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23a71183-cbf7-4382-8417-a00f8bb5482f | Anticoagulant of choice for ESR by Wintrobes method -a) Citrateb) Heparinc) Oxalated) EDTA | ab | cd | bd | ac | 1b
| single | Anticoagulant of choice for ESR by
Wintrobes method → Double oxalate & EDTA
Westergren method → Sodium citrate | Pathology | null | [
"edta"
] | 50,262 |
490df366-7f1a-429e-8714-40b3477faf45 | Anesthesia of choice for induction of anesthesia in children is? | Desflurane | Halothane | Sevoflurane | Isoflurane | 2c
| single | Sevoflurane REF: Morgan's anesthesia 3" ed p. 404, 570, 860, 884 "Sevoflurane is anesthetic of choice for induction in pediatrics because of rapid onset and non-pungency" Induction in pediatrics patient Inhalation -- Sevoflurane in N20 Intravenous (preferred) - rapid acting barbiturate like thiopental or Propofol followed by non-depolarizing muscle relaxant. Intramuscular- Ketamine Muscle relaxant (MR)- Rocuronium | Anaesthesia | null | [
"isoflurane",
"halothane",
"sevoflurane",
"desflurane"
] | 50,270 |
f761d7f8-7920-4ae5-a3fe-ce2103321cb4 | Calcitriol acts on | G protein coupled receptor | Cytosolic receptor | Intranuclear receptor | Enzymatic receptors | 1b
| single | Bioactive vitamin D or calcitriol is a steroid hormone that has long been known for its impoant role in regulating body levels of calcium Nuclear or cytosolic receptors include the binding sites for steroid hormones, thyroid hormones, vitamin D, and retinoic acids Ref-Goodman and Gillman 12th/e p1282 | Anatomy | General anatomy | [
"calcitriol"
] | 50,289 |
7c0fe204-9243-4492-80c3-b48527fd4889 | In the management of pulmonary emboli, -PA (alteplase) is infused for: March 2013 | 1-3 hours | 4-6 hours | 7-9 hours | 10-12 hours | 0a
| single | Ans. A i.e. 1-3 hours Dose and time for infusion of Alteplase for Pulmonary embolism is 100 mg over 2 hours. | Pharmacology | null | [
"alteplase"
] | 50,290 |
1a364881-49a8-4d39-8a9f-ec3017a6d14b | A 30 yr old male presents to the OPD with Erectile dysfunction. Basic screening evaluation is unremarkable. Which of the following should be the next step in the evaluation/management of this patient? | Cavernosometry | Neurological testing | Oral Sildenafil citrate trial | Penile ultrasound doppler study | 2c
| multi | Specialised investigations such as Penile Doppler Ultrasound, Dynamic Infusion Cavernosography and Neurological testing are rarely necessary in the evaluation of Erectile Dysfunction. These investigations are indicated in selected complicated cases and are not indicated for the initial evaluation of Erectile Dysfunction. So the most appropriate next step in management in this patient would be a trial of oral phosphodiesterase type 5 inhibitor sildenafil. Evaluation of a patient with sexual dysfunction involves taking thorough history and performing physical examination. Basic laboratory investigations done includes estimation of CBC, lipid profiles, serum prolactin and testosterone. Additional diagnostic testing is rarely necessary in the evaluation of erectile dysfunction. Specialized test involves (1) studies of nocturnal penile tumescence and rigidity, (2) vascular testing (in-office injection of vasoactive substances, penile Doppler ultrasound, penile angiography, dynamic infusion cavernosography/cavernosometry), (3) neurologic testing (biothesiometry-graded vibratory perception, somatosensory evoked potentials), and (4) psychological diagnostic tests. Ref: Harrison's Internal Medicine, 18th Edition, Chapter 48 | Psychiatry | null | [
"sildenafil"
] | 50,310 |
127e2103-8213-4554-a6a7-c63623be8a9a | Pigment deposition on cornea seen in –a) Chloroquineb) Digoxinc) Ranitidined) Amiodarone | b | ad | ac | ab | 1b
| single | Causing pigment deposition in cornea
i) Superficial
Amiodarone
Chloroquine
Chlorpromazine
Clofazimine
Indomethacin
Naproxen
Suramine
Tilorone
ii) Stromal
Phenothiazines (chlorpromazine) | Ophthalmology | null | [
"amiodarone"
] | 50,350 |
3103539e-86b7-4866-8c5f-6f56573cff60 | Which of the following drugs can produce a dramatic improvement in patients with resistant Type II lepra reaction? | Thalidomide | Steroids | Dapsone | Clofazimine | 0a
| single | Steroids are the drug of choice for both type 1 as well as type 2 lepra reaction. Thalidomide is used in steroid-resistant type 2 lepra reaction. | Pharmacology | null | [
"clofazimine",
"thalidomide",
"dapsone"
] | 50,352 |
6778d10f-4bd3-45d1-9728-85fd5190da24 | A 70 kg young athlete was planned for surgery. During anaesthesia, vecuronium was not available, so repeated doses of succinylcholine was given intermittently up to 640 mg. During recovery, patient was not able to spontaneously respire and move limbs. What is the cause? | Pseudocholinesterase deficiency | Phase II blockade | Muscle weakness due to repeated fasciculations | Undiagnosed muscular dystrophy | 1b
| single | Continued presence of the drug causes persistent depolarization resulting in flaccid paralysis-phase blockade 1. Phase 2 blockade is slow in onset and results from desensitization of of the receptor to A-ch. Psuedocholinestrase enzyme deficiency usual dose results in prolonged apnea and paralysis which lasts for hours. From padmaja 4th edition Page no 86 And from KD Tripati 7th edition Page no 349 | Pharmacology | Anesthesia | [
"vecuronium"
] | 50,357 |
af5ed518-d047-4055-a95b-dd2f17f56014 | Patients suffering from multidrug resistant tuberculosis can be treated with all the following drugs except | Tobramycin | Amikacin | Ciprofloxacin | Claruthromycin | 0a
| multi | Refer KDT 6/e p 748 Aminoglycosides effective in MDR tuberculosis are Amikacin, kanamycin, capreomycin Tobramycin is not effective against mycobacterium Ciprofloxacin and Clarithromycin are also used for tuberculosis | Pharmacology | Chemotherapy | [
"amikacin",
"ciprofloxacin"
] | 50,360 |
06804b9b-c451-4b91-afb7-a8dcd830addb | For DNA test, liquid blood is preserved in: Karnataka 07; DNB 09; UP 10; NEET 13, 14 | Sodium citrate | Potassium oxalate | EDTA | Sodium fluoride | 2c
| single | Ans. EDTA | Forensic Medicine | null | [
"edta"
] | 50,375 |
2af57865-e9cb-412b-9216-933ab9f5c6c2 | All are true about ramelteon except : | Agonist at MT1 and MT2 receptors | Is a substrate of CYP1A2 | Has high addiction liability | Approved for treatment of insomnia | 2c
| multi | Ramelteon is a non-addictive drug. | Pharmacology | null | [
"ramelteon"
] | 50,379 |
01d2f239-8898-42ec-ae94-8c79425656eb | All are the side effects of tacrolimus EXCEPT : | Hepatotoxic | Nephrotoxic | Ototoxic | Neurotoxic | 2c
| multi | Ototoxicity is not a side effect of tacrolimus.
Tacrolimus can cause nephrotoxicity, neurotoxicity, hepatotoxicity and diabetes mellitus.
