Download Neet PG Pharmacology MCQs Question Bank
2.DrugNOTusedinpulmonaryhypertension a)Calciumchannelblocker b)Endothelinreceptorantagonist c)Alphablocker d)Prostacyclin CorrectAnswer-Calphablockers[Ref-Harrison17th/ep1577,1578]PulmonaryhypertensionGeneralmanagementDiuretictherapymaybeusefulasitrelievespulmonaryedema.Anticoagulanttherapyisadvocatedforallpatients.SpecificmanagementCalciumchannelblockersPatientswhohavesubstantialreductionsinpulmonaryarterialpressureinresponsetoshortactingvasodilatorsatthetimeofcardiaccatheterizationshouldheinitiallytreatedwithcalciumchannelblockers.EndothelinreceptorantagonistBostenanisanon-selectiveendotheliumreceptorantagonist,isanapprovedt/t,forpatientswhoareNYHA.functionalclassesIIIandIV.Phosphodiesterase-5inhibitorsSlidenafilisusedforpatientswhoareNYHAfunctionalclassesIIandProstacyclinsIloprostisaprostacyclinanalogueusedinPAHpatientswhoare
NYHAfunctionalclassesIIIandIV.Pulmonarycirculationisuniqueinthatitaccommodatesabloodflowthatisalmostequaltothatofalltheotherorgansofbodybutstillmaintainslowpressure.Thefactorsresponsibleforlowpressureinpulmonarycirculation(evenwithlargevolumeofblood)are:--Largerdiameterofpulmonaryvesselsduetothinwallofpulmonaryarteryandarterioles.-Greatercompliance(distensibility)ofpulmonaryvessels.numoralfactorsresponsibleformaintainingpulmonarycirculation:?NormallyNOcausesvosodilationandproliferationofsmoothmusclesbyrintheconc.ofcGMP--)thisincreasesthediameterofpulmonaryvessels.causesvosodilationanddecreasedproliferationofsmoothmusclesbyincreasingtheconc.ofcAMPincreaseinthediameterofpulmonaryvessels.Prostaglandinalsodecreasescoagulation.Endothelincausesvasoconstrictionandincreasesmoothmuscleproliferationsilumenofpulmonaryvessels.-NormallythevasodilatorsandantiprolifeaveeffectsofNOandPGI7dominateInPulmonaryhypertensionThereislproductionofNO(andcGMP)andPGI2(andcAMP),tvasoconstrictionandproliferationofsmoothmuscles,stlumenofpulmonaryvessel.DecreasedproductionofPGI2alsocausesincreasedcoagulation.ThereisTproductionofendothelin,/vasoconstrictionandsmoothmuscleproliferation,.1lumen.Drugtherapyinpuhnonan,hypertensionistargettedatthesegrowthfactorpathwayswhichareinvolvedinthepathogenesisofpulmonaryhypertension:EndotheliumreceptorantagonistBostenanisanendothelinreceptorantagonist.Itpreventsendothelinmediatedcontractionofvessels.Phosphodiesterase-5
inhibitorsNitricoxidemediatesitsactionthroughincreasingcGMPconcentration.IncreasedcGMPrelaxesthevessels.cGMPisdegradedbyanenzymephosphodiesterase-5(PDE-5).-Slidenafanilisaphosphodiesterase5inhibitor.ItreducesthedegradationofcGMP,thuscausingvascularrelaxationandreducingpulmonaryhypertension.ProstacyclinsInpulmonaryhypertension,thelevelofprostacyclineisreduced.Thiscausespulmonaryconstrictionasprostacyclincausesdilatationofpulmonaryvessels.
3.Regardingefficacyandpotencyofadrug,allaretrue,EXCEPT: a)Inaclinicalsetup,efficacyismoreimportantthanpotency b)Inthelogdoseresponsecurve,theheightofthecurve correspondswithefficacy c)ED50ofthedrugcorrespondstoefficacy d)Drugsthatproduceasimilarpharmacologicaleffectcanhave differentlevelsofefficacy CorrectAnswer-CED50referstoEffectiveDoseofadrugneededtoproduceaparticularresponsein50%ofpopulation.Itisaquantitativemeasureofthepotencyofadrug.SmallertheED50value,morepotentisthedrug.Ref:EncyclopediaofPsychopharmacologyByIanP.Stolerman,Volume2,Page456
4.Zero-orderkineticsisotherwiseknownassaturationkinetics.Itisindependent of: a)Plasmaconcentration b)Clearance c)Volumeofdistribution d)Halflife CorrectAnswer-AAns.A.PlasmaconcentrationInzero-orderkineticsorsaturationkinetics,eliminationmechanismsbecomesaturatedandunabletoprocessmoredrugswhendrugconcentrationsrise.Consequently,fordrugsthatareeliminatedbyzero-orderkinetics,aconstantamountofdrugiseliminatedperunittimeregardlessofdrugplasmaconcentration.
5.Filgrastimisusedintreatmentof: a)Anemia b)Neutropenia c)Malaria d)Filarial CorrectAnswer-BAns.is.B.NeutropeniaFilgrastimisarecombinanthumangranulocytecolonystimulatingfactor(G-CSF)whichisa175-aminoacidglyco-protein.ItdiffersfromthenaturalgranulocytestimulatingfactorduetoitslackinglycosylationandthepresenceofanextraN-terminalmethionine.Ithasprovedtobeeffectiveinthetreatmentofsevereneutropenia.Ref:GoodmanandGilman'sThePharmacologicalBasisofTherapeutics,11thEdition,Pages1429-32;ImmunopharmacologyByManzoorM.Khan,Pages49-50
6.Guanethidineisusedinthetreatmentofwhichofthefollowingcondition? a)Thyrotoxicophthalmopathy b)Ptosis c)Bell'spalsy d)Horner'ssyndrome CorrectAnswer-AGuanethidine(10%)eyedropsisusefulindecreasinglidretractioninThyrotoxicophthalmopathy.Itisanadrenergicneuronblockerwhichactsbyinhibitingthereleaseofnoradrenalineinresponsetonervestimulation.
7.Finasterideisa: a)5alphareductaseinhibitor b)PDEinhibitor c)Alphalablocker d)Androgenreceptorblocker CorrectAnswer-AFinasterideisacompetitiveinhibitoroftheenzyme5-alphareductasewhichisresponsiblefortheconversionoftestosteroneintoamoreactivedihydrotestosteroneresponsiblefortheandrogenaction.Whenusedinbenignprostatichypertrophy,itreducestheprostatesizeandincreasedpeakurinaryflowrate.Itisalsousedinmalepatternbaldnessandasapalliativetreatmentinprostaticcarcinoma.Ref:KDTripathiTextbookofPharmacology,5thEdition,Page272
8.A47-year-oldwomanpresentswithcomplaintsofnervousnessandincreased sensitivitytohotweather.Sheisdiagnosedwithhyperthyroidismandprescribedpropylthiouracil.Whatistheprincipalmechanismbywhichthisdrugacts? a)DecreasingtheefficacyofTSHbindingtothethyroidTSH receptor b)Decreasingtherateofproteolysisofthyroglobulin c)Increasingtheamountof3,3',5'-triiodothyronine(reverseT3; rT3) d)Inhibitingdeiodinationofthyroxine(T4) CorrectAnswer-DPropylthiouracilworksprimarilybyinhibitingtheperipheralconversionofT4toT3.Thethyroidextractsiodidefromtheplasmaand,inanoxidativeprocess,iodinatedtyrosineresiduesinthyroglobulinmolecules.Monoiodotyrosineanddiiodotyrosineareformedandthencoupledtoproduceeitherthyroxine(tetraiodothyronine,T4)ortriiodothyronine(T3). ProteolyticcleavageofthyroglobulinmoleculesleadstofreeT3orT4,whichisthenreleasedintothecirculation;T3isseveraltimesmorepotentthanT4.PeripheraldeiodinationofT4atthe5'positionleadstoT3formation(mainlyintheliver);thisstepisinhibitedbypropylthiouracil.DecreasingtheefficacyofTSHbinding,decreasingtherateofthyroglobulinproteolysis,increasingtheamountofrT3formation,andinhibitingtheuptakeofiodideintothethyroid,wouldalltendtodecreasetheformationofthyroidhormonesinthethyroiditself.
9.SpironolactoneshouldNOTbegivenwiththefollowingpharmacologicalagent: a)Chlorothiazide b)b-blocker c)ACEinhibitors d)Amlodipine CorrectAnswer-CUnlikemostotherdiuretics,K+-sparingdiureticsreduceurinaryexcretionofK+andcancausemild,moderate,orevenlife-threateninghyperkalemia.Theriskofthiscomplicationisgreatlyincreasedbyrenaldisease(inwhichmaximalK+excretionmaybereduced)orbytheuseofotherdrugsthatreduceorinhibitrenin(betablockers,NSAIDs,aliskiren)orangiotensinIIactivity(angiotensin-convertingenzymeinhibitors,angiotensinreceptorinhibitors).SincemostotherdiureticagentsleadtoK+losses,hyperkalemiaismorecommonwhenK+-sparingdiureticsareusedasthesolediureticagent,especiallyinpatientswithrenalinsufficiency.Ref:IvesH.E.(2012).Chapter15.DiureticAgents.InB.G.Katzung,S.B.Masters,A.J.Trevor(Eds),Basic&ClinicalPharmacology,12e.
10.Maximumplasmaproteinbounddrugis? a)NTG b)Verapamil c)Aspirin d)GTN CorrectAnswer-BAns.is'b'i.e.,VerapamiloAmongthegivenoptionsonlyverapamilhassignificantplasmaproteinbinding(seetextofthechapter).
11.CYP3Ainhibitorsis/are- a)Ritonavir b)Amiodarone c)Verapamil d)aandc CorrectAnswer-DAns.is'a'i.e.,Ritonavir;'c'i.e.,VerapamilCYP3A4/3A5inhibitorsareoRitonaviroErythromycinoItraconazoleoTroieandomycinoVerapamiloClarithromycinoAzamulinoDiltiazemoKetoconazoleoGrapefruitjuice(Furanocoumarins)
12.Inthemetabolismofalcohol,highdoses ofaspirin&phenytoin,mechanismis? a)Firstpasskinetics b)Firstorderkinetics c)Zeroorderkinetics d)Secondorderkinetics CorrectAnswer-CAns.is'c'i.e.,Zeroorderkinetics
13.TypeBadversedrugreaction- a)Augmentedeffectofdrug b)UnpredictableBizzarereaction c)Effectseenonchronicuseofdrug d)Delayedeffectofdrug CorrectAnswer-BAns.is'b'i.e.,UnpredictableBizzarereactionTypesofadversedrugreaction 1. TypesA(Augmented)reaction.2. TypesB(Bizzare)reaction3. TypesC(Chronic)reaction4. TypesD(Delayed)effects5. TypesE(Endingofuse)reaction
14.Urinarybladderspasmolytichavinglocal anaestheticproperty- a)Tamsulosin b)Terazosin c)Oxybutynin d)Yohimbine CorrectAnswer-CAns.is'c'i.e.,OxybutyninoOxybutynin,anewerantimuscarinic,hashighaffinityforreceptorsinurinarybladderandsalivaryglandsalongwithadditionalsmoothmusclerelaxantandlocalanaestheticproperties.
15.Dopamineallofthefollowingistrue Except? a)CausesincreaseinGIIsehemia b)Positiveionotropic c)Improvesrenalperfusion d)CausesVasoconstriction CorrectAnswer-AAns.is'a'i.e.,CausesincreaseinGIIschemiaoDopamineactsondopamine(Di&D2)andadrenergic(a1+a2+[31)receptors,withnoactiononp,receptors.oAtlowesteffectivedoseitstimulatesD1receptorsinrenal&mesentricbloodvessels-->improvesrenalandmesentricperfusion.oAtmoderatelyhighdosesitactsas13,agonist-->positiveionotropic.oAthighdosesitactivatesa-adrenoreceptors-->vasoconstriction.
16.Allarealpha-blockerexcept? a)Atenolol b)Prazosin c)Indoramine d)Idazoxan CorrectAnswer-AAns.is'a'i.e.,Atenolol
17.Thesideeffectsofdigitalisareallexcept ? a)Ventriculartachycardia b)Vasodilatation c)Nauseaandvomiting d)VentricularBigemini CorrectAnswer-BAns.is'b'i.e.,VasodilatationDigitaliscausesmildvasoconstriction(notvasodilatation).
18.Whichofthefollowingpotassiumsparing diureticalterscardiacmortality- a)Spironolactone b)Amiloride c)Triamterene d)Epleronone CorrectAnswer-AAns.is'a'i.e.,SpironolactoneoAmongpotassiumsparingdiuretics,aldosteroneantagonists(Spironolactone,eplerenone)reducemortalityinCHF.
19.Antiandrogenusedinheartfailure? a)Carvedilol b)Sampatrilat c)Spironolactone d)Abiraterone CorrectAnswer-CAns.is'c'i.e.,SpironolactoneoSpironolactoneandeplerenonearethealdosteroneantagonists.Theyareusedaspotassiumsparingdiuretics.Theirdiurecticeffectisquitefeeble,butinCHFthesedrugsreducethemortality(atdoseslowerthandiureticdoses)byantagonizingtheeffectofaldosterone(reversalofremodelling).Spironolactonealsopossessesanti-androgeniceffects.
20.Iodinecontentinamiodarone- a)10-20% b)20-40% c)40-60% d)60-80% CorrectAnswer-BAns.is'b'i.e.,20-40%
21.Whichistrueaboutcalciumchannel blockers- a)Verapamilcausesreflextachycardia b)Diltiazamcausesreflextachycardia c)Nifedipinecausesreflextachycardia d)Nifedipinehaslongert1/2thanfelodipine CorrectAnswer-CAns.is'c'i.e.,NifedipinecausesreflextachycardiaDHPs(nifedipine)causereflextachycardia.oFelodipine-itdiffersfromnifedipineinhavinggreatervascularselectivity,largetissuedistributionandlongert1/2.
22.Centrallyactingantihypertensivedrugis? a)Phenoxybenzamine b)Methyldopa c)Propanolol d)Prazosin CorrectAnswer-BAns.is'b'i.e.,MethyldopaoCentrallyactingsympatholyticantihypertensivesareclonidine,methyldopa,guanabenz,guanfacine,moxonidineandrilmenidine.
23.Wrongaboutclonidineis- a)Alpha2receptoragonist b)FirstlineforAMID c)Suddenwithdrawalcausesreboundhypertension d)Controlsloosemotionsduetodiabeticneuropathy CorrectAnswer-BAns.is'b'i.e.,FirstlineforADHD*BehaviouraltherapyisthefirstlinetherapyforthetreatmentofADHD.ThefirstlinedrugforADHDisMethylphenidate.*Clonidineisapartialagonistwithhighaffinityandhighintrinsicactivityat2receptors.Suddenwithdrawalofclonidinemaycauselifethreateninghypertensivecrisis.*Clonidineisusedtocontrolloosemotionsduetodiabeticneuropathy.Itmaybeactingby2receptormediatedenhancementofsaltabsorptioningutmucosa.
24.Whichofthefollowingcausesincreased renninonprolongeduse? a)Clonidine b)Enalapril c)Methyldopa d)Blocker CorrectAnswer-BAns.is'bi.e.,Enalapril
25.Sideeffectofthiazidediureticsareall except? a)Hyponatremia b)Hypokalemia c)Erectiledysfunction d)Hypocalcemia CorrectAnswer-AAns.is'A'i.e.,HypocalcemiaThiazidescausehypercalcemia(seeaboveexplanation).
26.Desmopressinispreferredover vasopressinbecausedesmopressin- a)Morepotent b)MoreselectiveforVireceptor c)Haslittlevasconstrictoractivity d)aandc CorrectAnswer-DAns.is'a'i.e.,Morepotent;'c'i.e.,HaslittlevasconstrictoractivityoDesmopressinislongeractingoDesmopressinisV2selective--)NoV,mediatedvasoconstriction.oDesmopressinis12timesmorepotentthanvasopressin.
27.Indiabetesinsipidus,diureticshowing paradoxicalantidureticactivity- a)Thiazide b)Triamterene c)Spironolactone d)Furosemide CorrectAnswer-AAns.is'a'i.e.,ThiazideThiazidediureticsparadoxicallydecreaseurineoutputinDIduetoformationofcAMPindistaltubuleseffectiveinbothcentralandnephrogenicDI.
28.TrueregardingConivaptanis- a)VasopressinAntagonist b)V2selectiveaction c)Givenorally d)All CorrectAnswer-AAns.is'a'i.e.,VasopressinAntagonist
29.5HT1agonistsusedas?( a)Antianxietydrugs b)Antipsychoticdrugs c)GERD d)Chemotherapyinducedvomiting CorrectAnswer-AAns.is'a'i.e.,Antianxietydrugs5-HTIAagonists(Buspiron,ipsapirone)actasantianxietydrugs.
30.PGE2causeallexcept- a)Waterretention b)Uterinecontraction c)Flushing d)None CorrectAnswer-AAns.is'a'i.e.,WaterretentionoPGE2causesincreaseinwaterexcretionbyinhibitingADHaction.
31.Allarethefollowingarethefunctionsof PGElexcept- a)Erectiledysfunction b)Erectiledysfunction c)Inductionofpuberty d)PDA CorrectAnswer-CAns.is'c'i.e.,Inductionofpuberty
32.Dinoprostis- a)PGEl b)PGE2 c)PGF2alpha d)PGI2 CorrectAnswer-CAns.is'c'i.e.,PGF2alphaoDinoprost-PGF2alpha,intraamnioticallyformidtermabortion.oDinoprostone-PGE2,intravaginallyformidtermabortion.
33.Whichenzymeisirreversiblyinhibitedby aspirin? a)Lipooxygenase b)Cyclooxygenase c)Thromboxanesynthase d)Phospholipase CorrectAnswer-BAns.is'b'i.e.,Cyclooxygenase
34.Whichdrugdoesn'tincludeDMARD: a)Chloroquine b)Vincristine c)Azathioprine d)Leflunomide CorrectAnswer-BAns.is'b'i.e.,VincristineoDiseasemodifyingantirheumaticdrugs(DMARDs):? 1. ImmunosuppresantsMethotrexate,azathioprine,cyclosporine2. Sulfasalazine3. Choloroquineorhydroxychloroquine4. Leflunomide5. Goldsod.thiomalate,Auranofin6. d-Penicillamine
35.Whichofthefollowingdrugsisusefulin acuteattackofgout? a)Furosemide b)Sulfinpyrazone c)Allopurinol d)Piroxicam CorrectAnswer-DAns.is'd'i.e.,PiroxicamDrugsusedinacutegouti)NSAIDsDrugofchoiceii)Colehicineiii)Corticosteroids
36.Efficacyofsalmeterolisincreasedifitis givenalongwith- a)Theophylline b)Corticosteroid c)Ipratropium d)Sodiumcromoglycate CorrectAnswer-BAns.is'b'i.e.,CorticosteroidoConcurrentuseofinhaledsalmeterolwithinhaledglucocorticoidproduceseffectsequivalenttodoubledoseofthecorticoidalone.
37.Whichisanintermediateactinginsulin? a)Insulinlispro b)Regularinsuin c)NPHinsulin d)Insulinglargine CorrectAnswer-CAns.is'c'i.e.,NPHinsulin
38.HbA1Cisdecreasedmostby? a)Biguanides b)Sulfonylureas c)Thiazolidinediones d)Acarbosc CorrectAnswer-BAns.is'b'i.e.,SulfonylureasEffectoforalhypoglycemicinloweringbloodglucosecanbemeasuredbyreductioninHbAlCleveli)OralhypoglycemicwithmaximumdecreaseinHbAlcsulfonylureas.ii)OralhypoglycemicwithminimumdecreaseinHbAICGlucosidaseinhibitors(Acrarbose,Migital)
39.Whichantidiabeticdrugisusedbothfor typeI&IIDM- a)Sulphonylureas b)Metformin c)Acarbose d)Pramlinitide CorrectAnswer-DAns.is'd'i.e.,PramlinitideoPramlinideistheonlyapproveddrug,besideinsulin,tobeusedinbothtype-Iandtype-2DM.
40.Leastglucocorticoidactionisseenwith? a)Fludrocortisone b)Cortisone c)Dexamethasone d)Betamethasone CorrectAnswer-BAns.is'b'i.e.,CortisoneLeastpotentglucocorticoid-->Cortisone
41.Steroidingestedforlongtimeleadstoall ofthefollowingexcept- a)Avascularnecrosisofheadoffemur b)Cataract c)Glaucoma d)Growthretardation CorrectAnswer-CAns.is'c'i.e.,GlaucomaGlaucomaoccursaftertopicaltherapy(notsystemic)
42.Whichofthefollowingisasynthetic estrogen? a)Estrone b)Estriol c)Estradiol d)Diethylstibestrol CorrectAnswer-DAns.is'd'i.e.,DiethylstibestrolSyntheticprogesterones1.Progesteronederivatives-->Medroxyprogesterone,Megestrol,Dydrogesterone,Hydroxyprogesterone,Nomegestrol.2.19-Nortestosteronederivatives-->Norethindrone,Lynesternol,Allylesterone,Levonorgestrel,Desogestrel,Norgestimate,Gestodene.Syntheticestrogens 1. Steroidal---->Ethinylestradiol,mestranol,tibolone.2. Nonsteroidal---->Diethylstilbestrol,hexestrol,dienestrol
43.Whichofthefollowingisanaromatase inhibitor? a)Tamoxifen b)Letrozole c)Danazol d)Taxane CorrectAnswer-BAns.is'b'i.e.LetrozoleAromataseinhibitorsareoftwotypesoTypeI(steroidal)aromataseinhibitor-Theycauseirreversibleinhibitionofaromatase,e.g.Exmestane,formestane.oTypeII(non-steroidal)aromataseinhibitor-Theycausereversibleinhibitionofaromatasxee.g.Anastrazole,Letrozole,vorozale.
44.Whichofthefollowingisaselective progesteronereceptormodulator- a)Onapristone b)Ulipristal c)Nomegestrol d)Toremifene CorrectAnswer-BAns.is'b'i.e.,UlipristaloUlipristalisaSPRMapprovedforuseasanEmergencyContraceptive.oSPRM(selectiveprogesteronereceptormodulators):Asoprisnil,ulipristal,onapristone,mifepristone.
45.Sideeffectofoxytocinisallexcept? a)Placentalabruption b)Fetaldistress c)Peripheralvasculardisease d)Waterintoxication CorrectAnswer-CAns.is'c'i.e.,PeripheralvasculardiseaseoSideeffectsofOxytocinaredueto:i)ADHlikeaction-Waterintoxicationii)Excessiveuterinecontractions,priortolabour-Fetaldistress,Placentalabruption,Uterinerupture.
46.Shortactingnondelpolarizingblocker? a)Rocurorium b)Suxamethonium c)Mivacurium d)Pancuronium CorrectAnswer-CAns.is'c'i.e.,Mivacurium
47.Drugofchoiceinlignocainetoxicity- a)Bretylium b)Amiodarone c)Isoprenaline d)Diazepan CorrectAnswer-DAns.is`d'i.e.,DiazepanIflignocainetoxicityissuspected,stoptheinjectionimmediately.Ensureadequateoxygenation,whetherbyfacemaskorbyintubation.Anticonvulsantssuchasbenzodiazepinesandbarbituratesarethedrugofchoiceforseizurecontrol.oSuccinylcholineissometimesalsousedtoterminatetheneuromusculareffectsofseizures.IfCVSsymptomsoccur(cardiacdepressionandhypotension),IVfluidandvasopressoragentsmayberequired.Ifmetabolicacidosisdevelops,useofsodiumbicarbonatecanbeconsidered,although,asinotherinstancesofacutemetabolicacidosis,thisiscontroversial.
48.Cardiotoxicityofbupivacaine- a)Depressedpacemakeractivity b)Toxiccompounddamagingmyocardialcells c)Depressedneuralcontrolonheart d)VascularthrombosisandMyocardialischemia CorrectAnswer-AAns.is'a'i.e.,DepressedpacemakeractivityoLocalanaestheticsblockcardiacsodiumchannelsandthusdepressabnormalcardiacpacemakeractivity,excitability,andconduction.Atextremelyhighconcentrations,localanaestheticscanalsoblockcalciumchannels.
49.Localanaestheticinjecteddirectlyintothe tissue? a)Infiltrationanaesthesia b)Nerveblock c)Fieldblock d)Bier'sblock CorrectAnswer-AAns.is'a'i.e.,InfiltrationanaesthesiaoInfiltrationanaesthesiaistheinjectionoflocalanaestheticdirectlyintotissuewithouttakingintoconsiderationthecourseofcutaneousnerve.
50.Whichoneofthefollowingagents sensitizesthemyocardiumtocatecholamines- a)Isoflurane b)Ether c)Halothane d)Propofol CorrectAnswer-CAns.is'c'i.e.,HalothaneoHalothanetendstosensitizethehearttoarrhythmogenicactionofadrenaline-contraindicatedinpheochromocytoma.
51.TrilenewhenusedwithSodalimecauses ? a)Renaldamage b)ARDS c)Myocardialdepression d)Hepatitis CorrectAnswer-BAns.is'b'i.e.,ARDSoFollowingagentsreactwithsodalime:SevofluraneisdegradedbycontactwithCO2absorbant(sodalime)inanaesthesiamachine,yieldingavinylethercalledCompoundAwhichcancauserenaldamage.Trileneproducesphosgene(causingARDS)anddicholoroacetylene(causesneurotoxicity)whenusedwithsodalime.
52.Dissociativeanaesthesiaisproducedby- a)Ketamine b)Etomidate c)Propofol d)Thiopentone CorrectAnswer-AAns.is'a'i.e.,KetamineDissociativeanaesthesiaischaracterizedbyprofoundanalgesia,immobility,amnesiawithlightsleepandfeelingofdissociationfromonceownbodyandthesurroundingsCatalepticstate.oKetamine(phencyclidine)inducesdissociativeanaesthesia.
53.ThedrugforOPDanalgesiais- a)Morphine b)Pethidine c)Fentanyl d)Alfentanil CorrectAnswer-DAns.is'd'i.e.,Alfentanil Drugsusefulfordaycaresurgery oPropofoloSevoflurane,desflurane&isofluraneoMidazolamoMivacuriumoAlfantanil
54.Inducingagentofchoiceinshock? a)Isoflurane b)Desflurane c)Ketamine d)Thiopentone CorrectAnswer-CAns.is'c'i.e.,KetamineInducingagentofchoiceinAsthma&COPDKetamine.InhalationalagentofchoiceinAsthma&COPDHalothane.
55.Fosphenytoindifferentfromphenytoinin whichofthefollowing- a)Canbeusedinabsenceseizures b)Canbemixedwithsaline c)Canbegivenorally d)Itisthedrugofchoiceformyoclonicseizures CorrectAnswer-BAns.'b'i.e.,CanbemixedwithsalineWhilephenytoincannotbeinjectedinadripofglucosesolution,fosphenytoincanbeinjectedwithsalineandglucose.
56.Toxicdoseoflithium- a)0.6 b)12 c)2.6 d)<0.6 CorrectAnswer-CAns.is'c'i.e.,2.6
57.Lithiumcausesallexcept- a)Polyuria b)Nephropathy c)Ebstein'sanomaly d)Hyperthyroidism CorrectAnswer-DAns.isdi.e.,HyperthyroidismLithiumisknowntoexacerbatepsoriasisandcauseacne.ItisknowntocauseEbstein'sanomalyinchildren.Italsocausesthyroiddysfunction,hypothyroidismandnothyperthyroidism.Lithiumnephrotoxicityiswellknown.
58.Whichofthefollowingisaselective serotonin&norepinephrinereuptakeinhibitor? a)Fluoxetine b)Venlafaxine c)Sertaline d)Arnoxipine CorrectAnswer-BAns.is'b'i.e.,VenlafaxineoImportantSNRIsare:-Venalafaxine,Milnacipram,desvenalafaxine,Duloxetine.
59.AllofthefollowingareCNSstimulants except? a)Amphetamines b)Benzodiazepines c)Cocaine d)Methylphenidate CorrectAnswer-BAns.is'b'i.e.,BenzodiazepinesCNSstimulantsareamphetamine,methylphenidate,atomoxetine,modafinil,cocaine,pemolineandcaffeine.
60.Allofthefollowinghaveinteractionwith warfarinexcept- a)Barbiturate b)Oralcontraceptive c)Cephalosporins d)Benzodiazepens CorrectAnswer-DAns.is'd'i.e.,Benzodiazepenes
61.Whichpreventsplasminogenactivators? a)Streptokinase b)Aminocaproicacid c)Reteplase d)Clopidogrel CorrectAnswer-BAns.is'b'i.e.,AminocaproicacidoEpsilonaminocaproicacid(EACA)competitivelyinhibitsplasminogenactivation.
62.Clopidogrelmechanismofaction- a)ThromboxaneA2inhibition b)InhibitADPmediatedcAMPactivation c)GPIIb/Inainhibitors d)None CorrectAnswer-BAns.is'b'i.e.,InhibitADPmediatedcAMPactivation
63.Mostpotentstatin- a)Simvastatin b)Pravastatin c)Rosuvastatin d)Simvastatin CorrectAnswer-CAns.is'c'i.e.,RosuvastatinoTwomostpotentstatinsarePitavastatin(mostpotent)androsuvastatinmostpotent).
64.Antilipidemicdrugsthatprevent hypercholesterolemiabyinhibitingabsorption- a)Ezetimibe b)Orlistat c)Cholestyramine d)Statins CorrectAnswer-AAns.is'a'i.e.,EzetimibeEzetimibeinhibitstheabsorptionofcholesterolbybidningtotransporter[NPC-1L1(NiemannPickCl,likel)SRBl,145KDa]locatedinintestinalbrushborder.Note:Orlistatalsoreducescholesterolabsorption,butitisananti-obesitydrug(notanantilipidemicdrug).
65.WhichisnotaS/EofCimetidine? a)Impotence b)Gynaecomastia c)Atrophicgastritis d)Galactorrhea CorrectAnswer-CAns.is'c'i.e.,Atrophicgastritis
66.Thecommonestside-effectofCisaprideis - a)Abdominalcramps b)Diarrhea c)Headache d)Convulsions CorrectAnswer-BAns.is'b'i.e.,DiarrheaCisaprideisaprokineticagentandoftenproducesloosestools(diarrheaisthusthecommonestsideeffect)
67.Druginhibitingbacterialproteinsynthesis areallexcept- a)Aminoglycosides b)Chloramphenicol c)Clindamycin d)Sulfonamides CorrectAnswer-DAns.is`d'i.e.,SulfonamidesoSulfonamidesaffectintermediarymetabolismbyinhibitingfolatesynthase.
68.Multipledrugresistanceistransferred through- a)Transduction b)Transformation c)Conjugation d)Mutation CorrectAnswer-CAns.is'c'i.e.,ConjugationResistancetomultipledrugsistransmittedbyRfactor(plasmid)-Rfactoristransferredfromonebacteriumtootherbyconjugation.-Transductionandmutationusuallycauseresistancetoonedrug.-Transformationisnotinvolvedsignificantlyindrugresistance.
69.Longestactingsulphonamideis- a)Sulfadiazine b)Sulphadoxine c)Sulfamethoxazole d)Sulfamethiazole CorrectAnswer-BAns.is'b'i.e.,SulfadoxineSulfadoxineandsulfamethopyrazinearelongactingsulfonamides.
70.Sulphonamideinjectioncausesdecrease infolicacidby? a)Competitiveinhibition b)Noncompetitiveinhibition c)Uncompetitiveinhibition d)Allostericinhibition CorrectAnswer-AAns.is'a'i.e.,CompetitiveinhibitionBacteriasynthesizetheirownfolicacidofwhichparaaminobenzoicacid(PABA)isaconstituent-Sulfonamides,beingstructuralanaloguesofPABA,inhibitbacterialfolatesynthasecompetitively.
71.Allaretrueaboutciprofloxacinexcept? a)C/Iinpregnancy b)DNAinhibition c)Mostpotent1stgenerationfluoroquinolone d)MoreactiveatacidicpH CorrectAnswer-DAns.is'd'i.e.,MoreactiveatacidicpHCiprofloxacinisthemostpotentfirstgenerationFQ.oCiprofloxacininhibitDNAgyraseandiscontraindicatedinpregnancy.ItislessactiveatacidicpH.
72.Whichofthefollowingisnotmechanism forresistancetoMRSA- a)Resistanceischromosomallymediated b)ProducedmainlybyalterationinPBPs c)MRSAresistanceisabsolutelybeta-lactamaseindependent d)Intrinsicresistanceisknown CorrectAnswer-CAns.is'c'i.e.,MRSAresistanceisabsolutelybeta-lactamhhaseindependent
73.Bleedingisseenwiththeuseof- a)Cefaloridine b)Cefazolin c)Moxalactum d)Ceftazidime CorrectAnswer-CAns.is'c'i.e.,MoxalactamoCeftriaxone,cefoperazone,moxalactam&cefamandolecancausehypoprothrmbinemiaandbleeding.
74.Widestspectrumaminoglycosideis- a)Streptomycin b)Amikacin c)Framycetin d)Netilmicin CorrectAnswer-BAns.is'b'i.e.,Amikacin
75.Redmansyndromeisdueto- a)Vancomycin b)Polymyxin c)Rifampicin d)Teicoplanin CorrectAnswer-AAns.is'a'i.e.,VancomycinVancomycincancauseredmensyndrome.
76.Nottrueaboutclofazamine? a)UsedinDLE b)Causesichthyosisandhyperpigmentation c)InterferesDNAsynthesis d)Usedinleprareaction CorrectAnswer-AAns.is'a'i.e.,UsedinDLEoClofazimineinterfereswithtemplatefunctionofDNA,isusedinleprareactionandcancauseicthyosisandhyperpigmentation.
77.DrugusedinhepatitisBinfectionis- a)Entecavir b)Astacavir c)Zanamivir d)Abacavir CorrectAnswer-AAns.is'a'i.e.,EntecaviroEntecaviristheDOCforchronichepatitisBinfection.
78.Whichofthefollowingantimalarialisa slowactingschizonticide- a)Artemether b)Mefloquine c)Pyrimethamine d)Quinine CorrectAnswer-CAns.is'c'i.e.,PyrimethamineoAntimalarialsthatactonerythrocyticphaseofschizogonyarecallederythrocyticschizontocides.Theavailabledrugscanbedividedinto?1.Fastacting-Chloroquine,amodiaquine,quinine,mefloquine,halofantrine,lumefantrine,atovaquone,artemisinin.2.Slowacting-Pyrimethamine,Proguanil,sulfonamides,tetracyclines.
79.Whichofthefollowingisnotusedas treatmentforlymphaticfilariasis- a)Ivermectin b)DEC c)Praziquantel d)Albendazole CorrectAnswer-CAns.is'c'i.e.,PraziquanteloDrugsusedinlymphaticfiliriasisareDEC,ivermectin,albendazaleanddoxycycline.
80.Drugthatcancausehypertrophicpyloric stenosisis? a)Tertacyclin b)Erythromycin c)Ampicillin d)Rifampicin CorrectAnswer-BAns.is'b'i.e.,ErythromycinoMaternalandinfantuseoferythromycinandothermacrolideantibioticshavebeenreportedasriskfactorsforinfantilehypertrophicpyloricstenosis(IHPS).
81.ResistancetoMethotrexatedevelopsdue to? a)RapidCancercellmultiplication b)Deficiencyofthymidylatekinase c)Deficiencyofthymidylatesynthetase d)Increasedproductionofdihydrofolatereductase CorrectAnswer-DAns.is'd'i.e.,IncreasedproductionofdihydrofolatereductaseMethotrexateresistanceoMethotrexateresistancemaybeduetoanyofthefollowingmechanism:?i)Defectivetransportintocellsii)ProductionofalteredformofDHFRthathavedecreasedaffinityformethotrexateiii)IncreasedconcentrationsofintracellularDHFRthroughgeneamplificationoralteredgeneregulationiv)Decreasedabilitytosynthesizemethotrexatepolyglutamatesv)Increasedexpressionofadrugeffluxtransporter,oftheMRP(multidrugresistanceprotein)class
82.Whichoneofthefollowingstatementsis falseregardingvincristine- a)Itisanalkaloid b)Itsuseisassociatedwithneurotoxicity c)Itdoesnotcausealopecia d)Itisausefuldrugforinductionofremissioninacute lymphoblasticleukaemia CorrectAnswer-CAns.is'c'i.e.,Itdoesnotcausealopecia*Vincristinebelongstotheplantalkaloidgroupofanticancer.*UsefulforinducingremissioninchildhoodALL(notusefulinmaintenancetherapy)*Itcanalsobeusedforpediatricsolidtumors(Wilm'stumor,neuroblastoma,rhabdomyosarcoma)andlymphomas.*Prominentadverseeffects?*PeripheralneuropathyAlopeciaSIADH
83.Aboutvincaalkaloidstrueis? a)Inhibitsmitoticspindle b)Enhancespolymerizationoftubulin c)InhibitstopoisomeraseI d)InhibitstopoisomeraseII CorrectAnswer-AAns.is'a'i.e.,InhibitsmitoticspindleVincaalkaloids(vincristine)inhibitmitoticspindlesbypreventingpolymerizationoftubulin
84.AllaretrueregardingSunitinibexcept- a)Itinhibitstyrosinekinasereceptors b)Itisusedforrenalcellcarcinoma c)ItisusedforthetreatmentofGIST d)Itisexcretedprimarilyinurine CorrectAnswer-DAns.is'd'i.e.,ItisexcretedprimarilyinurineSunitinibinhibitsmultipleTyrosinekinasereceptors.ItinhibitsPDGF,VEGFandc-kit.oSunitinibandsorafinibareusedinrenalcellcarcinoma(inRCCthereisoverexpressionofVEGF)andGIST(inGISTthereisoverexpressionofC-Kit&PDGF).oItiseliminatedprimarilybyhepaticroutewithexcretioninfaeces.
85.WhichofthefollowingAntineoplastic drugsSHOULDNOTbegivenbyrapidIVinfusion? a)Cyclophosphamide b)Cisplatin c)Bleomycin d)Cytosinearabinoside CorrectAnswer-BAns.is`b'i.e.,CisplatinoCisplatinisthemostcommonculpritcausingchemotherapyinducednauseaandvomiting,thereforecisplatinisgivenasslowi.v.infusion(neverbolus)topreventvomiting.
86.Modeofactionofazathioprine? a)IL-2 b)T-cellblockade c)Decreasedlymphophagocyticactivity d)Wide-spreadantitumoractivity CorrectAnswer-BAns.is'b'i.e.,T-cellblockade
87.Intracranialpressuremaybeincreasedby allofthefollowingdrugsexcept- a)HypervitaminosisA b)Corticosteroids c)Quinolones d)Aminoglycosides CorrectAnswer-DAns.is'd'i.e.,Aminoglycosides
88.Whichofthefollowingdrugcauses hirsutism? a)Phenytoin b)Valproate c)Carbamazepine d)Phenobarbitone CorrectAnswer-AAns.is'a'i.e.,Phenytoin
89.Extrapyramidalsyndromelikesideeffects areseenin- a)Haloperidol b)Clozapine c)Tetracycline d)Ketoconazole CorrectAnswer-AAns.is'a'i.e.,HaloperidolDrugscausingextrapvramidaleffectsoButyrophenones(Haloperidol)oMethyldopaoOCP'SoReserpineoLevodopaoMetoclopromideoPhenothiazinesoTricyclicAntidepressants
90.Whichofthefollowingdrugsis associatedwithuntowardsideeffectofrenaltubulardamage- a)Cisplatin b)Steptozotocin c)Methysergide d)Cyclophosphamide CorrectAnswer-AAns.is'a'i.e.CisplatinSomenephrotoxicagentswhichcausetubularnecrosis.oAminoglycosidesoColistinoMethoxyfluranesoSulfonamidesoAmphotericinBoCyclosporineoPolymyxinoTetracyclinesoCephaloridineoIntravenousimmuneglobulinoRadioiodinatedcontrastoAcetaminophenmediumoCisplatin
91.Allofthefollowingareknownadverse effectsofthalidomide,except: a)Diarrhoea b)Teratogenicity c)DVT d)Neuropathy CorrectAnswer-AAnsis'a'i.e.DiarrhoeaoThalidomidecausesconstipationandnotdiarrhoea.
92.Firstorderkineticsis: September2005 a)Absorptionofthedrugisindependentoftheserum concentration b)Eliminationofthedrugisindependentoftheserum concentration. c)Eliminationofthedrugisproportionaltotheserum concentration d)Absorptionofthedrugisproportionaltotheserum concentration CorrectAnswer-CAns.C:Eliminationofthedrugisproportionaltotheserumconcentration.A0-orderkineticshasaratewhichisindependentoftheconcentrationofthereactant(s).Increasingtheconcentrationofthereactingspecieswillnotspeeduptherateofthereaction.Zero-orderreactionsaretypicallyfoundwhenamaterialthatisrequiredforthereactiontoproceed,suchasasurfaceoracatalyst,issaturatedbythereactants.Withfirst-orderelimination,therateofeliminationisdirectlyproportionaltotheserumdrugconcentration(SDC).ThereisalinearrelationshipbetweenrateofeliminationandSDC.Althoughtheamountofdrugeliminatedinafirst-orderprocesschangeswithconcentration,thefractionofadrugeliminatedremainsconstant.Theeliminationrateconstant(Kel)representsthefractionofdrugeliminatedperunitoftime.
93.Whichofthefollowingdrugisnotgivenin acutemania:September2009 a)Lithium b)Lamotrigine c)Valproate d)Olanzapine CorrectAnswer-BAns.B:LamotrigineLamotrigineisnotrecommendedforacutemania.Itisespeciallyusefulinrapidlycyclingbipolardepression.
94.Statinhavinglongesthalflife: September2012 a)Rosuvastatin b)Pravastatin c)Simvastatin d)Lovastatin CorrectAnswer-AAns.Ai.e.RosuvastatinRosuvastatinItisacompetitiveinhibitoroftheenzymeHMG-CoAreductase,havingamechanismofactionsimilartothatofotherstatins.Itsapproximateeliminationhalflifeis19handitstimetopeakplasmaconcentrationisreachedin3-5hfollowingoraladministration.
95.Lowmolecularweightheparinmainly inhibitswhichfactor:September2009 a)FactorIlia b)FactorVIIIa c)FactorXa d)FactorXIIa CorrectAnswer-CAns.C:FactorXa
96.Drugofchoiceforplasmodiumvivaxis: September2006 a)Mefloquine b)Chloroquine c)Artesunate d)Quinine CorrectAnswer-BAns.B:ChloroquineChloroquineremainsthetreatmentofchoiceforclinicalcureandsuppressiveprophylaxisofalltypesofmalaria,exceptthatcausedbyresistantP.falciparum.Inshorttimevisitorstochloroquine-sensitiveendemicareas,suppressivedoseshouldbestarted1weekbeforeandcontinuedfor4weeksafterreturning.
97.Whichofthefollowingisteratogenic: a)Folate b)Cyanocobalamin c)VitaminA d)VitaminC CorrectAnswer-CAns.C:VitaminAPharmacologicaldosesofvitaminAareteratogenicandinpregnancythedailydosemustnotexceed6000-8000IU.SyntheticanaloguesofvitaminA:*Tretinoin*Isotretinoin*Etretinate*Acetretin*TeratogenicdrugsDrugsandmedications:*TobaccoCaffeine*Drinkingalcohol(ethanol)(fetalalcoholspectrumdisorder),*Isotretinoin(13-cis-retinoicacid)*Temazepam*Nitrazepam*Aminopterinormethotrexate*AndrogenichormonesBusulfan*Captopril,enalapril*Coumarin*Cyclophosphamide*Diethylstilbestrol*Phenytoin(diphenylhydantoin)
Lithium*Methimazole*Penicillamine*Tetracyclines*Thalidomide*Trimethadione*Flusilazole*ValproicacidEnvironmentalchemicals:*Polycyclicaromatichydrocarbons(polynucleararomatichydrocarbons)*Polychlorinatedbiphenyls(PCBs)*Polychlorinateddibenzodioxinsa.k.adioxin,*OrganicmercuryIonizingradiation:*Atomicweaponsfallout(Iodine-131,uranium)*BackgroundradiationDiagnosticx-rays*RadiationtherapyInfections:*Cytomegalovirus*Herpesvirus*ParvovirusB19*Rubellavirus(Germanmeasles)*Syphilis*ToxoplasmosisAneasywaytoremembermaternalinfectionsisTORCH:Toxoplasmosis,Otheragents,Rubella,CMVandHSV.Metabolicimbalance:*AlcoholismDiabetes*Folicaciddeficiency*Iodinedeficiency*Hyperthermia
98.Halflifeofalbuminis: a)5days b)10days c)20days d)40days CorrectAnswer-CAns.C:20daysAlbuminhasaserumhalf-lifeofapproximately20days.Ithasamolecularmassof67kDa.AlbuminissynthesizedintheliveraspreproalbuminwhichhasanN-terminalpeptidethatisremovedbeforethenascentproteinisreleasedfromtheroughendoplasmicreticulum.Theproduct,proalbumin,isinturncleavedintheGolgivesiclestoproducethesecretedalbumin.Humanserumalbuministhemostabundantproteininhumanbloodplasma.Itisproducedintheliver.Albumincomprisesabouthalfofthebloodserumprotein.Itissolubleandmonomeric.
99.Whichofthefollowingisanionicchannel ? a)-1receptors b)-1receptors c)Nicotiniccholinergicreceptors d)Muscariniccholinergicreceptors CorrectAnswer-CAns.is'c'i.e.,Nicotiniccholinergicreceptors
100.Dose-responsecurveinHormesis? a)Straightline b)Sigmoid c)InvertedUorJshaped d)Hyperbola CorrectAnswer-CAns.is'c'i.e.,InvertedUorJshapedHormesisisadoseresponsephenomenoninwhichlowdoseshavestimulatoryeffectwhilehighdoseshaveinhibitoryeffect.ThedoseresponsecurvemaybeJ-shapedorinvertedUshapted,thelatterbeingobserved,forexample,withtheeffectofchemotacticpeptidesonneutrophiladhesion.
101.Mosteffectiveagenttopreventmotion sicknessis? a)Ephedrine b)Nedocromil c)Cyproheptidine d)Hyoscine CorrectAnswer-DAns.is`d'i.e.,HyoscineMotionsicknessismoreeasilypreventedthancured.Transdermalhyoscine(scopolamine)isthebestagentforthepreventionof/notionsickness.Antihistaminescanalsobeusedforprevention.
102.Agentusedfortreatmentofheparin inducedthrombocytopenia? a)Lepirudin b)Abciximab c)Warfarin d)Alteplase CorrectAnswer-AAns.is'a'i.e.,LepirudinHeparininducedthrombocytopenia(HIT)Heparininducedthrombocytopeniaisanimportantadverseeffectofheparinadministration,usuallycausedbyunfractionatedheparin,butmayalsobeseenwiththeuseoflowmolecularweightheparin(LMWH).HITmaybeoftwotypes: 1. Type1(Non-immunemediated):-Itismildandheparinmaybe continued. 2. Type2(Immunemediated):-Itisduetoformationofantibodies againstplatelets.Paradoxicalthrombosiscanoccur.Heparinmustbediscontinuedimmediately.WarfarinandLMWarecontraindicated.Lepirudin(adirectthrombininhibitor)isanticoagulantofchoice.Alternativesaredanaparoid,hirudinandArgatroban.
103.Mostcommonlyusedcholinesterase regeneratoratNMjunctionis? a)Pralidoxime b)Obidxime c)Diacetylmonoxime d)Edrophonium CorrectAnswer-AAns.is'a'i.e.,PralidoximePralidoximeismostcommonlyusedcholinesterasereactivater.OXIMESOximesPralidoxime2-PAM,obidoximeanddiacetyl-monoxime(DAM)]areusedinorganophosphatepoisoning.oOximesactsbyreactivatingcholinesteraseenzyme.MechanismofactionInorganophosphatepoisoningesteraticsiteofcholinesteraseisphosphorylatedandanionicsiteisfree.Phosphorylatedcholinesterasereactsveryslowlywithwater.However,ifmorereactiveOHgroupsintheformofoximesareprovided,reactivationoccursmorethanamilliontimefaster.OximesattachtoanionicsiteandprovidemorereactiveOHgroups.OximesareineffectiveinCarbamatespoisoning.Pralidoximeiscontraindicatedincarbamatespoisoning,becausenotonlyitdoesnotreactivatecarbamylatedenzyme,ithasweakanti-chEactivityofitsown.RememberObidoximeismorepotentthanpralidoxime.Pralidoximeandobidoximearelipidinsoluble,whilediacetyl-monoxime(DAM)islipidsolublesoitcancrossBBBandregenerate
AChEinbrain.Atropineisusedinbothorganophosphateandcarbamateanticholinesterasepoisoning.
104.Maximumsterilisingactionisshownby whichantiTBdrug? a)Rifampicin b)INH c)Pyrazinamide d)Streptomycin CorrectAnswer-AAns.is'a'i.e.,RifampicinTherearethreemainpropertiesofantituberculardrugs:- i. Bactericidalactivity(tuberculocidalactivity). ii. Sterilizingactivity. iii. Abilitytopreventresistance BactericidalactivityIsoniazidandrifampicinarethemostpowerfulbactericidaldrugs,activeagainstallpopulationsofTBbacilli.PyrazinamideandstreptomycinarealsobactericidalagainstcertainpopulationsofTBbacilli.SterilizingactivitySterilizingacitivityistheabilitytokillallthebacilliinlesionsasrapidlyaspossible.Rifampicinisthemostpotentsterilizingantituberculardrug.Pyrazinamideisalsohavingsterilizingaction.TopreventresistanceEthambutolandthioacetazoneareusedinassociationwithmorepowerfuldrugstopreventemergenceofresistance.
