
Metronidazole?
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3. Write short notes on Any three ofthe following
(3x6=18) (18)
a) Use of Antimicrobial combinations.
b) Bedaquiline.
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c) Protease Inhibitors.d) Artemisinin detivatives.
4. Answer any five of the following
briefly
(2x5=10) (10)
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a) Why is cilastatin combined withImipenem.
b) Why low dose Ritonavir is
combined with other protease
inhibitors
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c) Why Tazobactam is combined withpiperacillin.
d) Why Rifampin coadministration can
lead to oral contraceptive failure
e) Why sulfamethoxazole is selected
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for combining with trimethoprimf) Why aminoglycosides can
potentiate neuromuscular blockade
Section 2
5. Answer any one
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(10)a) Classify anti diabetic drugs. Explain
mechanism of action of insulin.
Discuss types insulin prepration and
insulin analogues
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(3+3+4=10)b) Describe the mechanisms of
action, pharmacological actions,
adverse effects and interactions
methylxanthines.
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(4+24+24+2=10)6. Answer Any Two of the following
(2x6=12) (12)
a) A 16-year-old patient is in the
emergency department receiving
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nasal oxygen. She has a heart rate of125 bpm, respiratory rate of 40
breaths/min, and a peak expiratory
flow <50% of the predicted value.
Wheezing 1) and rales are audible
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without a stethoscope. How will thispatient be managed? Classify
bronchodilators and discuss the role
of inhaled corticosteroids.
b) Mr X is an otherwise healthy 45-
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year-old male who works in a highstress job as an air traffic controller at
a major airport. He reports 2 weeks of
aoeburning stomach pain,
sometimes accompanied by
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aoeindigestion and bloating. Thepain initially occurred several times a
day, usually between meals, and
sometimes awakened him at night,
but it has increased in frequency
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during the past week. Physicalexamination is normal except for
epigastric tendemess on palpation of
the upper abdomen. Mr X. underwent
upper Gl endoscopy, which revealed
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a single 0.5-cm ulcer in the duodenalbulb. The ulcer base was clear
without evidence of active bleeding.
Antral gastritis was biopsy positive for
H. pylori. What is the treatment plan
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for Mr X. Discuss the tole andmechanism of action of Proton Pump
Inhibitors.
c) Mrs Y, a 28-year-old primigravida,
is admitted to the labor and delivery
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suite for labor induction. She is at 42weeks?TM gestation by dates and
ultrasound and has a normal obstetric
examination. Cervical examination
reveals an unfavorable cervix for
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labor induction; Bishop score is 4..What pharmacologic agents can be
used for cervical ripening? Her Bishop
score is now 9 but she has not
developed a consistent pattern of
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uterine contractions, What drugtherapy should be initiated at this
point and why?
7. Write short notes on Any three of
the following
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(3x6=18) (18)a) Thyroid inhibitors.
b) 5-HT; antagonists
c) Calcineurin inhibitors
d) Desferrioxamine
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8. Answer any five of the followingbriefly
(2x5=10) (10)
a) Cisapride predisposes to torsades
de pointes
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b) NSAIDs are contraindicated inpatients of Bronchial asthma.
c) Bisphosphonates are advised to be
taken empty stomach with lots of
water.
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d) COVAXIN
e) Oxytocin may cause water
intoxication.
f) Centchroman
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