Unlike cyclosporine, it do not cause hirsutism. | Pharmacology | null | [
"tacrolimus"
] | 50,388 |
a696a24c-bdd3-46ab-a52c-ea5dc3b09422 | Sensorimotor neuropathy may be caused by all, except: | DM | Lead poisoning | Arsenic | Isoniazid | 1b
| multi | Answer is B (Lead poisoning): Inorganic lead poisoning is not associated with a sensorimotor neuropathy Inorganic lead poisoning is primarily associated with a pure motor neuropathy. Selective motor neuropathy with wrist drop is characteristic of lead poisoning. Conditions that may cause Sensorimotor Neuropathies Polyneuropathy associated with Sensorimotor neuropathies (Harrison) Systemic Disease Diabetes mellitus Sensory, Sensorimotor, Motor Uremia Sensorimotor Porphyria (3 types) Sensorimotor Vitamin deficiency excluding B12 Sensorimotor Chronic liver disease Sensory or Sensorimotor Primary systemic amyloidosis Sensorimotor Chronic obstructive lung disease Sensory or Sensorimotor Malabsorption (sprue, celiac disease) Sensory or Sensorimotor Carcinoma (sensorimotor) Sensorimotor Carcinoma (demyelinating) Sensorimotor Multiple Myeloma, lytic type Sensory, Motor or Sensorimotor MGUS IgA Sensori motor IgG Sensorimotor 1gM Sensorimotor or Sensory Cryoglobulinemia Sensorimotor Drugs Amiodarone (antiarrhythmic) Sensorimotor Aurothioglucose (antirheumatic) Sensorimotor Isoniazid Sensorimotor Metronidazole (antiprotozoal) Sensory or Sensorimotor Misonidazolc (radioscnsitizer) Sensory or Sensorimotor Environmental Toxins Arsenic (herbicide; insecticide) Sensorimotor Diptheria toxin Sensorimotor y-Diketone hexacarbons (solvents) Sensorimotor Organophosphates Sensorimotor Thallium (rat poison) Sensorimotor | Medicine | null | [
"isoniazid"
] | 50,395 |
b5a02aff-2159-4f92-8c5f-59e00367fb22 | The drug of choice in scleroderma induced hypeensive crisis is - | ACE inhibitors | Thiazides | b - blockers | Sodium nitroprusside | 0a
| single | Ans. is 'a' i.e., ACE inhibitors | Pharmacology | null | [
"nitroprusside"
] | 50,400 |
0d6af5e2-cb62-4f76-8dd5-4e07effe74bb | A term infant is born to a known HIV-positive mother. She has been taking antiretroviral medications for the weeks prior to the delivery of her infant. Routine management of the healthy infant should include which of the following? | Admission to the neonatal intensive care unit for close cardiovascular monitoring | HIV ELISA on the infant to determine if congenital infection has occurred | A course of zidovudine for the infant | Chest radiographs to evaluate for congenital Pneumocystis carinii | 2c
| single | The transmission of HIV from mother to infant has decreased in recent years, due in large part to perinatal administration of antiretroviral medications to the mother and a course of zidovudine to the exposed infant. Studies suggest that a better than 50% decrease in transmission can be seen with appropriate medications as outlined.IVIG has not been shown to have a role in decreasing perinatal transmission. Healthy asymptomatic term infants born to HIV-infected mothers do not need special monitoring, nor do they need routine radiographs.An HIV ELISA is an antibody test and will be positive in the infant born to an HIV-infected mother due to maternal antibodies that are passed through the placenta; it is not a useful test in the newborn infant to determine neonatal infection because of this expected transfer of maternal (and not infant) immunoglobulin. The confirmatory Western blot also assays for antibodies to HIV and is similarly unhelpful in the newborn period. | Pediatrics | New Born Infants | [
"zidovudine"
] | 50,409 |
667a0ede-e851-42df-9aaf-dc11efce82ff | All are Anxiolytic Except | Buspirone | Fluoxetine | Diazepam | Nitrazepam | 1b
| multi | B i.e. Fluoxetine | Psychiatry | null | [
"fluoxetine",
"diazepam"
] | 50,410 |
75fd865e-1982-4802-8b2b-f5add1a75c6c | Which inhibits adenyl cyclase enzyme? | Somatostatin | Calcitonin | Epinephrine | Thyroxine | 0a
| single | Somatostatin acts directly on the acid-producing parietal cells a G-protein coupled receptor which inhibits adenylate cyclase, thus effectively antagonising the stimulatory effect of histamine to reduce acid secretion.Ref: DM Vasudevan, 7th edition | Biochemistry | Endocrinology | [
"epinephrine",
"thyroxine"
] | 50,414 |
2547ea24-8491-43c1-80f2-fd3a09d5c40b | A 40 yr old diabetic man comes with a complaint of inability to bend his ring finger and development small nodules on the palm.What will be not be a pa of your management in this patient? | Wait and watch | When more than 15 degree flexion deformity involved at PIP :Subtotal fasciectomy | When more than 30 degree flexion deformity involved at MCP :Subtotal fasciectomy | Collagenase injection | 1b
| multi | This is a condition of Dupuytren's contracture Flexion deformity- because of abnormal fibrosis of palmar aponeurosis leading to cord or nodule formation. M/C cause is Idiopathic MCP>PIP>DIP involved most commonly Ring finger more common than little finger involved Treatment: Conservative by stretching and inj. collagenase When more than 30 degree involved at MCP and more than 15-20 degree at PIP subtotal fasciectomy is done | Orthopaedics | Neuromuscular disorders | [
"collagenase"
] | 50,421 |
36f37718-f3ba-4dcb-8299-497b88378df0 | Grey baby syndrome is caused by | Amikacin | Tetracycline | Vancomycin | Chloramphenicol | 3d
| single | Amikacin - nephrotoxicity, ototoxicity and neuromuscular blockade Tetracycline - nephrotoxicity when given along with diuretics, phototoxicity, , affect dentition and bones in young children, Fanconi syndrome and Renal tubular acidosis. Vancomycin - red man syndrome Chloramphenicol- grey baby syndrome,nephrotoxicity,ototoxicity. | Pharmacology | Protein Synthesis Inhibitors | [
"amikacin",
"tetracycline",
"chloramphenicol",
"vancomycin"
] | 50,422 |
2c17dc50-1d9d-41e7-94ee-6cea88544b6b | Clomiphene citrate is not known to produce which of the following effects in a young female of 30 years of age (child bearing age group) ? | Hot flushes | Ovulation | Decreased FSH and LH secretion | Polycystic ovaries | 2c
| single | null | Pharmacology | null | [
"clomiphene"
] | 50,469 |
df03c7ed-7acf-4804-9d1c-08a6fde815ec | Antidepressant used in the prophylaxis of migraine - | Amitrvptiline | Fluoxetine | Citalopram | Trazadone | 0a
| single | Ans. is 'a' i.e.. Amitryptiline Prophylaxis of migraineAatrhypertensivesAntidepressantsAnticonvulsantsBeta blockersCalciumACETricyclycicSerotonin/horepinephrineValproateTopiramateGabapentino Metoprolol channel inhibitorsantidepressantsreuptake inhibitor o Propranolol bolckers ARB's|| o Timololo Verapamil o Amitryptilineo Venaiafaxine o Nimodiptne o Nortriptiline o Doxepin o Protriptyline | Medicine | Headache | [
"fluoxetine",
"citalopram"
] | 50,471 |
ba21aab6-7f9a-454d-b2cc-589c06bea513 | Which of the following is an ester linked local anaesthesia – | Cocaine | Lidocaine | Bupivacaine | Dubicaine | 0a
| single | null | Anaesthesia | null | [
"lidocaine",
"bupivacaine"
] | 50,495 |
0e4bcd69-feca-42a6-8bf8-a4c6ce03a8f9 | Biotin is needed in | Krebs cycle | Urea cycle | Fatty acid synthesis | Pyruvate dehydrogenase | 2c
| single | Biotin acts as co- enzymes for carboxylation reactions .Bioitin captures a molecule of CO2 which is attached to nitrogen of biotin molecule.Energy required for this reaction is provided by ATP.Tgen activated carboxyl group is transferred to the substrate.Biotin requiring CO2 Fixation reactions. Acetyl CoA + CO2 + ATP=Methyl malonyl CoA + ADP+ Pi This is the rate limiting reaction in fattyacid synthesis. Propionyl CoA + CO2 + ATP = Methyl malonyl CoA + ADP + Pi In oxidation of odd chain fatty acids. Pyruvate+ CO2 + ATP = Oxaloacetate + ADP + Pi Oxaloacetate acts as catalyst for TCA cycle and as enzyme in gluconeogenic pathway Reference: DM.VASUDEVAN.TEXTBOOK SEVENTH EDITION page no 485 Co-enzyme Main reaction using the co -enzyme Group transferred Thiamine pyrophosphate(TPP) oxidativedecarcoxylation of alpha keto acids in BPG shunt Hydroxyethyl Pyridoxalphosphate(PLP) Transamination, decarcoxylation of amino acids Aminogroup Biotin fatty acid synthesis, TCA cycle carbondioxide Co- enzyme-A ( Co-A) TCAcycle, fatty acid synthesis,gluconeogenisis, activation of acetoacetate, detoxification Acylgroup Tetrahydrofolate (FH4) Transmethylation reactions where methyl group required for synthesis of choline , epinephrine , creatine. One carbon groups Adenosinetriphosphate(ATP) universal energy currwncy Phosphate | Biochemistry | vitamins | [
"biotin"
] | 50,496 |
e19d7c48-e038-4252-973e-3bf8af82455b | Atropine is substituted by phenylephrine to facilitate fundus examination when: | Mydriasis is required without cycloplegia | Cycloplegia is required | Mydriasis and cycloplegia both are required | Cycloplegia and Mydriasis both are not required | 0a
| multi | null | Pharmacology | null | [
"atropine",
"phenylephrine"
] | 50,502 |
97fa2499-26a6-43e3-bd86-cdaecda1c71d | Flumazenil false is ? | It is a specific antagonist of BZD | It may be used in barbiturate poisoning as it acts on the same receptor GABAA | Given intravenously | Acts on GABAA receptor | 1b
| multi | Ans. is 'b' i.e., It may be used in barbiturate poisoning as it acts on the same receptor GABAA Flumazenil is specfic antagonist of BZDs. i.e., it acts on BZDs binding site of GABAA receptors, which is different from Baributurate binding site. Therefore, flumazenil does not antagonize barbiturates not effective in barbiturates poisoning. | Pharmacology | null | [
"flumazenil"
] | 50,506 |
910b08bd-ea83-4e91-a829-358bfc30c681 | True statement about Neuro-cysticercosis is - | Usually presents with seizures | Albendazole is more effective than praziquantel | Usually presents with 6th nerve palsy and hemiparesis | High does steroid are given for hydrocephalus | 0a
| multi | Answer- A. Usually presents with seizuresMost common site of neurocysticercosis is brain parenchyma."Parenchymal brain calcifications are the most common fnding of neurocysticercosis on neuroimaging. | Medicine | null | [
"albendazole"
] | 50,508 |