105.Cyclicpeptidechainispresentin? a)GramicidinA b)GramicidinB c)GramicidinD d)GramicidinS CorrectAnswer-DAns.isdi.e.,GramicidinSGramicidinGramicidinisaheterogeneousmixtureofthreeantibioticcompounds,gramicidinsA,BandC,makingup80%,6%,and14%,respectively,allofwhichareobtainedfromthesoilbacterialspeciesBacillusbrevisandcalledcollectivelygramicidinD.GramicidinDcontainslinearpentadecapeptides,thatischainsmadeupof15aminoacid.ThisisincontrasttogramicidinS,whichisacyclicpeptidechain.GramicidinisactiveagainstGram-positivebacteria,exceptfortheGram-positivebacilli,andagainstselectGram-negativeorganisms,suchasNeisseriabacteria.Itstherapeuticuseislimitedtotopicalapplication,asitinduceshemolysisinlowerconcentrationsthanbacteriacelldeath,soitcannotbeadministeredinternally.
106.Neuropsychiatrysymptomsareseen withwhichantiTBdrug? a)INH b)Rifampicin c)Pyrazinamide d)Streptomycin CorrectAnswer-AAns.is'a'i.e.,INHAdverseeffectsofINHPeripheralneuritis(mostcommon),hepatitis,opticneuritis&atrophy,seizure,ataxia,muscletwitching,toxicencephalopathy,psychoses,rashes,fever,arthralgia,acne,lupuslikesyndrome,hemolyticanemiainG6PDdeficiency.Note:MostcommonantituberculardrugwhichisimplicatedincausingperipheralneuropathyisINH.
107.Maintainencedoseiscalculatedbyusing valueof? a)Clearance b)Volumeofdistribution c)Oralbioavailability d)Dailydosage CorrectAnswer-AAns.is'a'i.e.,ClearanceDrugdosingFordrugswithlongert1/2adosethatissufficienttoattainthetargetconcentrationaftersingleadministration,ifrepeatedwillaccumulateaccordingtoplateauprincipalandproducetoxicitylateron.Ontheotherhand,ifthedosingissuchastoattaintargetlevelatsteadystate,thetherapeuticeffectwillbedelayedbyabout5halflivesandthislapseoftimemaybeundesirablesometime.Suchdrugsareoftenadministeredbyinitialloadingdoseandsubsequentmaintenancedoses.Loadingdose
108.Anticancerdrugwithdisulfuramlike action- a)Procarbazine b)Nitrosurea c)5FU d)Methotrexate CorrectAnswer-AAns.is'a'i.e.,ProcarbazineDisulfiramlikereactionCertaindrugswhentakenconcurrentlywithalcoholproducedisulfiramlikeactions.Thatmeansthesedrugsproducesimilardistressingsymptomsasdisulfiram,whentakenwithalcoholflushing,burningsensation,throbbingheadache,prespiration,unesasiness,tightnessinchest,vomiting,dizziness,visualdisturbances,mentalconfusion,posturalfaintingandcirculatorycollapse.ThedrugscausingDisulfiramlikeactions i. Chlorpropramide ii. Animalcharcol iii. Cephalosporins(Cefoperazone,moxalactam,cefamandole) iv. Griseofulvin v. Metronidazole vi. Procarbazine vii. Citratedcalciumcarbamide viii. Tinidazine ix. Cynamide
109.CB1antagonistusedinsmoking cessationis? a)Naloxona b)Rimonabant c)Vareniloline d)Bupripion CorrectAnswer-BAns.is'b'i.e.,RimonabantRimonabantAselectivecannabinoidreceptor-1(CB-1)antagonistwhichisbeingtriedasantismokingandantiobesitydrug.
110.IVdiazepamhaswhichofthefollowing effectwhichisnotseenbyotherroutes? a)Analgesia b)Sedation c)Hypotension d)Coronarydilatation CorrectAnswer-DAns.is'd'i.e.,CoronarydilatationMechanismofactionofbenzodiazepines(BZDs)Benzodiazepinesactpreferentiallyonmidbrainascendingreticularformation(whichmaintainswakefulness)andonlimbicsystem(thoughtandmentalfunction).Musclerelaxationisproducedbyactiononmedulla.Ataxiaisduetoactiononcerebellum.BZDsactsonGABAAreceptors.GABA,,,receptorhas5subunitsa/p,p,a/y.GABAbindingsiteisonp.subunit,whileBZDsbindingsiteisona/ysubunit.BZDsreceptorincreasetheconductanceofCl-channel.BZDsdonotthemselvesincreaseCl-conductance,i.e.theyhaveonlyGABAfacilitatorybutnoGABAmimeticaction.(BarbiturateshavebothGABAfacilitatoryandGABAmimeticactions).EffectonCNSIncontrasttobarbiturates,BZDsarenotgeneraldepressant,butexertrelativelyselectiveanxiolytic,hypnotic,musclerelaxantandanticonvulsanteffects.
TheantianxietyactionofBZDsisnotdependentontheirsedativeproperty-->withchronicadministrationreliefofanxietyismaintained,butdrowsinesswanesoffduetodevelopmentoftolerance.Stage2sleepisincreased,whileREM,Stage3&4sleeparedecreased.Nitrazepamistheonlybenzodiazepine,whichincreasesREMsleep.Clonazepananddiazepamhavemoremarkedmusclerelaxantproperty.Clonazepam,diazepam,nitrazepamandflurazepamhavemoreprominentanticonvulsantactivitythanotherBZDs.Diazepam(butnototherBZDs)hasanalgesicaction.Diazepamproducesshortlastingcoronarydilatationoni.v.injection.Diazepamdecreasesnocturnalgastricsecretionandpreventsstressulcers.
111.Bromocriptineisusedinfollowing clinicalsituationsexcept? a)TypeIIDM b)HepaticComa c)Cyclicalmastalgia d)Hypoprolactinemia CorrectAnswer-DAns.is`d'i.e.,HypoprolactinemiaUsesofBromocriptiveBromocriptineisapowerfuldopamineagonist.Itsuppressesprolactinsecretionwhilepromotingsecretionofgonadotropins.Itstherapeuticusesare: i. Suppressionoflactationingalactorrhea ii. Cyclicalmastalgia iii. Inductionofovulationinanovulatoryinfertilitycausedby hyperprolactinemia iv. Parkinsonism v. Acromegalyduetosmallpitutarytumours vi. Hepaticcoma vii. Recently,ithasbeenapprovedfortreatmentoftype2DM.
112.FollowingistrueaboutGnRHagonists except? a)Usedincasesofprecociouspuberty b)Theyhaveactionsimilartogonadotropinreleasinghormone c)Longactingpreparationscanbeusedasnasalspray d)Ganirelixisthemostpotentagent CorrectAnswer-DAns.is'd'i.e.,GanirelixisthemostpotentagentGnRHagonistsLongactingGnRH(LHRH)agonistscausesreversiblepharmacologicalorchiectomy(medicalcastration)andareusedforprecociouspuberty,prostaticcarcinoma,endometriosis,premenopausalbreastcancer,uterineleiomyoma,polycysticovariandiseaseandtoassistinducedovulation.GnRHagonistshaveactionsimilartoGonadotropinreleasinghormone,i.e.,theyincreasethesecretionofgonadotropins(FSH,LH).Thenhowdotheysuppressgonadolfunction?Letssee.GnRHagonistsincreasesGnsecretion.Butafter1-2weekstheycausedesensitizationanddown-regulationofFSH/LHreceptors.(continousexposuretoagonistmaycausedownregulationofreceptors)-->suppressionofgonadalfunction.Spermatogenesis/ovulationceaseandtestosterone/estrogenlevelsfalltocastrationlevelbecausetheactionofGonadotropins(FSH&LH)isnotthere(thesehormonespromotegametogenesisandsecretionofgonadalhormones).PreparationofsuperactiveGnRHanaloguesare-->Busereline,Goserelin,Leuprolide,Nafarelin,Triptorelin.
Superactive/LongactingGnRHareusedasnasalsprayorSCinjection.Cetrorelix,ganirelixandabarelixareGnRhantagonists.Theseareusedsubcutanouslyforthetreatmentofuterinefibroid&endoinetriosisandforcontrolledovarianstimulationinin-vitrofertilization.GnRhagonistsaswellasGnRhantagonistscancausehotflushes,lossoflibidoandosteoporosisasadverseeffects.
113.Femaleoncarbimazoletherapypresents withsuddenfever,rigorsandsorethroat.Whichistheinvestigationofchoiceforthispatient? a)Checkbloodcounts b)CheckCreactiveprotein c)TakethroatSwab d)Treatformalaria CorrectAnswer-AAns.is'a'i.e.,CheckbloodcountsThemostcommonsideeffectofcarbimazoleismaculopapularpruriticrash,whilemostseriousadverseeffectisagranulocytosiswhichisreversible.Patientinthegivenquestionpresentswithsuddenonsetfever,rigorsandsorethroat.Infectionofanysitewhichissuddenonsetandrapidlyprogressiveinapatientoncarbimazoletherapythesuspicionshouldbedevelopmentofagranulocytosis,soitisessentialtodobloodcounts.
114.Selectivebeta2blockeris? a)Butoxamine b)Betoxolol c)Esmolol d)Bisoprolol CorrectAnswer-AAns.is'a'i.e.,Butoxamine
115.Betablockerwithmembranestabilizing propertyareallexcept? a)Acebutolol b)Betaxolol c)Carvedilol d)Bevantolol CorrectAnswer-DAns.is'd'i.e.,Bevantolol
116.Longestactingbetablokeris? a)Nodalol b)Esmolol c)Carvedilol d)Acebnolol CorrectAnswer-AAns.is'a'i.e.,NodalolNodalolislongestacting-blocker.Esmololisshortestacting-blocker.RememberNodalolislongestactingP-blocker.Esmololisshortestactingn-blockerAcebutololpossessesallactivitiesi.e.,cardioselectivity,partialagonistactivity,membranestablizingactivityandlipidinsolubility.BetablockersapprovedfortreatmentofCHF:Carvedilol(mostwidelyused),metaprolol,bisoprolol.Carvedilolisa13/+132+aladrenoreceptorblockerwitha:i3blockingpropertyofI:9.Itproducesperipheralvasodilatationduetoa-1blockadeaswellascalciumchannelblockade(directeffect).Atenolol,sotalolandnodalolareprimarilyexcretedbykidneyshouldnotbegiveninrenalfailure.Sotalol,penbutololandpindololhavealmost100%bioavailibility.Penbutololhasmaximumoralabsorption.Carvedilolhasmaximumplasmaproteinbinding.Celiprololhasminimumplasmaproteinbinding.
117.Bevacizumabisusedin? a)Carcinomacolon b)Livercarcinoma c)Renalcellcarcinoma d)Pancreaticcarcinoma CorrectAnswer-AAns.is'a'i.e.,Carcinomacolon
118.Cabergolineisusedin- a)Acromegaly b)Hyperprolactinoma c)Bothaandb d)Noneoftheabove CorrectAnswer-CAns.is'c'i.e.,BothaandbProlactinisphysiologicallyinvolvedinlactation.Inabreastwhichhasbeenprimedbyfemalehormones(estrogenandprogesteron),prolactininducesandmaintainslactationbystimulatingsynthesisofmilk.Prolactinistheonlypituitaryhormonewhichisprimarilyundertheinhibitorycontrolofhypothalamus.Itssecretionisinhibitedbydopamine(prolactininhibitingsubstance)throughD2receptors.Therefore,dopamineagonistsinhibitprolactinrelease,andD,antagonists(antipsychotics,metoclopromide)causehyperprolactinemia.oBromocripitine,asyntheticergot,isapotentdopamineagonistwithgreateractiononD2receptors.OnDireceptorsitactsaspartialagonistorantagonist.Italsohasaweaka-adrenergicblockingaction.Bromocriptinedecreases(i)Prolactinsecretion,(ii)GImotility,and(iii)GHsecretioninacromegaly.ItstimulatesCTZtocausenauseaandvomiting.Itisusedinhyperprolactinemia,suppressionoflactationingalactorrhea,cyclicmastalgia,parkinsonism,acromegaly,hepaticcoma,andtype2DM(recentlyapproved).CabergolineisanotherD2agonist,whichismorepotentandlongeractingthanbromocriptine.Itispreferredforacromegalyand
hyperprolactinemia.Quinagolide,otherD,agonist,itseffectiveforhyperprolactinemia.
119.Flulikesyptomsissideeffectofwhich antiTBdrug? a)NH b)Rifampicin c)Pyrzinamide d)Streptomycin CorrectAnswer-BAns.is'b'i.e.,Rifampicin
120.WhichofthefollowingSSRIisa prodrug? a)Fluoxetine b)Paroxetine c)Citalopram d)Fluvoxamine CorrectAnswer-AAns.is'a'i.e.,FluoxetineSelectiveserotoninreuptakeinhibitors(SSRI)5-HT(serotonine)isthemajorplayerindepressiveillnessandserotonergicpathwaysarecloselyrelatedtomooddisordersespeciallydepression.Thus,drugsaffectingthe5-HTlevelsintheneuralsynapseandserotonergicpathwaysareeffectiveinthetreatmentofdepression.Therefore,theSSRIshavebeenshowntoalleviatedepressionandarethemostcommonlyuseddrugsinthetherapyofdepression.Thesedrugsactbyinhibitingreuptakeof5-HT.Thesedrugsarenow1stchoicefordepression.AdvantagesoverTCAs.1.Littleornosedation,noweightgain.2.Nointerferencewithpsychomotororcognitivefunction.3.Noanticholinergicsideeffects.4.Noposturalhypotension(noactionofa-adrenergicreceptors).5.Nopropensitytocauseseizuresorarrythmias.
121.Tamoxifene? a)SSRI b)SERM c)SNRI d)DNRI CorrectAnswer-BAns.is`b'i.e.,SERMTamoxifenisaselectiveestrogenreceptormodulator(SERM).
122.Letrozolebelongstowhichgroup? a)SERM b)SERD c)LHRHanalogues d)Aromatseinhibitors CorrectAnswer-DAns.is'd'i.e.,AromataseinhibitorsAromataseinhibitorsAromataseinhibitorsaredrugswhichinhibittheenzymeAromatase.Aromataseisanenzymeresponsiblefortheconversionoftestosterone(androgens)toestrogens.Thisconversionofandrogenstoestrogensoccurinseveraltissuesincludingovary,adrenalcortex,peripheraltissues.InhibitionofAromataseleadstodecreaseinestrogenlevel.Aromataseinhibitorspreventtheconversionofandrogenstoestrogensonlyinpostmenopausalwomen,notinpremenopausalwomen.Inpremenopausalwomen,asthelevelofestrogensdecreaseitactivatesthepituitaryhypothalamicaxis.Activationofpituitaryhypothalamicaxisleadstoincreasedsecretionofpituitarygonadotropins.Thepituitarygonadotropinsinturnincreasethesecretionofestrogens.Thustheestrogenlevelreturnsbacktotheirnormallevel.Ontheotherhandaromataseinhibitorseffectivelydecreasethesecretionofestrogeninpostmenopausalwomen.Inpostmenopausalwomen,theproductionofestrogenfromandrogensoccurs,onlyinextraovariansitessuchasperipheraltissueswheretheconversionofandrogenstoestrogensisblocked
byaromataseinhibitors.UseofaromataseinhibitorsAromataseinhibitorsareusedinthet/tofHormonereceptorpositivebreastcarcinomasinpostmenopausalwomen.Theyarenoteffectiveinpremenopausalwomen.HowareAromataseinhibitorsusefulinBreastcarcinomas?Inbreastcarcinomas,estrogendeliversgrowthsignalstothehormonereceptors.Thehormonereceptorsuponreceivingthegrowthsignals,causetheproliferationoftumorcells.Aftertheinhibitionbyaromataseinhibitors,estrogenleveldecreases,thisleadstolesserdeliveryofgrowthsignalsandinturnlesserproliferationoftumorcells.Aromataseinhibitorsareoftwotypes:TypeI(steroidal)aromataseinhibitor-Theycauseirreversibleinhibitionofaromatase,e.g.Exmestane,formestane.TypeII(non-steroidal)aromataseinhibitor-Theycausereversibleinhibitionofaromatasee.g.Anastrazole,Letrozole,vorozale.Aboveclassificationisbasedonchemicalstructure(steroidalornon-steroidal)andtypeofinhibition(reversibleorirreversible).Basedontheevolutionthearomataseinibitorsarc: i. FirstgenerationAminoglotethimide ii. SecondgenerationSteroidaltypeI(Example,formestane),non- steroidaltypeII(Anastrazole,Letrozole,Vorozole,fadrozole)Sideeffects-Hotflushes,nausea,diarrhoea,dyspepsia,thinningofhairandJointPain(Arthralgia)andincreasedriskoffracture.Thereisnoendometrialproliferation(noriskofendometrialcarcinoma),noriskofvenousthromboembolismandnodeteriorationoflipidprofile.RememberAnastrozoleandletrozolearenonsteroidolcompound,whileexemestaneissteroidol.oExemestanealsohasweakandrogenicactivity.Anastrozoleismorepotentthanletrozole.FirstgenerationaromataseinhibitorsAminoglutethimide.SecondgenerationaromataseinhibitorsLetrozole,anastrozole,fadrozoleandexemestone.
123.TADALAFILfalseis? a)Itislongestactingphosphodiesteraseinhibitor b)ItcannotbeusedforthetreatmentofPAH c)Itisusedinerectiledysfunction d)Itshalflifeis17-5hours CorrectAnswer-BAns.is'b'i.e.,ItcannotbeusedforthetreatmentofPAH 1. Tadalafilisthelongestactingphosphodiesteraseinhibitorusedfor erectiledysfunction. 2. Itshalflifeis17.5hours.3. Itcanbeusedasonce-dailyphosphodiesterasetype5(PDE5) inhibitorforthetreatmentofpulmonaryarterialhypertension(PAH).
124.Amphetaminecauseswhichofthe following? a)IUGR b)Cardiacanamoly c)Cleftlip d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AlltheaboveFollowingarethefetalorneonataleffectsofamphetamines:IUGRAbruptioplacentaeGlassyeyedlookPrematurityHypoglycemiaLethargyCardiacanamoliesSweatingFeedingproblemsCleftpalatePoorvisualtracing
125.Whichofthefollowingdrugsis contraindicatedinliverdysfunction? a)Pefloxacin b)Vancomycin c)Amikacin d)Hydralazine CorrectAnswer-AAns.is'a'i.e.,Pefloxacin
126.Bevacizumabis? a)AntiVEGFantibody b)Histonedecyclaseinhibitor c)Proteosomeinhibitor d)Her2neuinhibitor CorrectAnswer-AAns.is'a'i.e.,AntiVEGFantibody
127.Irreversiblehearinglosscausedby? a)Gentamycin b)Clarithromycin c)Bothoftheabove d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,GentamycinGentamycinisthemostcommonlyusedoftheaminoglycosides.Itproducesvestibulartoxicityandirreversiblehearingloss.Clarithromycinisknowntoproducereversiblehearingloss.
128.Mechanismofactionofcolchicineis? a)Inhibitsgoutyinflammation b)Inhbitsthereleaseofchemotacticfactors c)Inhibitsgranulocytemigration d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AlltheaboveColchicineItisneitheranalgesicnorantiinflammatory.Itspecificallyinhibitsgoutyinflammation.Itisinhibitsreleaseofchemoattractantmolecules.Itinhibitsgranulocytemigrationintothejoint.Itisantimitoticcausesmetaphasearrestbybindingtomicrotubules.Itincreasesgutmotility.
129.Drugusedintreatmentofmigraine? a)5HT1agonist b)5HT1antagonist c)Dlagonist d)D1antagonist CorrectAnswer-AAns.is'a'i.e.,5HT1agonist
130.DrugofchoiceforMRSAinfection? a)Ciprofloxacin b)Oxacillin c)Vancomycin d)Clindamycin CorrectAnswer-CAns.is'c'i.e.,VancomycinMethicillinresistancestaphylococcusaureus(MRSA)MRSAisabacteriumresponsibleforseveraldifficult-to-treatinfectionsinhumans.Itmayalsobereferredtoasmulti-drugresistantstaphylococcusaureusoroxacillinresistantstaphylococcusaureus(ORSA).MRSAisbydefinitionanystrainofstaphylococcusaureusthatisresistanttoa13-lactamsincludingpenicillin,methicillin,cloxacillin,nafcillin,oxacillinandcephalosporins.Resistancedevelopsduetoalterationintranspeptidase(penicillinbindingprotein)onwhichall13-lactamantibioticact:so,MRSAisresistanttoall0-lactamantibiotics.MRSA(especiallycommunityacquiredMRSA;CA-MRSA)displayenhancedvirulence,spreadingmorerapidlyandcausingdiseasemuchmoreseverethantraditionalstaphylococcusaureus.
131.Hypolipidemicdrugsactonallexcept? a)HMGCoAreductase b)Lipoproteinlipase c)AcylCoA,cholesterolacyltransferase1 d)Peripheraldecarboxylase CorrectAnswer-DAns.is'd'i.e.,PeripheraldecarboxylaseHypolipidemicdrugs 1. HMG-CoAreductaseinhibitors(statins)-Lovastatin,Simvastatin, Pravastatin,Atorvastatin,Rosuvastatin. 2. Bileacidsequestrants(Resins)-cholestyramine,colestipol.3. Activatelipoproteinlipase(fibricacidderivatives)-clofibrate, gemfibrozil,bezafibrate,fenofibrate. 4. Inhibitlipolysisandtriglyceridesynthesis-Nicotinicacid.5. Other-Probucol,Gugulipid,Ezetimibe,Avasimibe,Torcetrapib. Ezetimibeinhibitsintestinalcholesteroleabsorption.AvasimibeinhibitsenzymeacylCoenzymeA:cholesterolacyltransferase-1(ACAT-1)whichcausesesterificationofcholesterol.TorcetrapibinhibitscholesterolestertriglyceridetransportproteinTHDLcholesterol.
132.Followingarethesideeffectsof fenfluramineexcept? a)Pulmonaryhypertension b)Valvulardefects c)Suddendeaths d)Dizziness CorrectAnswer-DAns.is'd'i.e.,DizzinessFenfluramineandDexfenfluramineTheyreducethefoodseekingbehaviorbyenhancingtheserotonergictransmissioninthehypothalamus.TheywereextensivelyusedforslimmingTolerancedevelopstotheanorecticactionofin2-3monthsEchocardiographicabnormalities,valvulardefects,pulmonaryhypertensionandsuddendeathsarethedocumentedsideeffects.ThesedrugshavebeendiscontinuedbyUSFDA.
133.Cholinergicdrugwhichactsonheartby decreaseinlevelsofcAMPandduetoopeningofK+channelsis? a)Methacholine b)Oxotremorine c)Bethanechol d)DMPP CorrectAnswer-AAns.'a'i.e.,Methocholine
134.Pramlintideis? a)Syntheticamylinanalogue b)InhibitorofDPP4 c)GLP1analogue d)PPARgamma CorrectAnswer-AAns.is'a'i.e.,SyntheticamylinanalogueNEWERANTIDIABETICDRUGSExenatideExenatideisasyntheticglucagon-likepeptide-1(GLP-1)analogue.GLP-1isanimportantincretinthatisreleasedfromgutinresponsetooralglucose.ButGLP-1cannotbeusedclinicallyasitisdegradedrapidlybyenzymedipeptidlypeptidase(DPP-4).ExenatideisresistanttoDPP-4.ItactssimilartoGLP-1Enhancementofpostprandialinsulinrelease,suppressionofglucagonreleaseandappetiteaswellasslowingofgastricemptying.Itisgivenbysubcutaneousroute&usedintype2DMNauseaismostimportantsideeffect.SitagliptinThisisorallyactiveinhibitorofDPP-4.ItpreventsdegradationofendogenousGLP-1andotherincretins,potentiatingtheiraction,resultinginlimitationofpostprandialhyperglycemia.Itisusedintype2DM.OtherDPP-4inhibitorisvildagliptinPramlintide
Thisisasyntheticamylinanalogue(Amylinisapolypeptideproducedbypancreatic(3-cellswhichreducesglucagonsecretionfroma-cellsanddelaysgastricemptying).Pramlintideattenuatespostprandialhyperglycemiaandexertsacentrallymediateanorecticaction.oItisgivenbysubcutaneousrouteandisusedinbothType1andType2DM.GlucomannanThisispowderedextractfromtuberofkonjar.Itispromotedasadietaryadjunctfordiabetes.Itswellsinstomachbyabsorbingwaterandisclaimedtoreduceappetite,bloodsugar,serumlipidsandrelieveconstipation.BromocriptineRecentlybromocriptinehasbeenapprovedbyFDA,asanadjuncttodietandexercisetoimproveglycemiccontrolintype2DM.IthasbeenfoundthatdopaminealterinsulinresistancebyactingonhypothalmusandbromocriptineblocksO2receptors.
135.Mannitolisnotusefulfor? a)Glaucoma b)RaisedICT c)Impendingrenalfailure d)Pulmonaryedema CorrectAnswer-DAns.is'd'i.e.,PulmonaryedemaMannitolItisanonelectrolyteoflowmolecularweightthatispharmacologicallyinert.Itraisesosmolarityofplasmaandtubularfluid.Mannitoldecreasestubularwaterandelectrolytereabsorptionby? 1. Duetoosmoticeffect,fluidisretainedinthelumenofPT.2. InhibitstransportprocessesinthickAscL+1-mostimportantcause ofdiuresis. 3. ExpandsECF(rintravascularvolume)-drawswaterfromthe intracellularcompartmentincreasesGFRandinhibitsreninrelease. 4. Increasesrenalbloodflow,especiallytomedulla-3medullary hypertonicityisreducedcorticomedullaryosmoticgradientisdissipatedpassivesaltreabsortionisreduced.Uses-RaisedIOT(glaucoma),raisedICT,tomaintain.GFRandurineflowinimpendingrenalfailure,andtocounteractlowosmolalityofplasma/ECFduetorapidhemodialysis.ContraindicationsAcutetubularnecrosis(ARF),anuria,pulmonaryedema,AcuteLVF,cerebralhemorrhage.
136.WhichantiTBdrugisavoidedinHIV patient? a)INH b)Rifampicin c)Pyrazinamide d)Streptomycin CorrectAnswer-BAns.is'bi.e.,RifampicinAllHIV-infectedTBpatientsarecandidatesforART,andtheoptimaltimingforitsinitiationisassoonaspossibleandwithinthefirst8weeksofanti-TBtherapy.Rifampin,apotentinducerofenzymesofthecytochromeP450system,lowersserumlevelsofmanyHIVproteaseinhibitorsandsomenon-nucleosidereversetranscriptaseinhibitors-essentialdrugsusedinART.Insuchcases,rifabutin,whichhasmuchlessenzyme-inducingactivity,hasbeenrecommendedinplaceofrifampin.However,dosageadjustmentforrifabutinand/ortheantiret-roviraldrugsmaybenecessary.
137.VitKisavailableasallexcept? a)Menoquinone b)Menadione c)Phytonadione d)Phytoquinone CorrectAnswer-DAns.is'd'i.e.,PhytoquinoneVitamin-KItisafatsolublevitamin.Itisthemajorcoagulantofhumanbody(coagulantsaresubstanceswhichpromotecoagulation).Itisofthreetypes?a)K1(fromplants)-Phytonadioneb)K2(Producedbybacteria)-MenaquinonesC)K3(Synthetic)-MenadioneHalflifeofvitKis72hours-MahenderbhanSingh5th/e-348litKactsasacofactoratalatestageinthesynthasisofcoagulationfactorsbyliver-Prothrombin(factorII),FactorVII,IXandX(alsoprotein'C'&Protein'8").Itcatalyzesthefinalstepinactivationofthesefactorsi.e.gammacarboxylationofglutamateresidueswhichconfersonthemthecapacitytobindCa+2andtogetboundtophospholipidssurfaces-propertiesessentialforparticipationinthecoagulationcascade.
138.Whichofthefollowinganticancerdrugs arecompetitiveinhibitorsoftyrosinekinase? a)Imatinibandsunitinib b)Letrozole c)Bicalutamide d)Fulvestrant CorrectAnswer-AAns.is'a'i.e.,ImatinibandsunitinibMoleculartargetedagentsTyrosinekinaseinhibitorsCompetitiveinhibitorsImatinib,Nilotinib,Sunitinib,Dasatinib,Erlotinib,Gefitinib,Lapatinib,Sorafenib(Rememberallendwith'nib').MonoclonalantibodiesCetuximab,panitumumab.HER2/neu(ERBB2)inhibitorsMonoclonalantibody-Trastuzumab.TargetedantibodyGemtuzumab(antiCD-33),Rituximab(anti-CD20),Alemtuzumab(antiCD-52).Vascularendothelialgrowthfactor(VEGF)inhibitorMonoclonalantibody-Bevacizumab.ProteosomeinhibitorsBortezomib.HistonedeacetylaseinhibitorVorinostatDNA-methyltransferaseinhibitor5-azacytidine,2-deoxy-5azacytidine.All-trans-retinoicacid.Biologicalresponsemodifier-RecombinantIL-2(aldesleukin,denileukin).
139.Thalidomideisusedin? a)Mutilplemyeloma b)Squamouscellcarcinoma c)Basalcellcarcinoma d)Masopharyngealcarcinoma CorrectAnswer-AAns.is'a'i.e.,MultiplemyelomaClinicalusesofthalidomideAIDSrelatedaphthousulcersAIDSrelatedwastingsyndromeMultiplemyelomaandothersolidtumoursPreventionofgraftversushostdiseaseaftertransplantationRheumatoidarthritisAnkylosingspondylitisCrohn'sdiseaseandBechet'ssyndromeErythemaNodusumLeprosum
140.Whichdrugpreventperipheral conversionofT4toT3- a)Propylthiouracil b)Propranolol c)Iodides d)aandbboth CorrectAnswer-DAns.is'a'i.e.,Propylthiouracil&'b'i.e.,Propranolol
141.Daclizumabactsthrough? a)cGMPactivation b)Adenylcyclaseinhibition c)IL2receptorblocker d)IL10receptorblocker CorrectAnswer-CAns.is'c'i.e.,IL2receptorblockerMonoclonalantibodies(daclizumabandbasiliximab)thatblocktheinterleukin2receptorandareusedinpreventionofgraftrejectionasimmunosuppresant.
142.1,25dihydrocholecalciferolactson? a)Surfacereceptors b)Cytosolicreceptors c)Intranuclearreceptors d)Noneoftheabove CorrectAnswer-CAns.is'c'i.e.,Intranuclearreceptors
143.Followingisfalseaboutaripiprazole except? a)OnlyantipsychoticwithD1agonisticactivity b)Ithas5HT1Aantagonisticaction c)Ithasmaximumsedatingpotential d)Itisthedrugofchoiceintreatmentofacutemania CorrectAnswer-DAns.is`d'i.e.,ItisthedrugofchoiceintreatmentofacutemaniaAtypicalantipsychotics-->Olanzapine,risperidone,aripiprazoleorquetiapinewithorwithoutbenzodiazepineisthetreatmentofchoiceforacutemania.AripiprazoleOnlyantipsychoticwithD2agonisticactivity.(allothersareD2antagonists).LongestactingItalsohas5HT,Aagonisticand5HT2antagonisticactivity-Alsoknownasdopamine-serotininestabilizer.Itisleastsedatingantipsychoticcancauseinsomnia.
144.MechanismofactionofactinomycinDis ? a)InhibitsDNAdependentRNAsynthesis b)ActivatesDNAdependentRNAsynthesis c)InhibitsRNAdependentDNAsynthesis d)ActivatesRNAdependentDNAsynthesis CorrectAnswer-AAns.is'a'i.e.,InhibitsDNAdependentRNAsynthesisTheanticancerantibioticsareActinomycin-D(Dactinomycin)Daunorubicin(Rubidomycin)MitomycinCDoxorubicinMitoxantroneMithramycin(plicamycin)BleomycinsTheseanticancer,antibioticsobtainedfrommicro-organismsandhaveprominentantitumouractivity.Mechanismofaction:TheyareintercalatedbetweenDNAstrandsandinterferewithitstemplatefunction.Actinomycin`D'inhibitsDNAdependentRNAsynthesis.BleomycincauseDNAbreakageandfreeradicalformation.Doxo-anddaunorubicininhibitTopoisomeraseI&II.Mitomycinactslikealkylatingagents.MitoxantranebindstoDNAtoproducestrandbreakageandinhibitsbothDNA&RNAsynthesis.RememberAllantitumorantibioticsarecellcyclenonspecificexceptfor
bleomycinwhichactsinG2phase.
145.Neostigmineisusedinthefollowing except? a)Myastheniagravis b)Cobrabite c)Atonyofbladder d)Glaucoma CorrectAnswer-DAns.is'd'i.e.,Glaucoma
146.Xenobioticsaremetabolizedto? a)Increasewatersolubility b)Increaselipidsolubility c)Makethemnonpolar d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,IncreasewatersolubilityBIOTRANSFORMATION(METABOLISM)Mostofthedrugsaretreatedbythebodyasforeignsubstances(xenobiotics).Likeotherforeignsubstances(xenobiotics),bodytriestoeliminatedrugsbyvariousmechanismsforriddingitselfofchemicalintruders.Biotransformationmeanschemicalalterationofthedruginthebody.Whydrugtransformationisnecessary?Kidneyplaysapivotalroleinterminatingtheactivityofdrugs.Forrenalexcretionthedrugtendstobepolar(lipidinsoluble/watersoluble)sothatitcannotdiffusebackfromtubularlumenandcanbeexcreted.Butpharmacologicallyactiveorganicmolecules(drugs)tendtobelipophlic(nonpolar)andremainsunionizedoronlypartiallyionizedatphysiologicalpH.Biotransformationisneededtorendernonpolar(lipidsoluble)compoundspolar(watersoluble)sothattheyarenotreabsorbedintherenaltubulesandareexcreted.SitesandprocessesofbiotransformationPrimarysiteofdrugmetabolismisliver,othersare-kidney,intestine,lungandplasma.Biotransformationofdrugsmayleadto:-
ActivemetabolitefromanactivedrugManydrugsarepartiallyconvertedtooneormoreactivemetabolites.Theeffectsobservedarethesumtotalofthatduetotheparentdruganditsactivemetabolite.ActivationofinactivedrugsFewdrugsareinactiveassuchandneedconversioninthebodytooneormoreactivemetabolites.Suchadrugiscalledprodrug.
147.Doseofcentchromanis? a)30mg b)60mg c)120mg d)240mg CorrectAnswer-AAns.is'a'i.e.,30mgCetchroman(Saheli)Ormeloxifene,researchproductofCentralDrugResearchInstitute,Lucknow,India.Itisapotentnon-steroidalcompoundwithpotentanti-estrogenicandweakestrogenicproperties.Itistakenorally(30mg)twiceaweekforfirstthreemonthsthenonceaweek.Itworksprimarilybypreventingimplantationoffertilizedovum.Itdoesnotinhibitovulation.ItisavoidedinPCOD,withliverandkidneydiseasesandintuberculosis.Theremaybeatendencyofoligomenorrhoea.Thefailurerateis1-4/100womanyearsofuse.Failurerateislesswithincreaseddoses.Itisdevoidofanysignificantadversemetaboliceffect.Thismayalsobeusedasaemergencycontraceptive.
148.Pharmacoviglanceisusedfor? a)Tomonitordrugtoxicity b)Tomonitorunauthorizeddrugmanufacture c)Monitoringofstudents d)Checkcosts CorrectAnswer-AAns.is'a'i.e.,TomonitordrugtoxicityPharmacovigilancePharmacovigilanceisthescienceandactivitiesrelatingtodetection,assessment,understandingandpreventionofadverseeffectsoranyotherdrugrelatedproblem.
149.Branchthatdealswithmedicinaldrugs obtainedfromplantsandothernaturalresources- a)Pharmacognosy b)Pharmacogenetics c)Pharmacogenomics d)Pharmacopia CorrectAnswer-AAns.is'a'i.e.,PharmacognosyPharmacognosy:Itisthebranchthedealswiththeknowledgepertainingtothemedicinaldrugsobtainedfromplantsandothernaturalsources.Pharmacogenetics:StudyofgeneticbasisforvariabilityindrugresponsePharmacogenomics:Useofgeneticinformationtoguidethechoiceofdruganddoseonanindividualbasis.
150.Drugscausingpepticulcerareallexcept ? a)Clopidogrel b)NSAID c)Mycophenolatemofetil d)Propylthiouracil CorrectAnswer-DAns.is'd'i.e.,PropylthiouracilDrug/Toxincausingpepticulcerdisease:BisphosphonatesChemotherapyClopidogrelCrackcocaineGlucocorticoids(whencombinedwithNSAIDs)MycophenolatemofetilPotassiumchloride
151.Whichistheantidepressantwithno anticholinergiceffects? a)Imipramine b)Mianserine c)Fluoxamine d)Amitryptiline CorrectAnswer-CAns.is'c'i.e.,FluoxamineAntidepressantswithnoanticholinergic(antimuscarinic)action.BupropionEscitalopramFluvoxamineParoxetineTrazodoneCitalopramDuloxetineVenlafaxineSertalineMirtazapineFluoxetineistheonlySSRIwhichhassomeanticholinergicaction.RememberAntidepressantswithnosedativeactionBupropionCitalopramFluvoxamineProtriptylineDuloxetine
EscitalopramVenlafaxine(Note:First6drugsaresameinbothgroups)
152.Inverseagonistofbenzodiazepine receptoris- a)Phenobarbitone b)Flumazenil c)Betacarboline d)Gabapentin CorrectAnswer-CAns.is`c'i.e.,Betacarboline
153.Dantroleneactson? a)Raynodinereceptor b)Cannabinoidreceptor c)Bothoftheabove d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,RaynodinereceptorDantroleneDantroleneisadirectlyactingskeletalmusclerelaxant.MechanismofactionNormallyexcitation(depolarizationofendplate)iscoupledwithcontractionbyCa"Excitationcontractioncoupling.DantroloneactsonRyanodinereceptors(RyR)CalciumchannelsinsarcoplasmicreticulumofskeletalmusclesandpreventstheirdepolarizationtriggeredopeningnoreleaseofintracellularCa+2NoexcitationcontractioncouplingNocontraction.Thatmeansmusclecontractionisuncoupledfromdepolarizationofthemembrane.DantroleneisDOCformalignanthyperthermia.Itcanalsobeusedin 1. Neurolepticmalignantsyndrome.2. ToreducespasticityinUMNdisorders,hemiplegia,paraplegia, cerebralpalsyandmultiplesclerosis.Muscularweaknessisthedoselimitingsideeffect.Othersideeffectsaresedation,malaise,lightheadedness,troublesomediarrhoeaandlivertoxicity.RememberQuininealsoactsasdirectlyactingmusclerelaxant.Itincreasesrefractoryperiodanddecreasesexcitabilityofmotorend
plates.Itcanbeusedinnocturnallegcramp.
154.Colistinisobtainedfrom? a)Bacteria b)Fungi c)Actinmycetes d)Herbs CorrectAnswer-AAns.is'a'i.e.,BacteriaAmongstthegivenoptionsnodrugsisobtainedfromfungus.Antibioticsareobtainedfrom-1.Fungi-Penicilllin,Cephalosporin,Griseofulvin.2.Bacteria-PolymyxinB,Colistin,Bacitracin,Tyrothricin,aztreonam.3.Actinomycetes-Aminoglycosides,Tetracyclines,Chloramphenicol,macrolides,Polyenes.
155.DrugnotactingonP2y12receptoris? a)Ticlopidine b)Clopidrogel c)Dipyridamole d)Prasugrel CorrectAnswer-CAns.is'c'i.e.,DipyridamoleDipyridamole:inhibitsphosphodiesteraseaswellasblocksuptakeofadenosinetoincreaseplateletcAMPwhichinturnpotentiatesPGI2andinterfereswithaggregation.Ticlopidine,ClopidogrelandprasugrelactontheP2y12receptorandinhibitsADPaswellasfibrinogeninducedplateletaggregation.Note:PrasugrelisthelatestmostpotentandfastestactingP2Y12purinergicreceptorblocker.Itisusedinacutecoronarysydromesandwhenstrongantiplateletactionisrequired).
156.Allreleasehistamineexcept? a)Pancuronium b)D-TC c)Succinylcholine d)Mivacurium CorrectAnswer-AAns.is'a'i.e.,PancuroniumPropertiesofNMBlockersLongestactingNeuromuscularblockerPancuronium(durationofaction120-180minutes).(Goodman&Gilman11th/ep.222)(Note:InsomebookspipecuroniumorDoxacuriumhavegivenasthelongeractivity).ShortestandfastestactingneuromuscularblockerSuccinylcholine(suxamethonium)-durationofaction5-8minutes.Shortestactingcompetitive(nondepolarizing)neuromuscularblockerMivacurium(durationofaction12-18minutes).FastestactingnondepolarizingblockerRocuronium(canbeusedforendotrachealintubationasanalternativetoSch).Non-depolarizingneuro-muscularblockerscancauseganglionblock,vagalblockandHistaminerelease(differentagentshasdifferentpropensity).HistaminereleaseiscausedbyD-TC(maximumtendency),succinylcholine,mivacurium,doxacurium,atracurium,tubocurarinecancausebronchoconstriction.VirtuallynohistaminereleasePancuroniumVagalblockiscausedbyPancuronium,recuronium,Gallamine.MaximalvagalblockandtachycardiaiscausedbyPancuronium(Previouslyitwasgallamine,butitisnotusednow).
Vagalstimulationiscausedbysuccinylcholine(cancausebradycardia).Ganglionblockiscausedbyd-Tc,Metocurine,Alcuronium.Maximumganglionblockadeiscausedbyd-TC.GanglionstimulationiscausedbySuccinylcholine.
157.FalseregardingCytochromeP450is? a)Theyareessentialfortheproductionofcholesterols,steroids, prostacyclinsandthromboxaneA2 b)Theyabsorblightwith45nmwavelength c)Theyoccurpredominantlyinliver d)Theyarenonhemeproteins CorrectAnswer-DAns.isdi.e.,TheyarenonhemeproteinsCYTOCHROMEP450TheyCYP450areessentialfortheproductionofcholesterols,steroids,prostacyclinsandthromboxaneA2.Theyarealsoessentialforthemetabolismofforeignchemicalsanddetoxificationofdrugs.CYP450enzymesaresonamedbecausetheyareboundtomembraneswithinacell(cyto)andcontainahemepigment(chromeandP)thatabsorbslightatawavelengthof450nmwhenexposedtocarbonmonoxide.Therearemorethan50CYP450enzymes,buttheCYP1A2,CYP2C9,CYP2C19,CYP2D6,CYP3A4,andCYP3A5enzymesmetabolize90percentofdrugs.
158.Omalizumabis? a)AntiIgMantibody b)AntilgGantibody c)AntiIgEantibody d)AntiIgDantibody CorrectAnswer-CAns.is'c'i.e.,AntiIgEantibody
159.Nicotinicacid? a)IncreasesHDL b)Increasedtriglyceridesynthesis c)TypeIIhyperlipoproteinemia d)DecreasedhydrolysisofVLDL CorrectAnswer-AAns.is'a'i.e.,IncreasesHDLNicotinicacid(Niacin)Therearcthreemaintypeoflipasesrelatedtometabolismoflipoproteins? 1. LipoproteinlipasePresentinbloodvesselsandcauseshydrolysis oftryglyceridecontentofVLDLandchylomicrones. 2. HepaticlipaseConvertsIDLtoLDLbyhydrolysingthetriglyceride contentofIDL. 3. HormonesensitivelipasePresentintracellularlyinperipheral tissueandcausesintracellularlipolysisbyhydrolysingtriglycerides.Niacin(Nicotinicacid)inhibitsintracellularlipolysisbyinhibitinghormonesensitivelipaseintracellularFFAtoliver-4.1,triglyceridesynthesis.NiacinalsoincreasestheactivityoflipoproteinlipaseThydrolysisofVLDLtriglyceride.NicotinicacidalsoreducestheproductionofVLDLinliverbyinhibitingTG-synthesisindirectlytheVLDLdegradationproductsIDLandLDLarealsoreduced.NicotinicacidisthemosteffectivedrugtoraiseHDL-CH.IncreasedHDLisduetointerferenceofdirectpathwayofHDLcholesteroltoliverwhichinvolvesapo-AiNiacindecreasesapo-A,mediatedhepaticclearance.
NicotinicacidisusedintypeI,III,IV&Vhyperlipoproteinemias.
160.HIVintegraseinhibitoris? a)Elvitegravir b)Abacavir c)Maraviroc d)Tenofovir CorrectAnswer-AAns.is'a'i.e.,ElvitegravirIntegraseinhibitorsRaltegravirandElvitegraviractbyinhibitingenzymeintegrase.
161.Plateletadhesionisinhibitedby? a)Nitricoxide b)SubstanceP c)Thrombin d)IL2 CorrectAnswer-AAns.is'a'i.e.,NitricOxide
162.Whichofthefollowingisthelongest actingoralanticoagulant? a)Bishydroxycoumarin b)Warfarin c)Acenocoumarol d)Phenindione CorrectAnswer-AAns.is'a'i.e.,BishydroxycoumarinBishydroxycoumarin(Dicumarol)isthelongestactingoralanticoagulant.Ethylbiscoumacetateistheshortestactinganticoagulant.
163.FunctionofM2receptorinheart? a)SAnodehyperpolarisation b)AVnodeincreasedvelocityofconduction c)Increasedcontractilityofventricles d)IncreasedAchreleasefromcholinergicnerveendings CorrectAnswer-AAns.is'a'i.e.,SAnodehyperpolarization
164.Methysergideisbannedasitcauses? a)Pulmonaryfibrosis b)Pleuraleffusion c)Syncope d)Myocarditis CorrectAnswer-AAns.is'a'i.e.,PulmonaryfibrosisMethysergideItischemicallyrelatedtoergotalkaloidsandantagonizestheactionofserotoninonsmoothmusclesincludingthatofbloodvessels,withotproducingergotlikeeffects.Itisapotent5HT2A/2Cantagonist.Ithasbeenusedformigraineprophylaxis,carcinoidandpostgastrectomydumpingsyndrome.Prolongedusehascausedabdominal,pulmonaryandendocardialfibrosis,becauseofwhichithasgoneintodisrepute.
165.Dopamineat1-2Microgram/Kg/minproduces? a)Renalvasodilatation b)Positiveionotropiceffect c)Mesentericvasoconstriction d)Generalisedvasoconstriction CorrectAnswer-AAns.is'a'i.e.,RenalvasodilatationDopamineproducesdose-dependentaction:Atlowdose(1-2?g/kg/min)causesdilationofrenalandmesentericvesselsoftenreferredtoasrenaldose.Atmoderatelyhighdose(2-10?g/kg/min)producesapositiveionotropiceffectbystimulating1receptoronheartcardiacdose.Athighdoses(>10?g/kg/min)producesvasoconstrictionbystimulating1receptorsvasculardose.
166.Whichofthefollowingisaunivalent directthrombininhibitor? a)Argatroban b)Hirudin c)Bivalirudin d)Lepirudin CorrectAnswer-AAns.is'a'i.e.,ArgatrobanDirectthrombininhibitors(DTIs)Thisisaclassofmedicationsthatactasanticoagulantsbydirectlyinhibitingthethrombin(unlikeheparinwhichinhibitsthrombinindirectlythroughantithrombinso,heparinisanindirectthrombininhibitor).
167.Treatmentagentforscarletfeveris a)Penicillin b)Ciprofloxacin c)Erythromycin d)Chloramphenicol CorrectAnswer-AAns.is'a'i.e.,PenicillinTreatment:Immediatehospitalizationandisolationofthepatientisindicated.Penicillinisthetreatmentofchoice.
168.Atomoxetineisusedfor? a)Nocturnalenuresis b)ADHD c)Tempertantrums d)Patentductusarteriosus CorrectAnswer-BAns.is'b'i.e.,ADHDAtomoxetineitisselectivenorepinephrinereuptakeinhibitorandisapprovedforuseinADHD.Itisindicatedinchildren>6yearsandinadultswithconcentrationandattentionproblems.Atomoxetineabsorbedorally,hydroxylatedbyCYP2D6andexcretedinurine,mainlyasglucuronide.Whilemajorityofindividualsareextensivemetabolizers(EM),fewarepoormetabolizers(PM)duetopolymorphismofCYP2D6.InhibitorsofCYP2D6likefluoxetine,paroxetine,quinidineincreaseconcentrationandtoxicityofatomoxetine.ItshouldnotbegivenwithMAOinhibitorsandiscontraindicatedinglaucoma.