10e852a6-17ab-4a08-9be4-c87b5e86892c | A woman attends antenatal clinic with complaint mild pain in lower abdomen on left side, her periods are regular and UPT was positive at home. A TVS was done and uterine cavity is empty, and no adnexal mass is seen. Her serum beta HCG is 700 IU/L. what is the next step? | Give single dose of methotrexate | Perform laparoscopy | Perform serum beta HCG after 48 hr | Perform serum Beta HCG after 7 days | 2c
| multi | Ans. C. Perform serum beta HCG after 48 hrThis is a case of pregnancy of unknown location. The beta HCG value is less than the discriminatory zone of 1500mIU/ml on TVS. "With these PULs, serial b-hCG level assays are done to identify patterns that indicate either a growing or failing IUP. Levels that rise or fall outside these expected parameters increase the concern for ectopic pregnancy. Thus, appropriately selected women with a possible ectopic pregnancy, but whose initial b-hCG level is below the discriminatory threshold, are seen 2 days later for further evaluation. Trends in levels aid diagnosis." | Gynaecology & Obstetrics | Ecotopic Pregnancy | [
"methotrexate"
] | 50,530 |
862ee773-a036-49ad-a84d-1144e7eebf25 | Anesthetic agent (s) safe to use in ICP | Halothane | Thiopentone | Ketamine | Ether | 1b
| single | Anesthetic agents safe to use in raised intracranial pressure (ICP) are thiopentone, propofol & etomidate. Ref: Manuel C Pardo Jr and Ronaldo D Miller 7th Ed. | Anaesthesia | null | [
"ketamine",
"halothane"
] | 50,537 |
84a2c889-5043-4383-820e-8a3cd64379e9 | A 60 year old male comes to casuality with acute retention of urine since 12 hours. On examination there was distended bladder. His son gives a history of taking some drug by the patient. Since 2 days as he is suffering from depression. The most likely drug is - | CPZ | Amitriptyline | Haloperidol | Pimozide | 1b
| single | Amitriptyline can cause urinary retention due to anticholinergic action. | Psychiatry | null | [
"amitriptyline"
] | 50,543 |
033bb428-4650-48db-a3db-3830fe117449 | All of the following are true about depolarizing agents, EXCEPT: | Rocuronium undergoes no metabolism | Pancuronium resembles noradrenaline | Atracurium's duration of action can be markedly prolonged by hypothermia | Vecuronium effect is not altered in renal failure | 1b
| multi | Pancuronium consists of a steroid ring on which two modified ACh molecules are positioned. It resembles ACh enough to bind (but not activate) the nicotinic ACh receptor. Rocuronium undergoes no metabolism and is eliminated primarily by the liver and slightly by the kidneys. Because of its unique metabolism, atracurium's duration of action can be markedly prolonged by hypothermia and to a lesser extent by acidosis. Vecuronium is metabolized to a small extent by the liver. It depends primarily on biliary excretion and secondarily (25%) on renal excretion. Although it is a satisfactory drug for patients with renal failure, its duration of action is somewhat prolonged. Ref: Butterwoh IV J.F., Mackey D.C., Wasnick J.D. (2013). Chapter 11. Neuromuscular Blocking Agents. In J.F. Butterwoh IV, D.C. Mackey, J.D. Wasnick (Eds), Morgan & Mikhail's Clinical Anesthesiology, 5e. | Anaesthesia | null | [
"atracurium",
"vecuronium",
"rocuronium",
"pancuronium"
] | 50,551 |
17bfd869-5204-4027-a005-3a56b81beaa6 | Which is a soft steroid used in bronchial asthma | Budesonide | Dexamethosone | Ciclesonide | Fluisolide | 2c
| single | Ciclesonide has got high topical, systemic activity ratio Refer Katzung 11/e p348 | Pharmacology | Respiratory system | [
"ciclesonide"
] | 50,557 |
07d1d7fa-9005-4e33-8aec-da8c2c5c6ee0 | A 47yrs old female c/o headache, changes in vision, seizures from past 2yrs. Now she has developed weakness . side of body. A CT scan was being ordered by the physician which showed well circumscribed mass abutting the skull in left hemisphere. On contrast enhanced MRI shows - What is the next step in management of this patient? | Surgical excision | Chemotherapy with doxorubicin | Cerebral angiography with tumor embolization | Preoperative radiation therapy followed by surgical excision | 0a
| multi | Most likely diagnosis in this patient is meningioma (CECT finding & findings points towards it) it is a slow growing tumor arising from arachnoid layer. predominately occurs in females peak incidence around 45yrs primary treatment of meningioma includes - surgical excision (with radiation therapy - if complete resection is not possible) 11 -15% recurrence is there, even after gross total resection. | Surgery | CNS Tumors | [
"adriamycin"
] | 50,574 |
9e8e5a43-b7b3-4015-9394-1ee1a1005ac3 | Treatment of 42-year-old obese man with blood glucose 450 mg, urine albumin 2+ Sugar 4+ Ketone 1+ is - | Insulin | Glibenclamide | Glipizide | Metformin | 0a
| single | null | Medicine | null | [
"glipizide",
"metformin"
] | 50,582 |
0b12a527-751f-492a-bd96-fab61129e430 | A 55-year-old female who is taking propanolol for the management of a cardiovascular disease experiences an acute asthmatic attack. Which of the following drugs would you prescribe to attenuate this asthmatic attack? | Cromolyn sodium | Salbutamol | Beclomethasone | Ipratropium bromide | 3d
| single | (Ref: KDT 6/e p222) Inhaled b2 agonists are the agens of choice for termination of acute attack of bronchial asthma. However, as the patient is receiving b-blockers, treatment with b2 agonists will be ineffective (receptors are already blocked). Therefore, other bronchodilators like anticholinergic agents (ipratropium) or methylxanthines (theophylline) will be useful in such a case. | Pharmacology | Other topics and Adverse effects | [
"ipratropium",
"salbutamol",
"cromolyn"
] | 50,591 |
5b0a82a5-9260-4e87-9653-5641ff9b2ebe | Drugs that act on microtubules are all except | Colchicine | Vinblastine | Paclitaxel | Fluconazole | 3d
| multi | Ceain drugs bind to microtubules and thus interfere with their assembly or disassembly. These include colchicine, vinblastine, paclitaxel, and griseofulvin.Fluconazole inhibits the fungal cytochrome P450 enzyme 14a-demethylase. | Physiology | General physiology | [
"paclitaxel",
"fluconazole",
"colchicine"
] | 50,610 |
fb47d590-26ea-4780-aad0-88d47fe31e5e | A 49-year-old male is diagnosed with hypertension. He is a known asthmatic. His creatinine and potassium are both slightly elevated. Which of the following drugs would be appropriate in his case? | Amlodipine | Spironolactone | Propranolol | Hydrochlorthiazide | 0a
| multi | Answer: a) Amlodipine* Amlodipine is a dihydropyridine-type calcium channel blockers. Dihydropyridine calcium channel blockers (amlodipine) do not have contraindications related to renal impairment or potassium levels and can be safely administered in patients with asthma.* Hydrochlorothiazide is metabolized by the kidney, so it would not be a good choice in this patient as there is renal impairment (as indicated by elevated creatinine), because the drug itself can aggravate renal failure.* Spironolactone is a potassium-sparing diuretic. In this patient, it would only worsen the already elevated potassium level.* Beta-blockers are contraindicated in the presence of asthma.TREATMENT OF HYPERTENSION WITH CO-EXISTING CONDITIONSConcomitant conditionDrugs preferredDrugs to be avoidedAnginab blocker ,CCBVasodilatorsBHPa-blocker Diabetes and hyperlipidemiaACEI, ARB, CCB, a-blockerb-blocker, diureticsElderly and isolated systolic hypertensionDiuretics, CCB Low renin hypertensionDiuretics, CCB High renin hypertensionACEI, ARB, b-blocker AsthmaCCB, diuretics, ACEI, ARBb-blockerCHFACEI, diureticsCCBPost MIb-blocker, ACEI DM with CRF/proteinuriaACEI Peripheral Vascular DiseaseCCB, a-blockerb-blockerThyrotoxicosisb-blockerVasodilators* Dihyropyridine calcium channel blockers work to block vascular calcium channels resulting in vascular smooth muscle relaxation and have no specific contraindications.* They can cause peripheral edema (due to venous dilation) and dizziness.* Non-dihydropyridine calcium channel blockers (verapamil and diltiazem) work mostly on cardiac calcium channels and thus decrease the heart rate and inotropy of the heart.* They can also be used to treat hypertension and are contraindicated in systolic congestive heart failure.* Hydrochlorothiazide is not effective to treat hypertension when renal insufficiency is present. Propranolol is a non-cardioselective beta-blocker (blocks both beta-1 and beta-2 receptors) which can worsen asthmatic bronchoconstriction (cardioselective beta-blockers do this to a lesser degree). Spironolactone, an aldosterone antagonist, is also contraindicated in renal insufficiency and with elevated potassium levels.Recommendations of JNC-8 (Joint National Committee)* >60 years of, not diabetic/ not CKD:, target BP level; <150/90 mmHg* 18 to 59 years without major comorbidities + >60 years with DM/ CKD/Both; goal is <140/90 mmHg.* First-line medications: thiazide-type diuretics, calcium channel blockers (CCBs), ACEIs, and ARBs* Second- and third-line: higher doses or combinations of ACEIs, ARBs, thiazide-type diuretics, and CCBs.* Later-line alternatives: Beta-blockers, Alpha-blockers, Alphal/beta-blockers (eg, carvedilol), Vasodilating beta-blockers (eg, nebivolol), Central alpha2-adrenergic agonists (eg, clonidine), Direct vasodilators (eg, hydralazine), Loop diuretics (eg, furosemide), Aldosterone antagonists (eg, spironolactone), Peripherally acting adrenergic antagonists (eg, reserpine),* When initiating therapy, patients of African descent without chronic kidney disease should use CCBs and thiazides instead of ACEIs.* Use of ACEIs and ARBs is recommended in all patients with CKD.* ACEIs and ARBs should not be used in the same patient simultaneously.* CCBs and thiazide-type diuretics should be used instead of ACEIs and ARBs in patients over the age of 75 with impaired kidney function due to the risk of hyperkalemia, increased creatinine, and further renal impairment.Preferred Parenteral Drugs fc>r Selected Hypertensive EmergenciesHypertensive encephalopathyNitroprusside, nicardipine, labetalolMalignant hypertension (for IV therapy)Labetalol, nicardipine, nitroprusside, enalaprilatStrokeNicardipine, labetalol, nitroprussideMyocardial infarction/unstable anginaNitroglycerin, nicardipine, labetalol, esmololAcute left ventricular failureNitroglycerin, enalaprilat, loop diureticsAortic dissectionNitroprusside, esmolol, labetalolAdrenergic crisisPhentolamine, nitroprussidePostoperative hypertensionNitroglycerin, nitroprusside, labetalol, nicardipinePreeclampsia/eclampsia of pregnancyHydralazine, labetalol, nicardipine | Pharmacology | C.V.S | [
"propranolol",
"spironolactone",
"amlodipine"
] | 50,646 |
b41cbe2d-f92f-4a50-bd89-bf500f2823bd | Pralidoxime acts in organophosphorus poisoning by- | Regenerating Cholinesterase | Inhibiting cholinesterase | Cholinergic action | None of the above | 0a
| multi | Ans-A | Unknown | null | [
"pralidoxime"
] | 50,650 |
4c7cc459-b2c9-4f65-8e1f-8b84881d19d8 | Which of the following is an antifibrinolytic agent? | Dabigatran | Protamine | Alteplase | Epsilon aminocaproic acid | 3d
| single | Ans. d. Epsilon aminoeaproic acid (Ref: Goodman Gilman 12/e p867; Katzung 12/e p616; KDT 7/e p628, 6/e p608) Epsilon-aminocaproic acid is a synthetic inhibitor of the ptasmin-plasminogen system. It is the only potent antifibrinolytic agent, which is commercially available."Aminoeaproic acid is a lysine analog that competes for lysine binding sites on plasminogen and plasmin, blocking the interaction of plasmin with fibrin. Aminocaproic acid is thereby a potent inhibitor of fibrinolysis and can reverse states that are associated with excessive fibrinolysis. "-- Goodman Gilman 12/e p867Aminoeaproic AcidEACA is a synthetic inhibitor of the plasmin-piasminogen systemQ.It is the only potent antifibrinolytic agent, which is commercially availableQ.Mechanism of Action:Aminoeaproic acid is a lysine analog that competes for lysine binding sites on plasminogen & plasmin, blocking the interaction of plasmin with fibrinQ.Aminocaproic acid is a potent inhibitor of fibrinolysis & can reverse states that are associated with excessive fibrinolysisQ.Therapeutic Uses:Used to reduce bleeding after prostatic surgery or after tooth extractions in hemophiliacsQ.Used to treat the overdose and/ or toxic effects of the thrombolytics like tissue plasminogen activator & streptokinaseQ.Side-effects:Hypotension, cardiac arrhythmias, rhabdomyolysis & generation of thrombiQ. | Pharmacology | Antiplatelets and Fibrinolytics | [
"alteplase"
] | 50,660 |
999ad80b-3580-4273-9cec-3b35b67627b3 | Steroid receptor superfamily is present in: | Vitamin D3 | Insulin | Glucagon | None of the above | 0a
| multi | All steroid, thyroid, Vit.D and retinoids includes in steroid hormone superfamily. | Physiology | null | [
"glucagon"
] | 50,684 |
99152b70-683e-45df-b54b-fdb0291e7c50 | Drug of choice for hypeensive emergency in pregnancy is: | Methyldopa | Nitroprusside | Labetalol | Nicardipine | 2c
| single | Labetalol is DOC for hypeension in pregnancy whether it is routine or emergency HTN. DOC for hypeensive emergency in non pregnant patients is Nicardipine. | Pharmacology | Hypeension, Arrhythmias, Dyslipidemia | [
"methyldopa",
"nitroprusside",
"labetalol"
] | 50,735 |
dd501ad8-90df-4254-89ce-221375ba676d | Which of the following drug used against glaucoma is contraindicated in patients with urine retention | Disopyramide | Flecainide | Lidocanine | Tocainide | 0a
| single | Class Ia Antiarrhythmics have anticholinergic property. Disopyramide is a class Ia antiarrhythmic with maximum anticholinergic action & hence contraindicated in patients with urine retention & glaucoma. | Pharmacology | null | [
"flecainide"
] | 50,761 |
967d8f54-10a0-44a7-8a29-77f84c8705b2 | All of the following belong to the steroid receptor superfamily except- | Vit D3 receptors | Thyroid receptors | Retinoid receptors | Epinephrine receptors | 3d
| multi | Ans. is d i.e., Epinephrine receptors o All steroidal hormone (glucocoicoids, mineralocoicoids, androgens, estrogens, progesterone), thyroxine, vit D and vit A (retinoid) function through transcription factor. | Pharmacology | null | [
"epinephrine"
] | 50,762 |
1f4ebfc9-a112-49da-8ea9-1fc045ec1964 | All of the following are anticholinergics, except | Ipratropium bromide | Dicyclomine | Atropine | Amphetamine | 3d
| multi | null | Pharmacology | null | [
"ipratropium",
"atropine"
] | 50,768 |
3e9d46c9-a572-4351-a638-488a1bc532a2 | A child has phocomelia. This is due to drug taken by mother - | Tetracycline | Thalidomide | Warfarin | Chloroquine | 1b
| single | Ans. is 'b' i.e., Thalidomide Thalidomide is the worst teratogen known in the history of medicine.It was widely used as sedative and hypnotic.It was also believed to reduce vomiting in pregnancy.It was a routine hypnotics in hospitals, was even recommended to help children adapt themselves to a convalescent home atmosphere. The indiscrete use of these drugs in pregnant women resulted in an outbreak of Phocomelia. Phocomelia means "seal extremities", it is a congenital deformity in which the long bones of the limbs are defective and substantially normal or rudimentary hands and feet arise on or nearly on the trunk like the flippers of seal. Thalidomide was subsequently banned.Now, decades later thalidomide has received approval from the food and drug administration in certain conditions.According to Indian Journal of pharmacology Clinical uses of thalidomideAIDS related aphthous ulcers(r)AIDS related wasting syndrome^Multiple myeloma and other solid tumoursQPrevention of graft versus host disease after transplantationQRheumatoid arthritisQAnkylosing spondylitisQCrohn's disease and Bechet's syndromErythema nodosum leprosumQ | Pharmacology | Adverse Drug Effect | [
"thalidomide",
"tetracycline",
"warfarin",
"chloroquine"
] | 50,783 |
56f16301-fafb-4cdd-b96a-d5ad7fad3d9a | pancreatitis is a side effect of | valproate | clonazepam | clozapine | amisulpride | 0a
| single | LETHAL SIDE EFFECTS OF VALPROATE - Hyperammonemia - Pancreatitis - Hepatic failure - Neural tube defects - Thrombocytopenia MINOR SIDE EFFECTS OF VALPROATE - Hair loss - PCOD - WEIGHT GAIN - TREMORS Ref.Kaplon and Sadock, synopsis of psychiatry, 11 th editiojn, pg no.935 | Anatomy | Pharmacotherapy in psychiatry | [
"valproate",
"clozapine"
] | 50,792 |
b53f4060-1f11-4a17-a34c-1d495637abe7 | Which of the following drug is not used in MDB under RNTCP | Levofloxacin | Cycloserine | PAS | Ethionamide | 2c
| single | Regimen for MDR-TB This regimen comprises of 6 drugs Kanamycin, Levofloxacin, Ethionamide, Pyrazinamide, Ethambutol and Cycloserine during 6-9 months of the intensive phase and 4 drugs-Levovfloxacin, Ethionamide, Ethambutol and Cycloserine during the 18 months of the continuation phase. RNTCP regimen for MDR-TB : 6 (9) Km Lvx Eto Cs Z E/ 18 Lvx Eto Cs E* (Reserve/substitute drugs : PAS, Mfx, Cm) Special adjustments to the standard regimen for MDR-TB are as follows: In case of intolerance to Kanamycin, then Capreomycin (or PAS if injectable agent not feasible) is the available substitute drug. - In case of intolerance leading to discontinuation of other oral second-line drug, p-aminosalicylic acid (PAS) is the available substitute drug. - Baseline Kanamycin mono-resistance should lead to substitution of Kanamycin with Capreomycin. - Baseline Ofloxacin mono-resistance should lead to substitution of Levofloxacin with the combination of Moxifloxacin and PAS. - Baseline Ofloxacin and Kanamycin resistance (i.e. XDR-TB) should lead to declaration of outcome, referral to DR-TB Centre for pre-treatment evaluation for regimen for XDR-TB. Ref : Park 23rd edition Pgno : 191 | Social & Preventive Medicine | Communicable diseases | [
"levofloxacin",
"cycloserine",
"ethionamide"
] | 50,799 |
24ef88d9-39f2-42a5-82c8-a8eaabbfc5a9 | Drug of choice for tonic–clonic seizures is: | Sodium valproate | Carbemazepine | Phenobarbitone | Felbamate | 0a
| single | null | Pharmacology | null | [
"valproate"
] | 50,801 |
1b47d8af-7c21-40f0-bb99-0495d1a05285 | Kidney secretes: March 2013 | Erythropoietin | Angiotensin I | Angiotensin II | Thrombodulin | 0a
| single | Ans. A i.e. Erythropoietin | Physiology | null | [
"erythropoietin"
] | 50,817 |
36dd9f81-9ac3-473a-98f3-716f27774873 | A 44-year-old man with a prior renal transplant presents to the clinic for evaluation of symptoms consisting of a cough and shortness of breath on exertion. There is no sputum production and he has no prior respiratory or cardiac illnesses. On physical examination, he appears dyspneic, respirations 24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse perihilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver. Which of the following is the most appropriate next step in management? | amphotericin B | cephalosporins | trimethoprim-sulfamethoxazole | aminoglycosides | 2c
| multi | The treatment of choice is trimethoprim-sulfamethoxazole. The patient has Pneumocystis jiroveci pneumonia, since he is immunocompromised from antirejection medications for his renal transplant. Alternate therapies include IV pentamidine or IV clindamycin and primaquine. | Medicine | Infection | [
"methenamine",
"trimethoprim"
] | 50,830 |
715360bf-f392-4495-a70e-9d739d36a3ae | The drug which is a specific inhibitor of the enzyme alcohol dehydrogenase and is useful in the treatment of methanol and ethylene glycol poisoning is: | Disulfiram | Ethylene glycol | Calcium leucovorin | Fomepizole | 3d
| single | Fomepizole (4-methylpyrazole) is a specific inhibitor of alcohol dehydrogenase and the drug of choice for methanol poisoning by retarding its metabolism. A loading dose of 15 mg/kg i.v. followed by 10 mg/kg every 12 hours till serum methanol falls below 20 mg/dl, has been found effective and safe. It has several advantages over ethanol, viz. longer t 1/2 and lack of inebriating action, but is not available commercially in India. | Pharmacology | Opioids and Alcohols | [
"disulfiram",
"fomepizole",
"leucovorin"
] | 50,834 |
fe5c2c5d-159b-4cbe-8e26-17ed89258bfe | Which of the following muscle relaxant causes pain on injection. | Vecuronium | Pancuronium | Rocuronium | Succinylcholine | 2c