169.WhichofthefollowingcanprolongQT interval? a)Nalidixicacid b)Ofloxacin c)Gatifloxacin d)Pefloxacin CorrectAnswer-CAns.is'c'i.e,Gatifloxacin
170.Streptokinasecausesincreasein? a)Plasmin b)Thrombin c)Kallikrein d)AngiotensinII CorrectAnswer-AAns.is'a'i.e.,PlasminStreptokinaseFibrinolyticdrugObtainedfromgroupCstreptococciStreptokinaseisinactiveassuch.Itcombineswith'circulatingplasminogenmoleculestoformanactivatorcomplex,whichthencauseslimitedproteolysisofotherplasminogenmoleculestogenerateactiveenzymeplasmin.
171.Betablockerwithdisomerresponsible forbetablockeractionis? a)Nebivolol b)Timolol c)Esmolol d)Propranolol CorrectAnswer-AAns.is'a'i.e.,NebivololNebivololisanovelbetal-blockerwithagreaterdegreeofselectivityforbetal-adrenergicreceptorsthanotheragentsinthisclassandanitricoxide(NO)-potentiating,vasodilatoryeffectthatisuniqueamongbeta-blockerscurrentlyavailabletoclinicians.Nebivololisaracemicmixturewithbeta-blockeractivityresidinginthed-isomer;incontrast,I-nebivololisfarmorepotentinfacilitatingNOrelease.Note:Betablockerswith1isomerhavingbetablockingactivityare:?Propranolol,atenolol,metoprolol,esmolol,timolol
172.Tocilizumabisantibodyagainst? a)IL2 b)IL4 c)IL6 d)IL8 CorrectAnswer-CAns.is'c'i.e.,IL6TocilizumabItistheantibodydirectedagainstIL6receptorItisapprovedforusein: i. Rheumatoidarthritis ii. Neuromyelitisoptica iii. Castleman'sdisease iv. Systemicjuvenileidiopathicarthritis
173.Fomepizoleactsasantidotefor? a)Methanolpoisoning b)Cannabispoisoning c)Leadpoisoning d)CadmiumPoisoning CorrectAnswer-AAns.is'a'i.e.,MethanolpoisoningMethanolishighlytoxicalcohol.Itismetabolizedtoformaldehyde(byalcoholdehydrogenas)andformicacid(byacetaldehydedehydrogenase).Itistheaccumulationofformicacidwhichcausestoxiceffectsinmethanolpoisoning.Accumulationofformicacidresultsinlacticacidosis/highaniongapmetabolicacidosiswithlowplasmabicarbonates,blindnessduetoretinaldamage,papilledema.Methanolpoisoningcanbetreatedbysupportivemeasures,gastriclavageandsodiumbicarbonate(totreatacidosis).Ethanolisusefulbecauseitcompetitivelyinhibitstheconversionofmethanoltoformicacid.Fomepizolecanalsobeusedasitisaspecificinhibitorofalcoholdehydrogenase.Folicacidorfolinicacid.EnhancethemetabolismformicacidtoCO2.Hemodialysismayalsobeused.
174.Aboutrectalroutetrueis? a)Usedforirritantandunpleasantdrugs b)Cannotbeusedinunconsciouspatient c)Thereispredictableabsorptionofdrug d)Diazepamcannotbegivenviarectalrouteofadministration CorrectAnswer-AAns.is'a'i.e.,UsedforirritantandunpleasantdrugsRectalrouteofadministrationItisarouteofsystemicdrugdelivery.Irritantorunpleasantdrugscanbeputintotherectumassuppositoriesorretentionenemas.Canbeusedinapatientwithrecurrentvomitingandinunconsciouspatient.Absorptionofdrugisslower,irregularandunpredictable.Drugabsorbedintotheexternalhemorrhoidalvein(50%)bypassestheliverbutnotthatabsorbedintotheinternalhemorrhoidalvein.Diazepam,indomethacin,ergotamineandparacetamolcanbeusedviarectalrouteofadministration.
175.Transdermalpatchisnotusedfor followingdrug? a)GTN b)Fentanyl c)Nicotine d)Naloxone CorrectAnswer-DAns.is`d'i.e.,Naloxone
176.Buprenorphinepartialagonistatwhich opioidreceptor? a)Mu b)Kappa c)Delta d)Lambda CorrectAnswer-AAns.is'a'i.e.,MuBuprenorphineispartialagonistonmureceptorandantagonistatKappareceptor.
177.Treatmentforimpetigo? a)Dicloxacillin b)Ciprofloxacin c)Gentamycin d)Amoxicillinandclavulanicacid CorrectAnswer-AAns.is'a'i.e.,DicloxacillinTreatmentofimpetigoiseitherdicloxacillinorcephalexincanbegivenatadoseof250mgfourtimesdailyfor10days.Topicalmupirocinointmentisalsoeffective.
178.Followingarethesideeffectsof thiazidesexcept? a)Hypokalemia b)Hypocalcemia c)Hepaticcoma d)Impotence CorrectAnswer-BAns.is'b'i.e.,HypocalcemiaFollowingarethesideeffectsofthiazides:HypokalemiaAcutesalinedepletion,hemoconcentrationandincreasedriskofperipheralvenousthrombosisDilutionsalhyponatremiaNauseaomittingdiarrheaRarelyheadache,giddiness,weakness,parethesias,impotenceHearinglossRashes,photosensitivityHyperuricemiaHyperglycemiahyperlipidemiaoHypercalcemiaMagnesiumdepletionAggravatedrenalinsufficiencyBriskdiuresisleadingtomentaldisturbanceandhepaticcoma
179.Weightgainisseenwithallofthe followingantipsychiatricmedicationsexcept? a)Quitiapine b)Resperidone c)Clozapine d)Molindone CorrectAnswer-DAns.is`d'i.e.,MolindoneAntipsychoticsusuallycauseweightgain.Quitiapine,olanzapine,clozapineandresperidone,allhavebeenimplicatedinweightgain.Molindonehasoftenbeenreportedtocauseweightlossratherthanweightgain.
180.Loadingdosedependson? a)Volumeofdistribution b)Eliminationrate c)Halflife d)Plasmavolume CorrectAnswer-AAns.is'a'i.e.,VolumeofdistributionLoadingdoseisgovernedbyvolumeofdistributionandvolumeofdistributionisaffectedbylipidsolubility.Maintenancedoseisgovernedbyclearance(excretion)ofdrugandhalflife.
181.Whichofthefollowingdrugshasboth antihelminthandantiprotozoalactivity? a)Nitazoxanide b)Emetine c)Chloroquine d)Diloxanidefuroate CorrectAnswer-AAns.is'a'i.e.,NitazoxanideNitazoxanideThisisthesalicylamidecogeneroftheantihelminthniclosamide,introducedforthetreatmentofgiardiasisandcryptosporidiosisandisalsoactiveagainstotherprotozoaandhelminthesincludingE.histolytica,T.vaginalis,AscarisandH.nana.Itisaprodrugwhichonnabsorptionisconvertedintoactivefortizoxanide.TizoxanideisaninhibitorofPFORenzymethatistheessentialpathwayofelectrontransportenergymetabolisminanaerobicorganisms.
182.Reasonforhepaticinvolvementinoral contraceptivesis? a)Estrogen b)Progesterone c)Estrogen+Progesterone d)Mixedtraceelements CorrectAnswer-AAns.is'a'i.e.,EstrogenHepatotoxicitywithoralcontraceptivepillsWhileearlyformulationsofOCPswereassociatedwithfrequentserumenzymeelevations,currentformulationsandhormonalreplacementtherapyhavenotbeenlinkedtoALToralkalinephosphataseelevationsatratesanyhigherthanoccurwithplacebo.EstrogensinOCPscancausemildinhibitionofbilirubinexcretionleadingtojaundiceinpatientswithinheritedformsofbilirubinmetabolismsuchastheDubinJohnsonsyndrome.Itcaninduceaclinicallyapparentcholestaticliverinjurywhichtypicallyarisesduringthefirstfewcyclesoftherapy,andrarelyafterthesixmonths.Ithasalsobeenlinkedtohepatictumors,bothbenignandmalignant.
183.A=ACEinhibitor,B=betablocker,C= calciumchannelblocker,D=diuretics.Forelderlywithhypertensionantihypertensivedrugofchoiceis? a)AorD b)AorB c)AorC d)CorD CorrectAnswer-DAns.is'd'i.e.,CorDPharmacologicaltreatmentofhypertensionIndicationsofdrugtherapy(theBritishhypertensionsocietyguidelines).WhensustainedBPexceeds160/100mmHgor.WhenBPisintherangeof140-159/90-99mmHgandthereistargetorgandamageorcardiovasculardisease.FordiabeticswhenBPexceeds140/90mmHg.TheoptimaltargetistolowerBPtoorbelow140/85mmHginnondiabeticsand140/80mmHgindiabetics(WHOtargetis130/85mmHg).DrugtherapyAsimplesteppedAB/CDregimenisused.
184.Whichdrugisusedinamytrophiclateral sclerosis? a)Riluzole b)Glatirame c)Tacrine d)Olanzapine CorrectAnswer-AAns.is'a'i.e.,RiluzoleDrugsusedinneurodegenerativedisordersMultiplesclerosisBeta-interferonorglatiramedecreasethefrequencyofrelapsesinrelapsingremittingMS.Recently,natalizumab(amonoclonalantibody)hasbeentried.AmyotropiclateralsclerosisRiluzole(NMDAantagonist)isusefulinALS.TorelievespasticityBaclofenmaybeused.
185.Rotigotineis? a)Dopamineagonist b)Dopamineantagonist c)GABAagonist d)GABAantagonist CorrectAnswer-AAns.is'a'i.e.,DopamineagonistRotigotineRotigotineisadopamineagonistdrugandisindicatedinthetreatmentofparkinosonism.Rotigotineisintendedtobedeliveredthroughtransdermalpatches,soastoensureaslowandconstantdosageina24-hourperiod.Sideeffectsare--skinreactionatthepatchsite,nausea,vomiting,diziness,drowsiness,insomnia.
186.Counterfeitdrugis? a)Fakemedicine b)Containsthewrongingredient c)Theyhaveactiveingredientinwrongdose d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AlltheaboveCounterfeitmedicineisfakemedicine.Itmaybecontaminatedorcontainthewrongornoactiveingredient.Theycouldhavetherightactiveingredientbutatthewrongdose.Counterfeitdrugsareillegalandmaybeharmfultoyourhealth.
187.Mostcommonreceptorfortypical antipsychoticsis? a)D1 b)D2 c)D3 d)D4 CorrectAnswer-BAns.is'b'i.e.,D2ANTIPSYCHOTICSAntipsychotic(neuroleptic)drugscanbedividedintotypicalandatypical.TypicalBlockD2receptorsHavesignificantextrapyramidalsymptoms(exceptforthioridazine)-Parkinsonism,Acutemusculardystonia,Akathisia,Malignantneurolepticsyndrome,Tardivedyskinesia.AtypicalThesearenewergeneration(secondgeneration)antipsychoticsthathaveweakD2blockingbutpotent5-HT2antagonisticactivity.CalledatypicalbecausetheyhavenoD2blockingproperty(exceptresperidone).Extrapyramidalsideeffectsareminimal(Resperidonecancausesomeextrapyramidaleffects).Havenoantiemeticeffect.ExamplesareClozapine,Risperidone,Olanzapine,Quetiapine,Aripiprazole,Ziprasidone.
188.Incretinlikefunctionisseenin? a)Exenatide b)Miglital c)Poiglitazone d)Repaglinide CorrectAnswer-AAns.is'a'i.e.,ExenatideExenatideisasyntheticglucagon-likepeptide-1(GLP-1)analogue.GLP-1isanimportantincretinthatisreleasedfromgutinresponsetooralglucose.ButGLP-1cannotbeusedclinicallyasitisdegradedrapidlybyenzymedipeptidlypeptidase(DPP-4).ExenatideisresistanttoDPP-4.ItactssimilartoGLP-1Enhancementofpostprandialinsulinrelease,suppressionofglucagonreleaseandappetiteaswellasslowingofgastricemptying.Itisgivenbysubcutaneousroute&usedintype2DMNauseaismostimportantsideeffect.
189.Patientontreatmentoncarbidopa+ levodopafor10yrsnowhasweaningoffeffect.Whatshouldbeaddedtorestoreaction? a)Tolcapone b)Amantadine c)Rasagiline d)Benzhexol CorrectAnswer-AAns.isAi.e.,TolcaponeBothEntacaponeandtolcaponeenhanceandprolongthetherapeuticeffectoflevodopa-carbidopainadvancedandfluctuatingparkinsonsdisease.Theymaybeusedtosmoothenoffthe'wearingoff',increase'on'timeanddecrease'off'time,improveactivitiesofdailylivingandallowlevodopadosetobereduced.TolcaponeItisadrugusedtotreatParkinson'sdisease(PD).Itisaselective,potentandreversiblenitrocatechol-typeinhibitoroftheenzymecatechol-O-methyltransferase(COMT).Incomparisonwithentacapone,anothernitrocatecholCOMTinhibitor,tolcaponehasalongerhalflife(2.9hoursvs.0.8hours)andcanbetterpenetratetheblood?brainbarrier,actingbothinthecentralnervoussystemandintheperiphery.However,entacaponeislesstoxicfortheliver.TolcaponeimprovesthebioavailabilityandreducestheclearanceoflevodopaandsubsequentlydopaminefromtheCNS.Withoutadministrationoftolcapone,thebeneficialeffectsof
levodopatendtowearoffmorequickly,resultinginmotorfluctuations.
190.Whichoftheseisnotusedforthe treatmentoftyphoid? a)Chloramphenicol b)Ciprofloxacin c)Ceftriaxone d)Cefixime CorrectAnswer-DAns.is'd'i.e.,Cefixime
191.LTantagonistsareusedinasthmafor? a)Alongwithbetaagoniststoreducesteroids b)Inplaceofbetablockersassoletherapy c)Prophylactictherapyformildtomoderateasthma d)Definitivetherapyinacuteattackofasthma CorrectAnswer-CAns.is'c'i.e.,ProphylactictherapyformildtomoderateasthmaMonteleukastandzafirleucastarecystenylLT1(cysLT1)receptorantagonists.Theyareindicatedforprophylactictherapyofmildtomoderateasthmaasalternativestoinhaledglucocorticoids.
192.Whichisalongactinginsulin? a)Lispro b)Aspart c)Glargine d)Glulicine CorrectAnswer-CAns.is'c'i.e.,Glargine
193.Steroidwithmaxmineralocorticoid activity? a)Fludrocortisone b)DOCA c)Prednisolone d)Triamsinolone CorrectAnswer-AAns.is'a'i.e,Fludrocortisone
194.Youngchildweighing20kgwasgivena druginthedose100mg/kgbodyweight.Theplasmaconcentrationofthedrugis2mg/dlandtheclearanceis200ml/hr.Whatisthetimerequiredtoreachsteadystateplasmaconcentration- a)10hrs b)20hrs c)30hrs d)40hrs CorrectAnswer-BAns.is'b'i.e.,20hoursVolumeofdistribution=totaldose/plasmaconcentrationTotaldose=dose/kgxbodyweight=100x20=2000mgVolumeofdistribution=2000/2=1000Halflife=0.693xVolumeofdistribution/clearance=0.693x1000/200=3.5hoursTimerequiredtoreachsteadystateplasmaconcentrationis5.5halflives=5.5x3.5=19.25hoursThereforethemostappropriateansweris20hours.
195.Patientonverapamilshouldnotbegiven betablockeras? a)Conductionblock b)Bronchospasm c)Neurogenicshock d)Anaphylaxis CorrectAnswer-AAns.is'a'i.e.,ConductionblockAdverseeffectsofCCBsNausea,constipationandbradycardiaaremorecommonwithverapamil.Verapamilcanaccentuateconductiondefect-shouldbeavoidedin2nd&3rddegreeblock,insicksinussyndromeandalongwith13-blocker.MostcommonsideeffectsofDHPsarepalpitation,flushing,hypotension,headache,ankleedema,drowsinessandnausea.Nifedipinecanparadoxicallyincreasethefrequencyofanginainsomepatients.Nifedinecancausevoidingdifficultyinelderly(relaxanteffectonbladder)andglucoseintolerance(decreasesinsulinrelease).
196.DrugthatdecreasesLpAinblood? a)Statin b)Nicotinicacid c)Ezetimibe d)CETPinhibitors CorrectAnswer-BAns.is'b'i.e.,NicotinicacidNicotinicacidreducesLp(a)whilestatinsdonothaveanyeffectonLp(a).
197.Glucuronidationtakesplacein? a)Liver b)RBC c)Pancreas d)Thyroid CorrectAnswer-AAns.is'a'i.e.,LiverGLUCURONIDATIONThisisthemostimportantsyntheticreactioncarriedoutbyagroupofUDP-glucuronosyltransferases(UGTs).Glucuronidationoccursmainlyintheliver,althoughtheenzymeresponsibleforitscatalysis,UDP?glucuronyltransferase,hasbeenfoundinallmajorbodyorgans(e.g.,intestine,kidneys,brain,adrenalgland,spleen,andthymus).Compoundswithahydroxylorcarboxylicacidgroupareeasilyconjugatedwithglucuronicacidwhichisderivedfromglucose.Examplesare-chloramphenicol,aspirin,paracetamol,lorazepam,morphine,metronidazole.Notonlydrugsbutendogenoussubstrateslikebilirubin,steroidalhormonesandthyroxineutilizethispathway.Glucuronidationincreasesthemolecularweightofthedrugwhichfavoursitsexcretioninbile.Drugglucuronidesexcretedinbilecanbehydrolysedbybacteriainthegut-theliberateddrugisreabsorbedandundergoesthesamefate.Thisenterohepaticcyclingofthedrugprolongsitsaction,e.g.phenolphthalein,oralcontraceptives.
198.Digitalisproduceswhichofthefollowing changesinECG? a)TallTwaves b)STsegmentelevation c)ProlongedQTinterval d)ProlongedPRinterval CorrectAnswer-DAns.is'd'i.e.,ProlongedPRintervalTherearesomecharacteristicECGchangesbydigitalisuse,someofwhichoccurattherapeuticconcentrationandsomeoccursattoxiclevel:AttherapeuticlevelProlongationofPRintervalScoopingofSTsegmentAlsoknownasdigitaliswaveordigsagthereisdownslopingSTdepression(initially)ShorteningofQTintervalDecreasedTwaveamplitude/orTwaveinversionAttoxiclevel:AbovechangesareamplifiedProlongationofPRintervalconductionblockmayoccurTwaveinversionSTdepressionQTintervalshortensfurtherIncreasedautomaticityArrhythmias
199.Antifungalwhichcanbeusedorallybut notivis? a)Voriconazole b)AmphoterecinB c)Terbinafine d)Noneoftheabove CorrectAnswer-CAns.is'c'i.e.,Terbinafine
200.Mechanismofactiontacrolimusis? a)Inhibitionofcalcineurin b)Antimetabolite c)mTORinhibitor d)InhibitionofDNAsynthesis CorrectAnswer-AAns.is'a'i.e.,InhibitionofcalcineurinTacrolimusItisamacrolideimmunosuppressantagent.Itsmechanismofactionissimilartocyclosporine,i.e.inhibitionoftranscriptionofIL-2andT-cellproliferation,butitbindstootherimmunophilincalledFKBP(incontrasttocyclosporinewhichbindstocyclophilin).Subsequentstepsaresome,i.e.inhibitionofcalcineurin,whichinhibitsTcellactivation.Tocrolimusis10-100timesmorepotentthancyclosporine.Itisalsomoretoxicthancyclosporin.Adverseeffectsarenephrotoxicity(mostcommon),neurotoxicity,hyperglycemia(DM).MechanismofnephrotoxicityPeriglomerularafferentarteriolarvasoconstricationandreducedGFR.
201.Longactingcorticosteroidis? a)Triamcinolone b)Betamethasone c)Hydrocortisone d)Prednisolone CorrectAnswer-BAns.is'b'i.e.,BetamethasoneShortactingglucocorticoids(t1/2:8-12hrs.):Cortisol,hydrocortisone.Intermediateactingglucocorticoids(t1/2:12-36hrs.):Prednisolone,methylprednisolone,triamcinolone.Longactingglucocorticoids(t1/2:36-54hrs.):Dexamethasone,betamethasone.
202.Plasmaproteinbounddrugdistributedin whichcompartment? a)Extracellular b)Intravascular c)Interstitial d)Extravascular CorrectAnswer-BAns.is'b'i.e.,IntravascularClinicalsignificanceofproteinbinding: 1. Highplasmaproteinbounddrugsarelargelyrestrictedtothe vascularcompartmentandtendtohavelowervolumeofdistribution. 2. Theboundfractionisnotavailableforaction.3. Highdegreeofproteinbindinggenerallymakesthedruglongacting, becauseboundfractionisnotavailableformetabolismorexcretion,unlessitisactivelyexcretedbyliverorkidneytubules. 4. 1nnephroticsyndromeandotherconditionscausing hypoproteinemia,proteinbindingwillbealtered.5.Highlyproteinbounddrugsarenotremovedbyhaemodialysisandneedspecialtechniquesfortreatmentofpoisoning. 5. Proteinbounddrugscangiverisetodisplacementinteractions:6. Inhypoalbuminemia,bindingmaybereducedandhigh concentrationsoffreedrugmaybeattained,e.g.phenytoinandfurasemide.
203.Adrenocorticalsuppressioncausing drugsareallexcept? a)Prednisone b)Ketoconazole c)Mitotane d)Spironolactone CorrectAnswer-DAns.is'd'i.e.,SpironolactoneDrugscausingadrenocorticalsuppressionare:Steroids(prednisone,hydrocortisone,anddexamethasone)AminoglutethimideFludrocortisoneKetoconazoleMegestrolMetyraponeMitotane
204.Followingaretheadvantagesof sustainedreleasepreparationovertheconventionalpreparationsexcept? a)Decreasedfrequencyofadministration b)Improvedcompliance c)Lessincidenceofhighpeaksideeffects d)Drugswithhalflife>4hoursaresuitable CorrectAnswer-DAns.is'd'i.e.,Drugswithhalflife>4hoursaresuitableActsforalongerperiod.Frequencyofadministrationisreduced-moreconvenient.Improvedpatientcompliance-asinglemorningdoseislesslikelytobeforgotten/omittedthana6or8hourlyregimen;amonthlyorquarterlyadministeredcontraceptiveoveronethathastobetakendaily.Largefluctuationsinplasmaconcentrationareavoided.Sideeffectsrelatedtohighpeakplamaleveljustafteradose(e.g.nifedipine)wouldbeminimized.Betterround-the-clockcontrolofbloodsugar,etc.Drugeffectcouldbemaintainedovernightwithoutdisturbingsleep,e.g.antiasthmatics,anticonvulsants,etc.
205.Whichantiepilepticdrugisleastsecreted inbreastmilk? a)Ethosuximide b)Clonazepam c)Gabapentin d)Carbamazepine CorrectAnswer-BAns.is'b'i.e.,Clonazepam
206.Drugwhichdecreasesefficacyof testosterone a)Isoniazid b)Ketoconazole c)Rifampicin d)None CorrectAnswer-BAns.is'b'i.e.,Ketoconazole
207.Fluoroquinolonewithminimum bioavailability? a)Levofloxacin b)Moxifloxacin c)Norfloxacin d)Ciprofloxacin CorrectAnswer-CAns.is'c'i.e.,Nortloxacin
208.Danazolhaswhichofthefollowing actions? a)Weakandrogenic b)Progestational c)Anabolic d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AlltheaboveDanazoleIthasweakandrogenic,anabolicandprogestationalactivity.Themostprominentactionissuppressionofgonadotropin(FSH/LH)frompitutaryinbothmenandwomeninhibitionoftesticular/ovarianfunction.Usesare: 1. Endometriosis(majoruse)2. Fibrocysticbreastdisease3. Infertility4. Menorrhagia5. Hereditaryangioneureticedema Sideeffectsarecompleteamenorrhoea,androgeniceffects(acne,hirusitism,decreasedbreastsize,deepeningofvoice,edema,weightgain),lossoflibidoinmen,hotflushesinwomen,nightsweatsandmusclecramp.Liverenzymemayberaised.
209.Agonistantagonistcombinationacting onthesamereceptoris? a)Isoprenalineandpropranolol b)Adrenalineandhistamine c)Salbutamolandleukotriene d)Estrogenandtamoxifen CorrectAnswer-AAns.is'a'i.e.,IsoprenalineandpropranololReceptorantagonists(Pharmalogicalantagonists)Receptorantagonistsarethosedrugsthatblockstheactionofagonistbyactingonsamereceptors.Example:Isoprenalineis1and2receptoragonistwhilepropranololhasantagonisticactionon1and2receptors.Note:PhysiologicalantagonistsPhysiologicalantagonistsarethosethatproduceoppositeactionbyactingondifferentreceptors.Example 1. HistaminecausesbronchoconstrictionviaH1receptorsandthis actionisantagonizedbyadrenalinewhichcausesbronchodilodationthrough1receptors 2. Leukotrienescausebronchoconstrictionviacystinylleukotriene receptorsandthisactionisantagonisedbysalbutamolwhichcausesbronchodilatationthrough2receptors.
210.NotadrugrecommendedforP. falciparumis? a)Quinine b)Ciprofloxacin c)Artemether d)Doxycycline CorrectAnswer-BAns.is'b'i.e.,Ciprofloxacin
211.Followingistrueaboutirondextran except? a)Itisparenteralironpreparation b)Itcanbegiveneitherivorim c)Itbindstotransferrin d)Itisnotexcreted CorrectAnswer-CAns.is'c'i.e.,Itbindstotrnasferrin
212.Comparedtohighmolecularweight heparinfollowingistrueaboutlowmolecularweightheparin? a)Monitoringisnotneededforlowmolecularweightheparin b)Dailytwosubcutaneousdosesareessential c)Theyareeasilyfilteredattheglomerulus d)Theydonotinteractwithplasmaproteins CorrectAnswer-BAns.is'b'i.e.,DailytwosubcutaneousdosesareessentialAdvantagesofLMWHLonger,moreconsistentandpredictableresponse-->Singledailydoseissufficientbysubcutaneousroute.oLowerriskofosteoporosisandHITsyndrome.Bleedingchancesareless:LMWheparinshaveadifferentanticoagulantprofile.TheyselectivelyinhibitfactorXawithlittleeffectonantithrombinandcoagulationingeneral.TheyactonlybyinducingconformationalchangeinATIII.Theyappeartohavelesserantiplateletaction.AsaresulttheyhaveasmalleffectonaPTTandwholebloodclottingtime.SinceaPTT/clottingtimesarenotprolonged(much)laboratorymonitoringisnotneeded,andtheincidenceofhaemorrhagiccomplicationisless.Theyareeasilyfilteredfromglomerularcapillariesbecauseoftheresmallermolecularweight.LMWheparinsdonotinteractwithplasmaproteins.
213.Mostvariableabsorptionisseenwith whichroute? a)Oral b)Intramscular c)Intravenous d)Perrectal CorrectAnswer-AAns.is'a'i.e.,OralOraladministrationofdrugsissafe,convenientandeconomical,buthasthepotentialforthemostvariableabsorptionpattern.ClinicalpharmacologyRoutesofdrugadministrationDrugsareadministeredbyvariousroutes.Differentrouteshavedifferentcharacteristics,sothattherouteofadministrationmayhaveaprofoundeffectuponthespeedandefficiencywithwhichthedrugsact.Theroutesofdrugadministrationmaybe:i)Localrouteii)SystemicrouteLocalroute-Drugisadministeredatthesiteoflesion.Systemicroute-Drugisadministeredthroughsystemicroutesisintendedtobeabsorbedintothebloodstreamanddistributedallover,includingthesiteofaction,throughcirculation.
214.Cephalosporincausing thrombocytopeniais? a)Cefixime b)Ceftazidime c)Cefoperazone d)Cefdinir CorrectAnswer-BAns.is'b'i.e.,CeftazidimeAdverseeffectsofcephalosporinsHypersensitivityreaction-Itisthemostusualsideeffect.Thereiscrossallergybetweenpenicillinsandcephalosporinein5-10%ofcases.Diarrhea-duetoalterationofgutflora,maximumwithoralcephradineandparentralcefperazone(cefperazoneissignificantlyexcretedinbile)MaycausepseudomembranouscolitiscausedbyCl.difficle.Superinfection-Mostcommonorganismsarecandidaandpseudomonas,lesscommonarestaphylococci,proteus.Ceftriaxoneachieveshighconcentrationinbileand,asthecalciumsalt,mayprecipitatetocausesymptomsresemblingcholelithiasis(Biliarypseudolithiasis).Nephrotoxicity-highestwithcephaloridine.Bleeding-ceftriaxone,cefoperazone,moxalactam&cefamandolecancausehypoprothrmbinemiaandbleeding.Disulfiramlikereaction-cefamandole,cefoperazone,moxalactamandcefotetancancausedisulfiramlikereactionwithalcohol.Neutropeniaandthrombocytopeniacanbecausedbyceftazidim.
215.Vareniclineactsby? a)Partialnicotinereceptoragonist b)Nicotinereceptorantagonist c)Bothagonistandantagonistatnicotinereceptor d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,PartialnicotinereceptoragonistVareniclineItispartialagonistatthenicotinereceptor.Itisusedinnicotineaddicts.
216.Anti-inflammatorydoseofaspirin? a)500mg/d b)1-2g/d c)3-6g/d d)6-12g/d CorrectAnswer-CAns.is'c'i.e.,3-6g/dTheanti-inflammatoryactionofaspirinisexertedathighdosesof3-6g/dayor100mg/Kg/day.Theanti-inflammatoryactionismainlyduetoinhibitionofCOX,causinginhibitionofPGssynthesis.InadditiontoCOXinhibition,quenchingoffreeradicalsmaycontributetoitsanti-inflammatoryaction.
217.Whichofthefollowingdrugsubstrate combinationsdonotmatch? a)CYP3A4/5-simvastatin b)CYP2D6-SSRI c)CYP2C8/9-mifepristone d)CYP2C19-propranolol CorrectAnswer-CAns.is'c'i.e.,CYP2C8/9-mifepristone
218.DrugswhichpotentiateeffectofNMDAat NMDAreceptorsareallexcept? a)Ketamine b)Asparticacid c)Dalanine d)Homocysteicacid CorrectAnswer-AAns.is'a'i.e.,KetamineKetamineisNMDAreceptorblockersoitdoesnotpotentiatetheNMDAaction.
219.Mostcommonrenalsequeloflithium toxicityis? a)NephrogenicDM b)Renaltubularacidosis c)Glycosuria d)MPGN CorrectAnswer-AAns.is'a'i.e.,NephrogenicDMLithiumassociatedrenaltoxicityTheuseoflithiumsaltsforthetreatmentofmanic-depressiveillnessmayhaveseveralrenalsequelae,themostcommonofwhichisnephrogenicdiabetesinsipidusmanifestingaspolyuriaandpolydipsia.Lithiumaccumulatesinprincipalcellsofthecollectingductbyenteringthroughtheepithelialsodiumchannel(ENaC),whereitinhibitsglycogensynthasekinase3anddown-regulatesvasopressin-regulatedaquaporinwaterchannels.Lessfrequently,chronictubulointerstitialnephritisdevelopsafterprolonged(greaterthan10-20years)lithiumuseandismostlikelytooccurinpatientsthathaveexperiencedrepeatedepisodesoftoxiclithiumlevels.
220.Mechanismofactionoftimololis? a)Nonselectivebetablocker b)Nonselectivealphablocker c)Selectivebeta1blocker d)Selectivebeta2blocker CorrectAnswer-AAns.is'a'i.e.,NonselectivebetablockerTimololisanonselectivebetablocker(betal+beta2).Thuswhenitisusedinthetreatmentofglaucomaitcanprecipitateanattackofasthmabyblockingbeta2receptors.
221.Mechanismofactionoflevosimendenis ? a)Inoconstrictor b)Potassiumchannelopener c)Sodiumchannelopener d)Betablocker CorrectAnswer-BAns.isbi.e.,PotassiumchannelopenerLevosimendonAnewionodilatorisLevosimendonIthasinodilatoreffectby:i)Inotropiceffect:Levosimendoniscalciumsensitiser,i.e.itincreasesthesensitivityofthehearttocalciumthatresultsinincreasedcardiaccontractilitywithoutariseinintracellularcalcium.ii)Vasodilatoryeffect:byopeningATP-sensitivepotassiumchannelsinvascularsmoothmusclesitcausessmoothmusclerelaxation.
222.Whichofthefollowingisnotananti histaminicdrugoftheethanolaminegroup? a)Clemastine b)Diphenhydramine c)Dimenhydrinate d)Chlorpheniramine CorrectAnswer-DAns.isdi.e.,ChlorpheniramineEthanolaminederivativegroupofantihistaminicsare:CarbinoxaminemaleateClemastinefumarateDiphenhydrmineHC1Dimenhydrinate
223.Allofthefollowingcanprecipitate porphyriaexcept? a)Steroids b)Griesiofulvin c)Penicillin d)Estrogen CorrectAnswer-CAns.is'c'i.e.,PenicillinPenicillinisasafedruginacuteintermittentporphyriaDrugsprecipitatingacuteintermittentporphyriaBarbituratesGriseofulvinChlorpropramideRifampicinOralcontraceptivesEstrogenPhenytoinSulfonamides
224.Adrughaving40%absorptionand hepaticextractionratioof0.6.Whatisthebioavailabilityofthatdrug? a)16% b)24% c)20% d)28% CorrectAnswer-AAns.is'a'i.e.,16%Absortionofdrugis40%i.e.if100mgofdrugistaken40mgwillbeabsorbed.Hepaticextractionratiois0.6i.e.outoftheabsorbeddose60%willberemovedbyliver;sofromtheabsorbed40mg60%removedi.e.24mgremoved.Thusfinallytheremaining16mgofthetotaldosetakenreachesthesystemiccirculation.Sobioavailabilityis16%as16mgofthetotal100mgfinallyreachedthesystemiccirculation
225.XDRTBisresistanceto? a)Isoniazid b)Isoniazid+Rifampicin c)Isoniazid+Rifampicin+Ethambutol d)Isoniazid+Rifampicin+Kanamycin CorrectAnswer-DAns.isdi.e.,Isoniazid+Rifampicin+KanamycinTreatmentofextensivedrugresistance(XDR)TBXDR-TBisdefinedasresistancetoanyfluoroquinoloneandatleastoneofthefollowingthreesecond-linedrugs(capreomycin,kanamycin,amikacin),inadditiontomultidrugresistance.TheRegimenforXDR-TBwouldbeof24-30monthsduration,with6-12monthsIntensivePhase(IP)and18monthsContinuationPhase(CP).Regimenis:-i)Intensivephase(6-12months):Sevendrugs:Capreomycin,PAS,moxifloxacin,highdoseINH,clofazimine,Linezolid,amoxyclay.ii)Continuationphase(18months):Sixdrugs:PAS,moxifloxacin,highdoseINH,clofazimine,linezolid,amoxyclay.
226.Mostserioussideeffectofvalproateis a)Fulminanthepatits b)Spinabifida c)Weightgain d)Thrombocytopenia CorrectAnswer-AAns.is'a'i.e.,FulminanthepatitsValproateValproateactsbymultiplemechanism: 1. ProlongationofinactivatedNa*channel.2. InhibitionofTtypeCa'current.3. InhibitionofdegradationofGABAbyGABAtransminase facilitationofGABAmediatedCl-channelopening.Itsmostseriousadverseeffectisfulminanthepatitisespeciallyinchildrenbelow3years.Usedduringpregnancy,ithasproducedspinabifidaandotherneuraltubedefects.Uses(otherthanepilepsy)-->mania&bipolarillness,prophylaxisofmigraine,trigeminalneuralgia,tardivedyskinesia.AdverseeffectofValproateNeurological-Ataxia,sedation,tremorSystemic-Hepatotoxicity,thromobocytopenia,GIirritation,weightgain,transientalopecia,hyperammonemia,pancreatitis,coagulationdisorder.
227.Hydroxyureamechanismofactionin cancerisbyinhibitingtheenzyme? a)Ribonucleotidediphosphatereductase b)Ribonucleotideoxidase c)DNAlyase d)DNAsynthetase CorrectAnswer-AAns.is'a'i.e.,RibonucleosidediphosphatereductaseHydroxyureaItblockstheconversionofribonucleotidestodeoxyribonucleotidesbyinhibitingtheenzymeribonucleosidediphosphatereductase;thusinhibitstheDNAsynthesis;Sphasespecific.Myelosuppressionisthemajortoxicity.GIdisturbancesandcutaneousreactions(pigmentation)alsooccur.ItisusedinCML,psoriasis,polycythemiaveraandsomesolidtumors.Itisalsousedasradiosensitizerbeforeradiotherapyandisafirstlinedrugforsicklecelldiseaseinadults.
228.Nitrosoureasusedinthetreatmentof cancerare? a)Carmustine b)5FU c)Methotrexate d)Cisplatin CorrectAnswer-AAns.is'a'i.e.,CarmustineNitrosoureasNitrosoureas(Lomustineandcarmustine)arehighlylipidsolublealkylatingagents-crossblood-brainbarrierEffectiveinmeningealleukaemiasandbraintumours.Nitrosoureasarehighlylipidsolubleandcancrossbloodbrainbarrierusedinbraintumorslikegliomas.BecausetheycrossBBB,mostcommonadverseeffectsarenausea,vomitingandotherCNSeffects.Bonemarrowdepressionispeculiarlydelayed,takingnearly6weekstodevelop.delayedneutropeniaNitrosoureascancausevisceralfibrosisandrenaldamage.
229.Gemcitabineisusedmainlyinwhich cancer? a)Colorectal b)Breast c)Pancreatic d)Cranipharyngioma CorrectAnswer-CAns.is'c'i.e.,Pancreatic
230.Oxcarbazepinetrueisallexcept? a)Metabolisesitself b)Lesschancesofhyponatremiathancarbazepine c)Itislessenzymeinducerthancarbamazepine d)Lesschancesofhepatotoxicitythancarbamazepine CorrectAnswer-BAns.is'b'i.e.,LesschancesofhyponatremiaOxcarbazepineItisrapidlyconvertedintoactivemetabolite.Druginteractionsandautoinductionofitsownmetabolismarelessmarked,becauseitisaweakenzymeinducer.Riskofhepatotoxicityislowerthanwithcarbamazepine.Chancesofhyponatremiaaremorewithoxcarbazepinecomparedtocarbamazepine.It1.5timeslesspotentthancarbamazepine.
231.Heparinactivatesfollowingfactors except? a)IIa b)VIIa c)IXa d)Xa CorrectAnswer-BAns.is`b'i.e.,VillaChemicalnatureandpreparationofHeparinHeparinisasulfatedmucopolysaccharidewhichoccursinthesecretorygranulesofmastcells.Itisthestrongestorganicacidinthebodyandinthesolutionitcarriesanelectronegativecharge.Itispreparedcommerciallyfromavarietyofanimaltissues(generallyporcineintestinalmucosaorbovinelung).MechanismofActionofHeparinHeparinactsbyactivatingantithrombinwhichisanaturallyoccuringinhibitorofactivatedcoagulationfactorsofintrinsicandcommonpathway.
232.Maximumlivertoxicityisseenwith whichanti-TBdrug? a)Isoniazid b)Rifampicin c)Pyrazinamide d)Streptomycin CorrectAnswer-CAns.is'c'i.e.,PyrazinamideThreefirstlineantituberculardrugsareassociatedwithhepatotoxicity:?i)Rifampicinii)INHiii)PyrazinamideOfthethree,rifampicinisleastlikelytocausehepatocellulardamage,althoughitisassociatedwithcholestaticjaundice.Pyrazinamideisthemosthepatotoxicofthefirstlinedrugs.Amongthesecond-linedrugs,ethionamide,PASandprotionamidecanalsobehepatotoxic,althoughlesssothananyofthefirstlinedrugs.
233.Fastestactingantithyroiddrugs? a)IodidesofNa/K b)Propylthiuracil c)Methimazole d)Nitrates CorrectAnswer-AAns.is'a'i.e.,IodidesofNaIodineandIodidesIodineisthefastestactingthyroidinhibitorMostimportantactionisinhibitionofhormonerelease(thyroidconstipation);butallfacetsofthyroidsynthesismaybeaffected.Excessiodideinhibitsitsowntransportinthyroidcellsandmayaltertheredoxpotentialofcells,thusinterferingiodinationreducedT4/T3synthesis(Wolff-chaikoffeffect).
234.Natalizumabisusedintreatmentof? a)Muliplesclerosis b)Breastcarcinoma c)Psoriasis d)Bcelllymphoma CorrectAnswer-AAns.is'a'i.e.,MultiplesclerosisTreatmentofmultiplesclerosis1.TreatmentofacuteattackCorticosteroids(Methylprednisolone,prednisolone)areused2.Treatmentwithdisease-modifingagentsthatreducethebiologicalactivityofMSDiseasemodifyingagentsformultiplesclerosisare(i)IFN-13la;(ii)IFN-13lb,(iii)Glatiramer;(iv)Natalizumab;(v)Finoglimod:(vi)Mitoxantrone;(vii)Cladaribine.3.OthertreatmentoptionsOtheroff-labeltreatmentoptionsare(i)methotrexate;(ii)cyclophosphamide;(iii)IVimmunoglobulins;(iv)azathioprine.4.SymptomaticTreatmentItincludeshealthydiet,regualrexercise.Treatmentofrigidity(baclofen,diazepam,tizanidine,dantroline)Treatmentofweakness(Potassiumchannelblockerslike4-aminopyridine)Treatmentofpainbyanticonvulsants(carbamezapine,phenytoin,gabapentin,pregabalin),orantidiepressants(mexiletin).TreatmentofUTI,bladderdysfunction,constipation,depression,fatigueandcognitiveproblems.
235.Specialfeatureofglargineinsulinis? a)Itproducesasmoothpeaklesseffect b)Itisnotsuitableforoncedailyadministration c)ItremainssoubleatpH7 d)Itcancontrolmealtimehyperglycemia CorrectAnswer-AAns.is'a'i.e.,ItproducesasmoothpeaklesseffectInsuinGlargineItislongactingbiosyntheticinsulin.ItremainssolubleatpH4oftheformulationandprecipitatesatneutralpHonsubcutaneousadministration.Onsetofactionisdelayed.Itproducesasmoothpeaklesseffect.Itissuitableforoncedailyadministration.Lowincidenceofnighttimehypoglycemia.Itdoesnotcontrolmealtimeyperglycemia.
236.MechanismofactionTrilostane? a)11betahydroxylaseinhibitor b)1alphahydroxylaseinhibitor c)3betahydroxysteroiddehydrgenaseinhibitor d)7alphahydrolaseinhibitor CorrectAnswer-CAns.is'c'i.e.,3betahydroxylsteroiddehydrogenaseinhibitor
237.Treatmentofchoiceforcheesereaction ? a)Prazocin b)Pentazocin c)Phentolamine d)Phenoxybenzamine CorrectAnswer-CAns.is'c'i.e.,PhentolamineCheesereactionCertainvarietiesofcheese,beer,wines,pickedmeatandfish,yeastextractcontainlargequantitiesoftyramine,dopa.InMAOinhibitedpatientstheseindirectlyactingsympathomimeticaminesescapedegradationintheintestinalwallandliverreachingintosystemiccirculationtheydisplacelargeamountofNAfromadrenergicnerveendingsHypertensivecrisis,cerebrovascularaccidents.Thiscanbetreatedbyi.v.injectionofarapidlyactingphentolamine.Prazosinandchlorpromazinearealternative.
238.Whyquinineisunsafeinpregnancy? a)Itcauseshemolysis b)Itcauseshypokalemia c)Itcauseshyponatremia d)Itcausessmoothmusclecontraction CorrectAnswer-AAns.is'a'i.e.,ItcauseshemolysisQuinineoccasionallycauseshemolysis,especiallyinpregnantwomenandinpatientswithfalciparummalariaresultinginhemogloginuriaandkidneydamage.Alsoifusedinpregnancyspecialcareshouldbetakentopreventhypoglycemia.OuinineItislevorotatoryalkaloidobtainedfromcinchonabark.Itsd-isomerquinidineisusedasanantiarrhythmic.Quinineisanerythrocyticschizontocideforallspeciesofplasmodium.Quininehasnoeffectonpreandexoerythrocyticstage.Mechanismofactionissimilartochloroquine.
239.AntiHIVdrugusedforpreventionof verticaltransmission? a)Nevirapine b)Lamivudine c)Efavirez d)Tenofovir CorrectAnswer-AAns.is'a'i.e.,NevirapineTreatmentduringpregnancyHIVinfectedmothercantransmitthevirustofetus/infantduringpregnancy,duringdeliveryorbybreastfeeding.Earlydiagnosisandantiretroviraltherapytomotherandinfantsignificantlydecreasetherateofintrapartumandperinataltransmission(verticaltransmission)ofHIVinfection.ZidovudinetreatmentofHIVinfectedpregnantwomenfromthebeginningofsecondtrimesterthroughdeliveryandofinfantfor6weeksfollowingbirthdecreasestherateoftransmissionfrom22.6%to<5%.Singledoseofnevirapinegiventothemotherattheonsetoflaborfollowedbyasingledosetothenewbornwithin72hoursofbirthdecreasedtransmissionby50%.Thisisthepreferedregimennowindevelopingcountries.
240.WhichdoesnotactbyblockingNMDA receptors? a)Methoxetamine b)Methadone c)Ketamine d)Diltiazem CorrectAnswer-DAns.is'd'i.e.,DiltiazemDrugsactingbyblockingNMDAreceptorsare: i. Methoxetamine ii. Phencyclidine iii. Methadone iv. Dizocilpine v. Felbamate vi. Dextropropoxyphene vii. Acamprost viii. Tramadol ix. Ketamine x. Pethidine xi. Atomoxetine xii. Nitrousoxide
241.Essentialdrugs? a)Includedinnationalpharmacopoeia b)ShouldalwaysbepresentatPHC c)Thosethatsatisfytheprimaryhealthcareneedsofthe population d)Lifesavingmedications CorrectAnswer-CAns.is'c'i.e.,ThosethatsatisfytheprimaryhealthcareneedsofthepopulationWHOhasdefinedEssentialMedicationsasthosethatsatisythepriorityhealthcareneedsofmajorityofthepopulation.
242.Mostcommonmitochondrialenzymefor metabolismdetoxificationreactionis? a)CYP3A4 b)CYP1A2 c)CYP2A6 d)CYP2B6 CorrectAnswer-AAns.is'a'i.e.,CYP3A4SubtypesofcytochromeP-450Dependingupontheextentofaminoacidsequencehomology,thecytochromeP-450(CYP)isoenzymesaregroupedintofamiliesdesignatedbycapitalletters(A,B,C....).Individualisoenzymesareagainallotednumerals(1,2,3....).ExamplesareCYP1A2,2A6,2B6,2C8,3A4/3A5.Inhumanbeings,onlyafewmembersofthreeisoenzymefamiliescarryoutmetabolismofmostofthedrugs.Cyp3A4/5carryoutbiotransformationoflargestnumber(nearly50%)ofdrugs.ImportantinducersofCYP3A4/3A5BarbituratesGlucocorticoidsRifampinMacrolideantibioticsCarbamazepinePhenytoinPioglitazone
243.Nonselectivebetaadrenergicantagonist is a)Nodalol b)Atenolol c)Bisoprolol d)Esmolol CorrectAnswer-AAns.is'a'i.e.,Nodalol
244.Insulinsecretionincreasingdrugby actingonbetacellsofpancreasis- a)Rapaglinide b)Metformin c)Poiglitazone d)Acarbose CorrectAnswer-AAns.is'a'i.e.,RapaglinideOralhypoglycemicdrugsmaybedividedintotwogroups.1.Group1Thesedrugsreduceplasmaglucosebystimulatinginsulinproduction,thereforecalledinsulinsecretogogues.Hypoglycemiaisawellknownsideeffect.Examplesare:i)Sulfonylureas:firstgeneration(chlorpropamide,tobutamide);secondgeneration(Glimipiride,glyburide,glipizide,gliclazide).ii)Megalitinnide/D-phenylalanineanalogues:Nateglinide,Rapaglinide.2.Group2Thesedrugsreducebloodglucosewithoutstimulatinginsulinproduction,thereforeareinsulinnonsecretogogues.Thesedurgsdonotcuasehypoglycemiawhenusedaloneandcancausehypoglycemia,onlywhenusedwithotheroralhypoglycemics.Examplesare:i)Biguanides:Metformin,Phenforminii)Thiazolidinediones:Rosiglitazone,Pioglitazone,Troglitazone.iii)a-glucosidaseinhibitors:Acarbose,miglital.
245.Antihypertensivewhichcannotbegiven inpregnancy? a)Labetolol b)Propranolol c)Esmolol d)Hydralazine CorrectAnswer-BAns.is'b'i.e.,Propranolol
246.Betablockersmaskalleffectsof hypoglycemiaexcept? a)Sweating b)Palpitations c)Dizziness d)Tremors CorrectAnswer-CAns.is'c'i.e.,DizzinessSymptomsofhypoglycemiaareattributableto:-i)Sympatheticstimulation:Sweating,tremor,tachycardiapalpitationsandanxiety.Thesearethewarningsigns.ii)Cerebralglucosedeficiency:Decreasedcognitivefunctions,dizzinessanddecreasedconcentration.Useofbeta-blockers,especiallyindiabeticswhoaretakingtreatment,maymasktypicalsympatheticsystemmediatedsymptomsofhypoglycemiasuchassweating,tremor,tachycardia,andpalpitations.Thus,dangerousseverehypoglycemiacanoccurwithoutanywarningsigns.