| single | Most of the patients who received rocuronium before loss of consciousness after induction with barbiturates or other drugs complained of severe burning pain in their vein and arm. Rocuronium is supplied in a sterile, nonpyrogenic, isotonic solution. The isotonicity is obtained using sodium chloride, and the pH of 4 is achieved by adding acetic acid or sodium hydroxide . The pain can be decreased by prior administration of intravenous lidocaine. Rocuronium produces a burning pain in the vein or arm if administered before the loss of consciousness after induction of anesthesia. Prior administration of lidocaine may reduce the pain. Otherwise, rocuronium should be administered after induction of anesthesia and loss of consciousness. | Anaesthesia | Neuromuscular Blocker | [
"vecuronium",
"rocuronium",
"pancuronium"
] | 50,855 |
1330f224-72f3-4566-94dc-c0a6e0fc3bab | All of the following drugs are bactericidal except : | Isoniazid | Tigecycline | Daptomycin | Ciprofloxacin | 1b
| multi | Tigecycline is a newer drug in the class 'Glycylcyclines.' Its mechanism of action and most properties are similar to tetracyclines. However, it is resistant to the efflux pump (major mechanism of resistance against tetracyclines). Most protein synthesis inhibiting drugs (including tetracyclines and tigecycline) are bacteriostatic except aminoglycosides. Isoniazid, ciprofloxacin and daptomycin are bactericidal. | Pharmacology | null | [
"isoniazid",
"ciprofloxacin",
"daptomycin"
] | 50,862 |
502af582-7737-4f64-8026-5d7194fd7087 | Therapeutic monitoring of plasma level of drug is done when using all of the following drugs except: | Warfarin | Gentamicin | Cyclosporine | Phenytoin | 0a
| multi | Therapeutic drug monitoring (TDM) is useful in the following situations: 1. Drugs with low safety margin-digoxin, anticonvulsants, antiarrhythmics, theophylline, aminoglycosides, lithium, tricyclic antidepressants, vancomycin In case of failure of response without any apparent reason-antimicrobials, To check patient compliance-psychopharmacological agents Monitoring of plasma concentration is of no value for1. Drugs whose response is easily measurable antihypeensives, hypoglycaemics, diuretics, oral anticoagulants(Warfarin), general anesthetics.2. Drugs activated in the body-levodopa.3. 'Hit and run drugs' (whose effect lasts much longer than the drug itself)-reserpine, guanethidine, MAO inhibitors, omeprazole.4. Drugs with irreversible action-organophosphate anticholinesterases, phenoxybenzamine. ref ; KD Tripathi pharmacology 7th edition (page no; 34) | Pharmacology | General pharmacology | [
"cyclosporine",
"gentamicin",
"warfarin",
"phenytoin"
] | 50,903 |
ad015d82-60d9-4e0b-88f5-a9d6915968ac | Antihormonal substance used to induce ovulation : | Mifepristone | Clomiphene citrate | Tamoxifen | Raloxifen | 1b
| single | Ans. is b i.e. Clomiphene citrate 1. Clomiphene citrate is the initial treatment for most anovulatory infeile women. It is chemically similar to tamoxifen Clomiphene is a non steroidal triphenylethylene derivative which demonstrates both estrogen agonist and antagonist propeies (predominant). It is the agent of choice for women with oligomenorrhea or amenorrhea having sufficient ovarian function to maintain estrogen at a serum level of 40pg/ml. Patient selection : Normal gonadotropicdeg normoprolactinemicdeg patients with normal cycle with absent or infrequent ovulation.deg PCOSdeg Post pill amenorrhea.deg Dose : Initial dose of 25 to 50mgdeg is given daily from D2 - D 5. Ovulation is expected to occur about 5 - 7 days after the last day of therapy. If ovulation doesnot occur, dose is increased in 50mg steps to a maximum of 250mg daily. (Although doses > 100 mg /day are not approved by FDA). Therapy is in given for 4-6 cycles. Clomiphene will be successful in inducing ovulation in about 70% of women, with ovaries producing estrogen Switch over from clomiphene to more aggressive therapy is done when : There is no response to clomiphenedeg (even with 100 mg / day dosing). There is ovulatory response to clomiphene but no pregnancydeg (following 3 to 6 months of ovulatory response to clomiphene). Patients with pituitary insufficiencydeg These patients usually respond to Gonadotropins. Note : Letrozole - 2.5mg (non steroidal aromatase inhibitor) is found superior to clomiphene. 2. Gonadotropin therapy : Prerequisite for Gonadotropin therapy : Ovarian reserve must be present. The Gonadotropins used are Human menopausal Gonodotropin : -- It is a formulation containing equal amounts of FSH and LH (751U each). -- It is prepared from hormones obtained from urine of postmenopausal women. HCG is required as an ovulatory trigger. FSH : purified urinary FSH and Recombinant FSH are also available. 3. Gonadotropin releasing hormone : Pulsatile GnRH : If other methods have failed then pulsatile GnRH is needed in patients with anovulation and hypothalamic insufficiency. Other drugs which can be used to for ovulation : Bromocriptine/Cabergoline : Are used to to treat anovulation caused by increase in serum prolactin level. Coicosteroids : Use to treat anovulation due to congenital adrenal hyperplasia. Also know : Mangement of unilateral proximal tubal block : Hysteroscopic cannulation or microsurgical tubo cornual anastomosis (if any periadenaxal adhesions are also present). Management of distal tubal block : Best is IVF. Surgical procedures like fimbrioplasty (lysis of fimbrial adhesions or dilatation of fimbrial stenosis) or neosalpingostomy may be done. Management of distal tubal block by hydrosalperix First laparoscopic salpingectomy followed by IVF Management of Bipolar tubal obstruction i.e. both proximal and distal tubal obstruction. Best is IVF Extra Edge : Lets quickly revise the tests for tubal patency. Tests for tubal patency : Rubins test : Outdateddeg Hysterosalpingography : screening procedure.deg Hystero contrastosonography Laparoscopy : Best technique for diagnosis of tubal and peritoneal pathology.deg Selective salpingography and falloscopy For evaluation of proximal tube obstruction. By falloscopy : tubal ostia and intra tubal architecture can also be seen. Time for performing tubal patency tests : D6-D 11 of the cycle. | Gynaecology & Obstetrics | null | [
"clomiphene",
"mifepristone",
"tamoxifen"
] | 50,918 |
e03ddcac-8ac0-4bbf-8145-4668099bd831 | Treatment of Behcet's syndrome consists of:
(A)Vincristine
(B)Aspirin
(C)Glucocorticoids
(D)Thalidomide | ABC | BCD | CAD | BCA | 1b
| single | The severity of the syndrome usually abates with time. Apart from the patients with CNS-Behcet's syndrome and major vessel disease, the life expectancy seems to be normal, and the only serious
complication is blindness.
Mucous membrane involvement may respond to topical glucocorticoids in the form of mouthwash or paste. In more serious cases, thalidomide (100 mg/d) is effective. Thrombophlebitis is treated with
aspirin, 32 5 mg/d. Colchicine can be beneficial for the mucocutaneous manifestations of the syndrome.
Uveitis and CNS-Behcet’s syndrome require systemic glucocorticoid therapy (prednisone, 1
mg/kgperdav) and azathioprine, 2-3 mg/kg per day. Interferon has proved to be very effective not only for CNS-Behcet's syndrome but also for refractory uveitis.
''Topical agent used in Behcet's syndrome: Steroids, tacrolimus & local anesthetics"- Neena Khanna 3rd/204
Chlorambucil, pentoxifylline & cyclosporine are also used in Behcet's syndrome-CMDT 06/851 INTERNET
Anti-TNF therapy such as infliximab has shown promise in treating the uveitis associated with the disease. Another Anti-TNF agent, Etanercept. may be useful in patients with mainly skin and
mucosal symptoms.
Interferon alfa-2a may also be an effective alternative treatment, particularly for the genital and oral ulcers
Dapsone and rebamipide have been shown, in small studies, to have beneficial results for mucocutaneous lesions.
Given its rarity, the optimal treatment for acute optic neuropathy in Behcet's disease has not been established. Early identification and treatment is essential. Response to ciclosporin.
perioculartriamcinolone and IV methylprednisone followed by oral prednisone has been reported although relapses
leading to irreversible visual loss may occur even with treatment. | Pathology | null | [
"thalidomide",
"vincristine"
] | 50,928 |
a0ece626-e1d7-4466-ac44-7e619d2b0193 | Minimum dose of tetracycline which causes discoloration of teeth: | 10mg/kg Body weight. | 20mg/kg Body weight. | 30mg/kg Body weight. | 40mg/kg Body weight. | 1b
| single | null | Pathology | null | [
"tetracycline"
] | 50,932 |
da90f89b-855e-42df-856a-b4b336168127 | The following drugs are useful in the treatment of isoniazid poisoning: | Pyridoxine | Diazepam | Bicarbonate | All of the above | 3d
| multi | Ans. (D) All of the above style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">(Ref: Harrison 17th ed/Table e35.4; American academy of family physicians, )MANAGEMENT OF ISONIAZID TOXICITYFive gram of IV pyridoxine given over 5 to 10 minutes is sufficient to counteract the neurotoxic effects of isoniazid in most cases.Diazepam, 5 to 10 mg administered intravenously, is the initial approach to seizure control, with the dose repeated as necessary.The acidosis associated with isoniazid toxicity appears to be lactic acidosis secondary to the seizure activity. Therefore, as the seizures are controlled, the acidosis usually decreases in severity. Since sodium bicarbonate may assist in correcting severe cases of acidosis, its administration should be considered if the pH is less than 7.1. | Pharmacology | Chemotherapy: General Principles | [
"isoniazid",
"diazepam"
] | 50,947 |
46958a2e-f5e0-47e1-8976-6b79820a2641 | Which of the following drugs can be used for the treatment of chloroquine resistant malaria in children ? | Chloroquine | Doxycycline | Tetracycline | Clindamycin | 3d
| single | null | Pharmacology | null | [
"tetracycline",
"doxycycline",
"chloroquine",
"clindamycin"
] | 50,963 |
15c4caf4-72c8-4f54-a087-14f6b74b9dae | Which of the following drugs, if given with terfenadine, can cause ventricular arrhythmias ? | Ketoconazole | Griseofulvin | Ampicillin | Sparfloxacin | 0a
| single | null | Pharmacology | null | [
"griseofulvin",
"ampicillin",
"ketoconazole"
] | 50,968 |
e0eca0e1-adaf-4eab-a5b1-063a05545fc7 | A patient on phenytoin therapy develops depression, for which he was prescribed tricyclic anti–depressants. He now complains of lassitude and his Hb reading is 8 gm/dl, the next step in the management of this patient | Chest X ray | MCV should be estimated | GGT should be estimated | None of the above | 1b