247.Latestoraldirectthrombininhibitoris? a)Ximelagatran b)Indraparinux c)Dabigatran d)Fondaparinux CorrectAnswer-CAns.is'c'i.e.,DabigatranXimelagatranwasthefirstoraldirectthrombininhibitorapproved;however,itwassubsequentlywithdrawnfromthemarketbecauseofreportsofliverfailure.Recentlyaneworaldirectinhibitor,dabigatran,wasapprovedforuseinEuropeforpreventionofvariousthromboembolisminpatientswhohaveundergonehiporkneereplacementsurgery.
248.Adverseeffectsofphenytoinincludeallofthefollowing except? a)Lymphadenopathy b)Ataxia c)Hypercalcemia d)Hirsutism CorrectAnswer-CAns.is'c'i.e.,HypercalcemiaPhenytoininterfereswithcalciummetabolismbydesensitizingtargettissuetovit.D,thiscauseshypocalcemia(nothypercalcemia).Attherapeuticlevel(10-20microg/ml)-Gumhypertrophy,hirsutism,hypersensitivity(rashes,lymphadenopathy,DLE,neutropenia),hyperglycemiaduetoinhibitionofinsulinrelease,megaloblasticanemia,pseudolymphoma,hypocalcemia,VitaminDdeficiencyandosteomalacia,andteratogenicity(fetalhydantoinsyndrome).Attoxiclevel(dose-related)cerebellarsyndrome(ataxia,vertigo),fallingBP,arrhythmias,drowsiness,mentalconfusion,Glsymptoms(epigastricpain,nausea,vomiting)andlocalvascularinjurybyivinjection.
249.Postmarketingsurveillanceincludedin whichphaseofdrugclinicaltrial? a)I b)II c)III d)IV CorrectAnswer-DAns.is'd'i.e.,IVSurveillanceaftermarketing,i.e.afterthedrugisoutinthemarketisapartofPhaseIVofclinicaltrials.Itincludesfollow-upofpatientstakingthedrugandadversedrugreaction(ADR)reportingaswellaslookingfornewertreatmentindications
250.Whichofthefollowingismostactive againstslowlydividingtubercularbacilli? a)Isoniazid b)Rifampicin c)Streptomycin d)Ethambutol CorrectAnswer-BAns.is'b'i.e.,Rifampicin
251.DrugcontraindicatedinG6PD deficiency? a)Chloroquine b)Primaquine c)Quinine d)Halofantrine CorrectAnswer-A:B:CAns.is'b>c>a'i.e.,Primaquine>Quinine>ChloroquineAmongantimalarialdrugs,primaquine,quinineandoccasionallychloroquinecancausehemolyticanemiainG6PDdeficiency.But,primaquinehasthehighestpotentialtocausehemolyticanemiainpatientswithG6PDdeficiencyand,thepatientswithG6PDdeficiencyarehighlysenstivetoprimaquine.ThehemolyticpotentialinG6PDdeficiencypatients-
252.Cardiacconductiondefectseenwith Tricyclicantidepressantsaredueto? a)NE&serotoninuptakeinhibitor b)Antimuscarinicactiononheart c)OnlyNEuptakeinhibition d)BothNEuptakeinhibitionandantimuscarinicactiononheart CorrectAnswer-DAns.is'd'i.e.,BothNEuptakeinhibitionandantimuscarinicactiononheartThecommonestcardiovasculareffectoftricyclicantidepressantoverdoseissinustachycardia.Duetoinhibitionofnorepincphrinereuptakeandtheanticholinergicaction.However,themostimportanttoxiceffectoftricyclicsistheslowingofdepolarisationofthecardiacactionpotentialbyinhibitionofthesodiumcurrentandthisdelayspropagationofdepolarisationthroughbothmyocardiumandconductingtissue.ThisresultsinprolongationoftheQRScomplexandthePR/QTintervalswithapredispositiontocardiacarrhythmias.Thisinhibitionofsodiumfluxintomyocardialcellscanoccurtosuchanextentthatdepressedcontractilitycanresultandthis,coupledwiththereductioninperipheralresistance,contributestohypotension.
253.Atmureceptor,buphrenorphineis? a)Partialagonist b)Partialantagonist c)Completeagonist d)Completeantagonist CorrectAnswer-AAns.is'a'i.e.,Partialagonist
254.RemissionwithSSRIorTCApatient againhavingrelapse.Theremaybedeficiencyof? a)Pyridoxine b)Cobalamine c)Ascorbate d)Retinol CorrectAnswer-BAns.is`b'i.e.,CobalamineSubjectswithvitaminB12deficiencyanddepressionmaypresentwithhistoryofpastepisodeswithspontaneousremissionorresponsetotreatmentwithantidepressantsandlaterrecognitionordevelopmentBudeficiency"Studieshavefoundthatsomepeoplewithdepressionmayhavelowlevelsoffolicacid,vitaminB12orvitaminD.
255.Sideeffectofsalmeterolis? a)Tremor b)Seizure c)Hypertension d)Hyperkalaemia CorrectAnswer-AAns.is'a'i.e.,TremorThemostcommonsideeffectsaremuscletremorandpalpitationHypokalemiaHyperglycemiaToleranceThroatirritationAnkleedema.Othersideeffectsareanxiety,headache,musclecramps,drymouth,arrhythmia,flushing(duetovasodilatation),hypoxemia,MI,disturbanceofsleepandbehavior.
256.Parenteraldirectthrombininhibitor? a)Ximelagatran b)Dabigatran c)Argatroban d)Heparin CorrectAnswer-CAns.is'c'i.e.,Argatroban ParentraldirectthrombininhibitorsArgatrobanBivalirudinHirudinLepirudinoMelagatranDesirudin OralDirectthrombininhibitors Dabigatran(recent)Ximelagatran(withdrawn)
257.Increasedinsulinsecretionfrombeta cellsisdoneby? a)Metformin b)Pramlidine c)Repaglinide d)Pioglitazone CorrectAnswer-C.Ans.is'c'i.e.,RepaglinideOralhypoglycemicdrugsmaybedividedintotwogroups:?1.Group1Thesedrugsreduceplasmaglucosebystimulatinginsulinproduction,thereforecalledinsulinsecretogogues.Hypoglycemiaisawellknownsideeffect.Examplesare: 1. Sulfonylureas:firstgeneration(chlorpropamide,tobutamide);second generation(Glimipiride,glyburide,glipizide,gliclazide). 2. Megalitinnide/D-phenylalanineanalogues:Nateglinide,Rapaglinide. 2.Group2Thesedrugsreducebloodglucosewithoutstimulatinginsulinproduction,thereforeareinsulinnon-secretogogues.Thesedurgsdonotcuasehypoglycemiawhenusedaloneandcancausehypoglycemia,onlywhenusedwithotheroralhypoglycemics.Examplesare: 1. Biguanides:Metformin,Phenformin2. Thiazolidinediones:Rosiglitazone,Pioglitazone,Troglitazone.3. a-glucosidaseinhibitors:Acarbose,miglital.
258.Verapamilisusedinall,except? a)Anginapectoris b)Atrialfibrillation c)Ventriculartachycardia d)Noneoftheabove CorrectAnswer-CAns.is'c'i.e.,VentriculartachycardiaUseofVerapamilasanantiarrhythmicPSVTAnginapectoris--AllCCB'sareeffectiveinreducingfrequencyandseverityofclassicalaswellasvariantangina.ItisbeneficialinanginainthefollowingwayClassicalanginaReducescardiacwork,mainlyasaresultofreducedafterload.VariantanginaPreventarterialspasm.HypertensionHypertrophiccardiomyopathySuppressnocturnallegcrampsMigraine
259.Highdoseofmorphineisusedwithout muchdangerin? a)Gallbladdersurgery b)Labour c)Myocardialinfarction d)Headinjury CorrectAnswer-CAns.is'c'i.e.,MyocardialinfarctionMorphineshouldbegivenpromptlyinmyocardialinfarctiontoallayapprehensionandreflexsympatheticstimulation.Morphineshouldbeusedcautiouslyingallbladderandbiliarytractdysfunctionasitcausesspasmofsphincterofoddiandcancauseacuteriseofintrabiliarypressure.Usedduringlabour,morphinecancauseneonatalrespiratorydistress.Headinjuryisacontraindicationformorphineuse.
260.Alldrugsareavailableastransdermal patchesinIndia,except a)Fentanyl b)Nitroglycerine c)Hyoscine d)Nicotine CorrectAnswer-CAns.is'c'i.e.,Hyoscine"TransdermalpatchesofNTG,fentanyl,nicotineandestradialareavailableinIndia,whereasthoseofisosorbidedinitrate,hyoscineandclonidinearemarketedelsewhere".--KDT
261.Trueaboutsitagliptinisallexcept a)UsedintypeIIDM b)Usedincombinationwithotheroralhypoglycaemic c)Cannotbeusedorally d)Allaretrue CorrectAnswer-CAns.is'c'i.e.,CannotbeusedorallySitagliptinThisisorallyactiveinhibitorofDPP-4.ItpreventsdegradationofendogenousGLP-1andotherincretins,potentiatingtheiraction,resultinginlimitationofpostprandialhyperglycemia.Itisusedintype2DM.OtherDPP-4inhibitorisvildagliptin.
262.Gynaecomastiaiscausedbywhichdrug ? a)Spironolactone b)Rifampicin c)Thiazide d)Propanolol CorrectAnswer-AAns.is'a'i.e.,Spironolactone
263.Mechanismofactionoftransexaminic acidis a)Decreasevascularpermeability b)Smoothmusclecontraction c)ActivatesPlasminformation d)Preventsfibrinolysis CorrectAnswer-DAns.is`d'i.e.,Preventsfibrinolysis
264.Spasmolyticanalgesicis a)Dicyclomine b)Physostigmine c)Tropicamide d)None CorrectAnswer-AAns.is'a'i.e.,DicyclomineAntispasmodic(spasmolytic)drugsareusedinvariouscolic(pain)e.g.abdominalcolicorrenalcolic.Amongthegivenoptions,dicyclomineisspasmolytic.Antispasmodicdrugs 1. Quaternarycompounds-Propantheline,Oxyphenonium,CIidinium, Pipenzolate,Methylbromide,Isopropamide,Glycopyrrolate. 2. Tertiaryamines-Dicyclomine,Valethamate,Pirenzepine.3. Vasoselectiveantispasmodic(drugsactingonurinarybladder)- Oxybutynin,Tolterodine,flavoxate.Drotaverine
265.Muscariniccholinergicreceptorsare seenatallsites,except? a)Stomach b)CNS c)Neuromuscularjunctio d)Glands CorrectAnswer-CAns.is'c'i.e.,NeuromuscularjunctionCholinergicreceptorsTherearetwotypesofcholinergicreceptors:MuscarinicFoundat-Allpostaganglionicparasympatheticsites,Fewpostaganglionicsympatheticsites(sweatgland&bloodvessels),CNS.Nicotinic--4Foundat-Ganglia(bothsympatheticandparasympathetic),Skeletalmuscles,Adrenalmedulla,CNS Muscarinic Nicotinic receptors receptors Type Organ Type Organ Neuromuscualr M1 Gastricgland NM junction M2 Heart (Skeletalmuscle) M3 Smoothmuscles, NN Ganglia,adrenal glandsand medulla endothelium M4 CNS M5 CNS
266.Maximumeffectofbronchodilatationin asthmaiscausedby? a)Corticosteroids b)Theophylline c)Anticholinergic d)2-Agonist) CorrectAnswer-DAns.is'd'i.e.,2-Agonist-agonistsinAsthmaBronchihave,-adrenergicreceptorswhichcausebronchodilatationSo,theadrenergicdrugsusedinasthmaareselective2agonists.-agonistsarethemosteffectivebronchodilators2-agonistshavesomeothereffectsalsoonairways(otherthanbonrchodilatation),thatareresponsibleforbeneficialeffectsinasthma:Inhibitionofreleaseofmastcellsmediatorsmastcellsstabilizingaction.Inhibitionofexudationandairwayedema.IncreasedmucociliaryclearanceDecreasedcough2-agonistshavenoeffectoninflammationnoantiinflammatoryaction.
267.SedativewithGABAfacilitatingaction butwithoutanticonvulsantandmusclerelaxantpropertiesandnoeffectonsleep? a)Diazepam b)Zolpidem c)Phenobarbitone d)Buspirone CorrectAnswer-BAns.is'b'i.e.,ZolpidemAmongthegivenoptions,threearesedative-hypnoticwithGABAfacilitatoryaction-Diazepam(abenzodiazepine)Butitalsohasanticonvulsantandmusclerelaxantproperty.it)PhenobarbitoneButithasanticonvulsantproperty.ZolpidemHasnoanticonvulsantandmusclerelaxantpropertyandhavenoeffectonsleeparchitecture.ZolpidemZolpidemisanon-benzodiazepinehypnotic.MinimalsuppressiveeffectonREMsleeparchitectureisnotdisturbed.
268.Advantagesofamoxicillinoverampicillin areallexcept? a)Betterbioavailability&fasteraction b)SpectrumincludesH.influenzae&Shigella c)Incidenceofdiarrheaislower d)Fooddoesnotinterferewithitsabsorption CorrectAnswer-BAns.is'b'i.e.,SpectrumincludesH.influenzae&ShigellaAmoxicillinisaclosecongenerofampicillin;similartoitinallrespectsexcept:Oralabsorptionisbetter;fooddoesnotinterferewithabsorption;higherandmoresustainedbloodlevelsareproduced.Incidenceofdiarrheaislower.ItislessactiveagainstShigellaandH.influenzae.Itisnowpreferredoverampicillinforbronchitis,urinaryinfections,SABEandgonorrhoea.
269.Visualfieldmonitoringisimportant beforestarting? a)Vigabatrin b)Topiramate c)Valproicacid d)Carbamazepine CorrectAnswer-AAns.is'a'i.e.,Vigabatrin
270.Lithiumdirectlyaffectswhichion? a)Sodium b)Potassium c)Magnesium d)Calcium CorrectAnswer-AAns.is'a'i.e.,SodiumDiuretics(particularlythiazides)decreasetherenalexcretionoflithiumandthusmayresultintoxicity.ThisisduetoincreasedreabsorptionofNa'andlithiumions(asacompensatoryresponsetoexcessivelossofNat).Interactionsoflithium 1. Diuretics(thiazide,furosemide)bycausingNa+losspromote proximaltubularreabsorptionofNa+aswellasLiPlasmaleveloflithiumrises. 2. Tetracyclines,NSAIDsandACEinhibitorscauselithiumretention.3. Lithiumtendstoenhanceinsulin/sulphonylureainduced hypoglycemia(lithiumhasinsulinlikeactiononglucosemetabolism). 4. LithiuminhibitstheactionofADHondistaltubulescauses nephrogenicDI. 5. Lithiumreducethyroxinesynthesisbyinterferingiodinationof tyrosine.
271.Abataceptis? a)TNFalphainhibitor b)Inhibitorofco-stimulationofTcells c)IL-1receptorantagonist d)MonoclonalantibodyagainstIL-6receptor CorrectAnswer-BAns.is'b'i.e.,Inhibitorofco-stimulationofTcellsT-cellcostimulatoryblockersAbataceptItisafusionproteinthatcombinestheextracellulardomainofthemoleculeCTLA4(CD154)withtheFcportionofahumanimmunoglobulin.ItinterfereswiththeinteractionsbetweenantigenpresentingcellsandTlymphocytes.Therefore,itaffectsearlystagesinthepathogeniccascadeofeventinRA.CTLA4hashighaffinityforCD28whenabataceptbindstoCD28onTcellsurface,itpreventsthesecondsignalfrombeingdelivered,thusturningdowntheTcellresponse.AdditionaleffectsaredecreasingtheproductionofTcell-derivedcytokinesincludingTNF.
272.Allofthefollowingaretherapeuticuses ofpenicillinG,except a)Bacterialmeningitis b)Rickettsialinfection c)Syphilis d)Anthrax CorrectAnswer-BAns.is'b'i.e.,RickettsialinfectionPenicillinGistheDOCfor 1. Meningococcalmeningitis 7. Leptospira Bacillusanthracis Actinomycesisraelii 2. 8. (anthrax) (Actinomycosis) Clostridiumperfringens Borreliaburgdorferi 3. 9. (gasgangrene) (Lymedisease) Clostridiumtetani 4. 10. Enterococci (tetanus)Corynebacterium 5. 11. Streptococci diphtheriae 6. Treponemapallidum 12. Susceptible (syphilis) pneumococci
273.Whichofthefollowingisassociatedwith hemorrhagicstroke? a)Phenylpropanolamine b)Terfenadine c)Quinidine d)Fenfluramine CorrectAnswer-AAns.is'a'i.e.,Phenylpropanolamine 1. Manyreportsassociatingphenylpropanolamineuseforweightloss withhaemorrhagicstrokeamongwomen,appearedinU.S.A.
274.Aminophyllineinhibitswhichenzyme? a)MAO b)Alcoholdehydrogenase c)Phosphodieseterase d)CytochromeP450 CorrectAnswer-CAns.is'c'i.e.,Phosphodiesterase
275.AllaresideeffectsofClozapine,except? a)Granulocytopenia b)Seizures c)Sedation d)Extrapyramidalsideeffects CorrectAnswer-DAns.is'd'i.e.,ExtrapyramidalsideeffectsSideeffectsofclozapineAgranulocytosisUnstableBP&TachycardiaWorseningofdiabetesSeisuresUrinaryincontinenceHypersalivation(sialorrhoea)WeightgainSedation
276.Mostcommonsideeffectofhaloperidol ? a)Hypotension b)Akathasia c)Drynessofmouth d)Ticdisorder CorrectAnswer-BAns.is'b'i.e.,Akathasia75%ofpatientsexperienceextrapyramidalsymptoms(Akathisia,Parkinsonism,acutemusculardystonia)withallclassical(typical)antipsychotics.Haloperidolisatypicalantipsychotic.
277.Maximumtachycardiaisseenwith a)Nifedipine b)Verapamil c)Propanolol d)Amlodipine CorrectAnswer-AAns.is'a'i.e.,Nifedipine
278.Eliminationafter4halflivesinfirstorder Kineticsis a)84% b)93% c)80.5% d)4.75% CorrectAnswer-BAns.is'b'i.e.,93% Halflife Elimination1t%2 50% 2t'/2 75% 30/2 87.5% 41 93.75% 5t'/ 96.875
279.Nottrueabouthypolipidemicdrugs a)Cholesterolreducingdrugsarecontraindicatedinchildless than8years b)Gemfibrozilcausesmyopathy c)Gemfibrozilcanincreasemyopathycausedbystatins d)Lovastatincancausehepaticdysfunction CorrectAnswer-AAns.is'a'i.e.,Cholesterol-reducingdrugsarecontraindicatedinchildlessthan8yearsContraindicationforusesofstatins(cholesterol-reducingdrugs)are-PregnancyBreastfeedingActiveliverdiseaseGemfibrozilcancausemyopathyanditcanaggravatemyopathycausedbystatins.Lovastatincancausehepaticdysfunction.
280.Mechanismofactionofaminoglycosides is? a)Inhibitionofproteinsynthesis b)Imagetocellmembrane c)Coagulationofproteins d)Inhibitionofcellwallsynthesis CorrectAnswer-AAns.is'a'i.e.,Inhibitionofproteinsynthesis
281.Botulinumtoxinactson a)Synapse b)Smoothmuscleofintestine c)Centralnervoussystem d)Sensorynerves CorrectAnswer-AAns.is'a'i.e.,SynapseBotulinumtoxinaffects 1. Neuromuscularjunction.2. Postganglionicparasympatheticnerveendings.3. Peripheralganglia. Centralnervoussystemisnotinvolvedandthereisnosensoryinvolvement.BotulinumtoxinactsbyinhibitingthecalciummediatedexocytosisofAChfromthevesiclesinthesynapse.
282.BotulinumtoxintypeBisusedinwhich disease? a)Glabellarlines b)Strabismus c)Cervicaldystonia d)Blepharospasm CorrectAnswer-CAns.is'c'i.e.,Cervicaldystonia
283.Allareusedforcarcinomahead&neck except? a)5FU b)Busulfan c)Cisplatin d)Methotrexate CorrectAnswer-BAns.is'b'i.e.,Busulfan
284.Alcoholmainlyincreases- a)TG b)LDL c)VLDL d)HDL CorrectAnswer-DAns.is'd'i.e.,HDLRegularintakeofsmalltomoderateamountsofalcohol(1-2drinks)hasbeenfoundtoraiseHDLcholesterollevelsanddecreaseLDLoxidation.Thismayberesponsiblefor15-35%lowerincidenceofcoronaryarterydiseaseinsuchindividuals.Riskreductionisgreatestinhighrisksubjectsandtheprotectionislostif>/=3drinksareconsumeddaily.
285.Firstgenerationcephalosporinsare activeagainst? a)Gramnegativebacteria b)Grampositivebacteria c)Anaerobes d)Dermatophytes CorrectAnswer-BAns.is'b'i.e.,Grampositivebacteria
286.Allaretrueaboutnitrousoxideexcept? a)Laughinggas b)Causesmegaloblasticanemia c)Causesdiffusionhypoxia d)Goodmusclerelaxant CorrectAnswer-DAns.is'd'i.e.,GoodmusclerelaxantNitrousoxideN,OItisalsocalledlaughinggas.Ithasgoodanalgesicbutpoormusclerelaxantactivity.SecondgaseffectanddiffusionhypoxiaoccurwithN20only.N20istheonlyanaestheticreportedtoproducehematologictoxicityandneurotoxicitywithlongtermadministration.BothtoxicitiesaretheresultoftheinteractionofN20withvitB12.
287.Whichofthefollowingisgivenorally a)Argatraban b)Alteplase c)Rivaroxaban d)Fondaparinux CorrectAnswer-CAns.is'c'i.e.,RivaroxabanRivaroxaban-itisanorallyactivedirectinhibitorofactivatedfactorXawhichhasbecomeavailableforprophylaxisandtreatmentofDVT.Alteplase-givenbyi.v.infusionduetoshorthalflifeof4-8minandoftenrequiresheparincoadministration.Argatroban-directthrombininhibitor;givenbyi.v.infusion;usedinplaceoflepirudinforshorttermindicationsinpatientswithheparininducedthrombocytopenia.Fondaparinux-100%bioavailabilitywithsubcutaneousinjection
288.Thebestdrugforcontrolofesophageal bleedingis? a)Vasopressin b)Octreotide c)GnRH d)Propranolol CorrectAnswer-AAns.is'a'i.e.,VasopressinTerlipressin(analogueofvesopressin)isconsideredthevasoactiveagentofchoiceforacutevaricealbleeding.Otherdrugsusedaresomatostatinanditsanalogocteride.
289.Shortactingglucocorticoidis? a)Fludrocortisones b)Dexamethasone c)Hydrocortisone d)Aldostrone CorrectAnswer-CAns.is'c'i.e.,HydrocortisoneShort-acting:Cortisol8-12hoursIntermediate-acting:Prednisolone18-36hoursLong-acting:36-54hours
290.ThebestagentforincreasingHDL cholesterolis? a)Statin b)Nicotinicacid c)Gugulipids d)Fibrates CorrectAnswer-BAns.is'b'i.e.,NicotinicacidNicotinicacid(Niacin)Therearethreemaintypeoflipasesrelatedtometabolismoflipoproteins? 1. LipoproteinlipasePresentinbloodvesselsandcauseshydrolysis oftryglyceridecontentofVLDLandchylomicrones. 2. HepaticlipaseConvertsIDLtoLDLbyhydrolysingthetriglyceride contentofIDL. 3. HormonesensitivelipasePresentintracellularlyinperipheral tissueandcausesintracellularlipolysisbyhydrolysingtriglycerides.Niacin(Nicotinicacid)inhibitsintracellularlipolysisbyinhibitinghormonesensitivelipaseintracellularFFAtolivertriglyceridesynthesis.NiacinalsoincreasestheactivityoflipoproteinlipaseThydrolysisofVLDLtriglyceride.NicotinicacidalsoreducestheproductionofVLDLinliverbyinhibitingTG-synthesisindirectlytheVLDLdegradationproductsIDLandLDLarealsoreduced.NicotinicacidisthemosteffectivedrugtoraiseHDL-CH.IncreasedHDLisduetointerferenceofdirectpathwayofHDLcholesteroltoliverwhichinvolvesapo-A,Niacindecreasesapo-A,
mediatedhepaticclearance.NicotinicacidisusedintypeI,III,IV&Vhyperlipoproteinemias.
291.Allofthefollowingareadverseeffectsof nicotinicacidexcept? a)Vasodilation b)Pancreatitis c)Liverdysfunction d)Hyperpigmentation CorrectAnswer-BAns.is'b'i.e.,PancreatitisAdverseeffectsofnicotineAdverseeffects1)Markedflushing,itching(pruritis)andheatduetocutaneousvasodilatation,2)Dyspepsia,vomitinganddiarrhoea,3)Liverdysfunction,4)Hyperpigmentationanddrynessofskin,5)Hyperglycemiaandhyperuricemia.Thecutaneouseffectsofnicotinicacidincludeflushingandpruritisoffaceanduppertrunk,skinrashesandacanthosisnigricans.ThesesymptomsareduetovasodilatoryactionofniacinthroughreleaseofPGsandcanbepreventedbypretreatmentwithaspirin.
292.Notahepatotoxicdrug? a)Chlorpropamide b)Allopurinol c)Streptomycin d)Halothane CorrectAnswer-CAns.is'c'i.e.,Streptomycin
293.Whichdrugcanbegivensubdermally? a)Nicotine b)Fentanyl c)GTN d)Progesterone CorrectAnswer-DAns.is'd'i.e.,ProgesteroneProgesteronecanbegivenintheformofsubdermalimplant.Subdermalcontraceptiveimplantsinvolvethedeliveryofasteroidprogestinfrompolymercapsulesorrodsplacedundertheskin.Thehormonediffusesoutslowlyatastablerate,providingcontraceptiveeffectivenessfor1-5years.
294.Botulinumtoxinmimics- a)Cholinergics b)Anticholinergics c)Adrenergics d)Antiadrenergic CorrectAnswer-BAns.is'b'i.e.,Anticholinergics
295.Dopaminereceptorwithinhibitoryaction ? a)D5 b)Di c)D2 d)None CorrectAnswer-CAns.is'c'i.e.,D2Twotypesofdopaminereceptors(DI,D2)wereoriginallydescribed.Threemore(D3,D4,D5)havenowbeenidentifiedandcloned.AllareGproteincoupledreceptorsandaregroupedintotwofamilies:Dllike:(Dl,D5)areexcitatoryD2like:(D2,3,4)areinhibitory
296.Thiazolidinedioneisassociatedwith increasedriskof? a)Heartfailure b)Pulmonaryfibrosis c)Myocarditis d)renaldysfunction CorrectAnswer-AAns.is'a'i.e.,HeartfailureThiazolidinedionesadverseeffectsPlasmavolumeexpansion,edema,weightgain,headache,myalgiaandmildanemia.Fewcasesofhepaticdysfunctionandsomecardiovasculareventshavebeenreported-CHFmaybeprecipitatedtheyarecontraindicatedinliverdiseaseandinCHF.Rosiglitazonehasbeenfoundtoincreasetheriskoffracture,especiallyinelderlywomen.GlitazoneswithinsulincanprecipitateCHFavoidsuchcombination.Thesedrugspreventtype2DMinprediabetics.
297.MechanismofActionofclofibrate? a)TheyincreaselipoproteinlipaseactivitythroughPPARalpha andcauseincreasedlipolysisoftriglycerides b)Inhibitslipolysisinadiposetissue c)InhibitsHMGCoAreductase d)Bindbileacidsandbilesaltsinsmallintestine CorrectAnswer-AAns.is'a'i.e.,TheyincreaselipoproteinlipaseactivitythroughPPARalphaandcauseincreasedlipolysisoftriglyceridesFibratesactbytranscriptionallyupregulatingLPL,apoA-IandapoA-1I,anddownregulateapoCIII,aninhibitoroflipolysisbyactivatinganuclearreceptor,PPARalpha(peroxisomeproliferatoractivatedreceptoralpha).oMajoreffectofthefibratesisto? 1. Increasedoxidationoffattyacidsinliverandstriatedmuscle2. IncreasedlipolysisoflipoproteintriglycerideviaLPL.3. ReduceTG(containedinVLDL)reducedVLDLsecretionbyliver.4. IncreaseHDL
298.Whichofthefollowingisa mineralocorticoidantagonist? a)Spironolactone b)Inamrinone c)Nicorandil d)Ketorolac CorrectAnswer-AAns.is'a'i.e.,Spironolactone
299.Beta2agonistusedinrescuetherapyin acuterespiratoryconditionsareallexcept- a)Terbutaline b)Salbutamol c)Bambuterol d)Ketotifen CorrectAnswer-DAns.is'd'i.e.,Ketotifen
300.Beta1antagonistusedincongestive cardiacfailure? a)Atenolol b)Metoprolol c)Salbutamol d)Terbutaline CorrectAnswer-BAns.is`b'i.e.,Metoprolol-blockersusedinCHFCardioselective-blockers(1-blockers) Atenolol Bisoprolol Celiprolol Esmolol Metoprolol Nebivolol Acebutalol Betoxalol Non- blockerwitha-blocking selective acting Carvedilol Dilovalol Medroxalol Bucindolol Labetalol Bevantolol Nipradilol Amongallthesefollowingthreeareusedmostcommonly 1. Carvedilol2. Metoprolol3. Bisoprolol
301.NSAIDScausegastriculcerbecause? a)TheyinhibitCOX-2enzyme b)Theyinhibitmucusproduction c)TheyincreaseHCIproduction d)Theydelaygastricemptying CorrectAnswer-BAns.is'b'i.e.,TheyinhibitmucusproductionProstaglandinsfunctionasnaturalulcerprotectivesbyenhancinggastricmucusandHCO3-production,aswellasbyimprovingmucosalcirculationandhealth.TheulcerogenicactionofNSAIDsmaybeduetolossofthisprotectiveinfluence.PGEanaloguesarecytoprotectiveatlowdosesandinhibitgastricacidsecretionathigherdoses.NSAIDsinhibitprostaglandinsecretionandthusantagonizesitscytoprotectiveeffect.MisoprostolisusedinNSAIDsinducedulcers.
302.Anandamideis? a)Opioid b)CK1antagonist c)D2blocker d)Cannabinoidneurotransmitter CorrectAnswer-DAns.is'd'i.e.,CannabinoidneurotransmitterAnandamide,alsoknownasN-arachidonoylethanolamineorAEA,isanendogenouscannabinoidneurotransmitter.ThenameistakenfromtheSanskritwordAnanda,whichmeans"bliss,delight",andamide.ItissynthesizedfromN-arachidonoylphosphatidylethanolaminebymultiplepathways.Itisdegradedprimarilybythefattyacidamidehydrolase(FAAH)enzyme,whichconvertsanandamideintoethanolamineandarachidonicacid.Assuch,inhibitorsofFAAHleadtoelevatedanandamidelevelsandarebeingpursuedfortherapeuticuse.
303.Metforminisusedintreatment&control of? a)Diabetes b)PCOD c)Pregnancyinducedhypertension d)Bothaandb CorrectAnswer-DAns.is'd'i.e.,BothaandbBiguanidesactsby:Suppresshepaticgluconeogenesisandglucoseoutputfromlivermajoraction.Enhanceinsulinmediatedglucosedisposalinmuscleandfat(Increasedperipheralutilizationofglucose)byenhancingGLUT-1transportfromintracellularsitetoplasmamembrane.Retartdintestinalabsorptionofglucose.Promoteperipheralglucoseutilizationbyenhancinganaerobicglycolysis.AlsoknowBesideDM,metforminisalsousefulinpolycysticovariandisease.Metforministheonlyoralhypoglycemicthatreducesmacrovasculareventsintype2DM.MetoforminisoneofonlytwooralantidiabeticsintheWHOmodellistofessentialmedicines(theotherbeingglibenclamide).
304.Hydroxyethylstarchisa? a)Vasodilator b)Inotrope c)Plasmaexpander d)Diuretic CorrectAnswer-CAns.is'c'i.e.,PlasmaexpanderPlasmaexpandersThesearehighmolecularweightsubstanceswhichexertscolloidalosmotic(oncotic)pressure,andwheninfusedi.v.retainfluidinthevascularcompartment.Humanplasmaorreconstitutedhumaalbuminarethebest,However,theformercarriestheriskoftransmittingserumhepatitis,AIDS,andlatterisexpensive.Thereforesyntheticcolloidsaremoreoftenused.Desirablepropertiesofplasmaexpanderare: 1. Shouldexertoncoticpressurecomparabletoplasma.2. Shouldremainincirculationandnotleakoutintissues,orbetoo rapidlydisposed. 3. Shouldbepharmacodynamicallyinert.
305.Drugthatbindsbileacidsintheintestine andpreventstheirreturntoliverviatheenterohepaticcirculationis? a)Niacin b)Fenofibrate c)Cholestyramine d)Gugulipid CorrectAnswer-CAns.is'c'i.e.,Cholestyramine
306.Sublingualnitroglycerinfortreatmentof acutechestpaincancause? a)Hypertension b)Headache c)Bradycardia d)Sexualdysfunction CorrectAnswer-BAns.is'b'i.e.,HeadacheDuetovasodilatationtheremaybetachycardia,palpitation,flushing,headache,dizzinessandfaintingmayoccur.AdverseeffectsDuetovasodilatationtachycardia,palpitation,flushing,headache,dizzinessandfaintingmayoccur.Rashesarecommonparticularlywithpentaerythritoltetranitrate.Methemoglobinemia.Sildenafilcausesdangerouspotentiationofnitrateaction(cGMPisincreasedbynitratesanditsbreakdownbyphosphodiesteraseisinhibitedbysildenafilmarkedaccumulationofcGMP)-severehypotension,MIanddeathmayoccurtheonlycontraindicationsofnitratesusearehypotensionorsimultaneoususeofsildenofil.
307.Raltegravircancause? a)Hypokalemia b)Hypocalcemia c)Hyperkalemia d)Hypercalcemia CorrectAnswer-CAns.is'c'i.e.,Hyperkalemia 1. Myopathy(musclepain,tiredness)andrhabdomyolysis.2. Skinreactions.3. Allergicreactions.4. Liverproblems.5. Immunereconstitutioninflammatorysyndrome(IRIS).6. Nonspecific:nausea,vomiting,diarrhea,headache. Notextbookhasmentionedanyelectrolyteabnormalityasasideeffectofraltegravir.So,Ihadtofindtheanswerofthisquestionindirectly.Raltegravircancauserhabdomyolysis,inwhichthereishyperkalemia.
308.TypeIIparalysisinorganophosphorous poisoningtreatmentis? a)Atropine b)Oximes c)Symptomatictreatment d)Notreatment CorrectAnswer-CAns.is'c'i.e.,SymptomatictreatmentParalysisduetoorganophosphate(OP)poisoningcanbethreetypes?1.TypeI(cholinergicphase)Treatmentofchoiceisatropinewithorwithoutoximes.2.TypeIIItisalsocalledasintermediatesyndrome.Itdevelops1-4daysafterresolutionofacutecholinergicsymptoms.Itismanifestedasparalysisandrespiratorydistress.Itinvolvesproximalmuscleswithrelativesparingofdistalmusclegroups.ThepathogenesispresumedtobedysfunctionofneuromuscularjunctioncausedbydownregulationofpresynapticandpostsynapticnicotinicreceptorsduetoreleaseofexcessiveAchandCa'respectively.Atropineisineffective,symptomatictreatmentisgiven.3.TypeIII
309.Whichanticancerdrugpreventsspindle formation? a)Busulfan b)Vincaalkaloids c)5-FU d)Methotrexate CorrectAnswer-BAns.is'b'i.e.,VincaalkaloidsTaxanes(PaclitaxelandDocetaxel)enhancespolymerizationoftubulin(amechanismoppositetothatofvincaalkaloids)themicrotubulesarestabilizedandtheirdepolymerizationisprevented.Vincaalkaloids(vincristine,vinblastine)preventpolymerizationandassemblyofmicrotubules.MitoticinhibitorsEnhancespolymerizationPreventpolymerizationTaxanesVincaalkaloids
310.WhichisaGABAtransaminaseinhibitor ? a)TCA b)Sertaline c)Valproate d)Gabpentin CorrectAnswer-CAns.is'c'i.e.,ValproateMechanismofactionFacilitationofGABAmediatedC1channelopeningBarbituratesandbenzodiazepinesbindtoGABAAreceptorandopenCl-channel.ValproteandvigabatrineinhibitenzymeGABAtransaminasewhichdegradesGABArconc.ofGABA.TiagabineinhibitstheuptakeofGABAintotheneuronesbyinhibitingGAT-1.GabapentineenhancestheGABAreleasefromsynapticvesicles.
311.Whichofthefollowingisan antipsychoticdrug? a)Flupenthixol b)Rasagiline c)Clobazam d)Divalproex CorrectAnswer-AAns.is'a'i.e.,FlupenthixolAntipsychotics(Neuroleptics)Antipsychoticsareagroupofpsychoactivedrugscommonlyusedtotreatpsychosis,e.g.Schizophrenia.Antipsychoticdrugsaredividedinto:Typicalantipsychotics(firstgenerationantipsychotics) 1. Phenothiazines-Chlorpromazine,Thioridazine,Trifluperazine, Fluphenazine. 2. Thioxanthenes-Thiothixene,Flupenthixol.3. Butyrophenones-Haloperidol,Trifluperidol,Penfluridol.4. Otherheterocyclics-Pimozide,Loxapine,Sulpiride B)Atypicalantipsychotics(secondgenerationantipsychotics)1.Clozopine3.Olanzopine5.Aripiprazole2.Risperidon4.Quetiapine6.Ziprasidone
312.WhichofthefollowingisaTCA? a)Amoxapin b)Citalopram c)Venlafaxine d)Bupropion CorrectAnswer-AAns.is'a'i.e.,AmoxapineAntidepressantsA.TypicalTricyclicantidepressantsNA+5HTreuptakeinhibitors:-Imipramine,Trimipramine,Amitriptyline,Clomipramine.PredominantlyNAreuptakeinhibitors:-Desipramine,Nortriptyline,Amoxapine,Reboxetine.b)Selectiveserotoninreuptakeinhibitors:-Fluoxetine,Paroxetine,Sertaline,Citalopram,Scitalopram.B.Atypical:-Trazodone,Mianserine,Mitrazapine,Venalafaxin,Duloxetine,Tianeptine,Amineptine,Bupropion.C.MAOinhibitors:-Tranylcypramine,Meclobemide,Clorgyline.
313.Allhavehighfirstpassmetabolism except? a)Lidocaine b)Propranolol c)Theophylline d)Morphine CorrectAnswer-CAns.is'c'i.e.,Theophylline
314.Drugusedforsympathectomyin experimentalanimalsis? a)Guanethidine b)Atropine c)Diazoxide d)Thebaine CorrectAnswer-AAns.is'a'i.e.,GuanethidineGuanethidineisusedforexperimentalsympthectomy.Guanethidineapolarguanidinecompoundwhichistakenupintoadrenergicnerveendingsbyactiveaminetransportandhasthreeimportantfacetsofaction:DisplacesNAfromstoragegranulesstochiometrically.InhibitsnerveimpulsecoupledreleaseofNAEngagesandblocksNAuptakemechanismattheaxonalmembrane.Itwasusedforsympathectomyinexperimentalanimal.
315.Gp2b3Ainhibitorsareallexcept? a)Abciximab b)Eptifibatide c)Tirofiban d)Prasugrel CorrectAnswer-DAns.is'd'i.e.,PrasugrelGlycoproteinslib/111ainhibitorsTheplateletglycoproteinmediatesplateletaggregationviabindingofadhesiveproteinssuchasfibrinogenandVonWillebrandfactor.GPIIb/Inainhibitors,inhibitplateletaggregationbyblockingGPIlb/Ma.Theyaremorecompleteinhibitorsthaneitheraspirinorclopidogrel/ticlopidinejjbecausetheyinhibitfinalpathwayinplateletaggregation(whetheritismediatedbyADPorTXA2),whileaspirinblocksonlyTXA2pathwayandclopidogrelblocksonlyADPpathway.Drugsare? 1. AbciximabAhumanizedmonoclonalantibodyagainstGPIIb/ 111a. 2. Eptifibatide3. TirofibanCompetitiveinhibitorsofGPI1b/IIIa4. Lamifiban InadditiontoinhibitingGplib/Iliareceptor,abciximabalsoinhibitsayP3receptor(whichbindsvitronectin)anda.132(aleukocyteintegerin).Thisactionisresponsibleforanti-inflammatoryandantiproliferativepropertiesofabciximab.
316.Modeofexcretionofcyclophosphamide is? a)Lung b)Liver c)Kidney d)Skin CorrectAnswer-CAns.is'c'i.e.,KidneyCyclophosphomideisprimarilymetabolized(80%)andmetabolitesareexcertedinurine.10to20%isexcretedunchangedinurineand4%isexcretedinbile.
317.Whichofthefollowingisnota cardioselectivebetablocker? a)Nebivolol b)Atenolol c)Betaxolol d)Oxprenolol CorrectAnswer-DAns.is'd'i.e.,Oxprenolol
318.Erlotinibisusedin? a)Coloncancer b)Pancreaticcancer c)Gallbladdercancer d)GIST CorrectAnswer-BAns.is'b'i.e.,Pancreaticcancer
319.Trueaboutlamotrigene? a)Decreasedefficacyindepression b)Firstchoiceinabsenceseizure c)t1/2is24hrs d)Notmetabolisedinliver CorrectAnswer-CAns.is'c'i.e.,t1/2is24hrs
320.Warfarinactsby a)InhibitionofVitaminKepoxidereductase b)Inhibitionofgammaglutamylcarboxylase c)ActivationofVitaminKepoxidereductase d)Activationofgammaglutamylcarboxylase CorrectAnswer-AAns.is'a'i.e.,InhibitionofVitaminKepoxidereductase
321.Sideeffectoftopiramateis? a)Weightloss b)Visualimpairment c)Insomnia d)Hemolysis CorrectAnswer-AAns.'a'i.e.,WeightlossTopiramateWeakcarbonicanhydraseinhibitorwithbroad-spectrumanticonvulsantactivity.Actsvia-prolongationofNa+channelinactivation,GABApotentiation,glutamatereceptorantagonism,neuronalhyperpolarisationviaK+channels.UsedinSPS,CPS,GTCS,myoclonicepilepsy,prophylaxisofmigraine.Readilyabsorbedorallyandmainlyexcretedintheurine.T1/2-24hrs.Adverseeffectsimpairmentofattention,sedation,ataxia,word-findingdifficulties,poormemory,weightloss,paresthesias,andrenalstones.
322.Prodrugofcetrizineis a)Foxefenadone b)Terfenadine c)Hydroxyzine d)Azelastine CorrectAnswer-CAns.is'C'i.e.,HydroxyzineCetrizineisametaboliteofHydroxyzinewithamarkedaffinityforperipheralH1receptors;penetratesthebrainpoorly.Itinhibitsthereleaseofhistamineandofcytotoxicmediatorsfromplateletsaswellaseosinophilchemotaxisduringthesecondaryphaseofallergicresponse.Itisindicatedinupperrespiratoryallergies,pollinosis,urticaria,andatopicdermatitis;alsousedasanadjuvantinseasonalasthma.
323.Whichofthefollowingisatricyclic antidepressant? a)Vanalafexine b)Fluoxetine c)Doxepine d)Citalopram CorrectAnswer-CAns.is'c'i.e.,Doxepine
324.Tetracyclineinjectioncausespalsyof whichnerve? a)Ulnar b)Median c)Radial d)SuperficialRadialNerveinjury CorrectAnswer-CAns.is'c'i.e.,Radial
325.Drugofchoiceforreversalofmuscle relaxantafteranaerthesia a)Pralidoxine b)Neostigmine c)Atropine d)None CorrectAnswer-BAns.is'b'i.e.,NeostigmineReversalofneuromuscularblockNondepolarisingmusclerelaxantshaveantagonisticactiononacetylcholineAnticholinesterasesactbyinhibitingtheactionofacetylcholinesterase(anenzymethatdegradesacetylcholinebycausingitshydrolysis).Anticholinesterasesthusincreasethelevelofacetylcholineattheneuromuscularjunction.Neostigminealsohassomeadditionaldirectactiononcholinergicreceptorsi.e.,itdepolarizesmotorendplate.ItdoesnotincreasethereleaseofACH.AccumulatedACHactsonprejunctionalmuscarinicautoreceptorsandinhibitsthereleaseofACH.
326.Drugofchoiceforclassicalangina attack? a)CCBs b)-blocker c)GTN d)Prazocin CorrectAnswer-CAns.is'c'i.e.,GTNForimmediatepre-exertionalprophylaxisandacuteattackSublingualglyceraltrinitrate(Drugofchoice)
327.Beta2-agonistcauseallexcept a)Hyperkalemia b)Hyperglycemia c)Tremer d)Palpitaion CorrectAnswer-AAns.is'a'i.e.,HyperkalemiaAdverseeffectsofinhalationalagonistsThemostcommonsideeffectsaremuscletremorandpalpitationHypokalemiaHyperglycemiaToleranceThroatirritationAnkleedemaOthersideeffectsareanxiety,headache,musclecramps,drymouth,arrhythmia,flushing(duetovasodilatation),hypoxemia,MI,disturbanceofsleepandbehaviour.
328.Mechanismofactionofprophylthiouracil ? a)Preventssynthesisofthyroglobulin b)Preventsiodinetrapping c)PreventsreleaseofT4&T3 d)Inhibitscoupling CorrectAnswer-DAns.is'd'i.e.,Inhibitscoupling
329.Nottrueaboutaztreonam? a)f3-lactarn b)Monobactarn c)Activeagainstpseudomonas d)Showscrossreactivitywithotherpenicillins CorrectAnswer-DAns.is'd'i.e.,ShowscrossreactivitywithotherpenicillinsAztreonamItbelongstomonobactamsgroupof13-lactamantibiotics.Itisactiveagainstgramnegativeorganismsincludingpseudomonas,buthasnoactivityagainstgrampositiveorganismsoranaerobesfi-lactamantibioticwithaminoglycosidesspectrum.Itistheonlyfi-lactamantibioticthatlackcross-reactivitywithotherP-lactamantibiotics,permitingitsusedinpatientsallergictopenicillinsorcephalosporins.
330.ClinicaleffectofvitaminDisreducedby ? a)Simultaneousingestionofphytates b)Simultaneousingestionoflactose c)Acidicenvironment d)None CorrectAnswer-AAns.is'a'i.e.,SimultoneousingestionofphytatesThemainclinicaleffectofvitaminDistoenhanceintestinalabsorptionofcalcium.Withanaverageintakeof1000mgofcalciumitsnetintestinalabsorptionisonly150-250mg/day.Calciumisabsorbedmainlyintheduodenumandjejunum(proximalintestine)byanactivetransportmechanismregulatedby1,25(OH)2D,(calcitriol).Parathormoneindirectlypromotesabsorptionofcalciumbyincreasingtherenalsynthesisof1,25(OH)2D3.Dietarylactose,proteinsandanacidicenvironmentpromotecalciumabsorption.Ontheotherhand,phytates,phosphates,oxalates,tetracyclineandandalkalineenvironmentimpaircalciumabsorption.
331.Allareproducedbylareceptorsexcept- a)Euphoria b)Sedation c)Dysphoria d)Constipation CorrectAnswer-CAns.is'c'i.e.,Dysphoria
332.Antitussiveopioidis? a)Ethylmorphin b)Pethidine c)Methadone d)Buprenorphine CorrectAnswer-AAns.is'a'i.e.,EthylmorphineAntitussives(coughcentersuppressants)Opioids:Codeine,ethylmorphine,pholcodeine.Non-opioids:Noscapine,dextromethorphan,chlophedianol.Antihistaminics:Chlorpheniramine,diphenhydromine,promethazine.Peripherallyactive:Prenoxdiazine.
333.Sugamadexisusedfor? a)Organophosphatepoisoning b)ReversalofNMblockers c)Treatmentoflocalanaestheticpoisoning d)Treatmentofcentralanticholinergicsyndrome CorrectAnswer-BAns.is'b'i.e.,ReversalofNMblockersSugamadexisanovelreversingagentdevelopedforterminatingtheactionofnondepolarizingmusclerelaxantsrocuroniumandvecuronium.Itisamodifiedy-cyclodextrinwithhighaffinityforrecuroniumandvecuronium.ItencapsulatesonemoleculeofNMblockerwithinitsmoleculeforminganinactivechelatewhichisexcretedinurinewithVAof2hours.Itssideeffectsaremildprecordialpain,nausea,alterationoftasteandrarelyallergy.
334.Shortestactingcalciumchannelblocker ? a)VerapamiI b)Amlodipine c)Nimodipinc d)Diltiazam CorrectAnswer-CAns.is'c'i.e.,NimodipineNimodipineisshortestactingCCB.Katzung10/1/2-191Nimodipineselectivelyrelaxescerebralvasculature-canbeusedinsubarachnoidhaemmorrhageorrupturedcongenitalintracranialaneurism.AmlodipineislongestactingCCB.Amlodipinehasmaximumoralbioavailabilitv.Nisoldipinehasminimumoralbioavailability.