| multi | null | Pharmacology | null | [
"phenytoin"
] | 50,999 |
e60b4320-08a2-479e-8245-53faf4cb619e | Drug inhibiting bacterial protein synthesis are all except- | Aminoglycosides | Chloramphenicol | Clindamycin | Sulfonamides | 3d
| multi | Ans. is `d' i.e., Sulfonamides o Sulfonamides affect intermediary metabolism by inhibiting folate synthase. | Pharmacology | null | [
"chloramphenicol",
"clindamycin"
] | 51,020 |
edc2e5e5-fb19-4d1d-8597-df0d884d2daf | What diagnosis is implied by the results of this gallium scan? | Mumps | Paget's disease | Sarcoidosis | Septic emboli | 2c
| multi | Answer C. SarcoidosisThe gallium scan shows nasal, parotid, lung, liver, spleen, subcutaneous-nodule, and mediastinal and epitrochlear lymph-node uptake. This pattern is most consistent with a diagnosis of sarcoidosis. | Medicine | Immunology and Rheumatology | [
"gallium"
] | 51,073 |
956ae8e9-4ddf-4982-8bd2-d351fbf271c6 | Drug used in case of Herpetic lesions | Acyclovir | Penicillin | Tetracycline | Ciprofloxacin | 0a
| single | null | Pathology | null | [
"tetracycline",
"ciprofloxacin"
] | 51,082 |
4b93dda3-3261-43c2-9340-8e0f558dd4ac | A patient of endogenous depression was administered imipramine. After how much time interval the therapeutic effect of Imipramine is likely to manifest? | 3 days | 1 week | 3 weeks | 3 months | 2c
| single | . | Pharmacology | All India exam | [
"imipramine"
] | 51,104 |
9d298814-ac70-422e-a5bf-4dfc7d65eee7 | A 30 yr old male presents to the OPD with Erectile dysfunction. Basic screening evaluation is unremarkable. The next step in the evaluation/management should be | Oral sildenafil citrate trial | Cavernosonometry | Doppler study | Neurological testing | 0a
| multi | Sildenafil citrate has been used for the treatment of erectile dysfunction. It is a competitive and selective inhibitor of cGMP (cyclic guanosine monophosphate)-specific PDE-5 (phosphodiesterase type 5). It prevents the rate of breakdown of cGMP causing enhanced relaxationof cavernosal smooth muscle, increase in aerial flow into corpus cavernosa, compression of subtunical veins, and hence penile erection. Other similar drugs include tadalafil and vardenafil. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 132 | Psychiatry | Sleep disorders and eating disorders | [
"sildenafil"
] | 51,111 |
c500be94-ddfb-41e2-a95c-549f94da10be | Which of the following is the drug of choice for follicle induction for infeility in PCOS: | Clomiphene citrate | GnRH agonist | Combined oral Pills | Letrozole | 3d
| single | Letrozole is the Drug of choice for Induction of ovulation in a case of PCOS; Mode of action- Aromatase Inhibitor Decrease Estrogen production Inhibit Negative feedback on FSH Letrozole preferred over Clomiphene Citrate because less chances of multifetal pregnancy high live bih rate OHSS : Rare with it Given for 5 days (D5-D9) Sta with 2.5mg Max dose 7.5mg | Gynaecology & Obstetrics | Infeility (Eggs'plantation!) | [
"clomiphene",
"letrozole"
] | 51,116 |
f66eb1e0-56e8-48d9-af09-0e582cc7d55b | An infant had a high-grade fever and respiratory distress at the time of presentation to the emergency room. The sputum sample showed gram-positive cocci having an a hemolytic activity. The suspected pathogen is susceptible to which of the following agent: | Novobiocin | Bacitracin | Oxacillin | Optochin | 3d
| single | Sputum showing gram-positive cocci with alpha-hemolytic activity in a patient with high-grade fever and respiratory distress is suggestive of pneumococcal pneumonia which shows optochin susceptibility. Both pneumococcus and Streptococcus viridans produce alpha-hemolysis on blood agar. Optochin sensitivity test is done to differentiate Pneumococcus from commensal like Streptococcus viridans. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | Microbiology | Bacteriology | [
"bacitracin",
"novobiocin"
] | 51,118 |
5c911115-3283-462e-9130-93b2569f79aa | Not an antidepressant- | Amitriptilline | Fluoxetine | Trazodone | Pimozide | 3d
| single | Ans. is 'd' i.e., Pimozide | Pharmacology | null | [
"trazodone",
"fluoxetine"
] | 51,129 |
f9512dec-53a2-459d-9870-fac1716342ff | Renal plasma flow is best determined by: | Inulin | Creatinine | PAH | Mannitol | 2c
| single | Ans. C. PAHa. Renal plasma flow - RPFi. Can be measured by infusing para-amino hippuric acid (PAH) and determining its urine and plasma concentration.ii. 90% of the PAH in arterial blood is removed in a single circulation through the kidney. It is therefore become common place to calculate the "renal plasma flow" by dividing the amount of PAH in urine by the plasma PAH level.iii. Effective renal plasma flow (ERPF): -iv. ERPF = UPAH X V = Clearance of PAHv. PPAH = 625 ml/min.vi. Actual - RPF = ERPF = 630 Extraction ratio 0.9 = 720 ml/min.b. Renal Blood flow = RPF x 11- Hematocrit =700x10.55=1273ml/mm.c. "for determination of the GFR do a creatinine or Inulin clearance test and for determination of RBF or RPF the PAH clearance is to be done" | Physiology | Glomerular Filtration, Renal Blood Flow, and Their Control | [
"mannitol"
] | 51,134 |
77f6efa7-c1c3-4111-98d8-19fb9b64fc37 | Which of the following is preferred for infertility treatment of a female with increased prolactin levels ? | Dopamine | Carbidopa | Cabergoline | Bromocriptine | 2c
| single | null | Pharmacology | null | [
"carbidopa",
"cabergoline",
"bromocriptine"
] | 51,139 |
b5dfa3c3-c841-4c76-a771-87ba597a77a6 | All are adulterants of heroin, except: | Chalk powder | Quinine | Charcoal | Fructose | 2c
| multi | C i.e Charcoal Morphine depress respiratory centre, so rate & tidal volume both are decreasedQ & death is due to respiratory failure. YawningQ, dysphoric mood & insomnia with water loss from different orifices (i.e. lacrymation, sweating, diarrhoea, vomiting, rhinorrhea) are characteristic symptoms of opioid withdrawl Opium (Morphine) poisoning has 3 stages Stage of Excitement - HallucinationQ, Euphoria, Maniacal features Stage of Stupor - Headache, nausea, vomiting, incapacity for exeion, a sense of weight in limbs, giddiness, drowsiness, stupor Stage of Coma - Abolished reflex, Pin point non reacting pupilQ, All secretions are suspended except sweat, respiratory depressionQ & paralysis -Charas or Hashish is resinous exudates from the leaves & stems of plant cannabis indica or Cannabis sativa.Q - The activa principle of cannabis is a fat soluble oleoresin, cannabinol (tetra h dro-cannabinol- THC). Cannabis is used in four forms Bhang Dried leaves & fruit shoots Majun Sweet meat made with bhang. It produces grandiose delusions in addition to effects of bhang Ganja Dried flowering tops of female plant.Q Charas or Hashish Resinous exudates from leaves & stem of plantQ | Forensic Medicine | null | [
"quinine"
] | 51,140 |
a089b3a5-70d5-4257-9f69-d31f916ca709 | True about tamoxifen is- | Selective estrogen receptor downregulator | Selective estrogen receptor modulator | Selective tissue estrogen activator regulator | Estrogen antagonist | 1b
| multi | Ans. is 'b' i.e., SERM * Has been explained in previous sessions | Pharmacology | Endocrinology | [
"tamoxifen"
] | 51,141 |
1d69169b-38f9-49eb-b237-f7ffa6f9dabb | Transaerial chemoembolization (TACE) is used in the treatment of unresectable hepatocellular carcinoma without poal vein thrombosis. The drug commonly used for TACE is: | Doxorubicin | Sorafenib | Tamoxifen | Carboplatin | 0a
| single | There are different treatment modalities for HCC. Curative treatments are resection, liver transplantation, Radiofrequency ablation (RFA), Percutaneous ethanol injection etc. Palliative treatments are TACE, Sorafenib etc. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Cha in Page 781. | Medicine | null | [
"tamoxifen",
"carboplatin",
"doxorubicin"
] | 51,146 |
52411363-8333-4571-8ab2-4872d5fbd235 | Resuscitation of a child with HR<60/min includes all of the following, except | Chest compression | Adrenaline | Endrotracheal tube intubation | Never give atropine | 3d
| multi | Ref. The Short Textbook of Pediatrics. Pg 271
Atropine is considered when there is a AV block | Unknown | null | [
"atropine"
] | 51,147 |
540b6a57-ac39-4d03-b2ed-12c7bc3d4d61 | Presence of trifluroacetic acid (TFA) in urine indicates that volatile anaesthetic agent used was | Halothane | Methoxyflurane | Trichloroethylene | None of the above | 0a
| multi | Ans. is 'a' i.e., Halothane | Surgery | null | [
"methoxyflurane",
"halothane"
] | 51,155 |
230158d2-3358-44dd-84b9-522a4e5b2323 | Site of action of vecuronium is? | Cerebrum | Reticular formation | Motor neuron | Neuro-muscular junction | 3d
| single | Ans. is 'd' i.e., Neuro-muscular junction* Vecuronium, a non-depolarizing blocker, acts on nicotinic receptors at myoneural junction.* Neuro-muscular blocker act at myoneural junction1. Competitive (Non-depolarizing) blocker: -# They compete with Achfor Nm receptors - called competitive blockers. They prevent binding of Ach to Nm receptors - No opening of Na+ channels - No depolarization, so these are called non-depolarizing blockers. Competitive blockers reduce the frequency of channel opening but not its duration or the conductance of a channel once it has opened. When the magnitude of end plate potential falls below a critical level, it is unable to trigger propagated muscle action potential - muscle fails to contract. Neostigmine (anticholinesterases) antagonises competitive blockers as it increases the concentration of Ach by inhibiting its degradation by cholinesterase. Therefore, Neostigmine is used for the reversal of competitive (nondepolarizing) blockers.2. Depolarizing blockers (Succinylcholine, Decamethonium)# Depolarizing blockers have affinity as well as submaximal intrinsic activity on NM receptors. They depolarize muscle end plates by opening of Na+ channels and initially produce twitching and fasciculations (not full contraction as these drugs have submaximal activity) - So, they are called depolarizing blocker. These drugs do not dissociate rapidly from the receptor (NM) - Persistant partial depolarization - Na+ channels get inactivated - flaccid paralysis. Neostigmine does not antagonize depolarising blockers (Therefore neostigmine cannot be used for reversal).Inf act neostigmine can potentiate the block as neostigmine and other anti-cholinesterase also inhibits pseudocholinesterase which metabolizes Sch.Under certain conditions depolarizing agents produce dual mechanism of neuromuscular blockade which can be divided into two phases :a) Phase I block* Rapid in onset* Result from persistant depolarization of muscle end plate - Typical mechanism of action of depolarizing blocker.* Has classical features of depolarization block.* Block is not antagonized by anticholinesterases (neostigmine).b) Phase II block (Dual block)* Slow in onset* Results from desensitization of receptor to ACh - Ach can not act on Nm receptors (similar to competitive blocker).* Resembles block produced by competitive blockers - Therefore, has characteristics similar to non-depolarizing (competitive) block.* Block is partially reversed by anticholinesterases (Neostigmine).# In man, normally, only phase I block is seen - typical depolarizing block.# Phase II block is seen when fluorinated anaesthetics have been given or when SCh is injected in high dose.# SCh also produces phase II block in patients with atypical or deficient pseudocholinesterase. | Anaesthesia | Muscle Relaxant | [