335.Benzylisoquinolinemusclerelaxantis? a)Vecuronium b)Rocuronium c)Doxacurium d)Pancuronium CorrectAnswer-CAns.is'c'i.e.,DoxacuriumCompetitive(nondepolarizing)blockersareoftwotypes-BenzylisoquinolonederivativesThisincludesd-TC,doxacurium,atracurium,cisatracurium,mivacurium,metocurine.Thesedrugshavetendencytoreleasehistamineandtoblockautonomicganglion.AmminiosteroidderivativesThisincludepancuronium,rocuronium,vecuronium,pipecuronium,rapacuronium.Thesedrugsdonotblockautonomicgangliaandhaveminimalhistaminereleasingproperty.
336.Acidicdrugsbindto? a)Globulin b)a-Iglycoprotein c)Albumin d)None CorrectAnswer-CAns.is'c'i.e.,AlbuminManynaturalsubstancescirculatearoundthebodypartlyfreeinplasmawaterandpartlyboundtoplasmaproteins,e.g.cortisol,thyroxine.Similarlydrugscirculateinproteinboundandfreestates,andthesignificanceisthatthefreefractionispharmacologicallyactivewhereastheproteinboundcomponentisareservoirofdrugthatisinactivebecauseofthisbinding.Acidicdrugsgenerallybindtoplasmaalbumin.Basicdrugsbindtoa,acidglycoprotein.Bindingtoalbuminisquantitativelymoreimportant.
337.Themostpotenttopicalcorticosteroidis a)Betamethasonevalerate b)Triamcinoloneacetonide c)Hydrocortisoneacetate d)Clobetasolpropionate CorrectAnswer-DAns.is`d'i.e.,Clobetasolpropionate
338.Orallyactivehormoneis? a)TSH b)Thyroxine c)GH d)Prolacin CorrectAnswer-BAns.is'b'i.e.,Thyroxine
339.Drugofchoiceforbleedingoesophageal varicesis? a)Ethanolamineoleate b)Octreotide c)Propanolol d)Phytonadione CorrectAnswer-BAns.is'b'i.e.,OctreotideAmongthegivenoptions,onlyocterideisused(otherwisevasopressineanalogueterlipressineistheDOC).Hasbeenexplainedinprevioussessions.
340.Maximumfirstpassmetaboilsmisseen bywhichroute? a)Intravenous b)Interaarterial c)Rectal d)Oral CorrectAnswer-DAns.is'd'i.e.,OralFirstpassmetabolismisseenwithoralandrectalroutes.Maximumfirstpassmetabolismisseenwithoralroute.Inrectalroute,drugabsorbedintoexternalhemorrhoidalveinsbypassesliver,butnotthatabsorbedintointernalhaemorrhoidalveinsFirstpassmetabolismoccurs,butlessthanoralroute(avoidsfirstpassmetabolismto50%).MostrapidonsetofactionisseenwithI.route.BioavailabilitybyI.Vrouteis100%.
341.Durationofactiondependson- a)Clearance b)Rateofelimination c)Bioavailability d)All CorrectAnswer-DAns.is'd'i.e.,All
342.Thiazidesacton? a)PCT b)DCT c)Glomerulus d)DescendinglimbofloopofHenle CorrectAnswer-CAns.is'c'i.e.,DCTTubularabsorptioncanbedividedintofoursites.Site1-ProximaltubuleFourmechanismsofNa'transporthavebeendefinedinthissegment?DirectentryofM.+alongelectrochemicalgradient.Nat-K*symportalongwithactivereabsorptionofglucose,aminoacids,organicanionsandPO43.ExchangewithWbyNa*IWexchangerlocatedintheluminalmembraneofproximaltubule(PT)epithelialcells.ThePTcellssecreteWwiththehelpofcarbonicanhydrase.WionexchangeswithNat-presentintubularfluidthroughNa+-H+exchanger(antiporter)andformsH2CO3bycombiningwithHCO3-.ThisH2CO3isbrokenintoH20+CO2bybrushbordercarbonicanhydrase;bothCO2andH20diffuseinsidethecellandrecombinetoformH2CO3withthehelpofintracellularcarbonicanhydrase.ThisH,CO3isthesourceofF1*.ThedissociatedHCO3-inthecellistransportedtocorticalE.C.F.bybasolateralmembraneNa-F-HCO3-symporterresultinginnetreabsorptionofNaHCO3.Carbonicanydraseinhibitors(acetazolamide)actpredominantlyinPCTandinhibitNaHCO3reabsorption.
ThedisroportionatelylargeHCO3-,acetate,PO4-3,passivedrivingforcesforCl-todiffusethroughtheparacellularpathway,particularlyinthelaterPT.ThistakesNa'andH,0alongtomaintainelectricalneutralityandisotonicity;reabsorptioninPTisisotonic.Osmoticdiuretics(mannitol)aresoluteswhicharenotabsorbedinproximaltubuleandthereforeretainwater.SiteIIAscendinglimbofloopofHenleThethickascendinglimbcanbedistinguishedintotwodistinctportion.Medullaryportionlinedbycuboidalcells.Corticalportionlinedbyflattenedcells.Bothportionsarerelativelyimpermeabletowaterbutabsorbsaltactivelyandthusdilutetubularfluid.InthemedullaryportionadistinctluminalmembranecarriertransportsionsinratioofNee-K+-2a.ThesodiumentersthecellispumpedtoECFbyNaATPaseatthebasolateralmembrane.ThisNa?-K?-2C1:symportisinhibitedbyloopdiuretics(eg-Furosemide).Inaddition,aNa*-C1-symportermovesCI-downitselectrochemicalgradientintoECFandcarriesNa+along.SiteIII-corticaldilutingsegmentofloopofHenleandearlyDTThissegmentisalsoimpermeabletoH20andcontinuestoabsorbsaltthroughNat-Ctsymporter.Thiazidediureticsactatthissite.SiteIV-latedistaltubuleandcollectingductInlateDTandCD,Naisactivelyreabsorbed;thecation-anionbalancebeingmaintainedpartlybypassiveCI-diffusionandpartlybysecretionofK+andFr.AbsorptionofNa+atthissiteoccursthroughaspecificamiloridesensitiveNet'channelandiscontrolledtoalargeextentbyaldosterone.Kparingdiureticsactatthissite.CollectingtubuleisthemostimportantsiteofICsecretionbythekidneyandthesiteatwhichvirtuallyalldiureticinducedchangesinKEbalanceoccur-asICsecretionoccursinexchangeofNat,highertheNa+loadinCDhigherwillbeK+excretioninurine-->Diuretics
whichactonPCT(maximumabsortionofNa+occursatPCT)likeacetazolamidewillcausemaximumkaliuresis(ICexcretioninurine).TheprincipalcellsarethemajorsitesofNat,IC-,andwatertransport,andintercalatedcellsaretheprimarysitesofFt'secretion.Thecollectingtubuleisalsothesiteatwhichthefinalurineconcentrationisdetermined.ADH(vasopressin)controlsthepermeabilityofthissegmenttowaterbyregulatingtheinsertionofpreformedwaterchannels(aquaporin2,AQP2)intotheapicalmembraneviaaGprotein-coupledcAMP-mediatedprocess.ADHalsostimulatestheinsertionofureatransporterUT1moleculesintotheapicalmembranesofmedullarycollectingtubulecells.Ureaconcentrationinthemedullaplaysanimportantrolemaintainingthehighosmolarityofthemedullaandintheconcentrationofurine.
343.Duetowhichsideeffectfelbamatecan bediscontiuned? a)Aplasticanemia b)Renalimpairment c)Gastrointestinaldisorder d)Seizures CorrectAnswer-AAns.is'a'i.e.,AplasticanemiaTwoseveresideeffectsoffelbamateareforwhichFDAhasissuedwarningthatdrugnotbeusedarehepaticfailureandaplasticanemia
344.Drugusedinpostprandialsugarcontrol is? a)Alfaglucosidase b)Biguinides c)Sulfonylurea d)Repaglinide CorrectAnswer-DAns.is'd'i.e.,Repaglinide
345.Hofmanneliminationis? a)Inactivationofdrugbymetabolizingenzyme b)Unchangedexcretionbykidney c)Excretioninfeces d)Inactivationbymolecularrearrangement CorrectAnswer-DAns.is'd'i.e.,InactivationbymolecularrearrangementHofmanneliminationThisreferstoinactivationofthedruginthebodyfluidsbyspontaneousmolecularrearrangementwithouttheagencyofanyenzyme.Atracuriumiseliminatedbythismethod.
346.Peripheralneuropathyasasideeffectis causedbywhichofthefollowinganticancerdrugs? a)Vincristine b)Cyclophosphamide c)Etoposide d)Irinotecan CorrectAnswer-AAns.is'a'i.e.,VincristineVincristine(Oncovin)AlkaloidderivedfromVincarosae.Vincristinebelongstotheplantalkaloidgroupofanticancer.RapidlyactinganticancerThisclassofdrugsarealsoknownasspindlepoison.Thesedrugsbindtomicrotubularprotein(tubulin)Thedrug-tubulincomplexthenattachesitselftomicrotubulesandcausesdepolymerizationofmicrotubules.Depolymerizationofmicrotubulecauses 1. Mitoticarrestatmetaphase2. Dissolutionofmitoticspindle3. Interferencewithchromosomesegregation UsefulforinducingremissioninchildhoodALL(notusefulinmaintenancetherapy)Itcanalsobeusedforpediatricsolidtumors(Wilm'stumor,neuroblastoma,rhabdomyosarcoma)andlymphomas.Prominentadverseeffects?PeripheralneuropathyAlopeciaSIADH
Vincristineisamarrowsparingdrugbutsometimesitmaycausemyelosuppressionwhichisverylessthanvinblastin.Indicationsofvincristine?HodgkinsdiseaseWilms'stumourCarcinomalungNonhodgkin:s.diseaseEwing'ssarcomaMyelomaVinblastineandvinorelbineareothervincaalkaloids.oVinblastine'smostimportantclinicaluseisthecurativetherapyofmetastatictesticulartumor.oVinblastinecancausebonemarrowsuppression(incontrastwithvincristin),alopecia,andnausea&vomiting.oAstheyarrestmitosis,allvincaalkaloidsactinMphase.
347.Drugusefulinbreastcanceris? a)Tamoxifen b)Cyproterone c)Testosterone d)Chlorambucil CorrectAnswer-AAns.is'a'i.e.,TamoxifenPharmacotherapvofbreastcancerManybreastcarcinomaspossessestrogenreceptorsEstrogenpromotestheirgrowth.DrugswhichdecreasetheactionofestrogenonbreastCAbyoneorothermechanisms,canbeusedinbreastCA.DrugsusedinBreastcancerSelectiveestrogenreceptormodulators(SERMs)-Tamoxifen,Tromifene.Selectiveestrogenreceptordownregulators(SERDs)-FulvestrantAromataseinhibitors-Letrozole,anastrozole,exemestoneLHRH(GnRh)analoguesAminoglutethemideHighdosesprogesterones-Megastrolacetate.
348.Whichofthefollowingdrugcancasue thyroiddysfunction? a)Amiodarone b)Ampicillin c)Ibutilide d)Acyclovir CorrectAnswer-AAns.is'a'i.e.,AmiodaroneDrugscausinghypothyroidismLithiumSulfonamidePhenobarbitonePhenytoinAmiodaroneParaminosalycylicacid(PAS)RifampicinCarbamazepine
349.Alldrugshaverecentlybeenwithdrawn fromIndiaexcept? a)Gatifloxacin b)Rafecoxib c)Cotrimoxazole d)Phenformin CorrectAnswer-CAns.is'c'i.e.,CotrimoxazoleDrugswhichhavebeenwithdrawanfromIndiaare(i)Rimonabant;(ii)gatifloxacin;(iii)sibutramine;(iv)rofecoxib&valdecoxib;(v)astemizole&terfinadine;(vi)fenfluramine&dexfenfluramine;(vii)phenformin;(viii)tegaserod;and(ix)rosglitazone.
350.Ranibizomabismonoclonalantibody against? a)IL-6 b)CD-20 c)VEGF d)EGFR CorrectAnswer-CAns.is'c'i.e.,VEGF
351.Allantiretroviraldrugsproduce peripheralneuropathyexcept? a)Stavudine b)Zalcitabine c)Didanosine d)lndinavir CorrectAnswer-DAns.is'd'i.e.,IndinavirCharacteristicsideeffectsofimportantantiretroviraldrugsLamivudin-Nausea,headache,fatigue.Stavudine-Peripheralneuropathy,lipodystrophy,hyperlipidemia,pancreatitis,rapidlyprogressiveascendingneuromuscularweakness.Didanosine-Peripheralneuropathy,pancreatitis,diarrhea,nausea,hyperuricemia.Zalcitabine-Peripheralneuropathy,oralulceration,pancreatitis.Zidovudin-Macrocyticanemia,neutropenia,nausea,headache,insomnia,asthenia.Tenofovir-Asthenia,headache,diarrhea,nausea,vomiting,flatulance,renalinsufficiency.Efavirenz-CNSeffects,rash,Tliverenzymes.Nevirapine-Rash,hepatitis,nausea,headache.Indinavir-Nephrolithiasis,nausea,indirecthyperbilirubinemia,headache,blurredvision,asthenia.
352.Drugofchoiceforfamilial hypercholesterolemia? a)Gemfibrogil b)Nicotinicacid c)Lovastatin d)Ceholestgramin CorrectAnswer-CAns.is'c'i.e.,Lovastatin
353.Whentwodifferentchemicalactontwo differentreceptorsandtheirresponsesisoppositetoeachotheronthesamecelliscalledas? a)Physiologicalantagonism b)Chemicalantagonism c)Reversibleantagonism d)Competitiveantagonism CorrectAnswer-AAns.is'a'i.e.,PhysiologicalantagonismPhysiologicalantagonistsarethosethatproduceoppositeactionbyactingondifferentreceptors.AntagonismWhenonedrugdecreasesorinhibitstheactionofother.EffectofdrugsA+B<effectofdrugA+effectofdrugB.Antagonismmaybe: 1. Physical2. Basedonphysicalproperty3. Chemical4. Thetwodrugsreactchemicallyandformaninactiveproduct.5. Physiological/functional6. Thetwodrugsactondifferentreceptorsorbydifferentmechanisms, buthaveoppositeoverteffectsonthesamephysiologicalfunctioniehavepharmacologicaleffectinoppositedirection. 7. Receptor Theantagonistinterfereswithbindingoftheagonistwithitsreceptororinhibitsthegenerationofresponseconsequenttosuchbinding.
354.Whichofthefollowingdrugsusedto treattype-IIdiabetesmellituscausesweightloss a)Metformin b)Glimepiride c)Repaglinide d)Gliclazide CorrectAnswer-AAns.is'a'i.e.,MetforminEffectofantidiabeticdrugsonweight 1. Increased:Sulfonylureas,insulin,pioglitazone2. Decreased:Metformin,GLP-1antagonists,pramlinitide3. Noeffect:DPP-4inhibitors
355.Whichofthefollowingisnotusedin acuteattackofseverepainduetogout? a)Indomethacine b)Colchicine c)Febuxostat d)Corticosteroids CorrectAnswer-CAns.is'c'i.e.,Febuxostat
356.Whichofthefollowingdevelopfirst duringdependenceofasubstance? a)Tolerance b)Physicaldependence c)Psychologicaldependence d)Withdrawalsymptoms CorrectAnswer-CAns.is'c'i.e.,PsychologicaldependenceDrugdependenceDrugdependence,asthenamesuggests,isastatewhereapersonbecomesdependentonadrugdespiteknowingtheharmfuleffectofthedrug.Thisstatearisesfromrepeated,periodicorcontinuousadministrationofadrug,thatresultsinharmtotheindividual.Thesubjectfeelsadesire,needorcompulsiontocontinueusingthedrugandfeelsillifabruptlydeprivedofit(withdraw!syndrome)Drugdependencyischaracterizedbythetriadof:i.PsychologicaldependenceFirsttoappearThereisemotionaldistressifthedrugiswithdrawnii.PhysicaldependenceFollowspsychologicaldependenceThereisphysicalillnessifthedrugiswithdrawn(withdraw!symptoms)iii.ToleranceTolerancemaybe 1. SelftoleranceTothedrugonwhichthesubjectisdependent2. CrosstoleranceTotheothersimilar(usually)ordissimilar
(sometimes)drugs.Thefrequencyofuseofdrugisusuallydailyanddurationisinevitablygreaterthan2-3weeks.
357.Whichoftheantithyroiddruginhibit iodinetrapping? a)Radioactiveiodine b)Iodides c)Methimozole d)Thiocyanades CorrectAnswer-DAns.is'd'i.e.,Thiocyanades
358.Longestactingglucocorticoidsis? a)Prednisone b)Prednisolone c)Cortisone d)Dexamethasone CorrectAnswer-DAns.is'd'i.e.,Dexamethasone
359.Studystateplasmaconcentrationis achievedafter? a)2t1/2 b)3t1/2 c)4t1/2 d)5t1/2 CorrectAnswer-DAns.is'd'i.e.,5t1/2Steadystate:Iffixeddoseofadrugisadministeredafterregularintervals,itsplasmaconcentrationstartsincreasing.However,asplasmaconcentrationrises,rateofeliminationalsostartsincreasing.Whenrateofadministrationbecomesequaltorateofelimination,plasmaconcentrationstabilizes.Thisiscalledsteadystate.1.Timetoreachsteadystatedependsont?.Ittakesapproximately5half-lives.2.Steadystateplasmaconcentrationacheiveddependsondoserate.
360.Whichofthefollowingisatopical sulfonamide? a)Sulfadoxine b)Mafenide c)Sulfamethopyrazine d)None CorrectAnswer-BAns.is'b'i.e.,MafenideClassificationofsulfonamidesShort-acting-Sulfadiazine,Sulfisoxaxole,Sulfamethizole,Sulfacystine.Intermediate-acting-Sulfamethoxazole.Long-acting-Sulfadoxine,Sulfamethopyrazine.TopicalSulfonamides-Sulfacetamidesodium,Mafenide,silversulfadiazine.SulfonamideforRAandulcerativecolitis-Sulfasalazine.
361.Whichisnotusedinstatusepilepticus? a)Lorazepam b)Phenytoin c)Phenobarbitone d)Valproate CorrectAnswer-DAns.is'd'i.e.,Valproate
362.Whichsecondgenerationantihistaminic doesnotproduceanactivemetabolite a)Loratidine b)Terfenadine c)Cetrizine d)None CorrectAnswer-CAns.is'c'i.e.,CetrizineImportantfactsaboutanhistaminicsLoratidine,desloratidine,ebastineandmizolastineareamongstthelongestactingantihistaminic(durationofaction24hrs).Allsecondgenerationantihistaminicsaremetabolizedtoactiveproductsexceptcetrizineandmizolastine.LoratidinehasleastCNSdepressionaction.Acrivastineistheshortestactingantihistaminic.OlopatodineisarecentlyapprovedtopicalHI-antihistaminicusedasnasalsprayforseasonalallergicrhinitis.
363.Nesiritidecausevasodilatationthrough? a)cAMP b)cGMP c)ATP d)K'ions CorrectAnswer-BAns.is'b'i.e.,cGMPNesiritideNesiritideisarecombinantformofhumanBNP(Brainnatriureticpeptide)thatdilatesthearterialandvenouscirculationinabalancedmanner.Itisonlyavailableforparentraladministration(oralbioavilabilityispoor)Ithasnatriuretic,diureticandvasodilatorproperties.Itdoesnothaveinotropicaction.Ithasbeenapprovedforuseinacutecardiacfailure.ItsV/2isonly18minutes.ItactsbyincreasingcGMPinsmoothmusclecells.Themainsideeffectishypotension.Thelimitingfactorisitsbreakdownbyenzyme,neutralendopeptidase(NEP)-inhibitorsofthisenzymeecadotrilarebeingtestedforCHF.
364.Whichofthefollowingisrenininhibitor? a)Losartan b)Benazepril c)Remikiren d)Imidapril CorrectAnswer-CAns.is'c'i.e.,Remikiren
365.Whichofthefollowingisusedfor prostaticcarcinoma? a)Danazole b)Clomiphene c)Finasteride d)None CorrectAnswer-CAns.is'c'i.e.,Finasteride
366.Whichanaestheticagenthasmaximum MAC? a)Ether b)Methoxyfluorane c)N20 d)Halothane CorrectAnswer-CAns.is'c'i.e.,N20MinimalalveolarconcentrationItisthelowestconcentrationoftheanaestheticinpulmonaryalveolineededtoproduceimmobilityinresponsetoapainfulstimulus(surgicalincision)in50%individuals.ItisthemeasureofpotencyofinhalationGAs.Blood:gaspartitioncofficientItisthemeasureofsolubilityofagentinblood.Itdeterminesthespeedofonsetandrecovery.Highertheblood:gaspartitioncofficient,lesserthespeedofinductionandrecovary-4morebloodsolubleagentshaveslowerinductionandrecovery.Oil:gaspartitioncofficientItisthemeasureoflipidsolubilityoftheagent,andthereforesolubilityinthefat-richtissuesoftheCNS.Thisequateswiththepotencyofindividualagents.Thereisadirectrelationshipbetweentheminimumalveolarconcentration(MAC)valueofinhaledanaestheticagentsandlipidsolubilityintermsoftheoil/gaspartitioncofficient.Remember
MaximumMAC-4N20MinimumMACHalothane(Previouslyitwasmethoxyflurane,butitisnotusednow)Maximumblood:gaspartitioncofficient-4EtherMinimumblood:gaspartitioncofficientDesfluraneMaximumoil:gaspartitioncofficientHalothane(Previouslyitwasmethoxyflurane,butitisnotusednow)Minimumoil:gaspartitioncofficient-->N20?
367.Treatmentofchoiceforprinzmetal's angina a)Nitroglycerine b)CCBs c)P-blockers d)Prazosin CorrectAnswer-AAns.is'a'i.e.,NitroglycerineTreatmentofvariantanginaPrinzmetal'svariantanginaisduetospasmofcoronaryvessels.Thedrugswhichdilatethecoronaryvessels,arethemaintreatmentofPrinzmental'sangina.Drugsare: 1. Nitrates2. Calciumchannelblockers(verapamil,diltiazem) Nitroglycerinisconsideredthedrugofchoiceforthepatientwithvariantangina.Prazosinaselectivea-blockermayalsobeusedbecauseitpreventsamediatedvasospasm.ii-blocker'sarecontraindicatedbecausetheycauseconstrictionofcoronaryarteryduetounopposedamediatedvasoconstriction.PreventionofvariantanginaIncontrastNitratesarenotusedforthepreventionofvariantanginabecauseofdelevelopmentoftolerance.CCBsaretheDOCforprevention.
368.Drugofchoiceforpheochromocytoma? a)Propranolol b)Phenoxybenzamine c)Prazosin d)Nitroprosside CorrectAnswer-BAns.is'b'i.e.,PhenoxybenzaminePharmacologicaltreatmentofpheochromocvtomaPreoperativelyorwhentumourcannotberemoved,bloodpressurecontrolisachievedbya-adrenoreceptorblockadewhichreversesperipheralvasoconstrictionPhenoxybenzomineistheDOCForhypertensivecrisesorintraoperativecontrolofBP,phentolamineistheDOC.Prazosinisanalternative.Nitroprussidecanalsobeused-Harrison17th/ep.1561.Inadrenalinesecretingtumors,iftachycardiapersists,13-blockercanbeaddedafterstartingoc-blockers.ACEinhibitororcalciumchannelblockerscanbeusedwhenbloodpressureisdifficulttocontrolwithphenoxybenzaminealone.Metyrosinehasbeenusedwithsomesuccesstoblockcatecholaminesynthesisinmalignantpheochromocytoma.Metaiodobenzylguanidine(MIBG)isactivelytakenupbyadrenergictissue123I-MIBGcanbeusedforselectivetherapeuticirradiationoffunctioningmetastasis.
369.Whichofthefollowingissecond generation3blocker? a)Propronolol b)Timolol c)Nodalol d)Atenolol CorrectAnswer-DAns.is'd'i.e.,Atenolol
370.Whichofthefollowingreducesthe efficacyoforalcontraceptives? a)Erythromycin b)Griseofulvin c)Cimetidine d)Disulfiram CorrectAnswer-BAns.is'b'i.e.,GriseofulvinContraceptivefailuremayoccurifthefollowingdrugsaregivenconcurrently:(a)EnzymeinducerEnhancesthemetabolismofestrogen&progesterone. 1. Phenytoin3.Carbamazepine5.Primidone 2.Phenobarbitone4.Rifampicin6.Griseofulvin(b)Suppressionofintestinalmicrofloraenterohepaticcirculation.1.Tetracyclines2.Ampicillin
371.Usesofalpha-2-agonistareallexcept? a)Sedation b)Glaucoma c)BenignHyperplasiaofprostate d)Hypertension CorrectAnswer-CBenignHyperplasiaofprostate.
372.Fluoroquinoloneswithmaximum bioavailabilityis? a)Moxifloxacin. b)Gatifloxacin. c)Levofloxacin d)Ciprofloxacin CorrectAnswer-CAns.C.Levofloxacin.Pharmacokineticsoffluoroquinolones:Goodoralbioavailability(exceptnorfloxacin).Levofloxacin-100%bioavailability.Multivalentcationsinterferewithabsorption(liketetracycline).
373.Mechanismofactionofbuspironeis? a)5HT1Apartialagonism. b)5HT1Bantagonism. c)5HT1Bpartialagonism. d)5HT2Cantagonism. CorrectAnswer-AAns.A.HT1Apartialagonism5HT1A:*Presynapticautoreceptor.*Modulatesserotoninrelease.Partial5HT1Aagonists:*Buspirone,isapirone,gepirone.*Usefulasanti-anxietydrug.
374.Whichstatementbestdescribes mechanismofactionofazole? a)Synthesisofergosterol b)Thymidylatesynthase c)TargetingBeta-1,3?glucan d)Disruptionofcellwall. CorrectAnswer-AAns.A.SynthesisofergosterolInhibitionof14a-lanosteroldemethylase,akeyenzymeinergosterolbiosynthesis?resultingindepletionofergosterol&accumulationoftoxic14a-methylatedsterolsinmembranesofsusceptibleyeastspecies?Destructionoffungus.
375.Whichisthefollowingisorallyactive directXainhibitor? a)Rivaroxaban b)Agrataban c)Dabigatran d)Bilverudin CorrectAnswer-AAns.a.RivaroxabanRivaroxaban,apixaban&edoxabanarefactorXainhibitors.Dabigatranetexilateisdirectthrombininhibitor.
376.Whichamongthefollowingismost probablereasonforpreferenceofCisatracuriumoveratracurium? a)Decreasedhistaminerelease b)Increasedhistaminerelease c)DuetoeliminationbyHofmannelimination d)IncreasedCNStoxicity CorrectAnswer-AAns.A.DecreasedhistaminereleaseCisatracurium:*UndergoesHofmannelimination.*Doesnotprovokehistaminerelease?Hence,preferredoveratracurium.*Noeffectonheartrate/BP/nilautonomiceffect.*Produceslesslaudanosinethanatracurium?Hence,lessCNStoxicity(seizures).
377.Whichofthefollowingdrugisusedin SIADH? a)Tolvapatan b)Desmopressin c)Vwbfactor d)Terlipressin CorrectAnswer-AAns.A.TolvaptanTolvaptan:*Vasopressinantagonists.*OrallyactivenonpeptideselectiveV2receptorantagonist.*MetabolizedbyCYP3A4?Notgiventopatientsreceivingthisisoenzymeinhibitor.*Givenoncedaily.*t?:6?8hours.Actions:*Increasesfreewaterclearancebykidney(aquaretic).*CorrectslowerplasmaNa+levels.Uses:*Usefulforhyponatremiatreatment.*HyponatremiacausedbyCHF,cirrhosisofliverorsyndromeofinappropriateADHsecretion(SIADH).Sideeffect:*Thirst&drymouth(mostfrequent).*Fever,G.I.upset&hyperglycaemia.
378.DrugactingonK+channelsinclude whichofthefollowing? a)Spironolacton b)Amiloride. c)Nicorandil d)Methyldopa CorrectAnswer-CAns.C.NicorandilNicorandil:Cardioprotectivepotassiumchannelopener.Causesischemicpreconditioning&coronarydilation?ByactivatingmyocardialATPsensitiveK+channels.AlsopossessesNO-releasingproperty.Usefulinangina.
379.Imipenem,anewerantibioticwitha broadantibacterialspectrum,iscoadministeredwithcilastatin.Whichofthefollowingisthebestreasonforthesame? a)CombinationofantibioticsissynergisticagainstPseudomonas specie b)Cilastatinaidsgastrointestinalabsorptionofactivemoiety, imipenem c)Cilastatininhibitsbeta=lactamaseenzymedestroyingimipenem d)Cilastatininhibitsanenzymeinkidneydestroyingimipenem CorrectAnswer-DAns.D.CilastatininhibitsanenzymeinkidneydestroyingimipenemImipenem-cilastatin0.5gi.v.6hourly(max4g/day).Effectiveinserioushospital-acquiredrespiratory,urinary,abdominal,pelvic,skin&softtissueinfectionsincludingneutropenic,cancer&AIDSpatients.ForPs.aeruginosainfections,itshouldbecombinedwithgentamicin.
380.DOCforsmokingcessation? a)Acamprosate b)Varenicline c)Thalidomide d)Tryptophan CorrectAnswer-BAns.B.Varenicline(IfBupropionisnotanoption)Anti-smokingdrugs:Bupropion(alongwithVarenicline&Nicotinereplacementtherapy)isaUSFDAapprovedfirst-lineagentforpharmacotherapyinsmokingcessation.Varenicline:Effectiveagentsforsmokingcessation.Syntheticdrugwithpartialagonistactionat4?2nicotinicreceptors.Hasantagonistpropertiespersistingduetolonghalf-life&highreceptoraffinity.Hence,preventsstimulanteffectofnicotineatpresynaptic4?2nicotinicreceptors-->resultsindopaminerelease.
381.DOCforCyclosporiasis? a)Trimethoprimsulfamethoxazolecombination b)Paromomycin c)Metronidazole d)Cyclosporin CorrectAnswer-AAns.A.Trimethoprimandsulfamethoxazolecombination.CombinationoftrimethoprimwithsulfamethoxazoleisDOCforcyclosporiasis&Isosporiasis(Protozoalinfection).
382.Mechanismofactionofcurarelike drugs? a)BlocksAChsynthesis b)BlocksAChreceptors c)Persistentdepolarization d)AgonisticwithAchreceptors CorrectAnswer-BAns.B.BlocksAChreceptorsTubocurarine,Cisatracurium,Rocuronium:CompetitiveantagonistatnAChreceptorsmainlyatNMjunction.d-tubocurarine:Obsoleteclinicalusage.PrototypeNMblocker.Longeractingisoquinolinederivative.MOA:Actspredominantlyatnicotinicreceptorsiteblockingtheirreceptors?Bycompetingwithacetylcholine(competitiveantagonism).
383.Adrugwithhighplasmabindingprotein propertyhaswhichofthefollowingproperties? a)LessGFR b)Lessdruginteraction c)Highervolumeofdistribution d)Lesstubularsecretion CorrectAnswer-AAns.A.LesserGFROnlyfreedrugscanbefilteredthroughglomerulus.Hence,PPBdecreasesGFR.Tubularsecretionisanenergyrequiringcarriermediatedactivetransport.hence,PPBdonotinterferewithtubularsecretion.
384.MechanismofactionofOseltamivir? a)Proteinsynthesisinhibitor b)Thymidylatesynthetaseinhibitor c)Neuraminidaseinhibitor d)Pyrimidineanalogs. CorrectAnswer-CAns.C.NeuraminidaseinhibitorNeuraminidaseinhibitors:Analogsofsialicacid.InterfereswithreleaseofprogenyinfluenzaA&Bvirusfrominfectedhostcells.Competitively&reversiblyinteractwithactiveenzymesite?>resultinginclumpingofnewlyreleasedinfluenzavirionstoeachother&tomembraneofinfectedcell.
385.Trueaboutcolchicinesis/are? a)Actsbyneutrophilrecruitment b)Causesmetaphasearrest c)Usefulinurate-loweringtherapy d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove.Colchicine:MOA:Actsbyinhibitinggranulocytemigrationintoinflamedjoint.Depolymerizationofmicrotubulesleadstoneutrophilrecruitmenttoinflamedtissue?Alteringneutrophilmotility.Decreasessecretionofchemotacticfactors&superoxideanionsbyactivatedneutrophils.Causesmetaphasearrest.Mostcommon&doselimitingtoxicity:Diarrhea.Alsocausekidneydamage,myopathy&bonemarrowdepression.Indications:Asarate-loweringtherapy(dailycolchicines)suppressingattacksprecipitatedbyabruptserumuricacidchanges.
386.Whichofthefollowingdrugisalpha2 agonist? a)Apraclonidine b)Timolol c)PGanalogues d)Verampamil CorrectAnswer-AAns.A.ApraclonidineApraclonidine?Selectivealpha2agonist.Usefulinglaucoma.Alphaagonists(Brimonidineandapraclonidine)arecontraindicatedinhypertensivecrisis.DipivefrinisaprodrugwhichisconvertedintoepinephrineinsidettreeyeUall,socansafelybeusedinhypertension.
387.DrugtodifferentiateMyastheniagravis fromcholinergiccrisis? a)Pyridostgmine b)Edrophonium c)Methacholine d)Clonidine CorrectAnswer-BAns.B.Edrophomium.Edrophonium?Usedasadiagnostictestformyasthenia.Steps:2mgdoseinjectedintravenously.Ifnoreactionoccursafter45seconds,anadditional8mgadministered.Ifthepatienthasmyastheniagravis,animprovementinmusclestrengthlastingforabout5minutesusuallyobserved.
388.ConversionofNorepinephrineto epinephrineismainlyby? a)S-adenosylmethionine b)Arginine c)Phenylalanine d)Dehydrogenease CorrectAnswer-AAns.A.S-adenosylmethionineS-adenosylmethionineisrequired&enzymeisphenylethanolamineN-methyltransferase.S-adenosylmethioninedonatesmethylgroupforconversionofNEtoEinpresenceofPhenylethanolamineNMethyltransferaseenzyme
389.DOCfordiphtheriacarrierstateis? a)Penicillin b)Antitoxin c)PenicillinOrerythromycin d)Ciprofloxacin CorrectAnswer-CAns.C.PenicillinorerythromycinContactsshouldreceiveantibiotics.BenzathinepenicillinG(600,000unitsforpersonsyoungerthan6yearsoldand1,200,000unitsforthose6yearsoldandolder)Oralerythromycin(40mg/kg/dayforchildrenand1g/dayforadults)for7-to10-daycourse.Identifiedcarriersincommunityalsoreceiveantibiotics.Maintainclosesurveillanceandbeginantitoxinatthefirstsignsofillness.
390.MOAofTeduglutideinshortbowel syndrome? a)GLP-2inhibitor b)HT1ainhibitor c)GLP-1analogs d)C-peptideanalogs CorrectAnswer-AAns.A.GLP-2inhibitorGlucagon-likepeptide-2(GLP-2)?Importantintestinotrophicgrowthfactor&mediatorofintestinaladaptation.FDAapprovedteduglutide(Gattex--NPS)totreatshortbowelsyndromeinadultpatientsrequiringadditionalnutritionfromI.V.parenteralnutrition.Effectivelyimprovesfluidabsorption.
391.DOCforchemotherapyinducedvomiting is? a)Graneseteron b)Prazosin c)Clonidine d)Dimenhydrinate CorrectAnswer-AAns.A.Granisetron.Granisetron:Serotonin5-HT3receptorantagonist.Usedasanantiemetictreatingnausea&vomitingfollowingchemotherapy&radiotherapy.Maineffect:Reducesvagusnerveactivity(VagusN.activatesvomitingcenterinmedullaoblongata).
392.Whatistheadvantageoffixeddose combinationofdrugs. a)Increasesefficacyofdrug b)Decreasesadverseeffects c)Patientcomplianceimproved d)Alloftheabove CorrectAnswer-DAns.D.AlloftheaboveAdvantagesofFDC:Safeandeffective.Reduces"pillburden"?Enhancingoveralltreatmentoutcome.Increasesefficiency.Reduceincidenceofadversedrugeffects.Improvespatientcompliance.Offerslowcost(comparedtoindividualcomponentsofactiveingredients).
393.DOCfordigitalisisinducedcentro-chilar tachycardia? a)Lidocaine b)Reducingdosageofdigoxinitself,reversesthecondition c)Verapamil d)Betablockers CorrectAnswer-AAns.A.LidocaineDigitalistoxicity:Features:Generallyunwell&lethargy.Nausea&vomiting.Confusion.Yellow-greenvision.Arrhythmias(e.g.AVblock,bradycardia)Dizziness.Precipitatingfactors:RenaldiseaseHypokalaemiaHypomagnesemiaHypoalbuminemiaHypothermiaHypothyroidismHypercalcemia.HypernatremiaAcidosis.Myocardialischaemia.PartialAVblock.
Drugs:Amiodarone.Quinidine.Verapamil.Spironolactone.Furosemide.Hydrochlorothiazide-CompetewithDCTsecretion,hencereducingexcretion.Management:Digibind.Correctventriculararrhythmiabylignocaine.Bradyarrhythmiasbypropanolol.Atrialtachyarrhythmiasbyatropine.Phenytoin.MonitorK+
394.Antiretroviraltherapyistobegivenin HIVinfectedpatientsirrespectiveofpresenceofsymptomsifCD4countislessthan? a)100 b)150 c)200 d)350 CorrectAnswer-CAns.C.200OfferARTtosymptomaticpatientsiftheCD4countis200?350cells/mm3ConsiderARTforasymptomaticpatientswithCD4countbetween200-350cells/mm3andmonitorcloselyfornewsymptoms.IftheCD4countis200?250cells/mm3,physicianscanconsiderrepeatingtheCD4testin4weeksinasymptomaticpatients.Thisistoruleoutthepossibilityofa20%marginoferrorinlaboratoryresults.PatientsshouldstartARTbeforetheCD4countdropsbelow200cells/mm3Ref:http://naco.gov.in/upload/Policies%20&%20Guidelines/1.%20Antiretroviral%20Therapy%20Guidelines%20for%20HIV-infected%20Adults%20and%20Adolescents%20Including%20Post-exposure.pdf
395.Carbapenemwhichhastendencyto causemaximumseizures? a)Imipenem b)Ertapenem c)Doripenem d)Meropenem CorrectAnswer-AAns.A.Imipenem.Imipenem:Carbapenemgrp.ofdrugs.Maximumtendencytocauseseizures.
396.Trueabouttreatmentofearlybreast carcinoma? a)Aromataseinhibitorsarereplacingtamoxifeninpremenopausal women b)Postmastectomyradiationtherapyisgivenwhen4ormore lymphnodesarepositive c)Tamoxifenisnotusefulinpost-menopausalwomen d)Inpremenopausalwomen,multidrugchemotherapyisgivenin selectedpatients CorrectAnswer-BAns.B.Postmastectomyradiationtherapyisgivenwhen4ormorelymphnodesarepositiveTamoxifen:Effectiveinbothpre&postmenopausalwomen(ifhormonereceptorpositive)DOCinpremenopausalwomenAromataseinhibitors:Provenmorebeneficialthantamoxifeninpostmenopausalwomen.MOA:Byloweringestrogeninpost-menopausalwomenwithhormone-receptor-positivebreastcancer.Inpost-menopausalwomen,mostofbody'sestrogenisfromandrogen.Aromataseinhibitorsinhibitsaromataseenzyme?blockingandrogenintoestrogen?loweringestrogenproducedoutsideovaries.Uses:1stlinetherapyinpostmenopausalwomen,adjuvantsettingor
secondaryagentafter1to2yearsofadjuvanttamoxifentherapy.Advantages:Reducedincidenceofendometrialcancer.Adverseeffects:Bonemineraldensityalteration-?osteoporosis&increasedfracturesinpostmenopausalwomen.Otheroptions:Inpremenopausalwomenwithanyformofadjuvantsystemictherapyshouldreceivemultidrugchemotherapy.
397.ApatientofRAistakingmethotrexate, steroidsandNSAIDssince4monthsbutactivityofdiseaseprogressionissame.Whatshouldbethenextprobablestep? a)StartmonotherapywithantiTNFalphadrugs b)Continuemethotrexateandsteroids c)Stoporalmethotrexateandstartparenteralmethotrexate d)Addsulfasalazine CorrectAnswer-DAns.D.Addsulfasalazine
398.IVMannitolisusedfortreatmentof a)Acutecongestiveglaucoma b)Pulmonaryedema c)Acuterenalfailure d)CHF CorrectAnswer-AAns.A.Acutecongestiveglaucoma.Mannitolmaybeusedtoreduceintraocularpressurewhengivenintravenously.
399.Variationinsensitivityofresponseto differentdosesofadrugindifferentindividualisobtainedfrom? a)Doseresponsecurve b)Therapeuticindex c)Bioavailability d)Phase1clinicaltrials CorrectAnswer-AAns.A.DoseresponsecurveThedose?responserelationship,orexposure?responserelationship,describesthechangeineffectonanorganismcausedbydifferinglevelsofexposuretoastressorafteracertainexposuretime,ortoafood.Appliestoindividuals,ortopopulations.
400.Whichoneoffollowingisfunctionsof PGI2? a)Inhibitsplateletaggregation b)Isavasodilator c)IspyrogeniclikePGE2 d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove.FunctionsofPGI2:InhibitsInhibitsplateletaggregation,vasodilatorplusbronchodilator&pyrogeniclikePGE2.
401.MechanismbywhichAchdecreases heartrateisby: a)Delayeddiastolicdepolarization b)Increaseinplateau c)Decreasepreload d)Increaseafterload CorrectAnswer-AAns:A.DelayeddiastolicdepolarizationAcetylcholinedecreasesheartrateprimarilybyinhibitingthespontaneousdepolarizationofcellsinSAnode;alsoknownasdiastolicdepolarization.ThisisachievedbyinhibitionofthefunnycurrentintheSAnode. Effectofacetylcholineoncardiovascularsystem Heartrate Achinhibitsfunnycurrentgenerationinthe decreases pacemakercellsofSAnode AVconduction AchblocksLtypecalciumchannelsintheAV decreases node Atrialcontraction Atriumissuppliedbycholinergicfibersmorethan decreases> theventricles.Achopenspotassiumchannels ventricular anddecreasescyclicAMPinthemyocardialcells. contraction Achincreasescalciuminendothelialcells,which Vasodilation stimulatescalciumdependentENOSandreleasesNOwhichcausesvasodilation.
402.WhichofthefollowingactthroughG proteincoupledreceptors? a)AchMuscarinicreceptors b)Insulinreceptors c)AchNicotinicreceptors d)GABA-Areceptors CorrectAnswer-AAns:A.AchMuscarinicreceptorsRef:Lippincott,6't'ed.,Pg.27-28Ml,M2,M3,M4andM5areAchMuscarinicreceptors.TheyareGproteincoupledreceptors
403.Trueaboutdrugmetabolism? a)GlucuronidationisphaseIreaction b)MostcommonenzymeinvolvedisCyp3A4/5 c)Reductionismostcommonreaction d)Cytochromep450isinvolvedphase-IIreaction CorrectAnswer-BAns.is'b'i.e.,MostcommonenzymeinvolvedisCyp3A4/5(Ref:KatzungIlth/ep.55)Cytochromep450enzymesaremicrosomalenzymesthatareinvolvedinphaseImetabolismofmanydrugs.MostofthedrugsaremetabolizedbyCyp3A4isoform.Cyp3A4/5carryoutbiotransformationoflargestnumber(nearly5O%)ofdrugs.
404.BenzodiazepinebindingsteonGABA receptorsison? a)y-subunit b)a-subunit c)-subunit d)-subunit CorrectAnswer-BAns.is'b'i.e.,a-subunit[Ref:Goodman(tGilman1I'h/ep.405,406;RecEttorsubunit&coffiplexesp.168]TheexactsubunitstructuresofnativeGABAreceptorsarestillareunknown,butitisthoughtthatmostGABAreceptorarecomposedofalpha,beta&gammasubunitsthatCoassemblewithsomeuncertainstoichiometry.BindingsiteofGABAisonbeta-subunit.Benzodiazepinesiteislocatedontheasubunitbutthestabilizationorcompletionofthatsiteintheassembled.Structurealsorequirestheysubunit.
405.Dexmedetomidineactsonwhichreceptorforits analgesicaction? a)5HT2A b)D2 c)2A d)D5 CorrectAnswer-CAns.'c'i.e.,2ADexmedetomidineisacentrallyactiveselectivealpha(2)agonistthathasbeenintroducedforsedatingcriticallyillventilatedpatientsinintensivecareunits.
406.NeuropathycausedbyINHincreasesin allexcept? a)Uremia b)Hyperthyroidism c)Diabetesmellitus d)Poornutrition CorrectAnswer-BAns.is'b'i.e.,Hyperthyroidism[RefKatzung11'h/ep.1069]isoniazidinducedperipheralneuropathy:Peripheralneuropathyisobservedin10to20%ofpatientsgivendosesgreaterthan5mg/kg/d,butitisinfrequentlyseenwiththestandard300-mgadultdose.Peripheralneuropathyismorelikelytooccurinslowacetylatorsandpatientswithpredisposingconditionssuchasmalnutrition,alcoholism,iliabetes,AIDS,anduremia.
407.Drugswhichareusedinacuteasthma include? a)Budesonide b)Terbutaline c)Salbutamole d)Theophylline e)Sodiumcromoglycate CorrectAnswer-B:C:DAns.is'b'i.e.,Terbutaline,'c'i.e.Salbutamole&'d'i.e.Theophylline[Ref:KDTVh/ep.223]Treatmentofacuteasthma:Theonlydrugseffectiveforthetreatmentofacuteattackofasthmaarebronchodilators(beta2-receptoragonists,anticholinergics,andmethylxanthines).Mildattacks:Forpatientswithmildattackinhalationofashortactingbeta-2receptoragonist,e.g.salbutamol(albuterol),terbutalineisused.Aninhaledanticholinergic,e.g.ipratropiummaybeaddedifthereisnosatisfactoryresponsetobeta2-agonistsalone.Inpatientswhoarerefractorytoinhaledtherapies,i.v.aminophylline(theophylline)maybeeffective.Severeattacks:Oxygenphtscontinuousadministrationofaerosolizedsalbutamol(albuterol)plussystemicsteroids,e.g.methylprednisolone,hydrocortisone.
Recently,MgSO4hasbeentriedinacutesevereasthmabyIVorinhalationroute.
408.Peripheralneuropathyis/arecausedby: a)Vincristine b)Sulfonamide c)Amiodarone d)Paclitaxel e)None CorrectAnswer-A:C:DAns.(A)Vincristine(C)Amiodarone(D)Paclitaxel[Ref:Harrison19th/2686-88,18th/3463-66;KDT7th/706]Sulfonamidenotmentionedinlistofdrugscausingneuropathies
409.Whichofthefollowingdrugsisnotan inhibitorofP-glycoprotein? a)Quinidine b)Erythromycin c)Verapamil d)Phenobarbitone CorrectAnswer-DAns.D.Phenobarbitone[RefKDT7Vep.15]P-glycoprotein:Productofmultidrugresistance1gene(ABCB1).Importantroleinpharmacokineticsofdrugs.AnATP-bindingcassette(ABC)transporterandisanimportantfactortolimitmembranepermeabilityinseveraltissuesand/oreliminationpathwaysintourine(renaltubles)andbile(liver).SomedrugsaresubstrateforbothCYP3A4andP-gp.Examples:CCBs:Verapamil,diltiazamAnticancerdrugs:Etoposide,daunorubicin,doxorubicin,paclitaxel,vincrisitineAntimicrobials:HIVprotoeaseinhibitors(indinavir,ritonavir),erythromycin,ketoconazoleImmunosuppressants:Cyclosporine,tacrolimus,sirolimus.Other:Digoxin,fexofenadine,loperamide.
410.Liposomedrugdeliverysystemisused forallexcept? a)Vincristine b)AmphotericinB c)Hyoscine d)Amikacin CorrectAnswer-CAns.C.HyoscineImportantdrugswithliposomedeliverysystems:AnticancerdrugsDonorubicin,Daunorubicin,vincristine,camptothecin,methotrexate,cisplatin,mitoxantraneAntifungalAmphotericinB,NystatinAntibioticsAmikacin,Ampicillin,ciprofloxacin,Ribavirin,Ganciclovir,chloroquineOthersIL-2,cyclosporin
411.Tachyphylaxisisseenwithwhichofthe followingdrugs? a)Pethidine b)Ephedrine c)Phenoxybenzamine d)Phentolamine CorrectAnswer-BAns.B.Ephedrine[RefKDT7th/ep.70&6th/ep.68;Laurence50/ep.448;Katzung11`"/ep.32]Tachyphylaxis:*Rapidlydiminishingresponsetorepeatedadministrationofadrug.Tachyphylaxismayoccurdueto:*Down-regulationofreceptors-Whentissuesarecontinuouslyexposedtoanagonist,thenumberofreceptorsdecreases(down-regulation).-Itoccursinasthmaticswhouse132-agonistbronchodilatorsexcessively.*Depletionofstoredneurotransmitter-Itisparticularlycommonwithindirectlyactingsympathomimeticsdrugs,e.g.amphetamine,tyramineandephedrine.-Itisduetodepletionofreleasablepoolofnoradrenalinefromadrenergicnerveterminals.
412.Synergesticactionisshownbythe followingdrugcombinationsexcept? a)Glibenclamideandmetformin b)Enalaprilandhydrochlorthiazide c)Levodopaandcarbidopa d)Hydrochlorthiazideandtriamterene CorrectAnswer-DAns.D.Hydrochlorthiazideandtriamterene[RefKDTp.56]SYNERGISM:Whentheactionofonedrugisfacilitatedorincreasedbytheother,theyaresaidtobesynergistic.Inasynergisticpair,boththedrugscanhaveactioninthesamedirectionorgivenaloneonemaybeinactivebutstillenhancetheactionoftheotherwhengiventogether.Additivedrugcombination:Aspirin+paracetamol-Asanalgesic/antipyreticNitrousoxide+halothane-AsgeneralanestheticAmlodipine+atenolol-AsantihypertensiveEphedrine+theophylline-Asbronchodilator
413.Oxidationinbiotransformationis? a)Functionalizationreaction b)Conjugationreaction c)Syntheticreaction d)Felsonreaction CorrectAnswer-AAns.A.Functionalizationreaction[Ref:KDT7th/ep.22,23]Biotransformationincludes2typesofreaction:PhaseI/Nonsynthetic/functionalizationreaction:Oxidation,reduction,hydrolysis,cyclization,decyclization.PhaseH/synthetic/conjugationreactions:Acetylation,glutathioneconjugation,glucoronideconjugation(glucuranization),glycineconjugation,methylation,sulfateconjugation(sulfuranation),nucleotidesynthesis.
414.Oxybutyninactsby? a)Adrenergicreceptorantagonist b)Muscarinicrece8ptorantagonist c)Histaminicantagonist d)Serotonergicantagonist CorrectAnswer-BAns.B.Muscarinicrece8ptorantagonist[RefKDT7thlep.113,117]Oxybutynin:Thisrecentlyintroducedantimuscarinic(muscarinicreceptorantagonist)hashighaffinityforreceptorsurinarybladderandsalivaryglandswithadditionalsmoothmusclerelaxantandlocalanestheticproperties.ItisrelativelyselectiveforM1/M3subtypesthanforM2.
415.Whichofthefollowingdrugcrosses BBB? a)Glycopyrrolate b)Neostigmine c)Physostigmine d)Alloftheabove CorrectAnswer-CAns.C.Physostigmine[RefKDTp.07,117]Physostigmine-RapidlyabsorbedfromGITandparenteralsites,penetratescorneafreelyandcrossesBBB(bloodbrainbarrier).Neostigmine-Itisaquarternaryammoniumcompoundwhichispoorlyabsorbedorallywithpoorcornealpenetrationanddoesn'tcrossBBB.Glycopyrrolate-Itisapotentandrapidlyactinganti-muscariniclackingcentraleffectsandisusedasapre-anaestheticmedication.
416.Whichofthefollowingisnottrueabout theactionofanticholinergicdrugs? a)AtropineisaCNSdepressant b)Atropinecausesmydriasis,abolitionoflightreflexand cycloplegia c)Atropinecausesbronchoconstriction d)Atropinecanincreasethechancesofhyperthermiainchildren CorrectAnswer-A:CAns.A.AtropineisaCNSdepressant&C.Atropinecausesbronchoconstriction[RefKDT7iVep.113,114]Actionsofanticholinergicdrugs:Theseareoppositeofparasympathetic(cholinergic)system.AtropinehasanoverallCNSstimulantaction.Stimulatesmedullarycentres-vagal,respiratory,vasomotor.Depressesvestibularexcitationandhasantimotionsicknessproperty.AbbrevatesrefractoryperiodofA-VnodeandfacilitatesA-Vconduction,PRintervalisshortened.DoesnothaveanyconsistentormarkedeffectonBP.UsedinarrhythmiaslikeAVblockanddigitalisinducedarrhythmia.Causesmydriasisduetocontractionofcircularmuscles(constrictorpupillae),abolitionoflightreflexandcycloplegia(paralysisofaccomodation).IncreasesintraoculartensionContraindicatedinglaucoma.Causesbronchodilatationandreducedairwayresistance,especiallyinCOPDandasthmapatients.Relaxesurinarybladder,urinaryretentionmay
occurcontraindicatedinbenignprostatehypertrophy.Decreasessweat,salivary,tracheobronchialandlacrimalsecretion.Decreasessecretionofacid,pepsinandmucusinthestomach.
417.Advantageofglycopyrolateover atropineis? a)Itisanaturalalkaloid b)ItlacksCNSpenetration c)CanbeusedinOPCpoisoning d)Ismorepotent CorrectAnswer-BAns.B.ItlacksCNSpenetration[RefKDT7thiep.117]Glycopyrrolate:Quarternarysyntheticcompound,whichispotentandrapidlyactingantimuscariniclackingCNSpenetrationandcentraleffects.Almostexclusivelyusedinpreanaestheticmedication.
418.Oximesareineffectiveinwhichofthe followingpoisoning:? a)Organophosphatepoisoning b)Amanitaphylloidespoisoning c)Carbamatepoisoning d)Dhaturapoisoning CorrectAnswer-CAns.C.Carbamatepoisoning[RefKDT7th/ep.111&6t/ep.105;Katzung11thiep.121]Oximes[Pralidoxime2-PAM,obidoximeanddiacetyl-monoxime(DAM)]areusedinorganophosphatepoisoning.Oximesactsbyreactivatingcholinesteraseenzyme.IneffectiveinCarbamatespoisoning.Pralidoximeiscontraindicatedincarbamatespoisoning,becausenotonlyitdoesnotreactivatecarbamylatedenzyme,ithasweakanti-chEactivityofitsown.Mostcommonlyusedcholinesterasereactivater.
419.Whichofthefollowingisanexampleof irreversiblecarbamate? a)Ambenonium b)Galantamine c)Propoxur d)Rivastigmine CorrectAnswer-CAns.C.PropoxurIrreversiblecarbamate:CarbarylPropoxur
420.38yroldpatientwithhighriskof coronaryarterydiseaseriskhashypertention,whichofthefollowingantihypertensivedrugswillbesuitableasafirstlinetreatmentforthispatient? a)ACEinhibitors b)Calciumchannelblockers c)Betaadrenergicblockers d)Diuretics CorrectAnswer-AAns.A.ACEinhibitorsPatientisrelativelyyounghypertensive(38yrs)withhighriskofcoronaryarterydisease,ACEinhibitors/Angiotensinreceptorblockeristhesuitablefirstlinetherapyformanagementofhypertentioninsuchpatients.
421.WhichofthefollowingisNOTaside effectofamiodarone? a)Pulmonaryfibrosis b)Cornealmicrodeposits c)Photosensitivity d)Tachycardia CorrectAnswer-DAns.D.Tachycardia[Ref:KDT7"Vep.534]Amiodaroneisabroadspectrumanti-arrhythmicdrugwhichbelongstoclassIIIoftheanti-arrhythmicdrugs.Followingaretheadverseeffects-FallinBP,bradycardiaandmyocardialdepressionoccursoni.v.injection.
422.Asideeffectofloopdiureticsisusedin ? a)Post-surgerycare b)Chronicanemia c)Bloodtransfusion d)Oncology/cancer CorrectAnswer-DAns.D.Oncology/cancerFurosemideandotherloopdiureticscausehypocalcemiabyincreasingCa2+excretion.Forthesamereasontheyareusedintumorinducedhypercalcemiatoreduceserumcalciumlevel.
423.Whyadenosinehasashorthalflife? a)Spontaneoushydrolysis b)Uptakeinsubcutaneoustissue c)UptakeinRBCandendothelialcells d)Renalexcretion CorrectAnswer-CAns.C.UptakeinRBCandendothelialcells[RefKDT6thIep.518;Katzung11thiep.244]AdenosineistheDOCforP.S.V.T.Administeredbyrapidi.v.injectioneitherasfreebaseorasATP.Actionisveryrapid-terminatesmorethan90%episodesofPSVTwithin30sec.Adenosineisveryshortacting(t.inblood-10sec)duetouptakeintoRBCsandendothelialcells.
424.Mechanismofactionofnicorandilis? a)K*channelblocker b)I('channelopener c)Na'channelblocker d)Cl-channelblocker CorrectAnswer-BAns.B.I('channelopener[Ref:KDT7th/ep.540,552]NicorandilThisdualmechanismanti-anginadrugthatactivatesATPsensitiveK+channels(potassiumchannelopener)therebyhyperpolarizingvascularsmoothmuscle.
425.Whichofthefollowingantiarrhythmic drugscandevelopLongQTsyndrome? a)Ibutilide b)Dofetilide c)Sotalol d)Alltheabove CorrectAnswer-DAns.D.AlltheaboveProarrhythmicManifestationsofMostFrequentlyUsedAntiarrhythmicAgents:AmiodarroneDigoxinDisopyramideDofetilideDronedaroneFlecainidesPropafenoneQuinidineSotalol
426.Whichofthefollowingisnottrueabout themechanismofactionofdigitalis? a)ItbindstotheintracellularfaceofNa'ATPaseenzyme b)ThereisriseinintracellularNa' c)Ithaspositiveionotropicaction d)Digitalisactionisindependentofcardiacinnervation CorrectAnswer-AAns.A.ItbindstotheintracellularfaceofNa'ATPaseenzyme[RefKDT7th/ep.496]Digitalismechanismofaction:Digitalisincreasestheforceofcontractionbyadirectactionindependentoftheinnervation.BindstotheextracellularfaceoftheNa+K+ATPaseandinhibitstheenzymecausingriseintheintracellularlevelsofNa+.TheraisedNa+inturninhibitstheNa+Ca2+exchangerandcausesriseinintracellularCa+.ThisraisedintracellularCa2+isresponsibleforthepositiveionotropiceffect.Thus,digitalisincreasesthecardiaccontractabilityandforceofcontraction.
427.Whichdruginhibitsboth cyclooxygenaseandlipooxygenase? a)Aspirin b)Indomethacin c)Imidazole d)BW755 CorrectAnswer-DAns.D.BW755[RefBiochemistryofeyebyElaineR.Bermanp.165]Drug-BW755Enzymeinhibited-Cyclooxygenaseandlipoxygenase
428.Drugactingon5HT4receptoris? a)Loxiglumide b)Renzapride c)Atractiloside d)Metoclopromide CorrectAnswer-BAns.B.Renzapride[RefKDT7th/ep.174]Renzapride:Renzaprideisacisapridecongenerwhichisaprokineticdruganditincreasesthegastrointestinalmotilitybyactingon5HT4receptors.Renzaprideisstillmoreselectivefor5HT4thancisapride.Italsohaslesserpropensitytocausecardiacarrhythmias.
429.Drugofchoiceforabortingtheacute attackofmigraineis? a)NSAIDslikeindomethacin b)Opioidslikemorphine c)Triptanslikesumatriptan d)Glucocorticoids CorrectAnswer-CAns.C.Triptanslikesumatriptan[RefKDT7th/eP.179]Treatmentandprophylaxisofmigraine:*Forabortinganacuteattackofmigraine,sumatriptan(oranyothertriptan)isthedrugofchoice.-OtherdrugsusedfortreatmentareNSAIDs,ergofamineanddihydroergotamine,andintranasalbutorphanol.*ForProphylaxis,Beta-blocker(propranolol)isthedrugofchoice.-Otherdrugsusedforprophylaxisaretricyclicantidepressants(amitriptyline),calciumchannelblockers(cinnarizine,verapamil),serotonineantagonists(methysergide,cyproheptadine),MAOinhibitors,andanticonvulsants(valproate,topiramate,gabapentine),fluxetin,onabotulinumtoxineA,pepaverineandphenalzine.
430.Rasburicaseisananalogueof? a)Xanthineoxidase b)IMPdehydrogenase c)AdenosineDeaminase d)UrateOxidase CorrectAnswer-DAns.D.UrateOxidaseRasburicaseisarecombinantversionofurateoxidase.ThecDNAofUrateoxidaseisobtainedfromAspergillusflavusandisintroducedintoSachhromycescervicae.Itisusedforreducinguratelevels.
431.Adverseeffectofmethysergideis? a)Metabolicsyndrome b)Endocardialfibrosis c)Peyronie'ssyndrome d)Drymouth CorrectAnswer-BAns.B.Endocardialfibrosis[RefKDT7th/ep.174]MethysergideChemicallyrelatedtoergotalkaloidswhichantagonizesactionof5HTonsmoothmusclesincludingthatofbloodvessels.MechanismofactionPotent5HT2A/2CantagonistwithNoaadrenergicordopaminergicaction.Uses:Migraineprophylaxis,carcinoidsyndromeandpostgastrectomydumpingsyndrome.AdverseeffectsAbdominal,pulmonaryorendocardialfibrosisisproducedwithprolongeduse.
432.Contraindicationforthetriptansiswhich ofthefollowing? a)Ischemicheartdisease b)Epilepsy c)Hepaticfailure d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove[RefKDT7th/ep.179]TriptansTheseare5-HTIDABreceptoragonists.AlltriptanscancausecoronaryvasospasmandarecontraindiatedinIHD.Othercontraindicationsarehypertension,epilepsy,hepaticorrenalimpairmentandduringpregnancy.Themostimportantadverseeffectsarefeelingofchestpressure,tightnessandpainwhichmaybeaccompaniedbyarrhythmiaandMIandappeartobeduetocoronaryvasospasm.
433.UseofPGF2aanaloguesis contraindicatedin? a)Postpartumharmorrhage b)Glaucoma c)Bronchialasthma d)Priapism CorrectAnswer-CAns.C.Bronchialasthma[RefKDT7th/ep.185,189]ProstaglandinF2a]PGF2aanaloguesaresmoothmuscleconstrictorwhichbringaboutcontractionofsmoothmusclesPGF2aanaloguelikecarboprostisusedforpostpartumhaemorrhagePGF2aanalogueslikelatanoprosthasbeenusedforglaucomaandisafirstlinedrugforopenangleglaucoma.Itiscontraindicatedinbronchialasthmaasitcausesbronchialmusclecontraction.
434.Advantageofformoteroloversalmeterol is? a)Itcanbeusedforprophylaxisinasthmatics b)Ithasgotafasteronsetofaction c)Itisashortactingbeta2agonist d)Italsohasbeta1agonisticaction CorrectAnswer-BAns.B.Ithasgotafasteronsetofaction[RefKDT7Vep.224;GoodmanGillman11thiep.720]FormoterolItisalongactingselective132agonistwhichacts12hourswheninhaled.Incomparisontosaletetrolithasfasteronsetofactionandisusedonaregularmorning-eveningscheduleforroundtheclockbronchodilatation.Dose:12-24pginhalationtwicedaily.
435.MechanismofactionofTeriparatideis? a)RecombinantPTH[rPTH] b)Recombinantcalcitonin c)Recombinantinsulin d)Recombinantprolactin CorrectAnswer-AAns.A.RecombinantPTH[rPTH]TeriparatideThisisrecombinantpreparationof1-34moleculesofaminoterminalofhumanPTH.Itduplicatesalltheactionsoflong(1-84)PTH.Diagnosticuse:Todifferentiatepseudofromtruehypoparathyroidism:teriparatideisgiveniv:ifplasmacalciumlevelfailstorise,thenitispseudohypoparathyroidism.
436.Anti-inflammatoryactionsof corticosteroidsaremediatedby? a)Byinhibitingangiogenesis b)Byinhibitingbreakdownofphospholipids c)Byincreasingvascularity d)Byincreasinggranulationtissueformation CorrectAnswer-BAns.B.Byinhibitingbreakdownofphospholipids[RefKDT7thiep.279]GlucocorticoidsinterfereatseveralstepsintheinflammatoryresponsebutthemostimportantoverallmechanismappearstobelimitationofrecruitmentofinflammatorycellsatthelocalsiteandproductionofproinflammatorymediatorslikePCs,LTs,PAFthroughinhibitionofphospholipaseA.
437.Whichofthefollowingisnotan inhalationalsteroids? a)Beclomethasone b)Betamethasone c)Budesonide d)Fluticasoneacetonide CorrectAnswer-BAns.B.Betamethasone[RefKDT7Vep.290]Corticosteroidmaybeusedasinhaledorsystemicdrugsinasthma.InhaledsteroidsTheseareglucocorticoidswithhightopicalandlowsystemicactivity.Commonlyuseddrugsarebeclomethasome,budesonide,fluticasoneandciclesonide.Inhaledsteroidsarethemosteffectiveanti-inflammatoryagentsusedinasthma.
438.Whichofthefollowingantithyroid medicationshadthemaximumchancesofcausingagranulocytosis? a)Carbimazole b)Clotrimazole c)Propylthiouracil d)Methimazole CorrectAnswer-CAns.C.Propylthiouracil[RefKDT7h/ep.253]Propylthiouracilhasgotmaximumchanceofcausingagranulocytosis.Itismostlyreversible.
439.Mifepristoneactsonwhichreceptor? a)TypeAprogesteronereceptor b)Estrogenreceptor c)LHreceptor d)Thyroidreceptor CorrectAnswer-AAns.A.TypeAprogesteronereceptor[RefKDT7hlep.319,320]MifepristoneItisapotent,19-norsteroid.Ithasanti-progestational,significantanti-glucocorticoidandanti-androgenicactivity.MifepristoneisapartialagonistandcompetitiveantagonistatbothAandBformsofprogesteronereceptor(PR)Intheabsenceofprogesterone(anovulatorycyclesaftermenopause)itexertsweakprogestionalactivityandinducespredecidualchanges.
440.Pegvisomantis? a)Somatostatinantagonist b)Somatotropinantagonist c)GHreceptorantagonist d)GHreceptoragonist CorrectAnswer-CAns.C.GHreceptorantagonist[RefKDT7th/ep.238]PegvisomantThispolyethyleneglycolcomplexedmutantGH.ItbindstoGHreceptorbutdoesnottriggersignaltransductionandactsasaGHreceptorantagonist.
441.Drugusedformedicalmanagementof acromegalyduetosmallpituitarytumorsis? a)Fulvestrant b)Pegvisomant c)Vigabatrin d)Cabergoline CorrectAnswer-BAns.B.Pegvisomant[RefKDT7h/ep.238]Pegvisomant:ThispolyethyleneglycolcomplexedmutantGH.ItbindstoGHreceptorbutdoesnottriggersignaltransductionandactsasaGHreceptorantagonist.Approvedfortreatmentofacromegalyduetosmallpituitaryadenomas.
442.Tiboloneisa? a)Naturalsteroidalestrogen b)Naturalnon-steroidalestrogen c)Syntheticsteroidalestrogen d)Syntheticnon-steroidalestrogen CorrectAnswer-CAns.C.Syntheticsteroidalestrogen[RefKDT7Vep.306,311]SyntheticestrogensSteroidalEthinylestradiol,mestranol,tibolone.NonsteroidalDiethylstilbestrol,hexestrol,dienestrol.
443.Tiboloneisusedfor? a)Fibroids b)Endometriosis c)Hormonereplacementtherapy d)Anovulatoryinfertility CorrectAnswer-CAns.C.Hormonereplacementtherapy[RefKDT7thiep.306,311]TiboloneItisa19-norsteroiddevelopedspecificallytobeusedforhormonereplacementtherapy,whichcombinesestrogenicandprogestationalpropertieswithweakandrogenicactivity.Inadoseof2.5mgdaily,itsuppressesmenopausalsymptomsandloweretheraisedGnlevels.Noendometrialstimulationhasbeennoted.Urogenitalatrophy,psychologicalsymptoms,libidoandosteoporosisareimprovedsimilartootherformsofHRT.IncreaseinbreastcancerriskappearstobelessthanwithcombinedHRT.Weightgain,increasedfacialhair,andoccasionalvaginalspottingmaybenoted.
444.Danazolactsthrough:? a)IncreasesreleaseofGn b)Increasesinsulinrelease c)InhibitionofreleaseofGn d)Inhibitionofinsulinrelease CorrectAnswer-CAns.C.InhibitionofreleaseofGn[RefKDT7th/ep.301]DanazoleIthasweakandrogenic,anabolicandprogestationalactivity.Themostprominentactionissuppressionofgonadotropin(FSH/LH)frompituitary.
445.MechanismofactionofVogliboseis:? a)pgalactosidaseinhibitor b)3lactaseinhibitor c)aglucosidaseinhibitor d)3glucosidaseinhibitor CorrectAnswer-CAns.C.aglucosidaseinhibitor[RefKDT7th/ep.277]VogliboseItisaglucosidaseinhibitorwhichpreventsbreakdownofcomplexcarbohydratesintosimplersugarslikeglucose.
446.Metyrosineactsbyinhibiting? a)PhenolethanolamineNmethylTransferase b)PhenylalanineHydroxylase c)TyrosineHydroxylase d)Tyrosinase CorrectAnswer-CAns.C.TyrosineHydroxylaseMetyrosineisaMethylL-tyrosineItisacompetitiveinhibitorofTyrosineHydroxylaseTyrosinehydroxylaseistheenzymewhichconvertsTyrosinetoDihydroxyphenylalanine(DOPA).Itistheratelimitingenzymeofcatecholaminesynthesis.
447.Whichofthefollowingoral hypoglycaemicdrugshasthelongestt1/2? a)Gliclazide b)Glimepiride c)Chlorpropamide d)Tolbutamide CorrectAnswer-CAns.C.Chlorpropamide[RefKDT6thlep.268]Tolbutamideisshortestactingsulfonylurea.Chlorpropamideislongestactingsulfonylureaandlongestactingoralhypoglycemic.Nateglinideisshortestactingoralhypoglycemic.Tolbutamide,becauseofshorterdurationofaction,issaferinelderlyandinthosepronetohypoglycemia.
448.Allofthefollowingareusesofoctreotide except:? a)Secretorydiarrhea b)Acromegaly c)Hepaticencephalopathy d)Bleedingesophagealvarices CorrectAnswer-CAns.C.Hepaticencephalopathy[RefKDT7tVep.238]Octreotideisasyntheticoctapeptidesurrogateofsomatostatinwhichis40timesmorepotentinsuppressingGHandprolactinsecretion.Itisalsoaweakinhibitorofinsulinsecretion.Uses:AcromegalySecretorydiarrheaassociatedwithcarcinoids,AIDS,cancerchemotherapyordiabetes.
449.Whichofthefollowingpairsiscorrect? a)Glibenclamide-Na'ATPblocker b)Biguanides-AMPKinaseactivation c)Vildagliptin-SGLT2inhibitor d)Voglibose-DPP4inhibitor CorrectAnswer-BAns.B.Biguanides-AMPKinaseactivation[RefKatzung11th/ep.741]BiguanideactsasanAMP-activatedproteinkinase(AMPK)activator.ActivationofAMPKhasahighnumberofpotentiallyantiatheroscleroticeffects,includingreducinginflammatorycelladhesiontobloodvesselendothelium&reducinglipidaccumulation.
450.Mechanismofactionofsulfonylureasis ? a)NaATPchannelblocker b)KATPchannelblocker c)CIATPchannelblocker d)CaATPchannelblocker CorrectAnswer-BAns.B.KATPchannelblocker[RefKDT7th/ep.270,274]Sulfonylureasprovokeabriskreleaseofinsulinfrompancreas.Theyactonthesocalled"Sulfonylureareceptors"(SUR1)onpancreatic(beta-cellmembrane-causedepolarizationbyreducingconductanceofATPsensitiveK.channels.ThisenhancesinfluxofCa'2--degranulation.Theydonotcausehypoglycemiainpancreatectomizedanimalsandtype1diabetes(Presenceofatleast30%offunctional[3-cellsinessentialfortheiraction).Aminoractionreducingglucagonsecretionbyincreasinginsulinandsomatostatinreleasehasbeendemonstrated.
451.NasallyactingGnRHanalogueis? a)Goserelin b)Triptorelin c)Nafarelin d)Leuprolide CorrectAnswer-CAns.C.Nafarelin[RefKDT7thiep.242]GnRHanaloguesareusedbySCroute,howevernafarilinandbusurelincanbeusedasintranasalspray.GnRHanaloguescancausehotflushes,lossoflibidoandosteoporosis.
452.Whichofthefollowingis/areside effect/sofgrowthhormoneadministration? a)Painatinjectionsite b)Glucoseintolerance c)Hypothyroidism d)Alltheabove CorrectAnswer-DAns.D.Alltheabove[RefKDT&hiep.234]AdverseeffectsofgrowthhormoneSomatropinandsomatremarerecombinantGHanalogues.Somatremhasanadditionalmethionineresidueandismoreimmunogenicthansomatropin,butallergicreactionsorresistancetotreatmentarenotaproblem.Painatinjectionsiteandlipodystrophycanoccur.Glucoseintolerance,hypothyroidism(duetounmaskingofTSHdeficiency),saltandwaterretention,handstiffiress,myalgias,headachearethepossibleadverseeffectsRiseinintracranialtensionoccursinfewcases.
453.Whichofthefollowingdrugshalts macrovascularaswellasmicrovasculareffectsofDM? a)Acarbose b)Biguanides c)Meglitinide d)Algaliptin CorrectAnswer-BAns.B.Biguanides[RefKDTTh/ep.276]Biguanides]*Biguanideslikemetforminarethe1stlinedrugsforthetreatmentofType2DM,whichactsbyAMPKactivation.*AdvantagesofBiguanidesareasfollows,-Nonhypoglycemic.-Promotesweightloss.-PreventsmacroaswellasmicrovascularcomplicationsofDM.
454.Whichofthefollowingarenaturally occurringopioid? a)Diacetylmorphine b)Ethylmorphine c)Morphine d)Pholcodeine CorrectAnswer-CAns.C.Morphine[RefKDT7"/ep.474]Classificationofopioids:Naturallyoccurringopiumalkaloids:-Morphine,codeineSemisyntheticopiates:-Diacetylmorphine(heroin),pholcodeineandethylmorphine.Syntheticopioids:-Pethidine(Meperidine),fentanyl,methadone,dextropropoxyphene,tramadol.
455.Mostpotentopioidis? a)Butorphanol b)Pentazocine c)Sulfentanyl d)Hdrocodone CorrectAnswer-CAns.C.Sulfentanyl[RefKDTp.476]Theorderofpotencyofopioids:Sufentanil>Fentanyl>Buprenorphine>Hydromorphone,Oxymorphone>Butorphanol>Levorphenol>Oxycodone>Hydrocodone>Nalbuphine,morphine,Methadone>Pentazocine>codeine>Mepridine(Pethidine)>Propoxyphane.
456.Allofthefollowingpairsarecorrect except? a)Peripheraldecarboxylaseinhibitor-Benserazide b)MAO-Binhibitor-Clorgyline c)COMTinhibitor-Entacapone d)Dopaminefacilitation-Amantadine CorrectAnswer-BAns.B.MAO-Binhibitor-Clorgyline[Ref:KDTThlep.439&&lep.439;Katzung11th/ep.513]Note:ClorgylineisaMAOAinhibitornotMAOB.
457.Whichofthefollowingisusedforthe patientonantiparkinsonianmedicationlevodopa+carbidopa,butpatientshowingmarkedon-offeffect? a)Bromocriptine b)Amatidine c)Selegeline d)Rimonabant CorrectAnswer-CAns.C.Selegeline[Ref:Harrison18th/ep.3326,3327]Ifthereiswearingoff(on-offeffect)COMTinhibitororMAO-Binhibitor(selegiline)isadded
458.Whichofthefollowingisnottrueabout benzodiazepines? a)Canproduceataxia b)HasGABAfacilitatorybutnoGABAmimeticaction c)REM,andStage3and4sleepisincreased d)Producesmusclerelaxationbyactiononmedulla CorrectAnswer-CAns.C.REM,andStage3and4sleepisincreasedRef:KDT6th/ep.394&5th/ep.317,363]Mechanismofactionofbenzodiazepines(BZDs):Musclerelaxationisproducedbyactiononmedulla.Ataxiaisduetoactiononcerebellum.BZDsactsonGABAAreceptors.EffectonCNS:Incontrasttobarbiturates,BZDsarenotgeneraldepressant,butexertrelativelyselectiveanxiolytic,hypnotic,musclerelaxantandanticonvulsanteffects.TheantianxietyactionofBZDsisnotdependentontheirsedativeproperty-withchronicadministrationreliefofanxietyismaintained,butdrowsinesswanesoffduetodevelopmentoftolerance.Stage2sleepisincreased,whileREM,Stage3&4sleeparedecreased.
459.Whichofthefollowingisnottrueabout barbiturate? a)ShowsGABAmimeticaction b)ShowsGABAfacilitatoryaction c)ItcandepressvoltagegatedNa.-andIC'channelsathigh concentrations d)Limbicsystemismostsensitivetothedepressiveactionof barbituratestoCNS CorrectAnswer-DAns.D.LimbicsystemismostsensitivetothedepressiveactionofbarbituratestoCNS[RefKDT7th/ep.399&6th/ep.391]ActiononCNS:BarbituratesactprimarilyattheGABA-BZDreceptor-ClchannelcomplexandpotentiateGABAergicinhibitionbyincreasingthelifetimeofCl-channelopeningcausedbyGABA(ContrastbenzodiazepineswhichenhancefrequencyofCIchannelopening)-GABAfacilitatoryaction.BarbituratesdepressallareasofCNS,butthereticularactivatingsystemismostsensitive.
460.Whichofthefollowingcanbeusedinthe managementoftardivedyskinesia? a)Cessationofantipsychoticmedication b)Baclofen c)Tetrabenazine d)Alltheabove CorrectAnswer-DAns.D.Alltheabove[RefKDT7th/ep.445,Harrisons18th/ep.3333]TardiveDyskinesia:Commonestofthetardivesyndromesandistypicallycomposedofchoreformmovementsinvolvingthemouth,lips,andtongue.Atypicalantipsychotics(e.g.,clozapine,risperidone,olanzapine,quetiapine,ziprasidone,andaripiprazole)areassociatedwithasignificantlylowerriskofTDincomparisontotraditionalantipsychotics.Treatmentprimarilyconsistsofstoppingtheoffendingagent.Ifthepatientisreceivingatraditionalantipsychoticandwithdrawalisnotpossible,replacementwithanatypicalantipsychoticshouldbetried.Inrefractorycases,catecholaminedepleterssuchastetrabenazinemaybehelpful.Tetrabenazinecanbeassociatedwithdosedependentsedationandorthostatichypotension.Otherapproachesincludebaclofen(40-80mg/d),clonazepam(1-8mg/d),orvalproicacid(750-3000mg/d).
461.Temazepamissuperiortodiazepamin? a)Longerdurationofaction b)Safelyusedinliverfailure c)Noactivemetaboliterequired. d)Highhepaticmetabolism CorrectAnswer-B:CAns.B.Safelyusedinliverfailure&C.Noactivemetaboliterequired.[RefKDT7'/ep.405]TemazepamIntermediateactingbenzodiazepine.Itsmetabolismisindependentofliverandhence,canbesafelygiveninpatientswithhepaticfailure.Temazepamdoesnothaveanactivemetabolitelikediazepam[Note:Diazepamisconvertedtoanactivemetabolite`desmethyldiazepam'(oxazepam)].
462.Drugcontraindicatedinabsence seizuresis a)Lamotrigine b)Clonazepam c)Tiagabine d)Ethosuximide CorrectAnswer-CAns.C.TiagabineCarbamazepine,vigabatrin,andtiagabinearecontraindicatedinthetreatmentofabsenceseizures,irrespectiveofcauseandseverity.
463.Mechanismofactionoftianeptinis:? a)Increase5HTuptake b)Decrease5HTuptake c)IncreaseDAuptake d)DecreaseDAuptake CorrectAnswer-AAns.A.Increase5HTuptake[RefKDT7th/ep.447]TianeptinAtypicalanti-depressantIncreases5HTuptakeandisneithersedativenorstimulant.Shownefficacyinanxio-depressivestates,particularlywithpsychosomaticsymptoms,aswellasendogenousdepression.Sideeffectsinclude:drymouth,epigastricpain,flatulence,drowsiness/insomnia,tremorandthebodyache.
464.VenalafaxineisanFDAapproveddrug forthetreatmentof? a)Majordepression b)Generalisedanxietydisorder c)Panicdisorder d)Alltheabove CorrectAnswer-DAns.D.Alltheabove[RefMedicalbasisofpsychiatarybySHossein,p.79]VenlafaxineItisserotoninandnoradrenalinereuptakeinhibitors(SNRI),butincontrasttoolderTCAsitdoesnotinteractwithcholinergic,adrenergic,histaminergicreceptorsanddoesnothavesedativeproperty.Itisfasteracting(otherfasteractingantidepressantsarebupropionandmirtazapine).ItraisestheBP(allotherantidepressantscausehypotension).ItisFDAapprovedforuseinmajordepression,generalizedanxietydisorder,andpanicdisorder.
465.FDAapproveddrugforrefractory schizophrenia? a)Amoxapine b)Haloperidol c)Clozapine d)Penfluridol CorrectAnswer-CAns.C.Clozapine[RefKDTriep.441]ClozapineisFDAapproveddrugforresistantschizophreniaItreducestheriskofsucidalbehaviorinyoungerpatientswithschizophrenia.
466.Trueaboutanti-Parkinsondrug levodopais:? a)Levodopaisanactivemetaboliteofdopamine. b)About50%ofadministeredlevodopaisperipherallyconverted tocarbidopa. c)About2%oftheadministeredlevodopacrossesbloodbrain barrier. d)Levodopahasnoroleinhepaticcoma. CorrectAnswer-CAns.C.About2%oftheadministeredlevodopacrossesbloodbrainbarrier.[RefKDT7th/ep.426]Levodopa:Levodopaisinactivebyitself,butistheimmediateprecursoroftheneurotransmitterdopamine.95%oftheoraldoseisdecarboxylatedintheperipheraltissues.About1-2%oftheadministeredlevodopacrossesthebloodbrainbarriertoreachthebrain,whichistakenupbythesurvivingdopaminergicneuronsandconvertedtodopamine.ThestimulationofexcitatoryDIaswellastheinhibitoryD2receptorsinstriatumachievesthesameneteffectofsmootheningmovementsandreducingmuscletone.Itproducesanon-specific'awakening'effectinthehepaticcoma.
467.Whichofthefollowingistrueabout ziprasidone? a)Profoundextrapyramidalsymptoms b)Causesweightloss c)Hasanti-depressantproperties d)Safeincardiacpatients. CorrectAnswer-CAns.C.Hasanti-depressantproperties[RefKDT7th/ep.442]Ziprasidone:Atypicalanti-psychoticIthasa5H1+5HT2+D2blockingactivitywithantagonismat5HT1Dandagonistat5HT1A.Beingatypicalitisfreefromextrapyramidalsideeffects(EPS)andhasgotgoodanxiolyticandantidepressantproperties.ItcausesmildweightgainandhyperglycemiaandcausesQTcprolongationandseriouscardiacarrhythmias.
468.Whichofthefollowingnephrotoxic drugsshouldbecompletelyavoidedinrenalfailure? a)Doxycycline b)Talampicillin c)Nitrofurantoin d)Nalidixicacid CorrectAnswer-B:C:DAns.B,TalampicillinC.Nitrofurantoin&D.NalidixicacidDrugstobeavoidedinrenalpatients:CephalothinTalampicillinNalidixicacidTetracyclines(exceptdoxycyline)Nitrofurantoin
469.Thetypicalmaintencedoseof Leveteracetamis? a)10-20mg/Kg/day b)20-30mg/Kg/day c)30-40mg/Kg/day d)40-50mg/Kg/day CorrectAnswer-CAns.C.30-40mg/Kg/day[RefKDT7hlep.420]LevetiracetamUniqueanti-convulsantwhichhasshownefficacyinrefractorypartialseizureswithorwithoutgeneralization.Dosage:Therecommendedstartingdoseis10mg/Kg/daygiventwicedaily.Thedosagecanbeincreasedweeklyorbiweeklyby10mg/Kg/day.Thetypicalmaintenancedoseis30-40mg/Kg/day.
470.Botulinumtoxinisusedintreatmentof? a)Axillaryhyperhidrosis b)Blepharospasm c)Cervicaldystonia d)Alloftheabove CorrectAnswer-DAns.D.Alloftheabove[RefKDT7th/ep.99]BotulinumtoxinAandBarehighlypotentexotoxinsproducedbyClostridiumbotulinumwhichcauses`botulinum'byinhibitingAchrelease.Itisusedintreatmentofblepharospasm,spasticcerebralpalsy,strabismus,spasmodictorticollis,nystagmus,hemifacialspasm,axillaryhyperhidrosis,spasticcerebralpalsywhichisduetocholinergicexcess.Ithasalsobeenusedforfacialwrinkles.
471.Whichofthefollowingantipsychotics showpartialD2agonistactivity? a)Aripiprazole b)Clozapine c)Quetiapine d)Ziprasidone CorrectAnswer-AAns.A.Aripiprazole[RefGoodman6Gillman1p.464,465,466;Katzung11"'/ep.495]Aripiprazole:OnlyantipsychoticwithD2agonisticactivity.(allothersareD2antagonists).LongestactingItalsohas5HT1Aagonisticand5HT2antagonisticactivity-Alsoknownasdopamine-serotininestabilizer.Itisleastsedatingantipsychoticcancauseinsomnia.
472.Whichdrugisgiveninthepaindueto diabeticneuropathy? a)Lamotrigine b)Navalproate c)Gabapentin d)Morphine CorrectAnswer-CAns.C.Gabapentin[RefKDT7th/ep.409]GabapentinThisislipophilicGABAderivatve.GabapentinenhancesGABAreleasebutitselfdoesnotactasaagonistattheGABAAreceptor.ItcrossestothebrainandenhancesGABAreleasebutdoesnotactasagonistatGABAAreceptor.Gabapentinisconsideredtobeafirstlinedrugforpainduetodiabeticneuropathyandpostherpeticneuralgia.UsesGTCSandpartialseizuresPainduetodiabeticneuropathyPostherpeticneuralgiaProphalaxisofmigraine
473.Topicalantifungalofchoicefor aspergillusinfectionofeyeis? a)Miconazole b)Clotrimazole c)Econazole d)Fluconazole CorrectAnswer-BAns.B.Clotrimazole[RefKhuranaOphthalmology4th/ep.422]Clotrimazole:FungistaticandiseffectiveagainstCandida,Aspergillusandmanyothers.Its1percentsuspensioniseffectivetopicallyandisthetreatmentofchoiceinAspergillusinfectionsoftheeye.
474.Whichofthefollowingisatopical antifungalagent? a)Benzylbenzoate b)Brimetenide c)Butenafine d)Posconazole CorrectAnswer-CAns.C.Butenafine[RefKDT7thiep.796]Butenafine:Butenafineisabenzylaminecongeneroftheterbinafine,whichactsbyinhibitingtheenzymesqualeneepoxidase.Usedonlytopicallyfortreatmentofdermatophytosis.Efficacyintineacruris/corporis/pedisissimilartothatofterbenafine.
475.Fastestactingantimalarialdrugis? a)Chloroquine b)Quinine c)Mefloquine d)Artether CorrectAnswer-DAns.D.Artether[RefHarrisons18th/ep.26-2]Artemisininderivatives:Artesunate,artemether,arteether,andtheparentcompoundartemisininaresesquiterpenelactonesderivedfromthewormwoodplantArtemisiaannua.Thesearethefastestactingerythrocyticschizontocide.
476.Whichofthefollowingincreases AmphoterecinBinducednephrotoxicity? a)Vancomycin b)Cyclosporin c)Acyclovir d)Alltheabove CorrectAnswer-DAns.D.Alltheabove[RefKatzung11th/ep.836]"Aminoglycosides.vancomycin,cyclosporineerothernephrotoxicdrugsenhancerenalimpairmentcausedbyAMB"RiskfactorsforamphotericinBinducednephrotoxicityFollowingriskfactorsincreasethechancesofnephrotoxicitycausedbyamphotericin:Concomitantuseofdiuretics.Abnormalbaselinerenalfunction(kidneydiseases)Dehydration(volumedepletion):-Itisakeyfactorfortherenaltoleranceofallthepotentialnephrotoxicdrugs.Therefore,allpatientsshouldreceive1-2litersofisotonicsalinepriortoamphotericinBinfusion.Concomitantuseofnephrotoxicdrugs:-Aminoglycosides,vancomycin,cyclosporine,tacrolimus(FK-506),acyclovir,NSAIDS,radio-contrastagentsHigheraveragedailydoseofamphotericinB.
477.Erythromycinisusedinthetreatmentof whichGITdisorder? a)Bacillarydysentery b)Amoebicdysentery c)Diabeticgastroparesis d)Ulcerativecolitis CorrectAnswer-CAns.C.Diabeticgastroparesis[RefKDT7h/ep.753]Erythromycin:Macrolideantibiotic.Erythromycinstimulatesmotilin(anuppergastrointestinalpeptidehormone)receptorsintheGITwhichinducesgastriccontractions,hastensgastricemptyingandpromotesintestinalmotilitywithoutsignificanteffectoncolonicmotility.Ithasbeenoccasionallyusedtoaffordshorttermsymptomaticreliefindiabeticgastroparesis,however,undesirablealterationofgutfloralimitsitsuse.
478.Whichmacrolideisactiveagainst Mycobateriumleprae? a)Azithromycin b)Roxithromycin c)Clarithromycin d)Framycetin CorrectAnswer-CAns.C.Clarithromycin[RefKDT7th/ep.754,780,Harrisons18thiep.1364-65]Clarithromycinisanewermacrolide,whichiseffectiveagainstMAC(Mycobacteriumaviumcomplex),atypicalmycobacteriaandMycobacteriumleprae.
479.Ivermectinisthedrugofchoicefor whichofthefollowinginfections? a)Trichuriasis b)Onchocerciasis c)Loiasis d)Trichinosis CorrectAnswer-BAns.B.Onchocerciasis[RefKDT7h/ep.853]Ivermectin:ExtremelypotentsemisyntheticderivativeofnematodalprincipalobtainedfromStreptomycesavermitilis.DOCforsingledosetreatmentofonchocerciasisandstrongyloidosis.Onlyoraldrugeffectiveagainstscabiesandpediculosis.ActsbyglutamategatedCI-channelwhichcausestonicparalysisinnematodes.
480.Whichofthefollowingcausesretinal pigmentation? a)Quinine b)Chloroquine c)Mefloquine d)Atovaquone CorrectAnswer-BAns.B.Chloroquine[RefKDT7thiep.823]Chloroquine:1stlineantimalarialdrug,whichisanerythrocyticschizonticide.However,itsprolongeduseofhighdoses(asinDLE,rheumatoidarthritis)maycauselossofvisionduetoretinaldamageintheformofretinalpigmentation.Causecornealdepositsandaffectvisionandarereversibleondiscontinuation.Lossofhearing,rashes,photoallergy,myopathy,grayingofhairmayoccur.
481.MechanismofactionofLinezolidis:? a)Inhibits30Sribosomesubunitof50Sribosome b)Inhibits23Sribosomesubunitof50Sribosome c)Inhibits5Sribosomesubunitof50Sribosome d)Inhibits5PS.ribosomesubunitof50Sribosome CorrectAnswer-BAns.B.Inhibits23Sribosomesubunitof50Sribosome[RefKDT7111ep.758]Linezolid:An`oxazoledianones'usefulintreatmentofMRSAandsomeVRSAstrainsItactsbyinhibitingbacterialproteinsynthesisbybindingto23Sfractionof50Sribosome.BindingofthelinezoliddistortsthetRNAbindingsiteoverlappingboth50Sand30Sribosomalsubunitsandstopstheproteinsynthesis.Itisapredominantlybacteriostaticdrug.
482.Whichofthefollowingisnottrueabout levamisole? a)Itisthelevoisomeroftetramisole b)Ithasimmunomodulatoraction c)Itcankillstrongyloideslarvaeandadultworms d)Itisusedagainstascariasisandancyclostomiasis CorrectAnswer-CAns.C.Itcankillstrongyloideslarvaeandadultworms[RefKDT7ffilep.852]Levamisole,Tetramisole:Tetramisolewasdevelopedinthelate1960s.Itisrecemic;itslevoisomer(levamisole)wasfoundtobemoreactiveandispreferrednow.Bothareactiveagainstmanynematodes,butuseisrestrictedtoascariasisandancylostomiasis,becauseactiononotherwormsispoor.Strongyloideslarvaearekilled,butadultwormsarenotsensitive.Thegangliainwormsarestimulatedcausingtonicparalysisandexpulsionofliveworms.Interferencewithcarbohydratemetabolism(inhibitionoffumaratereductase)mayalsobecontributing.Levamisoleisanimmunomodulatoraswell.LevamisolerestoresdepressedTcellfunction.Itwasonceusedasadiseasemodifyingdruginrheumatoidarthritisandasanadjunctinmalignancies,aphthousulcers,recurrentherpesbutrepeateddosesproducereactionsandnowithasbeenwithdrawn.
483.Whichofthefollowingisasideeffectof clofazimine? a)Reddishblackskindiscoloration b)Hemolyticanaemia c)Flulikesyndrome d)Axillaryfreckling CorrectAnswer-AAns.A.Reddishblackskindiscoloration[RefKDT7thlep.781,782]Clofazamine:1stlineanti-leproticdrugDyewithleprostaticandanti-inflammatoryproperties.Getsaccumulatedinmacrophagesandgetsdepositedinmanytissues.Includingsubcutaneousfatasneedleshapedcrystalsresponsibleforreddishblackskindiscoloration.Discolorationofskin,hairandbodysecretionsmayoccur.Conjunctivalpigmentationmayalsooccur.
484.Forsystemicmycosisfluconazoleis preferredoverketoconazolebecauseof- a)Greaterefficacy b)Longert1/2 c)Lessersideeffects d)Alltheabove CorrectAnswer-DAns.D.Alltheabove[RefKDT&lep.761]ImidazolesandTriazoles:Thesearepresentlythemostextensivelyusedantifungaldrugs.Fourimidazolesareentirelytopical,whileketoconazoleisusedbothorallyandtopically.Twotriazolesfluconazoleanditraconazolehavelargelyreplacedketoconazoleforsystemicmycosisbecauseofgreaterefficacy,Longert1/2,fewersideeffectsanddruginteractions.Theimidazolesandtriazoleshavebroadspectrumantifungalactivitycoveringdermatophytes,Candida,otherfungiinvolvedindeepmycosis(exceptmucor),Nocardia,somegrampositiveandanaerobicbacteria,e.g.Staph.aureus,Strep.faecalis,Bac.fragilisandLeishmania.Themechanismofactionofimidazolesandtriazolesisthesame.TheyinhibitthefungalcytochromeP450enzymelanosterol14-demethylase'andthusimpairergosterolsynthesisleadingtoacascadeofmembraneabnormalitiesinthefungus.ThelowerhosttoxicityoftriazolescomparedtoimidazoleshascorrelatedwiththeirloweraffinityformammalianCYP450enzymesandlesserpropensitytoinhibitmammaliansterolsynthesis.
However,becausetheyareactiveagainstcertainbacteriaaswell(whichdonothaveergosterol),othermechanismsofactionalsoappeartobeinvolved.
485.INHhepatotoxicityisduetowhich compound? a)INHacetylhydrazine b)INHsulfhydrazine c)INHmethylhydrazine d)Alloftheabove CorrectAnswer-AAns.A.INHacetylhydrazine[RefKDT7thlep.767]INHisextensivelymetabolizedinliver,mostimportantpathwaybeingN-acetylationbyNATZ.TherateofINHacetylationshowsgeneticvariationwithsomebeingFastacetylators-30to40%patients.Slowacetylators-60to70%patients.Isoniazidinducedperipheralneuritisismorecommoninslowacetylators.HepatotoxicminormetaboliteisproducedbyCYP2E1fromacetylhydrazine.
486.MechanismofactionofNiclosamideis:? a)Inhibitionofsubstratelevelphosphorylation b)Inhibitionofoxidativephosphorylation c)Inhibitionofprotoneffluxpumps d)Increaseproductionoffreeradicals CorrectAnswer-BAns.B.Inhibitionofoxidativephosphorylation[RefKDT7th/ep.854]NiclosamideactsbyinhibitingoxidativephosphorylationinmitochondriaandbyinterferingwithanaerobicgenerationofATP.Itismainlyactiveagainstcestodes-T.solium,T.saginata,DiphyllobothriumlatumandH.nana.
487.Whatistheeffectofcoadministrationof rifampicinandritonavirinpatientssufferingfromAIDS? a)AreaUnderCurvedecreasedby15% b)AreaUnderCurvedecreasedby35% c)AreaUnderCurveincreasedby15% d)AreaUnderCurveincreasedby35% CorrectAnswer-BAns.B.AreaUnderCurvedecreasedby35%[RefKucers:theuseofantibiotics6thednbyMLindsayGraysonp.1598]Coadministrationofritonavirwithrifampicin:Recommendationistousethecombinationwithcaution.Areaundercurvedecreasedby35%ThereisnochangeinrifampicinconcentrationItisrecommendedtomonitortheantiretroviralactivityofritonavir
488.Drugofchoiceforsurgicalprophylaxis is:? a)Cefaclor b)Ceftizoxime c)Cefazolin d)Cefoperazone CorrectAnswer-CAns.C.Cefazolin[RefKDT7th/ep.726]Cefazolinistheprototype1stgenerationcephalosporinthatisactiveagainstPnGsensitiveorganismsiestreptowcce,gonococciandgroup.Itisthepreferredparenteralfirstgenerationcephalosporinforsurgicalpeophylaxis.