"vecuronium"
] | 51,171 |
572a90dd-f1bc-45d9-a2bf-53d8dd7f58a8 | In treatment of Osteosarcoma all of the following are used except (REPEAT) | High dose Methotrexate | Cycloohosphamide | Vincristine | Doxorubicin | 2c
| multi | Though surgery is the form of primary treatment in Osteosarcoma but etoposide cycloohosphamide, Cisplatin, Doxorubicin have been used High dose Methotrexate has been the drug of choice and is the only FDA approved agent for this condition Ref Katzung 10th/891 | Pharmacology | Chemotherapy | [
"methotrexate",
"vincristine",
"doxorubicin"
] | 51,179 |
dce86bb6-0ff4-45b0-8d61-e30f2b17cb44 | Which of the following is not conveed into active metabolite | Lisinopril | Fluxotine | Cyclophosphamide | Diazepam | 0a
| single | all ACE inhibitor are prodrug except captopril and lisinopril drug -active metabolite fluxotine-non fluxotine Cyclophosphamide- adenophosphamide Diazepam-oxazepam Refer KDT 7/e p22 -23 | Anatomy | General anatomy | [
"lisinopril",
"cyclophosphamide",
"diazepam"
] | 51,184 |
407b777e-b8f5-4c3c-b7e3-a95896225948 | Drug of choice for ventricular arrhythmia due to myocardial infarction is | Quinidine | Amiodarone | lidocaine | Diphenylhydantoin | 2c
| single | Refer kDT 6/e p 519 Drug of choice for ventricular arrhythmias with myocardial infarction is lignocaine Drug of choice for supraventricular arrhythmia after myocardial infection is beta blockers cardiac function is adequate | Pharmacology | Cardiovascular system | [
"amiodarone",
"xylocaine",
"quinidine"
] | 51,203 |
e225e13d-0396-47db-958e-43a5ad7c3c75 | The production of cervical mucus is stimulated by : | Progesterone | Estradiol | Estriol | Pregnenolone | 1b
| single | Cervical mucus is a glycoprotein gel that expand and contract in response to cyclic changes in the steroid hormone environment across the menstrual cycle to facilitate or inhibit the passage of sperms. Estrogen stimulates cervical mucus production, and as levels rise during the follicular phase, mucus becomes more abundant and watery, less cellular, and more easily penetrated by sperm. Progesterone inhibits cervical mucus production and renders it opaque, viscid, and impenetrable. Ref: Clinical Gynaecologic Endocrinology and Infeility; 8th Edition, Chapter 27 | Gynaecology & Obstetrics | Reproductive physiology and hormones in females | [
"estriol"
] | 51,215 |
81bce5ef-7c7a-4307-ac5b-1b1a65201a47 | Which of the following antibiotic does not act by inhibiting protein synthesis ? | Vancomycin | Tetracycline | Streptomycin | Azithromycin | 0a
| single | null | Pharmacology | null | [
"azithromycin",
"tetracycline",
"vancomycin"
] | 51,249 |
613b20fa-4770-4b74-8147-1486c0eabd60 | Which of the following drugs can cause galactorrhea? | Omeprazole | Metoclopramide | Bromocriptine | Ranitidine | 1b
| single | Galactorrhea is caused by prolactin secretion. Dopamine normally inhibits the secretion of prolactin. Thus dopamine antagonists can cause hyperprolactinemia leading to galactorrhea. The drugs include: Typical Antipsychotics like Haloperidol Antiemetics like Metoclopramide Dopamine depleter like Reserpine. Drugs stimulating dopamine receptors like Bromocriptine and Cabergoline are used for treatment of Hyperprolactinemia. | Pharmacology | Pituitary-Hypothalmic System and Thyroid | [
"metoclopramide",
"bromocriptine",
"ranitidine",
"omeprazole"
] | 51,259 |
ffe1a875-2f3a-4280-9b43-5e5fc9927ec3 | Preferred fluid in a poly-traumatic patient with shock? | Ringer lactate | Normal saline | Dextran | Dextrose-normal saline | 1b
| single | Ans. (b) Normal salineRef.-.Harrison 18th ed. / 270Normal saline is the preferred fluid for volume expansion in a crashing patient with un-recordable BP. The main point to be noted is that if ringer lactate is infused in these patients, then lactate in the solution will never reach the liver where it is normally converted into bicarbonate. Hence the accumulated lactate will get broken into lactic acid that will worsen the status of patient of poly-trauma who is already acidotic. Dextran would not be indicated as it exhibits anti-thrombotic tendency. | Surgery | Miscellaneous (Fluid & Electrolyte) | [
"dextran"
] | 51,271 |
80d90d08-f819-4195-90f0-05a3d0545643 | Catalase positive novobiocin resistant bacteria is: | Staphylococcus aureus | Staphylococcus epidermidis | Staphylococcus saprophyticus | None of the above | 2c
| multi | Ans. is 'c' i.e., Staphylococcus saprophyticus(Ref: Ananthanarayan, 9th/e, p. 202)* All staphylococcus are catalase positive.* Staphylococcus saprophyticus is resistant to novobiocin. | Microbiology | Bacteria | [
"novobiocin"
] | 51,283 |
a9e4d73d-869e-47df-8039-19f88b29cdfa | All of the following agents are used in the treatment of hot flashes, EXCEPT: | Tamoxifen | Venlafaxine | Gabapentin | Paroxetine | 0a
| multi | Tamoxifen is a selective estrogen receptor modulator (SERM) which exhibits anti-estrogenic activity on tissues like breast and central nervous system and estrogenic activity on tissues like bone. Tamoxifen produces hot flashes and other adverse effects, including cataracts and nausea . The other three options - Venlafaxine, Gabapentin and Paroxetine are included in the non-hormonal treatment of hot flashes. Ref: Levin E.R., Hammes S.R. (2011). Chapter 40. Estrogens and Progestins. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e ; Treatment of the postmenopausal woman: By Rogerio A. Lobo, Pages 3-6. | Gynaecology & Obstetrics | null | [
"gabapentin",
"tamoxifen",
"paroxetine"
] | 51,330 |
4ad0838e-4aec-4723-9c44-a152a743ab92 | Which of the following barbiturate is used for induction? | Thiopentone | Naloxone | Naltrexone | Phenobarbitone | 0a
| single | Ans: a (Thiopentone) Ref: KDT, 6th ed,p. 374* Thiopentone sodium is an ultrashortacting thiobarbiturate highly soluble in water, yielding a very alkaline solution (pH 10.4)* On IV injection it produces loss of consciousness in one arm- brain circulation time * Ultrashort duration of thiopentone is because of methyl group added to it. At induction it causes mild hypokalaemia* Elimination half life of thiopentone is 10.4 hours but consciousness is regained after 15-20 min because of redistribution (drug redistributed from brain to tissues with less vascularity like muscle or fat)* 80-90% is bound to plasma proteins (mainly albumin)* Metabolized in liver and metabolic products are eliminated through kidney* MOA - inhibits function of synapse. Transmission of excitatory neurotransmitters like Ach is inhibited and that of inhibitory neurotransmitters like GABA is enhanced* Cerebral protection - cerebral oxygen consumption, cerebral metabolic rate and intra cranial tension are decreased (therefore agent of choice)* Causes hypotension and decreases intra ocular pressure* Pregnancy - crosses placental barrier and achieves high concentration in brain of fetus* Stimulates ADH action and has got antithyroid activity* * poor analgesic and muscle relaxant action* Intra arterial injection - very dreadful complication which may lead to gangrene and loss of limb if not diagnosed early* Absolute contraindication - acute intermittent porphyria and variegate porphyriaThiopentone induces enzyme aminolevulenic acid synthetase which stimulates formation of porphyrin in susceptible individuals Barbiturates Long acting- PhenobarbitoneShort acting- Butobarbitone- PentobarbitoneUltra short acting- Thiopentone- Methohexitone | Anaesthesia | General Anesthesia | [
"naloxone",
"naltrexone"
] | 51,332 |
e5e7854d-3d62-4512-be2e-1a7e559f1c01 | Pilocarpine is not used in young adults as it causes: | Retinal detachment | Myopia | Iris cysts | Shallow anterior chamber | 1b
| multi | Ans. (b) MyopiaRef: Khurana 6/e, p. 449; Kanski 7/e; p. 386Contraction of ciliary muscle results in accommodation and thus also cause transient, fluctuating myopia. | Ophthalmology | Glaucoma | [
"pilocarpine"
] | 51,353 |
a3ec7e91-5048-4de9-8b06-d6e9ca551fe1 | Maximum analgesic action found in – | Catecholamine | Propofol | Ketamine | Thiopentone | 2c
| single | Ketamine is different from most other anaesthetic induction agents in that it has significant analgesic action. | Anaesthesia | null | [
"ketamine",
"propofol"
] | 51,357 |
df6b1d88-d71d-410d-a38f-7e1934629338 | Malignant hypehermia is a rare complication of the use of the following anaesthetic: | Ketamine | Thiopentone sodium | Halothane | Ether | 2c
| single | Rarely, Halothane can cause Malignant hypehermia, which is treated with dantrolene Inhalational anesthetic agents and Depolarising NM blockers like succinylcholine can precipitate malignant hypehermia. | Pharmacology | Anaesthesia | [
"ketamine",
"halothane"
] | 51,360 |