489.Vapiprostisa? a)Thromboxanereceptorantagonist b)Thromboxanesynthetaseantagonist c)PGE1analogue d)PGI2analogue CorrectAnswer-AAns.A.Thromboxanereceptorantagonist[RefInternetncbiarticle]Vapiprost:Novelcongener,whichisarecentlydevelopedthromboxanereceptorantagonist.Itpreventsplateletaggregation,preventsthrombusformationandtherebypreventingvesselocclusion.ItisusuallyusedalongwithrtPAlikealteplase,renecteplase,tenecteplase.
490.Treatmentofclopidogreltoxicitycanbe donewith? a)Wholehumanblood b)Platelettransfusion c)vWftransfusion d)rFVIIainfusion CorrectAnswer-DAns.D.rFVIIainfusionrFVIIa(RecombinantfactorVila)hasbeenshowntorestorethrombingenerationinclopidogreltreatedbloodsamples,andshortenthrombingenerationlagtimeinpatientswhohadbeentreatedwithaspirinandclopidogrel,andinbloodsamplestreatedwithclopidogrel'sactivemetabolite.Thustheycanbeusedforthemanagementofclopidogreltoxicityinducedbleedingi.e.canbeusedtoreversetheeffectsofclopidogrel.
491.Whyisclopidogrelpreferredover ticlopidine? a)Lowerincidenceofneutropeniaandthrombocytopenia b)Lowerincidenceofdyslipidemia c)Lowerincidenceofhyperglycemia d)Lowerincidenceofposturalhypotention CorrectAnswer-AAns.A.Lowerincidenceofneutropeniaandthrombocytopenia[RefKDT6thiep.610]Clopidogrel:Thisnewercongenerofticlopidinehassimilarmechanismofaction,abilitytoinhibitplateletfunctionandtherapeuticefficacy,butappearstobesaferandbettertolerated(CLASSICSstudy).Clopidogrelissaferthanticlopidineasitislessassociatedwithhematologicaldyscrasiasthanuseofticlopidine.Alowerfrequencyofneutropenia,thrombocytopeniaandotherbonemarrowtoxicitycomparedtoticlopidinehasbeenrecorded.Theclopidogrelasaspirininpatientsatriskofischaemicevents(CAPRIE)trialhasfoundclopidogrelrecipientstohaveaslightlylowerannualriskofprimaryischaemiceventsthanaspirinrecipients.
492.Whichofthefollowingantilipidemicdrug isasterolabsorptioninhibitor? a)Gemfibrozil b)Simvastatin c)Nicotinicacid d)Ezetimibe CorrectAnswer-DAns.D.Ezetimibe[RefKDT7th/ep.635]3ClassificationofantihyperlipidemicdrugsHMGCoAreductaseinhibitor:Statins:Lovastatin,Simvstatin,Pravastatin,Atorvastatin,RosuvastatinBileacidsequestrantsResins:Colestipol,CholestyramineLPLactivator/PPARalphaactivator-Clofibrate,gemfibrozil,fenofibrate.Sterolabsorptioninhibitor-EzetimibeLipolysis&TGsynthesisinhibitor-Nicotinicacid
493.MechanismofactionofTorcetrapribis? a)Bileacidsequestrant b)Sterolabsorptioninhibitor c)Lipoproteinlipaseactivator d)CETPinhibitors CorrectAnswer-DAns.D.CETPinhibitors[Ref:KDT7hlep.641]CETPInhibitors:CETP,i.e.,Cholesterylestertransferproteinsinhibitorsareclassofcholesterolloweringagents.CETPfacilitatesexchangeofCHEwithT4betweenHDLandchylomicrons,VLDLandLDLwhichplaysanimportantroleinthedisposalofHDLassociatedCH.ExamplesofCETPinhibitors:Torcetrapib&AnacetrapibClinicaltrialshavebeenperformedandtorcetrapibwasfoundtoincreaseoccurrenceofcardiovasculareventslikeangina,MI,heartfailureanddeath.
494.MostpotentH2antagonistis:? a)Ranitidine b)Cimetidine c)Famotidine d)Nizatidine CorrectAnswer-CAns.C.Famotidine[RefKDT7h/ep.650&6thlep.629;Katzung1lthlep.1070]H2-receptorantagonistsDrugsinthisgrouparecimetidine,ranitidine,famotidine,roxatidine,nizatidineandloxatidine.FamotidineisthemostpotentH2blocker.FamotidinehassomeinverseagonisticactiononH2receptors.AllH2-blockersarecompetitiveblockersexceptfamotidine(competitive-noncompetitive)andloxatidine(noncompetitive).H2blockersareusuallygivenfor6-8weeks.
495.Notanadverseeffectofcimetidine? a)Confusionalstate,restlessness b)Gynecomastia c)Drymouth d)Decreasedprolactinlevels CorrectAnswer-DAns.D.Decreasedprolactinlevels[Ref:KDT7h/ep.650]Cimetidine:H2blockerwhichhasbeenreplacedbynewcongenersduetoitsmanyadverseeffects.Followingareitsadverseeffects:Welltoleratedbymostpatients:adverseeffectsoccurin<5%.Thesearegenerallymild.Headache,dizziness,bowelupset,drymouth,rashes.CNSeffectslikeconfusionalstate,restlessness,convulsionsandcomahaveoccurredinfrequentlyinelderlypatients,inthosewithrenalimpairment,especiallywithlargedosesinfused
496.Useofmetoclopramidebeyondweeks increasesthechancesoftardivedyskinesia? a)8 b)12 c)16 d)20 CorrectAnswer-BAns.B.12[RefPharmacologyandphysiologyforanesthesiabyHughE.Hemmingsp.511]FDAhasissuedablackboxwarningformetoclopramide,giventhehighiskofdevelopingtardivedyskinesiaifmetoclopramideuseextendsbeyond12weeks.
497.ThetwomoleculesofAminosalicylate coupledviaazobondform? a)Mesalazine b)Olsalazine c)Balsalazine d)Sulfasalazine CorrectAnswer-BAns.B.Olsalazine[RefKDT7h/ep.684]Olsalazine?2moleculesofaminosalicylate(ASA)coupledbyazobonds.Balsalzine5ASAlinkedto4?aminobenzoyl-(3alanine.Sulfasalazine5ASAlinkedtosulfapyridinebyazobond.Mesalazine:-pHcoatedtabletof5ASA
498.Naturalanticancerdrugis? a)Paclitaxel b)Methotrexate c)Cyclophosphomide d)Alloftheabove CorrectAnswer-AAns.A.Paclitaxel[RefGoodman&Gilman11th/ep.1350-1354;Katzung1p.949]Antimitoticdrugsofnatural(plant)sources.VincristineVindesinePaclitaxelVinblastineVinorelbineDacetaxelOthernaturalanticancerdrugsareEpipodophyllotoxins(Etoposide)BleomycinAnthracyclins(Doxorubicin,daunorubicin)CamptothecinsMitomycin'C'Actinomycin'D'
499.Drugactingon'S'phaseofcycle? a)Chlorambucil b)Methotrexate c)Vincristine d)Paclitaxel CorrectAnswer-BAns.B.Methotrexate[RefKDT7"lep.823]CellcyclespecificTheykillactivelycyclingcellandtheirsiteofactionisconfinedtoonephaseofthecellcycle.Drugscausingcellcyclespecificinhibitionaregivenbelow:G,phase:VinblastineSphase:Mtx,cytarabine,6-TG,6-MP,Hydroxyurea,mitomycinG2phase:Bleomycin,etoposide,Daunorubicin,TopotecanMphase:Vincristine,vinblastine,paclitaxel,dacetaxel,Ixabepilone,Estramustine.
500.Mechanismofactionofaprepitantis? a)RANKligandinhibitor b)MMDAantagonist c)NK1receptorantagonist d)5HT3antagonist CorrectAnswer-CAns.C.NK1receptorantagonist[RefGoodman&Gillman's11`"/ep.1005]AprepitantAprepitantisanantiemeticsubstancethatbelongstoaclassofdrugscalledsubstancePantagonists.Thecompoundmediatesitseffectbyblockingtheneurokinin1(NK1)receptor.Aprepitantcrossesthebloodbrainbarrier.Aprepitantisusedforchemotherapyinducednausea&vomiting(CINV),andpost-operativenausea&vomiting(PONY).Afterabsorptionaprepitantisboundextensivelytoplasmaproteins(>95%);itismetabolizedavidly,primarilybyhepaticCYP3A4andisexcretedinthestools.
501.UseofHAARTisassociatedwith hepatotoxicityapproximatelywhatpercentageofpatients? a)10% b)20% c)30% d)40% CorrectAnswer-AAns.A.10%[RefHarrisons18th/ep.2566]HighlyActiveAntiretroviralTherapy(HAART):Combinationantiretroviraltherapy(cART),alsoreferredtoashighlyactiveantiretroviraltherapy(HAART),isthecornerstoneofmanagementofpatientswithHIVinfection.Indirecthyperbilirubinemia,resultingfromdirectinhibitionofbilirubinconjugatingactivitybyUDP-glucuronosyltransferase,usuallywithoutelevationofaminotransferaseoralkalinephosphataseactivities,occursin-10%ofpatientstreatedwiththeproteaseinhibitorindinavir.
502.Bendamustineisusefulforthe managementof? a)Chroniclymphoidleukemia b)Coloncarcinoma c)Breastcarcinoma d)Renalcarcinoma CorrectAnswer-AAns.A.Chroniclymphoidleukemia[RefHematologyBasicprinciplesandpracticebyRonaldHoffman,p.819]BendamustineItisachemotherapymedicationusedinthetreatmentofchroniclymphocyticleukemia(CLL),multiplemyeloma,andnon-Hodgkin'slymphoma.ItworksbyinterferingwiththefunctionofDNAandRNA
503.Abraxaneisa:? a)Albuminbounddocetaxel b)Globulinbounddocetaxel c)Albuminboundpaclitaxel d)Globulinboundpaclitaxel CorrectAnswer-CAns.C.Albuminboundpaclitaxel[RefKatzung11thlep.1235]Abraxaneisanovelalbuminboundpaclitaxelwhichhasgotlesserpropensitytocausehypersensitivityreactionsthanpaclitaxel.Abraxaneisuseinthetreatmentoftheadvancedmetastaticbreastcarcinomapatients.Paclitaxelactsbyinhibitingmicrotubulinpolymerizationandinhibitsdivisionofmetastaticcells.
504.AbataceptbindstoonTcellsurface a)CDII b)CD20 c)CD22 d)CD28 CorrectAnswer-DAns.D.CD28[RefKatzung11th/ep.634]AbataceptItisafusionproteinthatcombinestheextracellulardomainofthemoleculeCTLA4(CD154)withtheFcportionofahumanimmunoglobulin.ItinterferewiththeinteractionsbetweenantigenpresentingcellsandTlymphocytes.Therefore,itaffectsearlystagesinthepathogeniccascadeofeventinRA.CTLA4hashighaffinityforCD28,whenabataceptbindstoCD28onTcellsurface,itpreventsthesecondsignalfrombeingdelivered,thusturningdowntheTcellresponse.
505.Cardiotmdcityisthesideeffectof:? a)Bleomycin b)Topotecan c)Rubidomycin d)Procarbazine CorrectAnswer-CAns.C.Rubidomycin[RefKDT7th/ep.826]AnthracyclineinducedcardiotoxicityRubidomycinanddoxorubicinaretheanthracyclineanti-tumorantibioticsTheyhavecardiotoxicityasaadverseeffect.ThiscanmanifesteitheracutelywithECGchanges,arrhythmiasandhypotension,whicharereversible,orbedelayedlikeCHF.
506.Tocilizumabactsasanantagonistat whichreeptor- a)ILI b)IL2 c)IL6 d)TNF CorrectAnswer-CAns.C.IL6[RefHarrisons18thiednp.2750]TocilizumabisahumanizedmonoclonalantibodydirectedagainstthemembraneandsolubleformsoftheIL-6receptor.IL-6isaproinflammatorycytokineimplicatedinthepathogenesisofRA,withdetrimentaleffectsonbothjointinflammationanddamage.IL-6bindingtoitsreceptoractivatesintracellularsignalingpathwaysthataffecttheacutephaseresponse,cytokineproduction,andosteoclastactivation.
507.MechanismofactionofBasiliximabis? a)TNFainhibitor b)IL1antagonist c)IL2antagonist d)IL6antagonist CorrectAnswer-CAns.C.IL2antagonist[RefKDT7`/ep.878,884]BasiliximabandDaclizumabTheyarehighlyhumanizedchimericmonoclonalantiCD25antibodywhichbindstoandactsasIL2receptorantagonist.CombinedwithotherimmunosuppressantslikeazathioprineandMMFtopreventrenalandothertransplantrejectionreactions.Plasmat1/2ofDaclizumabisaround3weekswhichismuchlongerthanBasiliximab.
508.Estramustineisacombinationof? a)Estradiol+normustine b)Estriol+normustine c)Estriol+mechloroethamine d)Estriol+cyclophosphamide CorrectAnswer-AAns.A.Estradiol+normustine[RefKDT7thiep.858,866]EstramustineComplexofestradiolandnitrogenmustardnormustinewhichhasweakestrogenicbutnoalkalytingproperty.Itbindstoptubulinandinterfereswithitsorganizationofmicrotubulesexertinganti-mitoticaction.
509.Pemetrexedisindicatedforuseinwhich ofthefollowing? a)Mesoepithelioma b)Nonsmallcelllungcarcinoma c)Ewingssarcoma d)Osteosarcoma CorrectAnswer-A:BAns.A.Mesoepithelioma&B.Nonsmallcelllungcarcinoma[Ref:KDT7th/ep.858,863]Pemetrexedisanewercongenerofmethotrexatewhichprimarilytargetstheenzymethymidylatesynthase.Uses:Incombinationwithcisplatin,pemetrexedisapprovedfortreatmentofmesoepitheliomaandnonsmallcelllungcarcinoma.
510.Whichofthefollowingisnottrueabout purineantagonists? a)Azathioprineisusedasimmunosuppresant b)Drugsareactivatedbyhypoxanthineguaninephosphoribosyl transferase[HGPRTase] c)FludoribineisthedrugofchoiceforCLL d)Cladarabineisdegradedbyadenosinedeaminase CorrectAnswer-DAns.D.Cladarabineisdegradedbyadenosinedeaminase[RefKatzungIlth/ep.948]Purineantagonists6-mercaptopurine(6-MP),6-thioguanine,fludarabineandcladarabinearepurineanaloguesthatareusedincancerchemotherapy.CladarabineistheDOCforHairycellleukemiaasitisresistanttodegradationbyadenosinederminase.
511.Panitumumabisusedforwhichcancer? a)Coloncancer b)Lungcancer c)Breastcancer d)Osteoclastoma CorrectAnswer-AAns.A.Coloncancer[RefHarrisons18thiep.677]PanitumumabItisamonoclonalantibodyagainstEGFreceptor.Itisusedformanagementof(Colorectal)coloncancer.
512.Cetuximabisusedtotreat? a)Adamantinoma b)BasalcellCa c)ColorectalCa d)Crohn'sdisease CorrectAnswer-CAns.C.ColorectalCa[RefKDT7th/ep.870,Harrisons18thiep.677]CetuximabCetuximabisEGF(Epithelialgrowthfactor)receptorantibody,whichpreventscellgrowth,proliferationandmetastasis.ItisapprovedforHeadneckandfacesquamouscellCaasadjuvantwithcisplatin.ItisalsousedforEGFreceptor+vecolorectalCa.
513.Whichofthefollowingisnotanadverse effectofcyclophosphamide? a)Hemorrhagiccystitis b)Infertility c)Bonemarrowsuppression d)Diabetesinsipidus CorrectAnswer-DAns.D.Diabetesinsipidus[RefHarrison17e/ep.521;Goodman&Gilman11th/ep.1326;Katzung11tVep.941]ToxicityofCyclophosphamideBonemarrowsuppression(relativeplateletsparing)PulmonarytoxicityCardiac(athigherdoses)CystitisInfertilityGIToxicityAlopeciaTeratogenesis
514.Adverseeffectoftheimatinibareall except? a)Periorbitaledema b)Myalgia c)Pleuraleffusion d)Arthralgia CorrectAnswer-DAns.D.Arthralgia[RefKDT7th/ep.870]Imatinibisatyrosinekinaseinhibitor,whichinhibitsPDGF(Plateletderivedgrowthfactor)receptoraswell.Uses: 1. CML-Chronicmyeloidleukemia2. DOCforc-kit+veGIST(GastrointestinalStromalTumor) Adverseeffects:Abdominalpain,vomiting,fluidretention,pleuraleffusion,periorbitaledema,myalgia,liverdamageandCHF.
515.Defectindiscriminatingbluegreen visionisduetowhichdrug:? a)Alprostadil b)Primaquine c)Sildenafil d)Primaquine CorrectAnswer-CAns.C.Sildenafil[RefKDT7thlep.303-304]Sildenafil(Viagra)actstoincreasecGMPbyinhibitingitsbreakdownbyphosphodiesteraseisoform5(PDE-5).Recommendedthatatleast6hourspassbetweenuseofanitrateandtheingestionofsildenafil.Sildenafilalsohaseffectsoncolorvision,causingdifficultyinblue-greendiscrimination.TwosimilarPDE-5inhibitors,tadalafilandvardenafil,areavailable.
516.Racecadotrilisusedfor? a)Chronicdiarrhea b)Acutesecretorydiarrhea c)Chronicconstipation d)Diabeticgastroparesis CorrectAnswer-BAns.B.Acutesecretorydiarrhea[Ref:KDT7th/ep.686]Racecadotrilisrapidlyconvertedtothiorphan,anenkephalinaseinhibitorwhichpreventsthedegradationofencephalin(ENK)whicharemainly8opioidreceptoragonists.Itdecreasesintestinalhypersecretionwithoutaffectingmotilityandusedforshorttermtreatmentofacutesecretorydiarrhea.
517.Trueabouttrienteneis: a)Itisthedrugoffirstchoiceinwilsonsdisease b)Itismorepotentcuriureticagentthanpenicillamine c)Trientinetherapycancauseirondeficiency d)Trientinecannotbegivenorally CorrectAnswer-CAns.C.Trientinetherapycancauseirondeficiency[RefHarrisons18thiep.3189]PenicillamineVstrientineinwilsondiseasePenicillamineisthedrugofchoicefortreatmentofwilson'sdisease.However,thedrugproducesundesirablesideeffectsandinsomepatientsbecomeintolerable.Trientineisindicatedespeciallyinpatientswhoareintoleranttopenicillamine.Trientineislesspotentcupriureticagentthanpenicillamine.Trientineisorallyeffectiveandshortacting.Trientinemaycauseirondeficiency;thiscanbeovercomewithshortcourseofirontherapybutironandtrientineshouldnotbeingestedwithin2hoursofeachother.
518.Whichofthefollowingdrugsis associatedwithpriapism? a)Hydralazine b)Prazocin c)Resperidone d)Alltheabove CorrectAnswer-DAns.D.AlltheaboveDrugsthatmaycausepriapism:AnticoagulantsHaloperidolhydralazineNifedipineOlanzapinePapaverinePhenothiazinesPhentolaminePrazosinRisperidoneTrazodone
519.WhichofthefollowingisaCl-channel activator? a)Lubriprostone b)Nefazodone c)Varenioline d)Valethamate CorrectAnswer-AAns.A.Lubriprostone[RefHarrisons18th/ep.2500]ChlorideChannelActivatorsLubiprostoneisabicyclicfattyacidthatstimulateschloridechannelsintheapicalmembraneofintestinalepithelialcells.Chloridesecretioninducespassivemovementofsodiumandwaterintothebowellumenandimprovesbowelfunction.LubiprostoneisanewclassofcompoundsfortreatmentofchronicconstipationwithorwithoutIBS.
520.Whichdrugisusedinthetreatmentof TypeItyrosinemia? a)Nitisinone b)Alogliptin c)Pemoline d)Milrinone CorrectAnswer-AAns.A.Nitisinone[RefNelson20'Vep.641]Adietlowinphenylalanineandtyrosinecanslowbutdoesnothalttheprogressionofthecondition.Thetreatmentofchoiceisnitisinone,whichinhibitstyrosinedegradationat4-HPPD.Thistreatmentpreventsacutehepaticandneurologiccrises.Althoughnitisinonestopsorgreatlyslowsdiseaseprogression,somepretreatmentliverdamageisnotreversible.
521.Modafinilisadrugusedinwhichofthe followingconditions? a)Prematureejaculation b)Premenstrualsyndrome c)Shiftworkdisorder d)Erectiledysfunction CorrectAnswer-CAns.C.Shiftworkdisorder[RefKDT7th/ep.487]ModafinilItisanewerpsychostimulantpopularwithnightshift(callcentre)workersandpeoplewhowanttoimprovealertnessandkeepawake.Itisclaimedtoincreaseattentionspan,andimproveaccuracycompromisedbyfatigueandsleepiness.Theapprovedindicationsarenarcolepsy,sleepapneasyndromeandshiftworkdisorder.
522.Acamprostateisusedfor? a)Alcoholabstinence b)Nicotineabstinence c)Opioidabstinence d)Cocaineabstinence CorrectAnswer-AAns.A.Alcoholabstinence[RefKDT7th/ep.393]AcamprosateisaweakNMDAreceptorantagonistwithmodestGABAAreceptoragonisticactivityusedformaintenanceofalcoholabstinence.Ithasalsobeenfoundtoreducerelapseofdrinkingbehavior.Itisstartedimmediatelyafteralcoholwithdrawalandgivenatadoseof666mg2-3timesaday.Loosemotionisthemostcommonsideeffect.
523.Depotpreparationsareadministeredby ? a)Subcutaneousroute b)Intravenousroute c)Intramuscularroute d)Bothsubcutaneousandintramuscularroute CorrectAnswer-DAns.D.BothsubcutaneousandintramuscularrouteAdepotinjectionisaninjection,usuallysubcutaneousorintramuscular,ofapharmacologicalagentwhichreleasesitsactivecompoundinaconsistentwayoveralongperiodoftime.Depotinjectionsareusuallyeithersolidoroilbased.
524.IfVmaxdecto80%duetoaninhibitor andKmissameasbeforewhichisthetypeofinhibition? a)CompetitiveEquilibriumtype b)Noncompetitive c)CompetitiveNonEquilibriumtype d)Noneoftheabove CorrectAnswer-BAns.B.NoncompetitiveDecreaseinVmaxwithnochangeinKmisseeninNon-competitiveinhibition.
525.Approximatedoseofdrugina5years oldchild? a)Sameasadultdose b)1/2ofadultdose c)1/3ofadultdose d)'Aofadultdose CorrectAnswer-CAns.C.1/3ofadultdoseTherearethreerule'sbywhichdrugcloseinchildrencancalculatedby: 1. Forchildren2yearsoldandolder(Young'srule)2. Forinfantandchildren<2years(Fried'srule)3. Child'sdosebyweightcanbecalculatedbyClark'srule: Child'sdose=[Weight(1b)/150]*adultdose.
526.ActivesubstanceinDakinsskindressing agentusedinburnsis? a)Mafenideacetate b)Silversulfadiazine c)Sodiumhypochlorite d)Nystatin CorrectAnswer-CAns.C.SodiumhypochloriteDakin'sskindressingagentcontainssodiumhypochlorite'Itisusedforsuperficialanddeepburns.
527.Oxidationofdrugsismainlytakesplace in? a)Nucleu b)SmoothER c)RoughER d)Cytoplasm CorrectAnswer-BAns.B.SmoothERMostofthemicrosomaldrugmetabolizingenzymes(Cyt.P450)arelocatedonsmoothendoplasmicreticulum.
528.Alkalinediuresisinacidicdrug poisoningisnotdonein? a)Aspirin b)Methotrexate c)Morphine d)Phenobarbitone CorrectAnswer-CAns.C.MorphineAcidicdrugs(barbiturate,methotrexate,salicylate)aremoreionizedatalkalineurineandarenotabsorbedfromrenaltubulesiftheurineisalkaline,andtheirexcretioninurineisincreased.Therefore,alkalinizationofurineisdonebyNaHCO2inpoisoningofacidicilrugs.
529.PermissionfromDCGI[Drugcontroller general,India]isneededbeforewhichphaseofdrugtrial? a)Phase1 b)Phase2 c)Phase3 d)Phase4 CorrectAnswer-AAns,.A.Phase1FollowingaretheprerequisitesforstartingaclinicaltrialinIndia:- 1. PermissionfromDCGl2. Approvalfromethicscommittee3. MandatoryregistrationontheICMRmaintainedwebsitewwwctri.in
530.Volumeofdistributionofadrugis500ml andtargetconcentrationofdruginbloodis5g/L.20%ofadministereddrugisreachedtosystemiccirculation.Whatwillbetheloadingdoseofthatdrug- a)1gm b)5gm c)12.5gm d)25gm CorrectAnswer-CAns.C.12.5gmLoadingdose=(TargetCp*Vd)/FTargetconcentration(Cp)=5gm/LVolumeofdistribution=500ml=0.5LF(Fractionofadministereddrugreachessystemiccirculation)=20Vo=0.25x0.5So,loadingdose=r2.5gm
531.ICcontentofRinger'slactate[mmol/L]? a)130 b)109 c)4 d)50 CorrectAnswer-CAns.C.4OneliterofRinger'slactatesolutioncontains:- 1. 130mEqofsodiumion=130mmoVl2. 109mEqofchlorideion=109mmol/L3. 28mEqoflactate=28mmol/L4. 4mEqofpotassiumion=4mmol/L5. 3mEqofcalciumion=1.5mmol/L
532.HalflifeofNicotineinblood? a)15minutes b)2hours c)5hours d)24hours CorrectAnswer-BAns.B.2hours'Nicotinehasahalf-Iifeofapproximately2hours(range1-2hours).
533.Volumeofdistributiondependsuponall except? a)Drugdose b)Plasmaconcentration c)Extentofabsorption d)Halflifeofdrug CorrectAnswer-DAnS.D.HalflifeofdrugAfteradrugreachestheblood,itmaybedistributedtovarioustissues.Thisisdeterminedbyahypotheticalparameter,volumeofdistribution.Volumethatwouldaccommodateallthedruginthebody,ifthecombinationthroughoutwasthesameasinplasmaiscalledvolumeofdistribution.Orinsimplewords,itkthefluidvolumethatwouldberequiredtocontainalltheadministereddruginthebodywithaconcentrationequaltoplasma.
534.Lorcaserinisusedas? a)Anti-anxiety b)Anti-smoking c)Anti-helminthic d)Anti-obesity CorrectAnswer-DAns.D.Anti-obesityLorcaserineisselective5-HT2cagonistwhichdecreasesappetiteintreatmentofobesity.
535.Capecitabinebelongstowhichclassof anticancerdrug? a)Antimetabolite b)Alkylatingagent c)Nitrogenmustards d)Vincaalkaloids CorrectAnswer-CAns.C.NitrogenmustardsAntimetabolitesPurineantagonists-Mercaptopurine,Thioguanine,Azathioprine,Fludarabine,CladaribinePyrimidineantagonists-S-Fluorouracil,Cytosinearabinoside(cytarabine),CaPecitabine,Gemcitabine.Folateantagonist-Methotrexate,Pemetrexed.
536.Whichantibioticshouldnotbegiven afterdrinkingmilk? a)Chloramphenical b)Tetracycline c)Erythromycin d)Sulfonamide CorrectAnswer-BAns.B.Tetracycline
537.Idoxuridineisusedfortreatmentof? a)Influenza b)RSV c)HSV d)HIV CorrectAnswer-CAns.C.HSVIdoxuridineisusedonlytopicallyforkeratoconjunctivitisbyHSV'
538.XDRTBisdefinedas? a)MDRplusresistancetofluoroquinolone b)MDRplusresistancetofluoroquinoloneandstreptomycin c)MDRplusresistancetofluoroquinoloneandAmikacin d)MDRplusresistancetoAmikacin CorrectAnswer-DAns.D.MDRplusresistancetoAmikacinMDRisdefinedasresistanceINHandrifampicinwithorwithoutresistancetootherdrugs.XDRisdefinedasresistancetoINHandrifampicinaswellastoallfluoroquinolonesandoneofnjectabledrugs(capreomycin,kanamycin,amikacin).
539.Longestactingcarbapenems? a)Imipenem b)Meropenem c)Doripenem d)Ertapenem CorrectAnswer-DAns.D.ErtapenemErtapenemisalong-actingcarbepenemwithabroadspectrumantimicrobialactivitysimilartooldercarbapenems,imipenemandmeropenem.However,unlikeimipenem,ithasPooractivityagainstpseudomonas.
540.Highvolumeofdistributiondependson ? a)Highplasmaproteinbinding b)Lipidsolubility c)Elimination d)Halflife CorrectAnswer-BAns.B.Lipidsolubility[Ref:Clinicalpharmacology3d/ep.31]Itadrughashighvolumeofdistribution(>42L),thedrugisthoughttobedistributedtoalltissuesofthebody,especiallyfattytissue.Agivendrugwillhavehighvolumeofdistribution,ifithas:Highlipidsolubility(non-polardrug)LowrateofionizationLowplasmaproteinbinding
541.Durationoferythromycinusedin treatmentofdiphtheriais? a)3days b)7days c)14days d)30days CorrectAnswer-CAns.C.14daysDrugofchoicefordiphtheriaiserythromycin.Totalcourseofantibioticsisgivenfor14daysAlternativeantibioticsarepenicillinG,clindamycinandrifampir.
542.DrugsusedforH.Pyloriareallexcept? a)Bismuth b)Amoxicillin c)Domperidone d)Clarithromycin CorrectAnswer-CAns.C.DomperidoneDrugsusefulforH.PyloriinfectionAmoxicillinTinidazole/metronidazoleOmeprazoleRanitidineTetracyclineBismuthClarithromycin.
543.Drugswhichisnotmetabolizedby acetylation? a)Dapsone b)Metoclopramide c)Procainamide d)INH CorrectAnswer-BAns.B.MetoclopramideDrugsmetabolizedbyacetylation:Sulfonamides(includingdapson)rProcainamideINHHydralazinePASClonazepam
544.Whichistopicalwayofdrug administration? a)Inhaledsteroid b)Transdermalpatch c)SublingualNTG d)Rectaldiazepam CorrectAnswer-AAns,A.InhaledsteroidInhaledCorticosteroids(usedinasthma)havehightopicalactivity.Theyactlocallytoreduceinflammationandhyper-reactivityofbronchialtree.Transdermalpatch,sublingualNTGandrectaldiazepamaresystemicroutesofdrugadministration.
545.NeuropathywithINHtherapyisleastin patients? a)Havingmalnutrition b)Alcoholics c)Fastacetylators d)VitaminBcomplexdeficiency CorrectAnswer-CAns.C.FastacetylatorsPeripheralneuropathyismorelikelytooccurinslowacetylatorsandpatientswithpredisposingconditionssuchasmalnutrition,alcoholism,diabetes,AIDS,anduremia.
546.Trueabouttransdermaldrugdelivery systemareallexcept? a)Appliedtochest,abdomenandback b)Drugisdeliveredataconstantrate c)Goodoptioninemergencysituations d)Fentanylisused CorrectAnswer-CAns,C.GoodoptioninemergencysituationsThemicroporemembraneintransdermalpatchissuchthatrateofdrugdeliverytoskinsurfaceislessthantheslowestrateofabsorptionfromtheskin.Thisoffsetsanyvariationintherateofabsorptionaccordingtothepropertiesofdifferentsites.Assuch,thedrugisdeliveredataconstantandpredictablerateirrespectiveofsiteofapplication.Usuallychest,abdomen,upperarm,lowerback,buttockormastoidregionarcutilized.TransdermalpatchesofGTN,fentanyl,nicotineandestradiolareavailableinIndia,whilethoseofisosorbidedinitrate,hyoscine,andclonidinearemarketedelsewhere.
547.Synergisticactionisshownbyallexcept ? a)Penicillinplussulfonamide b)Streptomycinplustetracycline c)Rifampicinplusdapsone d)Penicillinplustetracycline CorrectAnswer-DAns.D.PenicillinplustetracyclineCombinationofabactericidalwithabacteriostaticdrugmaybesynergisticorantagonisticdependingontheorganism.Iftheorganismishighlysensitivetothecidaldrug-responsetothecombinationisequaltothestaticdruggivenalone(apparentantagonism),becausecidaldrugsactprimarilyonrapidlymultiplyingbacteria,whilethestaticdrugretardsmultiPlication.Thishasbeenseenwithpenicillin+tetracydine/chloramphenicolonpneumococciwhicharehighlysensitivetopenicillin.Pneumococcalmeningitistreatedwithpenicillin+tetracyclinehadhighermortalitythanthosetreatedwithpenicillinalone.Penicillin+erythromycinforgroupAStreptococciandnalidixicacid+nitrofurationforE.colihavealsoshownantagonism.
548.Physiologicalantagonistsare? a)AdrenalineandIsoprenaline b)Histamineandadrenaline c)Isoprenalineandpropranolal d)Alloftheabove CorrectAnswer-BAns.B.HistamineandadrenalinePhysiologicalantagonistsarethosethatproduceoppositeactionbyactingondifferentreceptors.ExampleHistaminecausesbronchoconstrictionviaH1receptorsandthisactionisantagonizedbyadrenalinewhichcausesbronchodilatationthroughbeta2receptors(optiond).
549.Receptorlevelantagonismisshownby? a)AdrenalineandIsoprenaline b)Histamineandadrenaline c)Isoprenalineandpropranolol d)Alloftheabove CorrectAnswer-CAnS.C.IsoprenalineandpropranololReceptorantaoonists(Pharmalogicalantaqonists)ReceptorantagonistsarethosedrugsthatblockstheactionofagonistbyactingonsamerecePtors.ExampleIsoprenalineisbeta1&beta2receptoragonistwhilepropranololhasantagonisticactiononbeta1&beta2recePtors(option'c')
550.Emtricitabineisa/an? a)Alkylatingagent b)Antimetabolite c)Mitoticinhibitor d)Noneoftheabove CorrectAnswer-BAns.B.AntimetaboliteEmtricitabineisanantimetabolite,butitisnotananticancerdrug(itisananti-retroviraldrug).AIINRTIsareantimetabolites:-'AlthoughallNRTIshavesamebasicmechanismofaction,differentdrugsintheclassserveasantimetabolitesofdifferentpurineandpyrimidinebasesofDNA.
551.Fastestreceptormediatedactionis through? a)Cellmembranereceptors b)Intrinsicionchannels c)Enzymelinkedreceptors d)Intracellularreceptors CorrectAnswer-BAns.B.IntrinsicionchannelsFastestactingreceptors-ReceptorswithintrinsicionchannelsSlowestactingreceptors?Intracellularreceptors(receptorsregulatinggeneexpressions/transcriptionfactors)?Cytoplasmicornuclearreceptors.
552.Emtricitabineisclassifiedas? a)Alkylatingagent b)Antimetaboliteanticancer c)NRTI d)Noneoftheabove CorrectAnswer-CAns.C.NRTIEmtricitabineisananti-retroviraldrug.Itisanucleoside-reversetranscriptaseinhibitor(NRTI).Itisasyntheticcytidineanalogue.Majorsideeffectsarelacticacidosisandliverdysfunction.
553.Whichamongthefollowingispresent onlyiniv[intravenous]form- a)Vancomycin b)Meropenem c)Streptomycin d)Alloftheabove CorrectAnswer-BAns.B.MeropenemMeropenemisgivenintravenously.Vancornycinisusedintravenouslyforallinfections,exceptforpseudomembranouscolitis,whereitisusedbyoralroute.Streptomycinisadministeredbyintramuscularroute.
554.Sideeffectsofclonidineareallexcept? a)Xerostomia b)Sedation c)Impotency d)Diarrhea CorrectAnswer-DAns,.D.DiarrheaAdverseeffectsofclonidineare(i)drynessofmouth(xerostomia),nose'eye,(ii)sedation,(iii)mentaldepression'(iv)constipationand(v)impotency.Ithasnoeffectonlipidprofile.
555.Lipidinsoluble(3-blokceris- a)Timolol b)Carvedilol c)Pindolol d)Celiprolol CorrectAnswer-DAns.D.CeliprololLipidinsolublebetablocker:AcebutololAtenololBisoprololBetoxalolCarteololCeliprololEsmololNodalolSotalolLabetalol
556.Nonselectivea+1blockeris? a)Carvedilol b)Timolol c)Pindolol d)Acebutolol CorrectAnswer-AAns.A.CarvedilolCombinedalpha&betablockers:CarvedilolLabetalolBucindololBevantololNipradilolDilevalolMedroxalol
557.Quinineactsonwhichstageof plasmodiumlifecycle? a)Exoerythrocytic b)Pre-erythrocytic c)Erythrocytic d)Alloftheabove CorrectAnswer-CAns.C.ErythrocyticAnti-malarialdrugsactingonErythrocyticschizogony.Fastacting===Chloroquine,amadioquine,quininamefloquine,halofantrine,lumefanterine,atovaquone,artimisinin.Slowacting===Pyrimethamine,proguanil,sulfonamides,tetracyclines.
558.Non-selectiveBeta-blockerwith sympathomimeticactivity? a)Pindolol b)Acebutalol c)Nodalol d)Metoprolol CorrectAnswer-AAns.A.PindololBeta-blockerswithintrinsicsympatheomimetic(partialagonist)activity:AcebutololCarteololPindolol(non-selectivebetablocke).BipindololOxprenololPenbutololAlprenololLabetalolCeliprolol
559.Whichofthefollowingisnon-selective 3rdgenerationBetablocker? a)Betaxolol b)Celiprolol c)Carteolol d)Nadolol CorrectAnswer-CAns.C.CarteololNonselectivethirdgenerationbeta-blockersarecorteolol,Carvedilolandlabetalol.
560.Gametocidalantimalarialdrugforall speciesofplasmodium? a)Chloroquine b)Quinine c)Primaquine d)Mefloquine CorrectAnswer-CAns.C.PrimaquineGametocidal-ActsongametocytesForallspecies:Primaquine,artimisininsForP.vivax:Chloroquine,quinine
561.ActionofM,cholinergicreceptors? a)Skeletalmusclecontraction b)Acidsecretioninstomach c)Decreasedheartrate d)Salivationandlacrimation CorrectAnswer-CAns.C.DecreasedheartrateEffectofcholinergicsystemonheart(e.g.decreasedheartrate)isthroughM2receptors.
562.Levamisolisa/an? a)Immunomodulator b)Immunostimulant c)Antiheliminthic d)Alloftheabove CorrectAnswer-DAns.D.AlloftheaboveLevamisolisananti-helminthicdrugwithimmune-modulatoryaction.Atlowdosesithasimmune-stimulatoryaction.
563..Beta-blockershouldbeusedwith cautioninpatientof- a)Hypertension b)Glaucoma c)Conductiondefect d)CHF CorrectAnswer-CAns.C.ConductiondefectPartialandcompleteheartblockBeta1receptorsincreaseconductioninAVnode.Betablockersdecreaseconductionbyreducingsympatheticdriveonbeta1receptors-Worseningofblock.
564.Whichofthefollowingisnotexcretedin kidney? a)Ciprofloxacin b)Ofloxacin c)Levofloxacin d)Moxifloxacin CorrectAnswer-DAns.D.MoxifloxacinFluroquinolonethatareprimarilyexcretedbyrenalmechanismsandforwhichdoseadjustmentisneededinclude:CiprofloxacinGatifloxacinCinafloxacinLevofloxacilinLomefloxacilinNorfloxacinOfloxacin
565.Antimuscarinicdrugusedinoveractive bladder- a)Pirenzepine b)Trospium c)Tropicamide d)Atropine CorrectAnswer-BAns.B.TrospiumDrugsusedforoveractivebladder:Darifenacin,Solefenacin,Tolterodine,Trospiumchloride,Oxybutynin,Solifenacin,Flavoxate
566.Thymidineisresponsibleforresistance towhichantibiotic? a)Erythromycin b)Sulfonamide c)Tetracycline d)Nitroforantoin CorrectAnswer-BAns.B.SulfonamideThesulfonamidesareantimetabolitesthatcompetewithPABA,therebypreventingsynthesisoffolicacid.Thisinhibitionblockstheformationofthymidine,somepurines,methionineandglycine.Theenterococciareabletouseexogenousthymidineandarethereforeintrinsicallyresistanttothesulfonamides.
567.Anti-cholinesterasewithcentralaction? a)Neostigmine b)Physostigmine c)Pyridostigmine d)Edrophonium CorrectAnswer-BAns.B.PhysostigmineLipidsolubleagents(organophosphatesandphysostigmine)havemoremarkedmuscarinicandCNSeffect;andstimulategangliabutactiononskeletalmuscleislessprominent.
568.Antituberculardrugwhichmakesthe patientnon-infectiveearliest? a)INH b)Rifampin c)Ethambutol d)Pyrazinamide CorrectAnswer-AAns.A.INHInthosewithopenorinfectiouspulmonaryTB,thegreatmajorityofbacilliisfreelyreplicatinginthecavitywallsandisrapidlykilledbyINH,therebyspeedilyrenderingthepatientnon-infections.
569.Contraindicationofantimuscarinicdrug ? a)Glaucoma b)Asthma c)Pepticulcer d)Urinaryincontinence CorrectAnswer-AAns.A.GlaucomaAntimuscarinic(e.g.-atropine)drugsarecontraindicatedin: 1. Glaucoma2. Benignprostatichyperplasia
570.Maximumcycloplegicactionofatropine isseenat? a)30-40minutes b)1-3hours c)8-10hours d)1-2weeks CorrectAnswer-BAns.B.1-3hoursAtropineisapowerfulcycloplegicandmydriaticagent.Mostpotentcycloplegicavailableforoptometrists.Maximummydriasisisreachedtypicallyin30-40minuteswhilerecoverymaytakeaweekormore.Cycloplegiacommencesafter30minutesofapplication,withmarkedcycloplegiabeingreachedin1-3hours.Theeffectmaylastupto6-12daysbeforenormalaccommodationisrestored.
571.Oneofthefollowingisnotasideeffect ofatropine? a)Blurringofvision b)Diarrhoea c)Urinaryretention d)Confusionofelderly CorrectAnswer-BAns.B.DiarrhoeaSideeffectsandtoxicityofatropineDrymouthFeverDifficultyinswallowingConstipationDry,flushedhotskinDifficultyinmicturitionPalpitationDeliriumDilatedpupilPhotophobiaBlurredvisionRespiratorydepressionCardiovascularcollapsePsychoticbehaviorConvulsionandcoma
572.Specificfeatureofsimvastatin? a)Mostpotentstatin b)Longestactingstatin c)Lipophilic d)Notmetabolized CorrectAnswer-CAns.C.LipophilicStatinsarethemostpowerfulLDLloweringdrugs.Statinsarethemosteffectiveandbesttoleratedhypolipidemicdrugs.Simvastatinandlovastatinarelipophilicandhence,theirCNSpenetrationismorethanhydrophilicagentslikepravastatinandfluvastatin.
573.Longestactinganti-cholinesterase- a)Pyridostigmine b)Ambenonium c)Edrophonium d)Echothiophate CorrectAnswer-DAns.D.EchothiophateTherearetwobasiccategoriesofcholinesteraseinhibitors: 1. Reversibleinhibitors2. Irreversibleinhibitors Thereversibleinhibitorsproduceeffectsofmoderateduration,andtheirreversibleinhibitorsproduceeffectsoflongduration.Echothiophateisirreversibleinhibitor?longacting.
574.Ximelagatranisusedas? a)Antiplatelet b)Anticoagulant c)Fibrinolytic d)Antifibrinolytic CorrectAnswer-BAns.B.AnticoagulantDirectThrombinInhibitors:Thisgroupincludeshirudin,lepirudin,bivalirudin,argatroban,dabigatran,melagatran,andximelagatran.DabigatranandXimelagatran(aprodrugofmelagatran)canbegivenorally.Allotherdrugsareusedparenterally.ThesedrugsdirectlyinactivatefactorIIa(thrombin).Thesearetheanticoagulantofchoiceforheparin-inducedthrombocytopenia
575.Propranololisusedin? a)Thyrotoxicosis b)AVblock c)Cardiacarrest d)Alloftheabove CorrectAnswer-AAns.A.ThyrotoxicosisUsesofbeta-blockers:Hypertension.CardiactachyarrhythmiasMyocardialinfarctionClassicalanginapectorisCHFDissectinganeurismHOCMGlaucomaThyrotoxicosisPheochromocytomaCNSuses-Anxiety,essentialtremor,migraineprophylaxis,alcoholwithdrawal.EmergencymanagementofsymptomsofTOF.Prophylaxisofbleedinginportalhypertension.
576.Atropineplusdiphenoxylatecombination isusedfor? a)Glaucoma b)Iridocyclitis c)Diarrhea d)Motionsickness CorrectAnswer-CAns.C.DiarrheaDiphenoxylate(2.5mg)plusatropin(0.025mg)combinationisusedasantimotilitydrugfortreatmentofdiarrhea.
577.Maximumpotassiumlossiscausedby whichdiuretics? a)Furosemide b)Thiazide c)Acetazolamide d)Spironolactone CorrectAnswer-CAns.C.AcetazolamideForthesamedegreeofnatriuresisCAseinhibitorscausesmostmarkedkaliuresiscomparedtootherdiuretics.
578..Hyoscineisantagonistatwhich cholinergicreceptor? a)Muscarinic b)Nicotinic c)Both d)None CorrectAnswer-AAns.A.MuscarinicHyoscine(Scopolamine)actsbycompetitiveantagonismofacetylcholineatmuscarinicreceptors(Non-selectivereceptors).Ithaslittleeffectatnicotinicreceptors.
579.Fenoldopamisusedinthemanagementof? a)Hypertensiveemergencies b)Congestiveheartfailure c)Migraineprophylaxis d)Tachyarrhythmias CorrectAnswer-AAns.A.HypertensiveemergenciesFenoldopamItisperipheral,arteriolardilatorusedinhypertensiveemergenciesandpost-operativehypertension.ItactsasanagonistofdopamineD1receptors,resultingindilatationofperipheralarteriesandnatriuresis.Fenoldopamincreasesintraocularpressure>shouldbeavoidedinpatientswithglaucoma.
580.Drugofchoicefordruginducedpeptic ulcer? a)Prostaglandinanalogues b)H2-receptorantagonists c)Protonpumpinhibitors d)Antacids CorrectAnswer-CAns.C,.ProtonpumpinhibitorsDrugofchoiceforNSAIDsinducedpepticulcer>PPIsMostspecificdrugforNSAIDsinducedpepticulcer>Prostaglandinanalogue.
581.Trueaboutcardiacmusclefibers? a)Digitalisdecreasesforceofcontraction b)Na+-Ca+exchangerrequiresATPdirectly c)Na+-Ca+exchangeractstopumpCa2+intoheartmusclecells d)Allaretrue CorrectAnswer-CAns.C.Na+-Ca+exchangeractstopumpCa2+intoheartmusclecells3Na+/1Ca+2exchangerThispumptransportsCa+2inexchangeofNa+.WhenNa+concentrationinsidethemyocyteishigh,Na+/Ca+2exchangercauseeffluxofNa+outofthemyocytesandinexchangeitcausesinfluxofCa+2insidethemyocytes.Na+/Ca+2exchangerdoesnotrequireATPtofunction,ionsmovealongtheirconcentrationgradient.
582.Sideeffectsofamiodaroneareallexcept ? a)Hyperthyroidism b)Peripheralneuropathy c)Skindiscoloration d)Hyperglycemia CorrectAnswer-DAns.D.HyperglycemiaAdverseeffectsofAmiodaroneThyroiddysfunction(Hypothyroidismorhyperthyroidism)Bluishdiscolorationofexposedskin.PeripheralneuropathyMyocardialdepressionPulmonaryfibrosisCornealmicrodepositsPhotosensitivityHepatitisThrombocytopenia(Majorspecificsideeffect).
583.Whichamongthefollowingisrenin antagonist? a)Losartan b)Benazepril c)Remikiren d)Imidapril CorrectAnswer-CAns.C.RemikirenRenininhibitors:Aliskiren,remikiren,enalkiren.Aliskiren,remikiren,andenalkirenarethedrugsthatinhibittheenzymerenin.SothesedrugsdecreasetheactivityofRAAScausingafallinbloodpressure.Thesedrugscanbeusedorallyforthetreatmentofchronichypertension.
584.Whichoffollowingisastoolsoftener? a)Bran b)Senna c)Phenalphthalein d)Docusates CorrectAnswer-DAns.D.DocusatesStoolsoftener(Docusates,liquidparaffin)Theysoftenthestoolsbynetwateraccumulationinthelumenbyanactionontheintestinalmucosa.Theyemulsifythecoloniccontentsandincreasepenetrationofwaterintofeces.