0ba3932a-a8be-484c-809f-7e72fa31b880 | A 30-year old female complains of lower abdominal pain and purulent vaginal discharge. Her pulse rate is 98/min, temperature is 101oF, WBC and ESR are raised. Per vaginal examination reveals lower abdominal tenderness and cervical motion tenderness. What is the best treatment option for her? | Single IM injection of Ceftriaxone with oral doxycycline and oral metronidazole for 14 days | Single dose of Ceftriaxone injection with oral Azithromycin for 14 days | Oral Metranidazole for 14 days | Oral Oflaxacin and oral Metronidazole for 14 days | 0a
| multi | The best treatment is single IM injection of Ceftrixone with oral Doxycycline and oral metronidazole for 14 days. The diagnosis is pelvic inflammatory disease. Sexually transmitted organisms especially N.gonorrhoeae and C.trachomatis are implicated in many cases. The best treatment for OPD management of PID is: Inj. Ceftrixone 250mg IM single dose + Doxycycline 100 mg BD * 14 days +/- Metronidazole 500 mg BD * 14 days Best parenteral treatment for PID is : Inj. Cefotetan 2g IV BD + Doxycycline 100 mg BD or Inj. Cefoxitin 2g QID+ Doxycycline 100 mg BD To minimize disease transmission, women should be instructed to abstain from sexual intercourse until therapy is completed, symptoms have resolved, and sex paners have been adequately treated. Ref: Online resources | Gynaecology & Obstetrics | Infections of the genital tract | [
"metronidazole",
"azithromycin",
"doxycycline",
"ceftriaxone"
] | 51,362 |
1c2213b8-bcd6-4a50-9afd-c95e1d5c74de | Best anaesthetic drug to be given in day care surgery: | Ketamine | Sevoflurane | Desflurane | Propofol | 3d
| single | Ans. (d) PropofolRef: KDT 6th ed./373-374PROPOFOL* Anesthesia of choice for day care surgery.* Short acting, action diminishes the same day.* Advantage: has anti emetic property. It is safe in porphyria.* Disadv: Causes myocardial depression and hypotension. | Anaesthesia | Miscellaneous General Anesthesia | [
"ketamine",
"sevoflurane",
"desflurane",
"propofol"
] | 51,366 |
42fcf2f0-f933-49fd-8d67-602b988d3b2e | Main MOA brimonidine in glaucoma - | Decreased aqueous secretion | Increased trabecular outflow | Increased uveoscleral outflow | Reduce vitreous volume | 0a
| single | Brimonidine (0.2% : 2 times/day). It is a selective alpha-2-adrenergic agonist and lowers IOP by decreasing aqueous production. Because of increased allergic reactions and tachyphylaxis rates it is not considered the drug of first choice in POAG. It is used as second drug of choice and also for combination therapy with other drugs. Ref.AK Khurana 4th edition page no 223 | Ophthalmology | Glaucoma | [
"brimonidine"
] | 51,381 |
83e5e391-180a-425f-8b7a-3b864b2b5ca0 | Mucormycosis -a) Angio-invasionb) Lymph invasionc) Septate hyphaed) Long term deferoxamine therapy is predisposing factore) It may lead to blindness | acd | ade | abd | ad | 1b
| single | null | Microbiology | null | [
"deferoxamine"
] | 51,383 |
8a77376c-51e4-4c2e-946f-720572390f1f | Drug of choice as antidiabetic in obese patient: | Glipizide | Insulin | Tolbutamide | Metformin | 3d
| single | Ans. D. MetforminMetformin is the first line treatment in case obese diabetic patient as it is known to cause weight loss. It doesn't cause the release of insulin and thus less chances of hypoglycemia. | Pharmacology | Endocrinology | [
"glipizide",
"metformin",
"tolbutamide"
] | 51,389 |
70aa145c-cb91-40ed-b04b-73ffda9b3785 | Mitosis is arrested in ________ phase by using colchicine in cytogenetic analysis. | Prophase | Metaphase | Anaphase | Telophase | 1b
| single | null | Medicine | null | [
"colchicine"
] | 51,390 |
27cf10ee-16ce-4c86-b739-15f380471e95 | All of the following causes increase in heart rate except: | Halothane | Isoflurane | Sevoflurane | Desflurane | 0a
| multi | null | Pharmacology | null | [
"sevoflurane",
"desflurane",
"isoflurane",
"halothane"
] | 51,402 |
b950ee35-8a68-4f91-b2d1-a803352fcc4f | Side effects of Pilocarpine are A/E – | Shallow anterior chamber | Punctate stenosis | Follicular conjunctivitis | Posterior synechia | 1b
| multi | Most guides have given option a as the answer.
I have done extensive search on this. First you see the topical adverse effects of parasympathomimetic antiglaucoma drugs (from yanoff & Duker) :-
Directly acting (cholinergic agonists like pilocarpine, carbachol) → Miosis, uveitis, browache, cataracts, myopia, retinal detachment, colour vision changes, angle closure, ocular cicatracial pemphigoid.
Indirectly acting (anticholineesterases like demecarium) :- Intense miosis, iris pigment cysts, punctal stenosis, myopia, cataract, retinal detachment, angle closure.
Now see each option sequentially :-
Option '1'
Pilocarpine can cause shallow anterior chamber :-
"The use of pilocarpine is somewhat paradoxical since it is known to cause further shallowing of anterior chamber".
— Evidence - based ophthalmology.
Now you must be thinking then why pilocarpine is the drug of choice for angle closure glaucoma. Pilocarpine works by helping to open the angle by tensing the iris-diaphragm and pulling on the scleral spur. It may also help to resolve relative pupil block.
Option '2'
Punctal stenosis is caused by indirect cholinomimetic (cholinesterase) not by direct cholinomimetic (pilocarpine).
Option '3'
Rarely, pilocarpine can cause follicular conjunctivitis :-
"Pilocarpine and carbachol may both cause conjunctival follicle".
— Clinical ophthalmology.
Option '4'
Miotics (pilocarpine) makes the iris thin and pulls it away from lens removing the pupillary block, increasing the chances of posterior synechiae (due to stretching & increased surface of iris) and restoring aqueous flow by opening irido-corneal angle. | Ophthalmology | null | [
"pilocarpine"
] | 51,405 |
aa69e4c6-2f9c-45dd-b7d1-5ff7cdd2dee0 | Select the antibiotic most frequently associated with the Hypoplasia and staining of fetal teeth (SELECT 1 ANTIBIOTIC) | Tetracycline | Streptomycin | Nitrofurantoin | Chloramphenicol | 0a
| single | Fetal exposure to an antibiotic depends on many factors such as gestational age, protein binding, lipid solubility, pH, molecular weight, degree of ionization, and concentration gradient. Some antibiotics are even concentrated in the fetal compartment. Tetracycline is contraindicated in all three trimesters. It has been associated with skeletal abnormalities, staining and hypoplasia of budding fetal teeth, bone hypoplasia, and fatal maternal liver decompensation. Sulfonamides are associated with kernicterus in the newborn. They compete with bilirubin for binding sites on albumin, thereby leaving more bilirubin free for diffusion into tissues. Sulfonamides should be withheld during the last 2 to 6 weeks of pregnancy. With prolonged treatment of tuberculosis (TB) in pregnancy, streptomycin has been associated with fetal hearing loss. Its use is restricted to complicated cases of TB. Nitrofurantoin can cause maternal and fetal hemolytic anemia if glucose- 6-phosphate dehydrogenase deficiency is present. Chloramphenicol is noted for causing the gray baby syndrome. Infants are unable to properly metabolize the drug, which reaches toxic levels in about 4 days and can lead to neonatal death within 1 to 2 days. | Gynaecology & Obstetrics | Fetus & New Born and their Diseases | [
"tetracycline",
"chloramphenicol",
"nitrofurantoin"
] | 51,412 |
1075b481-d491-4c4f-94fe-48d97d1a59b0 | Drug of choice for MRSA skin infection is | Streptogramin | Vancomycin | Quinupristin | Linezolid | 1b
| single | (B) Vancomycin # Drugs used in the treatment of MRSA: Vancomycin, Linezolid, Teicoplanin, Cotrimoxazole, Oxacillin, RifampicinTREATMENT OF COMMON INFECTIONS OF THE SKINDiagnosis/ConditionPrimary TreatmentAlternative TreatmentAnimal bite (prophylaxis or early infection)Amoxicillin/clavulanate, 875/125 mg PO bidDoxycycline, 100 mg PO bidAnimal bitea (established infection)Ampicillin/sulbactam, 1.5-3.0 g IV q6hClindamycin, 600-900 mg IV q8h plusCiprofloxacin, 400 mg IV q12horCefoxitin, 2 g IV q6hBacillary angiomatosisErythromycin, 500 mg PO qidDoxycycline, 100 mg PO bidHerpes simplex (primary genital)Acyclovir, 400 mg PO tid for 10 daysFamciclovir, 250 mg PO tid for 5-10 daysorValacyclovir, 1000 mg PO bid for 10 daysHerpes zoster (immunocompetentAcyclovir, 800 mg PO 5 times daily forFamciclovir, 500 mg PO tid for 7-10 dayshost >50 years of age)7-10 daysorValacyclovir, 1000 mg PO tid for 7 daysCellulitis (staphylococcal or streptococcalb.c)Nafcillin or oxacillin, 2 g IV q4-6hCefazolin, 1-2 g q8horAmpicillin/sulbactam, 1.5-3.0 g IV q6horErythromycin, 0.5-1.0 g IV q6horClindamycin, 600-900 mg IV q8hMRSA skin infectionVancomycin, 1 g IV q12hLinezolid, 600 mg IV q12hNecrotizing fasciitis (group A streptococcalb)Clindamycin, 600-900 mg IV q6-8hplusPenicillin G, 4 million units IV q4hClindamycin, 600-900 mg IV q6-8hplusCephalosporin (first- or second-generation)Necrotizing fasciitis (mixed aerobes and anaerobes)Ampicillin, 2 g IV q4hplusClindamycin, 600-900 mg IV q6-8hplusCiprofloxacin, 400 mg IV q6-8hVancomycin, 1 g IV q6hplusMetronidazole, 500 mg IV q6hplusCiprofloxacin, 400 mg IV q6-8hGas gangreneClindamycin, 600-900 mg IV q6-8hplusPenicillin G, 4 million units IV q4-6hClindamycin, 600-900 mg IV q6-8hplusCefoxitin, 2 g IV q6h | Medicine | Miscellaneous | [
"linezolid",
"vancomycin"
] | 51,416 |
74b64e24-b9b1-4796-b918-d9ff2d840fff | Treatment for Pityriasis versicolor includes? | Griesofiilvin | Terbinafine | Itraconazole | All of the above | 2c
| multi | Ans. is 'c' i.e., Itraconazole 'Adequate treatment with itraconazole can be achieved with a total dose of as little as 1000mg, given as 200mg per day for 5-7 days." - IADVL 3rd/e p. 288* Selenium sulphide (2.5%) in detergent base is applied all over body below neck (sparing the genitalia), left overnight and washed of next morning. Two to three applications applied once or twice a week usually clears the infection.Treatment of P. versicolor1) Systemic agents:- azoles such as ketoconazole, fluconazole or itraconazole.2) Topical agents:-a) Azoles - clotrimazole, econazole, miconazole, ketoconazole.b) Others - selenium sulfide (2.5%), sodium thiosulphate (20%), whitfield's ointment (3% Salicylic acid + 6% Benzoic acid), zinc pyrithione(l%), tolnaftate, ciclopirox olamine. | Skin | Fungal Infection | [
"itraconazole",
"terbinafine"
] | 51,431 |
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