585.Reboundincreaseingastricacid secretionafterstoppingprotonpumpinhibitortherapyisdueto? a)Parietalcellhyperplasia b)Increasedhistaminerelease c)Hypergastrinemia d)HypersensitivityofAchreceptors CorrectAnswer-CAns.C.HypergastrinemiaReboundacidhypersecretion(RAH)resultsingastricacidsecretionabovepretreatmentlevelsafteracidsuppression.PPItherapyleadstodiminishedacidsecretionandantralD-cellreleasesofsomatostatin,whileincreasingG-cellreleaseofcirculatinggastrin.Theincreasedgastrinconcentrationexertsatrophiceffectonoxynticmucosa,causinghyperplasiaandincreasedfunctionalcapacityoftheenterochromafin-like(ECL)cellandparietalcell.IncreasedacidsecretionduetosustainedhypergastrinemiaisnotapparentduringPPItherapybutappearswithdrugcessationtheoretically,leadingtoacid-relatedheartburn,acidregurgitationordyspepsia,
586.WhichofthefollowingisaPAR antagonist? a)Prasugrel b)Ticlopidine c)Tirofiban d)Vorapaxar CorrectAnswer-DAns.D.VorapaxarPARsareactivatedafterthrombin-mediatedproteolyticcleavageoftheirN-terminalexodomain.PlateletactivationbythrombinismediatedviatwoPARs:PAR-IandPAR-4.PAR-Iisthemajorhumanplateletreceptor,exhibiting10-100timeshigheraffinityforthrombinwhencomparedwithPAR-4.TwoselectivePAR-Iantagonistsareunderclinicalevaluation:Vorapaxar(SCH530348)andAtopaxar(E5555).
587.Mechanismofactionofticgrelor? a)ReversibleinhibitionofADPaction b)IrreversibleinhibitionofADPaction c)ReversibleinhibitionofGPIIb/IIIa d)IrreversibleinhibitionofGPIIb/IIIa CorrectAnswer-AAns.A.ReversibleinhibitionofADPactionCangrelorandticagrelotarereversibleantagonistofADP(P2Y12),incontrasttoticlopidine,whichisirreversibleantagonist.
588.Antihypertensivedrugcausingerectile dysfunction? a)Calciumchannelblocker b)ACEinhibitors c)AT1receptorantagonists d)13-blockers CorrectAnswer-DAns.D.13-blockersImportantdrugscausingerectiledysfunctionBeta-blockersDiuretics(especiallythiazide)LithiumClonidineOCPsTCAs&SSRIsSedatives/hypnotics
589.Thiazidescausehypercalcemiaby? a)IncreasedCa"absorption b)IncreasedPTHsecretion c)Decreasedcalcitoninsecretion d)Decreasedcalciumexcretion CorrectAnswer-DAns.D.DecreasedcalciumexcretionThiazidescausehypercalcemiaby:-ReducedurinaryexcretionofcalciumduetoadirecttubulareffectorECFdepletionwithsecondaryincreaseintubularreabsorptionofsodiumandcalcium,orboth.IncreasedboneresponsivenesstotheresorptiveactionofvitaminDandPTH.
590.Drugaffectingpositivefreewater clearancewithoutaffectingnegativefreewaterclearance- a)Loopdiuretics b)Thiazides c)Acetazolamide d)Amiloride CorrectAnswer-BAns.b.ThiazidesLoopdiureticsabolishesthecortico-medullaryosmoticgradientandblockspositiveaswellasnegativefreewaterclearance.Thiazidesdecreasepositivefreewaterclearancewithoutaffectingnegativefreewaterclearance.
591.Mechanismofactionofticagrelor? a)Coxinhibition b)GPIIB/IIIAinhibition c)Inhibitionofthromboxanesynthase d)P2Y12receptorantagonist CorrectAnswer-DAns,D.P2Y12receptorantagonistTiclopidine,clopidogrel,Prasugrel?theyblockADPmediatedplateletactivationbyirreversibleantagonismofP2Y12receptoronADP.
592.Whichofthefollowingadverseeffectof ACEinhibitorsisnotduetobradykinin? a)Cough b)Angiodema c)Hypotension d)Noneoftheabove CorrectAnswer-CAns.C.HypotensionBradykininandsustanceParesubstrateforACE.ACEinhibitorsincreaselevelofthesekininsbyinhibitingACE,whichisresponsibleforcoughandangiodema.Coughandangioedemaareduetoelevatedbradykinin,causedbyinhibitionofbradykinin/srbstancePmetabolisminlungs.
593.WhichACEinhibitorinsafeinrenal failure? a)Captopril b)Enalapril c)Benazapril d)None CorrectAnswer-CAns.C.BenazaprilBenazaprilconferrredsubstantialrenalbenefitsinpatientswithoutdiabeteswhohadadvancedrenalinsuficiency".Benazaprilisconsideredsafeinrenalfailure.
594.Trueaboutheparininduced thrombocytopenia? a)Lowmolecularweightheparinisbetteralternative b)Antibodiesareformedagainstplatelets c)VitaminKisspecificantidote d)Within12hoursofstartingheparin CorrectAnswer-BAns.B.AntibodiesareformedagainstplateletsHeparininducedthrombocytopenia(HlT)HeParininducedthrombocytopeniaisanimportantadverseeffectofheparinadministration,usuallycausedbyunfractionatedheparin,butmayalsobeseenwiththeuseoflowmolecularweightheparin(LMWH).HITmaybeoftwotypes: 1. TypeI(Non-immunemediated):-Itismildandheparinmaybe continued. 2. Type2(Immunemediated):-Itisduetoformationofantibodies againstplatelets.Paradoricalthrombosiscanoccur.Heparinmustbediscontinuedimmediately.WarfarinandLMWarecontraindicated.Lepirudin(adirectthrombininhibitor)isanticoagulantofchoice.Alternativesaredanaparoid,hiruitinandArgaboban.
595.Sympathomimeticdrugwhichcauses decreaseinheartrate? a)Adrenaline b)Isoprenaline c)Noradrenaline d)None CorrectAnswer-CAns.C.Noradrenaline
596.Trueaboutoralironpreparations? a)Mostcommonlyusedpreparationisferrousgluconate b)Ferrousfumarateismostefficient c)Differentpreparationshavedifferentbiovailability d)Ferricpreparationsaremoreeffective CorrectAnswer-CAns.C.DifferentpreparationshavedifferentbiovailabilityPreferredrouteforironsupplementationisoral.Ferroussaltsareinexpensive,havegoodironcontentandarebetterabsorbedthanferricsalts.Mostcommonlyusedpreparationisferroussulfute,whichisthecheapestandaseffectiveasourceofelementalironasmoreexpensivepreparations.Itcontains32%ironindriedsaltand20%ironinhydratedsalt.Othereffectiveandinexpensivepreparationsareferrousgluconate(12%lron)andferrousfumarate(33%iron),whichareequivalenttoferroussulfate.
597.Na*-K*-2Cl-isinhibitedby- a)Thiazides b)Acetazolomide c)Furosemide d)Amiloride CorrectAnswer-CAns.C.FurosemideHighefficacy(highceilingorloopdiuretics-inhibitorsofNa+-K+-2Cl-)FurosemideBumetanideTorasemideEthacrynicacid
598.Atypicalsideeffectmontelukast? a)Goodpasturesyndrome b)Churg-Strausssyndrome c)Membranousglomerulonephritis d)Bronchialasthma CorrectAnswer-BAns.B.Churg-StrausssyndromeChurg-Strausssyndromecanbeceusedbyleukotrieneantagonists(e.g,Monteleukast).
599.Acetaminophen[Paracetamol]induced livertoxicityisdueto? a)N-acetylcystine b)NAPQ c)Co-Q d)Cytochrome'C' CorrectAnswer-BAns.B.NAPQParacetamolismetabolizedtoN-acetyl-paraaminobenzoquinoneimine(NAPQ)bymicrosomalenzymes.Thismetabolitehashighaffinityforsulf-hydrylgroupsandcancombinewiththeenzymesandotherbiomoleculesresultinginhepatotoxicity.N-acetylCystineisusedasanantidote.Itreplenishstheglutathionestoresofliverandpreventsbindingofthetoxicmetabolitetoothercellularconstituents.
600.Triptantakenbynasalrouteis? a)Sumatriptan b)Rizatriptan c)Naratriptan d)Frovatriptan CorrectAnswer-AAns.A.SumatriptanSumatriptancanalsobetakenas: 1. Nasalspray2. Suppository3. Subcutaneousinjection Besidesumatriptan,Zolmitriptancanalsobeusedbynasalroute.
601.Longacting13-2agonistis? a)Formoterol b)Isoprenaline c)Salbutamol d)Ephedrine CorrectAnswer-AAns.A.FormoterolBeta-2agonists:Usedinasthma.Longacting-Salmeterol,formoterol.Shortacting-Salbutamol,terbutaline.
602.PGE1analogueis? a)Carboprost b)Alprostadil c)Epoprostenol d)Dinoprostone CorrectAnswer-BAns.B.AlprostadilPGI2analogue-Epoprostenol,treprostinil.PGE1analogue-Alprostadil,MisoprostolPGE2analogue-Dinoprostone.PGF2(alpha)analogue-Carboprost,latanoprost,bimatoprost,travoprost.
603.Oralsoreduetoinhaledsteroidsare treatedby? a)Griseofulfin b)Amphotericin-B c)Fusidicacid d)Muprocinointment CorrectAnswer-BAns.B.Amphotericin-BOneofthecommonsideeffectofinhaledcorticosteroidsisoro-pharyngealcandidiasis,whichcanbetreatedby,Topicalantifungal(nystatin,clotrimazole,amphoterianBoralsuspension).Systemicoralazoles(fluconazole,itraconazole,posaconazole).
604.Whichofthefollowingantidiabeticdrug isinsulinsecretogogue? a)Pramlintide b)Glucomannan c)Exenatide d)None CorrectAnswer-CAns.C.ExenatideAmongparentralantidiabetic(hypoglycemic)drugs-Enenatideisinsulinsecretagogue,i.e.stimulateinsulinerelease.
605.Whichofthefollowingoralantidiabetic drugisinsulinsecretagogues? a)Metformin b)Pioglitazone c)Nateglinide d)Acarbose CorrectAnswer-CAns.C.NateglinideNateglinideisanoralantidiabeticdrugthatcausesthereleaseofinsulin(insulinsecretagogue).ItisaD-phenylalaninederivativewhichprincipallystimulatesthe1stphaseinsulinsecretion.Itisusedintype2diabetesmellitusalongwithotherantidiabetics,tocontroltheprandialriseinbloodglucose
606.Whichantithyroiddrugcrossesplacenta ? a)Carbimazole b)Propylthiouracil c)Both d)None CorrectAnswer-CAns.C.BothBothpropylthiouracilandmethimazole/carbimazolecrossplacenta.ButbecauseofhighproteinbindingcapacityofpropylthouracilistransferredlessacrossPlacenta).Therefore,itispreferredinpregnancy.
607.Betablockersusedinthyroidstorm cause? a)Quickreliefofsymptoms b)Increasedmetabolismofthyroxine c)Blockadeofthyroxinereceptors d)Decreasedsynthesisofthyroxine CorrectAnswer-AAns.A.QuickreliefofsymptomsNon-selectivebeta-blocker:Mostvaluablemeasureinthyroidstorm.Inthyroidstormmostofthesymptomsarebecauseofadrenergicoveractivityduetoincreasedtissuesensitivitytocatecholaminesinhyperthyroidism.Thisincreasedsensitivityisduetoincreasednumberofp-receptors.So,quickreliefcanbeobtainedbyblockingreceptors.
608.Whichofthefollowingistrue? a)GlucocorticoidsupregulateMHCexpression b)GlucocorticoidsactivateT-helpercells c)GlucocorticoidsactivatecytotoxicTcells d)Noneoftheabove CorrectAnswer-AAns.A.GlucocorticoidsupregulateMHCexpressionGlucocorticoidsbothinhibitaswellasupregulateMHCexpressiondependinguponcellsandspeciesinvolved.DexamethasoneincreasesMHCclass2expressiononhumanendothelialcellsandmonocyteswhereasitdownregulatesitonB-cells.GlucocorticoidshaveinhibitoryeffectonbothT-HelpercellsandcytotoxicTcells.
609.Foractivityofantipsychotic,actionis requiredatwhichreceptor- a)M,muscarinic b)D1dopaminergic c)DZdopaminergic d)5HT4serotonergic CorrectAnswer-CAns.C.DZdopaminergicTypicalantipsychoticactsbyblockingD2receptors(D2antagonists).
610.Mechanismofactionofopioids? a)Inhibitionofcyclooxylgenase b)Inhibitionofopioidreceptorsatspinallevel c)Inhibitionofopioidreceptorsatsupraspinallevel d)Inhibitionofopioidreceptorsatspinalandsupraspinallevel CorrectAnswer-DAns.D.InhibitionofopioidreceptorsatspinalandsupraspinallevelOpioidshavebothspinal&supra-spinalcomponentsfortheiranalgesiceffects.
611.Zonisamideactson? a)GABAreceptors b)TtypeCa2+channels c)Na+Channels d)Cl-channels CorrectAnswer-CAns.C.Na+ChannelsAnti-epilepticscausingprolongationofNa2+channelinactivation:PhenytoinCarbamazepineValproateLamotrigineTopiramateZonisamide
612.Opioid[morphine]causes? a)Increasedheartrate b)Increasedmuscletone c)Mydriaris d)Respiratorystimulation CorrectAnswer-BAns.B.IncreasedmuscletoneMorphinecausesbothstimulantanddepressiveeffects.OnCNSstimulation(Corticalareaandhippocampus)morphinecausesmuscularrigidity&convulsions.
613.Besidedepression,otheruseofSSRIs? a)Erectiledysfunction b)Retrogradeejaculation c)Prematureejaculation d)Sterility CorrectAnswer-A:CAns.A.Erectiledysfunction&C.PrematureejaculationSSRIsareeffectivelyusedinprematureejaculation.SSRIscancauseprolongationofpreorgasmicplateauandthusdelayejaculation.SSRIscanalsobeusedinerectiledysfunctionsecondarytodepression.OtherusesofSSRIs:Depression(mostcommonuse)OCDPanicdisorderSocialphobiaPTSDGeneralizedanxietydisordersPre-mensturaldysphoricdisorders
614.Whichofthefollowingdrugsactdirectly withoutsexualstimulation? a)Sildenafil b)Tadalafil c)Alprostadil d)Testosterone CorrectAnswer-CAns.C.AlprostadilAlprastadil(pGEl)isdirectlyinjectedintocorporacavernusaforerectiledysfunction'Itactsbyincreasingarterialinflow"byvasodilationandreducingoutflowbycontractingthecarporalsmoothmusclethatoccludesdrainingvenules.
615.
HealthyHumanvolunteerspartofwhichclinicaltrialphase? a)Phase1 b)Phase0 c)Phase3 d)Phase4 CorrectAnswer-AAns:A,Phase1.PhaseIofclinicaltrialishumanpharmacologyandsafety.PhaseIinvolvesnormalhumanvolunteers.
616.DOCforscorpionstingbiteis? a)EDTA b)Neostigmine c)N-acetylcysteine d)Prazosin CorrectAnswer-DAns:d.PrazosinDOCforpoisoningduetostingofscorpion?Prazosin.Prazosin:Analpha-blocker.Managementofscorpionstingbite:DependingupontheseverityofScorpionpoisoning:Immunotherapy-(dosedependingonantivenomtiter)PrazosinMidazolamAspirin
617.SiteofactionofamphotericinBis: a)Ribosomes b)Cellwall c)Plasmamembrane d)Protein CorrectAnswer-BAnswer:-B-CellwallPolyenedrugcompoundslikeAmphotericinBactsoncellmembrane-AmphotericinB,antifungalagent.ChemicallyapolyenecompoundObtainedfromStreptomycesnodosus.Polyeneshaveahighaffinityfor"ergosterol"presentinthefungalcellmembrane.Bindsandgetsinsertedintothecellmembraneforming"Micropore".Markedincreaseinpermeabilityofcellmembrane.PolyenedrugcompoundslikeAmphotericinBactsoncellmembraneAmphotericinB,antifungalagent.ChemicallyapolyenecompoundObtainedfromStreptomycesnodosus.Polyeneshaveahighaffinityfor"ergosterol"presentinthefungalcellmembrane.Bindsandgetsinsertedintothecellmembraneforming"Micropore".Markedincreaseinpermeabilityofcellmembrane.
618.Whichantiretroviraldrugalsohasanti hepatitisactivity? a)Abacavir b)Tenofovir c)Nevirapine d)Emtricitabine CorrectAnswer-DAnswer:D-EmtricitabineEmtricitabine,NRTIdrugwithbothantiretroviral&anti-hepatitispropertiesNucleosidereversetranscriptaseinhibitorforthepreventionandtreatmentofHIVinfectioninadultsandchildren.Alsousedincombinationwithtenofovir
619.Drugofchoiceforresistantrheumatic chorea? a)Valproate b)Haloperidol c)Diazepam d)Probenecid CorrectAnswer-AAnswer:-A-ValproateValproate,Sulpiride,&diazepamareusedforsymptomatictreatment.AcuteRheumaticFever:AbnormalimmuneresponsetogroupAstreptococcalinfectionCommonlyaffectingthejoints,heart,brain,andskin.Symptoms:Arthritis,relatedtocarditis&chorea.Sydenham'schorea/ChoreaminorCharacterizedbyrapid,uncoordinatedjerkingmovementsprimarilyaffectingtheface,handsandfeet.Signs&symptomsofchoreausuallydonotrespondwelltotreatmentwithantirheumaticagentsSymptomatictreatmentincludeanticonvulsants(eg,valproate,carbamazepine)andneuroleptics(eg,pimozide,haloperidol,risperidone,olanzapine
620.AtpKa=pH- a)Conc.ofdrugis50%ionicand50%non-ionic b)Absorptionofdrugis50%ionicand50%ionic c)Concofdrugis75%ionicand25%non-ionic d)Concofdrugis25%ionicand75%non-ionic CorrectAnswer-AAnswer:A-Concentrationofdrugis50%ionic&50%Non-ionicNumericallyequalpKa&pHrepresents50%drugionizationpKaisnegativelogarithmofacidicdissociationofweakelectrolyte.Onequalconcentrationsofionized&unionizeddrugs,log1iszero.Thus,whenpKaisnumericallyequaltopH(pKa=pH)50%drugisionized.
621.Physiologicaldoseofhydrocortisone (mg/kg/day)is- a)5mg/kg/day b)10mg/kg/day c)15mg/kg/day d)20mg/kg/day CorrectAnswer-BAnswer:-B-10mg/kg/dayThenormalrateofsecretionoftwoprinciplecorticoidsHydrocortisone-10mg/kg/day(nearlyhalfinmorninghours)Aldosterone-0.125mg/daily
622.Whatismechanismofactionof colchicineinacutegout? a)Inhibitionofpurinemetabolism b)Inhibitionofuricacidconversion c)Migrationofleukocytes d)Leukocytes,lymphocytesinhibitionµtubularinhibitor CorrectAnswer-DAnswer:D-Leukocytes,Lymphocytesmigrationinhibitionµtubularinhibitor.Colchicineactsbyinhibitingthegranulocytemigrationintotheinflamedjoint.AnalkaloidfromColchiumautumnaleSpecificallysuppressesgoutyinflammation.Doesn'tinhibitthesynthesisorpromotetheexcretionofuricacid.Mechanismofaction:Colchicineactsby,inhibitsthereleaseofglycoproteinBindstofibrillarproteintubulesinhibitinggranulocytemigrationintotheinflamedjoint.Anacuteattackofgoutstartsbyprecipitationofuratecrystalsinsynovialfluid.InflammatoryresponsestartswithgranulocytemigrationintojointPhagocytosinguratecrystalsreleasingglycoproteinGlycoproteinincreaseslacticacidproductionandreleasinglysosomalenzymescausingmorejointdestruction.
623.Basiliximabisan- a)IL-1receptorantagonist b)Anti-CD3antibody c)IL-2receptorantagonist d)TNFinhibitor CorrectAnswer-CAnswer:-C-IL-2receptorantagonistBasiliximabexhibitshighaffinitytowardsIL-2receptor,inhibitingit.Anti-CD-25antibodyHighaffinityforIL-2receptorShortplasmahalflife-1weekUsefulinpreventingtransplantrejectionreactions.Adverseeffects-Anaphylacticreactions&opportunisticinfections.
624.Pirenzapineisused- a)Gastriculcer b)Glaucoma c)Hypertension d)Congestivecardiacfailure CorrectAnswer-AAnswer:A-GastricUlcerPirenzepine,aselectiveM1anticholinergicdruginhibitinggastricacidsecretion.Lowtherapeuticdoserange.Usedfortreatinggastriculcer.
625.Whichofthefollowingantipsychotic haveincreasedprolactinsecretion- a)Olanzapine b)Ziprasidone c)Clozapine d)Risperidone CorrectAnswer-DAnswer:-D-RisperidoneSignificantriseinprolactinlevelsduringrisperidonetherapyisobserved.Risperidone-Antipsychoticdrugwithcombined5-HT2aanddopamineD2antagonistactivityHighaffinitytoalpha1,alpha2andH1receptorsMorepotentD2blockerthanclozapineAmelioratessymptomsofschizophreniaProlactinlevelsriseduringrisperidonetherapy,butlessepileptogenicthanclozapine.Producesextrapyramidalsideeffectsarelessonlyatlowerdoses(<6mg/day).Blockadeofthesecontributetoefficacyandsideeffectslikeposturalhypotension.Frequentlycausesagitation.
626.Whichofthefollowingisglucocorticoid synthesisinhibitor? a)Mifepristone b)Flutamide c)Finasteride d)Metyrapone CorrectAnswer-DAnswer:D-MetyraponeInhibits1113-HydroxylaseinadrenalcortexPreventsthesynthesisofhydrocortisone
627.Whichofthefollowingstatementsis incorrectw.r.tPrasugrel? a)Notaprodrug b)P2Ypurinergicreceptorblocker c)Hasastrongantiplateletactivity d)CausesintracranialhemorrhageinTIApatients. CorrectAnswer-AAnswer:A-NotaprodrugPrasugrelisaprodrug,similartoClopidogrelThienopyridinedrugclassIrreversibleantagonistofP2Y12ADPreceptorsRapidlyabsorbed,completelyactivated&exertsmoreconsistentplateletinhibition.Stronganti-plateletactivityBleedingcomplicationsaremoreseriousandfrequent.ContraindicatedinpatientswithhistoryofischemicstrokesandTIA's
628.Q-Telongationisseeninwhichdrug? a)Quinidine b)Amiodarone c)MagnesiumSulfate d)Lignocaine CorrectAnswer-AAnswer:A-QuinidineSpecificpatternofQ-Tprolongationisreferredtoas"Torsadesdepointes"DrugscausingTorsadesdePointesQuinidine(mostcommon)SotalolProcainamideDisopyramidePhenothiazinesTricyclicantidepressants
629.Sacubitrilis, a)ACEinhibitor b)Neutralendopeptidaseinhibitor c)Calciumchannelinhibitor d)Betaadrenergicblocker CorrectAnswer-BAnswer:B-Neuro-endopeptidaseinhibitorSacubitril,aprodruginhibitingneuro-endopeptidaseenzymeActivatedtoSacubitril,Inhibitingenzymeneprilysin(Neutralendopeptidases)CombinationdrugusedinheartfailurepatientsUsuallycombinedwithACEinhibitorslikevalsartaninratioof1:1
630.Niacintherapyiscontraindicatedin diabetesbecause- a)Increasesthebloodsugarlevels b)Causesscleroderma c)Difficulttogiveinjection d)Increasesthemetabolismoforalhypoglycemicdrugs CorrectAnswer-AAnswer:A-increasesthebloodsugarlevelsNiacintherapyhaspotentialeffectsonbloodsugarlevels.Increasesthebloodglucoselevelsindiabetespatients
631.Endothelinactsthroughwhich receptors? a)cAMP b)cGMP c)Na+receptors d)Calciumreceptos CorrectAnswer-AAnswer:A-cGMPEndothelin-1(ET-1)isapotentendogenousvasoconstrictor,mainlysecretedbyendothelialcells.
632.Whichisthecentrallyactingalpha2 agonistmusclerelaxant- a)Diazepam b)Bromocriptine c)Tizanidine d)Methocarbamol CorrectAnswer-CAnswer:-C-TizanidineCentralalpha2adrenergicagonistMechanismofaction:InhibitsthereleaseofexcitatoryaminoacidsinspinalinterneuronsFacilitatestheinhibitorytransmitterglycineInhibitspostsynapticreflexesReducingmuscletone,frequencyofmusclespasms.withoutreducingthestrengthofmuscle.Indications:SpasticityinneurologicaldisordersPainfulmusclespasmofspinalorigin.Contraindications:Patientsonantihypertensivesspeciallyclonidine.
633.Apixabanis- a)Antithrombininhibitor b)DirectXainhibitor c)Plateletactivator d)ClottingFactorXII CorrectAnswer-BAnswer:B-DirectXainhibitorDirectXainhibitorAnticoagulantfortreatment&prophylaxisofvenousthromboemboliceventsDVT&PE
634.Anaerobesareresistantintrinsically against- a)Betalactamantibiotics b)Aminoglycosides c)Azithromycin d)Metronidazole CorrectAnswer-BAnswer:B-AminoglycosidesAnaerobicbacteriaparticularlyareresistanttoaminoglycosidesduetolackofoxidativemechanismtodrivedruguptakingprocess.Intrinsicresistance/Insensitivity:InnateabilityofbacteriatoresistactivityofparticularantimicrobialagentInherentstructuralorfunctionalcharacteristicsallowsfortoleranceofaparticulardrugorantimicrobialclass.i.e.,Susceptibilitytothatparticulardrugisreduced.
635.Whichisnotbacteriostaticantibiotic- a)Clindamycin b)Vancomycin c)Tetracycline d)Cephalosporins CorrectAnswer-BAnswer:B-VancomycinBacteriostaticantibioticsLimitbacterialgrowthbyinterferingwithbacterialproteinproduction,DNAreplication,orotheraspectsofbacterialcellularmetabolism.Tetracyclines,sulfonamides,clindamycin,spectinomycin,trimethoprim,chloramphenicol,macrolidesandlincosamides.BactericidalantibioticsInhibitcellwallsynthesis(Irreversiblekilling)Aminoglycosides.cephalosporins.fluoroquinolones.metronidazole.penicillin.vancomycin
636.Whichofthefollowingcausesmelanosis coli? a)Senna b)Sorbitol c)MagnesiumSulphate d)Bisacodyl CorrectAnswer-AAnswer:A-SennaLaxativeabusewithdrugslikesennacausemelanosiscoliAnthranoidlaxatives(aloe,cascarasagrada,andsenna)arederivedfromnaturallyoccurringplantsConsideredtobestimulantlaxatives.Safershorttermuse.Longtermabusecancausemelanosiscoli&possiblyincreasesriskofcoloniccancer.
637.Whichamongthefollowingwillthe choiceofantibioticforabedriddenpatientwithcatheter-relatedUTIandpneumonia. a)Amoxicillin b)BetaLactamantibioticswithbetalactamase c)3rdgencephalosporins d)2ndgencephalosporins CorrectAnswer-BAnswer:B-BetaLactamAntibioticsContainsbetalactamaseenzymeforpotentactionagainstorganismscausingUTI
638.Mycoplasmaisresistantto- a)Ceftriaxone b)Cephalosporins c)Aminoglycosides d)Fluoroquinolones CorrectAnswer-AAnswer:A-CeftriaxoneMycoplasmashowsresistancetowardsCeftriaxone,athirdgenerationcephalosporin(betalactamantibiotic)Lackofcellwallinmycoplasmasmakesthemintrinsicallyresistantto-lactams&toallantimicrobialsthattargetcellwall.Mycoplasmapneumoniae:Mycoplasmapneumoniaeisapathogenicmycoplasmaresponsibleforrespiratorytractinfectionsinhumans.First-linetreatment:macrolides&relatedantibiotics,tetracyclinesandfluoroquinolonesispreferred.
639.Tadalafilshouldnotbegivenwith: a)Vasodilator b)Antibiotics c)Vasoconstrictors d)Valproate CorrectAnswer-AAnswer:A-VasodilatorsCombinationwithvasodilatorsresultsinsuddenchangesofbloodpressurevaluesTadalafilrelaxesmusclesofthebloodvesselsandincreasesbloodflowtoparticularareasofthebody.Usedtotreaterectiledysfunction(Impotence),andsymptomsofbenignprostatichypertrophy(Enlargedprostate)Eg:Takingtadalafilwithvasodilatordruglikenitratecancausesudden&seriousdecreaseinbloodpressure.
640.Trileneisdegradedby: a)EnzymaticDegradation b)NonEnzymaticdegradation c)ChemicalDegradation d)None CorrectAnswer-AAnswer:A.EnzymaticDegradationTrileneortrichloroethyleneisagoodanalgesic,lessdepressant,andnon-flammable.Cardiacdysrhythmia,ortachypnoeamayoccurduringadministration.Itshouldnotbeusedintheclosedcircuitasitreactswithsoda-limetoproduceatoxicgas(phosgene).Recoveryisslowandnauseaaswellasvomitingmaybepresent.Itshouldnotbeusedwithadrenalineinfiltrationlestdysrhythmiabeconvertedtoventricularfibrillation.Degradation:BroughtaboutbyenzymaticdegradationTheenzymethatstartsonebranchofthispathway,toluene1,2-dioxygenase,hasmanyothercatalyticabilities,whicharedocumentedinatableoftheReactionsofToluene1,2-Dioxygenase.Thespontaneousdegradationoftrichloroethyleneepoxidecanproduceasmanyasfourproducts:dichloroacetate,carbonmonoxide,glyoxylate,andformate.Thenumber,type,andproportionofproductsseendependsonthelocalenvironment.
641.Mechanismofactioncolchicineinacute gout a)Uricacidnephrolithiasis b)DeficiencyofenzymeXanthineoxidase c)Increaseinserumurateconcentration d)Renaldiseaseinvolvinginterstitialtissues CorrectAnswer-BAns.B.DeficiencyofenzymeXanthineoxidase.Goutisahereditarydisorderwithincreaseinserumuricacidduetoincreasedproduction,ordecreasedexcretionofuricacidanduricsalt.Thoughttobecausedbylackofanenzymeneededtocompletelymetabolisepurinesforrenalexcretion. Table1.MetabolicRiskFactorsforGout Obesity,eating13w-1nel-richfoods(highlevelsofmeatandseafoodconsumption)ExcessivealcoholintakeMetabolicsyndromeObesityHypertensionHyperlipiderniaHyperglycemiaType2diabetesmellitusHypertensionHyperlipiderniaSerumurate--elevatingmedicationsHistoryofurolithiasisChronickidneydisease,glomerular,orInterstitialrenaldisease;
Chronickidneydisease,glomerular,orInterstitialrenaldisease;polycystickidneydiseasePotentialgeneticoracquiredcauseofuricacidoverproduction,includingmalignancyLead,orheavy-metalintoxication
642.Whichdrugdecreasesthebone resorptioninosteoporosis? a)Teriparatide b)Risedronate c)Cortisone d)Cimetidine CorrectAnswer-BAnswer:B-RisedronateRisedronatebisphosphonatesinhibitsboneresorptionbyactionsonosteoclastprecursorsinosteoporosispatientsRisedronate:AminobisphosphonateIndications:Prevention&treatmentofosteoporosisMechanismofaction:InhibitsboneresorptionbyactiononosteoclastsReduceboneremodellingMorepotentinblockingthebonedissolutionprocess.Teriparatide,anPTHanalog,recombinanthumanPTHisalsoused,yetinseverecasesofosteoporosis,improvingtheskeletalmicroarchitecture
643.Whichofthefollowingistrueabout vitaminK? a)Anticoagulant b)Prolonguseofantimicrobialleadstodeficiency c)Dietaryallowanceis15-20mg d)Alloftheabove CorrectAnswer-BAns.B.ProlonguseofantimicrobialleadstodeficiencyCertainpeopleareatincreasedriskifthey:takecoumarinanticoagulantssuchaswarfarin,whichthinsthebloodaretakingantibioticshaveaconditionthatcausesthebodytonotabsorbfatproperly(fatmalabsorption)haveadietthatisextremelylackinginvitaminKVitaminKisagroupofstructurallysimilar,fat-solublevitaminsthehumanbodyrequiresforcompletesynthesisofcertainproteinsthatareprerequisitesforbloodcoagulationandwhichthebodyalsoneedsforcontrollingbindingofcalciuminbonesandothertissuesThebodyneedsvitaminKtoproduceprothrombin,aproteinandclottingfactorthatisimportantinbloodclottingandbonemetabolism.WithoutvitaminK,bloodcoagulationisseriouslyimpaired,anduncontrolledbleedingoccurs.PreliminaryclinicalresearchindicatesthatdeficiencyofvitaminKmayweakenbones,potentiallyleadingtoosteoporosis,andmaypromotecalcificationofarteriesandothersofttissuesDietaryallowanceforadultsperday-50-100mg.
644.Whichdrugsneedscontinuous monitoringofprothrombintime? a)Aspirin b)Lepirudin c)Digoxin d)Coumadin CorrectAnswer-DAns.D.CoumadinCoumadin(warfarin)isananticoagulant.Warfarinisacoumarinanticoagulantusedfortheprophylaxisandtreatmentofthromboemboliccomplicationsassociatedwithcardiacvalvereplacementandatrialfibrillation,aswellastheprophylaxisandtreatmentofvenousthrombosisandpulmonaryembolism.Increasedmetabolismofwarfarinresultsininsufficientprolongationofprothrombintime.
645.Whichisnotaprokineticagent? a)Dopamineantagonist b)5HT4agonist c)Macrolides d)Diphenylmethane CorrectAnswer-DAns:D.DiphenylmethaneProkineticdrugs:Thesearedrugsthatpromotegastrointestinaltransitandspeedgastricemptyingbyenhancingcoordinatedpropulsivemotility.Thisexcludestraditionalcholinomimeticsandanti-ChEswhichproducetonicandlargelyuncoordinatedcontraction.Drugsincluded:Metoclopramide,Domperidone,Cisapride,Mosapride,ItoprideRef:K.D.Tripathi7thEdition.Page663-665
646.Whichofthefollowingdrugsactby inhibitingDNAreplication? a)6Mercaptopurine b)ActinomycinD c)MitomycinC d)Asparaginase CorrectAnswer-AAns:A.6Mercaptopurine6-MercaptopurineactsbyinhibitingDNAreplication.Antimetabolites:TheseareanaloguesrelatedtothenormalcomponentsofDNAorofcoenzymesinvolvedinthenucleicacidsynthesis.Theycompetitivelyinhibittheutilizationofthenormalsubstrateorgetthemselvesincorporatedformingdysfunctionalmacromolecules.Includes:Folateantagonist-Methotrexate(Mtx)Purineantagonist-6-Mercaptopurine(6-MP)Pyrimidineantagonist-5-Fluorouracil(5-FU)PurineantagonistsMercaptopurine(6-MP)andthioguanine(6-TG).Thesearehighlyeffectiveantineoplasticdrugs.Aftersynthesisinthebodytothecorrespondingmonoribonucleotides,theyinhibittheconversionofinosinemonophosphatetoadenineandguaninenucleotidesthatarethebuildingblocksforRNAandDNA.Thereisalsofeedbackinhibitionofdenovopurinesynthesis.TheyalsogetincorporatedintoRNAandDNAwhicharedysfunctional.
Ref:K.D.Tripathi7thEdition.Page.858,862?863
647.DOCforOnychomycosis? a)Terbinafine b)Fluconazole c)Nystatin d)Itraconazole CorrectAnswer-AAns:A.TerbinafineOnychomycosis(afungalinfectionofthenail,usuallycausedbyadermatophyte).Onychomycosisismoredifficulttotreatthanmostdermatophytosisbecauseoftheinherentslowgrowthofthenail.Olderantifungalagents(ketoconazoleandgriseofulvin)areunsuitableforonychomycosisbecauseoftheirrelativelypoorefficacyandpotentialadverseeffects.Threerecentlydevelopedantimycoticagents(fluconazole,itraconazole,andterbinafine)offerhighcureratesandgoodsafetyprofiles.Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88888/
648.Theophyllinebywhatmechanismcauses diuresis? a)PDE3inhibition b)PDE4inhibition c)Beta2agonistaction d)AdenosineA1receptorantagonism CorrectAnswer-DAns:D.AdenosineA1receptorantagonismThemildlydiureticactionsofbothmethylxanthinesaremainlytheresultofinhibitionoftubularfluidreabsorptionalongtherenalproximaltubule.BasedupontheuseofspecificadenosinereceptorantagonistsandtheobservationofacompletelossofdiuresisinmicewithtargeteddeletionoftheA1ARgene,transportinhibitionbymethylxanthinesismediatedmainlybyantagonismofadenosineA1receptors(A1AR)intheproximaltubule.Methylxanthinesareweakrenalvasodilators,andtheyactascompetitiveantagonistsagainstadenosine-inducedpreglomerularvasoconstriction.Caffeineandtheophyllinestimulatethesecretionofreninbyinhibitionofadenosinereceptorsandremovalofthegeneralinhibitorybrakefunctionofendogenousadenosine.Sinceenhancedintrarenaladenosinelevelsleadtoreducedglomerularfiltrationrateinseveralpathologicalconditionstheophyllinehasbeentestedforitstherapeuticpotentialintherenalimpairmentfollowingtheadministrationofnephrotoxicsubstancessuchasradiocontrastmedia,cisplatin,calcineurininhibitorsorfollowingischemia-reperfusioninjury.
Ref:https://www.ncbi.nlm.nih.gov/pubmed/20859805
649.Whichofthefollowingantimicrobials shouldnotbegiventoachronicasthmaticpatientmanagedontheophyllinetherapy? a)Erythromycin b)Amoxicillin c)Cefotaxime d)Cotrimoxazole CorrectAnswer-AAns:A.ErythromycinDrugswhichinhibittheophyllinemetabolismandincreaseitsplasmalevelareErythromycin,Ciprofloxacin,Cimetidine,Oralcontraceptives,Allopurinol;Thedoseshouldbereducedto2/3.Ref:K.D.Tripathi7thEdition.Page.226-227
650.DOCofprophylaxisformotionsickness? a)Promethazine b)Prochlorperazine c)Metoclopramide d)Itopride CorrectAnswer-AAns:A.PromethazineMotionsickness:Antiemeticswiththeanticholinergic-antihistaminepropertyarethefirstchoicedrugsformotionsickness.Antidopaminergicandanti-HT3drugsarelesseffective.Allanti-motionsicknessdrugsactbetterwhentaken??1hourbeforecommencingthejourney.Oncesicknesshasstarted,itismoredifficulttocontrol;higherdoses/parenteraladministrationmaybeneeded.DrugsIncluded:Promethazine,diphenhydramine,dimenhydrinate:Thesedrugsaffordprotectionofmotionsicknessfor4?6hours.Promethazinetheoclate:Thissaltofpromethazinehasbeenspeciallypromotedasanantiemetic,buttheactiondoesnotappeartobesignificantlydifferentfrompromethazineHCl.
651.Whichofthefollowingantihypertensive drugisavoidedinpatientswithhighserumuricacidlevels? a)Hydrochlorothiazide b)Enalapril c)Prazosin d)Atenolol CorrectAnswer-AAns:A.HydrochlorothiazideLong-termuseofhigherdosethiazidesinhypertensionhascausedariseinblooduratelevels.Ref:K.D.Tripathi7thEdition.Page.585
652.Mechanismofresistancetopenicillins viabeta-lactamaseis a)Alteredpenicillin-bindingproteins b)Drugefflux c)Breaksdrugstructure d)Alterationin50Sribosomestructure CorrectAnswer-CAns:C.Breaksdrugstructure-lactamasesareproducedbystaphylococci,Haemophilus,gonococci,etc.whichinactivatepenicillinG.The-lactamasesmaybepresentinlowquantitybutstrategicallylocatedperiplasmically(asingram-negativebacteria)sothatthedrugisinactivatedsoonafterentry,ormaybeelaboratedinlargequantities(bygram-positivebacteria)todiffuseintothemediumanddestroythedrugbeforeentry.Beta-lactamantibioticssharethestructuralfeatureofabeta-lactamring.Thisfeatureisresponsiblefortheinhibitionofbacterialcellwallsynthesis.Thetargetmoleculesarepeptidoglycancross-linkingenzymes(e.g.transpeptidasesandcarboxypeptidases)whichcanbindbeta-lactamantibiotics(penicillin-bindingproteins,PBP).Bacterialcelldeathisinitiatedbybeta-lactamantibiotic-triggeredreleaseofautolyticenzymes.Incontrasttogram-positivebacteria(absenceofanoutermembrane),theantibiotichastopenetratethroughporinsoftheoutermembraneofgram-negativebacteriabeforetouchingPBP's.Bacterialresistancetobeta-lactamantibioticsincludesmodification
ofporins(permeabilitybarrier)andoftargets(lowaffinityofPBP'sforthedrug),productionofinactivatingenzymes(beta-lactamases)andinhibitionofreleaseofautolyticenzymes.Ref:K.D.Tripathi7thEdition.Page.717?720ncbi.nlm.nih.gov/pubmed/8314292
653.Apatientonlithiumtherapydeveloped hypertension.HewasstartedonThiazideforhypertension.Afterafewdays,hedevelopedcoarsetremorsandothersymptomssuggestiveoflithiumtoxicity.Whatistheprobablemechanismofinteraction? a)Thiazideincreasesthetubularreabsorptionoflithium b)Thiazideinhibitsthemetabolismoflithium c)Thiazidesactasanaddonthedrugtolithium d)Alloftheabove CorrectAnswer-AAns:A.ThiazideincreasesthetubularabsorptionoflithiumDrugInteraction:Diuretics+Lithium=Decreasedexcretion--riseinLi+level-toxicity;Diuretics(thiazide,furosemide)bycausingNa+losstopromoteproximaltubularreabsorptionofNa+aswellasLi+plasmalevelsoflithiumrise.Potassium-sparingdiureticscausemilderLi+retention.Management:Reducedoseoflithiumandmonitorlevel.Ref:K.D.Tripathi7thEdition.Page.449,932
654.Whichdrugactsviathetyrosinekinase receptor? a)Insulin b)TSH c)LH d)MSH CorrectAnswer-AAns:A.InsulinInsulinactsonspecificreceptorslocatedonthecellmembraneofpracticallyeverycell,buttheirdensitydependsonthecelltype:liverandfatcellsareveryrich.Theinsulinreceptorisareceptortyrosinekinase(RTK)whichisaheterotetramericglycoproteinconsistingof2extracellularand2transmembranesubunitslinkedtogetherbydisulfidebonds.Ref:K.D.Tripathi7thEdition.Page.261
655.Pegloticaseisusedforthetreatmentof anAnkylosingspondylosis a)ReactiveArthritis b)CPPD c)Chronictophaceousgout d)RefractoryRheumatoidarthritis CorrectAnswer-CAns:C.ChronictophaceousgoutPegloticase:Pegloticaseisamedicationforthetreatmentofthesevere,treatmentofrefractorychronicgout.Itisathird-linetreatmentinthoseinwhomothertreatmentsarenottolerated.RefGoutandothercrystalarthropathiesbyRobertTerkettaud]
656.Fluoroquinolonecontraindicatedinliver diseaseis a)Levofloxacin b)Pefloxacin c)Ofloxacin d)Lomefloxacin CorrectAnswer-BAns:B.PefloxacinPefloxacinhaslongert?:accumulatesonrepeateddosingachievingplasmaconcentrationstwiceashighasafterasingledose.Becauseofthis,itiseffectiveinmanysystemicinfectionsaswell.Thedoseofpefloxacinneedstobereducedinliverdisease,butnotinrenalinsufficiency.Ref:K.D.Tripathi7thEdition.Page.713
657.Atahighaltitudeof3000m,aperson complainsofbreathlessness.Allofthefollowingcanbeusedforthemanagementofthispersonexcept? a)Intravenousdigoxin b)Oxygensupplementation c)Immediatedescent d)Acetazolamide CorrectAnswer-AAns:A.IntravenousdigoxinManagementofAMSfollowsthreeaxioms:a)furtherascentshouldbeavoideduntilthesymptomshaveresolved,b)patientswithnoresponsetomedicaltreatmentshoulddescendtoaloweraltitudeandc)ifandwhenHACOissuspected,patientsshouldurgentlydescendtoaloweraltitude.Descentandsupplementaryoxygenarethetreatmentsofchoiceandforsevereillness,thecombinationprovidesoptimaltherapy.Remarkably,adescentofonly500to1000musuallyleadstoresolutionofacutemountainsicknesswhilehigh-altitudecerebraledema(HACO)mayrequirefurtherdescent.Simulateddescentwithportablehyperbaricchambers,nowcommonlyavailableinremotelocations,arealsoeffective.Medicaltherapybecomescrucialwhenthedescentisnotimmediatelypossible.Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923381/#!po=31.2500
658.ApatientwithdiabetesandCOPD developedpostoperativeurinaryretention.Whichofthefollowingdrugscanbeusedforshorttermtreatmenttorelievethesymptomsofthisperson? a)Bethanechol b)Methacholine c)Terazosin d)Tamsulosin CorrectAnswer-AAns:A.BethanecholBethanecholisapreferreddruginthetreatmentofpostpartumandpostoperativenonobstructiveurinaryretention,anditalsocancounteractbladderdysfunctionoftenseenwithphenothiazinesandtricyclicantidepressants.Itcanaffordsymptomaticreliefincongenitalmegacolonandgastroesophagealrefluxbutisrarelyusedforthese.Ref:https://www.pdr.net/drug-summary/Urecholine-bethanechol-chloride-801,K.D.Tripathi7thEdition.Page.104
659.Drugofchoiceforinvasiveaspergillosis is a)Posaconazole b)Voriconazole c)LiposomalAMB d)Caspofungin CorrectAnswer-BAns:B.VoriconazoleThepreferredtreatmentofprimaryIAisvoriconazole,whichhasbeenfoundtobesuperiortoamphotericinB.Azolesinterferewiththesynthesisofergosterolfoundinthefungalcellmembrane,whereaspolyenes--suchasamphotericinB--interferewithergosterolfunction.Anechinocandinthatdisruptsfungalcellwallsynthesis?caspofungin--anditraconazolehavebeenapprovedforsalvagetherapyofIA.Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4200583/
660.Whichofthefollowingdrugsactsby inhibitingthetranscriptionofDNAtoRNA? a)Rifampicin b)Nitrofurantoin c)Ciprofloxacin d)Novobiocin CorrectAnswer-AAns:A.RifampicinOverallinhibitionofRNAsynthesisbyrifampiciniscausedbyadestabilizingeffectonthebindingoftheintermediateoligonucleotidestotheactiveenzyme-DNAcomplex.RifampicinitselfcanonlyinteractspecificallywithRNApolymeraseiftheenzymeisfreeorinabinarycomplexwithDNA.Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC327649/
661.Apatientwasrecentlystartedon Fluphenazine.Afewweekslater,hedevelopedtremors,rigidity,bradykinesia,andexcessivesalivation.Thefirstlineofmanagementforthispatientis a)Selegiline b)Trihexyphenidyl c)Pramipexole d)Amantadine CorrectAnswer-BAns:B.Trihexyphenidyl*FluphenazinemayblocktheeffectsofagentsusedtotreatParkinson'sdiseasesuchaslevodopa/carbidopa.*Trihexyphenidylisanantispasmodicdrugthatexertsadirectinhibitoryeffectontheparasympatheticnervoussystem.-Italsohasarelaxingeffectonsmoothmuscle.-ItisindicatedinallformsofParkinsonism.*Trihexyphenidylworksasananticholinergicandisusedforthetreatmentoftremors,spasms,stiffness,andweakmusclecontrolseeninpatientswithParkinson'sdisease.-Itcanalsobeusedforthepreventionortreatmentofsimilarmuscularconditionswhicharecausedbycertaincentralnervoussystem(CNS)drugssuchasfluphenazine,haloperidol,chlorpromazine.Ref:https://www.ncbi.nlm.nih.gov/books/NBK519488/,https://www.ncbi.nlm.nih.gov/books/NBK519488/
662.Apersonwasgivenamusclerelaxant thatcompetitivelyblocksnicotinicreceptors.Whichofthefollowingdrugsisusedforreversalofmusclerelaxationaftersurgery? a)Neostigmine b)Carbachol c)Succinylcholine d)Physostigmine CorrectAnswer-AAns:A.NeostigmineNeostigminehasbeentraditionallyusedastheagentofchoicetoreverseNeuromuscularBlockade(NMB)aftermuscleparalysisduringgeneralanesthesia.Anticholinesterases(neostigmine)aregenerallyusedtoreversetheeffectsofneuromuscularblockingagents.Ref:https://www.hindawi.com/journals/cria/2017/8197035/
663.Whichofthefollowinganticancerdrugs arecompetitiveinhibitorsoftyrosinekinase? a)Imatinibandsunitinib b)Letrozole c)Bicalutamide d)Fulvestrant CorrectAnswer-AAns.is'a'i.e.,ImatinibandsunitinibMoleculartargetedagentsTyrosinekinaseinhibitorsCompetitiveinhibitorsImatinib,Nilotinib,Sunitinib,Dasatinib,Erlotinib,Gefitinib,Lapatinib,Sorafenib(Rememberallendwith'nib').MonoclonalantibodiesCetuximab,panitumumab.HER2/neu(ERBB2)inhibitorsMonoclonalantibody-Trastuzumab.TargetedantibodyGemtuzumab(antiCD-33),Rituximab(anti-CD20),Alemtuzumab(antiCD-52).Vascularendothelialgrowthfactor(VEGF)inhibitorMonoclonalantibody-Bevacizumab.ProteosomeinhibitorsBortezomib.HistonedeacetylaseinhibitorVorinostatDNA-methyltransferaseinhibitor5-azacytidine,2-deoxy-5azacytidineAll-trans-retinoicacid.Biologicalresponsemodifier-RecombinantIL-2(aldesleukin,denileukin)
This post was last modified on 23 November 2021