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51fad7eb-335c-4ca8-b9f9-39b0b601f4f7 | Most salt retaining Glucocoicosteroid ? | Hydrocoisone | Prednisolone | Betamethasone | Dexamethasone | 0a
| single | Ans. is 'a' i.e., Hydrocoisone Among glucocoicoids, hydrocoisone (coisol) has maximum aldosterone activity, i.e. salt retaining capacity.Glucocoicoid with max. mineralocoicoid activity 4 Hydrocoisone (coisol)Glucocoicoid with min. glucocoicoid activity - HydrocoisoneGlucocoicoid with no mineralocoicoid activity 4 Betamethasone, Paramethasone, Dexamethasone, Triamcinolone.Mineralocoiclid with no glucocoicoid activity 4 DOCAMaximum mineralocoicoid activity 3 Aldosterone.Maximum glucoicoid activity 4 dexamethasone, Betamethasone. | Pharmacology | null | [
"prednisolone",
"dexamethasone"
] | 85,467 |
90f3af66-5085-4d2c-9f99-311949c45a8e | A 70 year old male presented with excessive fatigue, fever & bleeding from gums while brushing. O/E- he has splenomegaly. CBC shows marked pancytopenia with presence of blasts. t(15;17)(q22;q12) cytogenetic rearrangement is found in this patient. Which of the following agents will you use in management of this patient? | Acyclovir | Daunorubicin | Rituximab | Tretinoin | 3d
| single | Given scenario suggests the diagnosis of Acute promyelocytic leukemia (APML) ATRA (all trans retinoic acid) is used in management of APML. Induces the differentiation of leukemic cells bearing translocation , where disruption of the RARA gene encoding a retinoid acid receptor occurs. Decreases the frequency of DIC S/E: APL differentiation syndrome- Occurring within the first 3 weeks of treatment, characterized by fever, dyspnea, chest pain, pleural and pericardial effusions, and hypoxemia Rx: Glucocoicoids, chemotherapy, and/or suppoive measures =Cytarabine and daunorubicin increases risk of disseminated intravascular coagulation (DIC) =Rituximab is a monoclonal antibody against CD20 used in autoimmune and malignant diseases | Medicine | AML & ALL | [
"rituximab"
] | 85,473 |
98edd048-26d6-4f49-a040-5fb8f9ebc5ee | The treatment of traumatic rupture of tympanic membrane is- | Aural packing | chloramphenicol ear dorps | Tympanoplasty | No active treatment | 3d
| single | Ans. is 'd' i.e., No active treatment T/T of traumatic rupture of tympanic membrane. Systemic antibiotics and topical optic medications are not required unless suppurative otorrhoea is present. Close follow up examination is necessary to ensure that Spontaneous healing occurs. If the tympanic membrane does not heal within several months, surgical graft repair should be considered. | Pediatrics | null | [
"chloromycetin"
] | 85,476 |
e7456b96-d86d-4d93-8445-c8b304c320df | A farmer with long history depression on antidepressants, consumed unknown substance and presented with bradycardia, hypersalivation, small pupils. What is the most probable diagnosis? | OP poisoning | Atropine | TCA | Paracetamol poisoning | 0a
| multi | Ans: A (OP poisoning) Ref: Harrison's Principles of internal Medicine. 18th edn.Explanation:MiosisMydriasisCholinergicsAnticholinergicsAntipsychoticsSympathomimeticsCarbamatesSSRIsOrganophosphatesSedative - hypnotics withdrawalOpioidsAlcohol Withdrawal syndromeClonidine Sedative - Hyponotics Clinical Features of Orqanophosphate PoisoningMuscarinic effectsCVS: Bradycardia , HypotensionResp: Rhinorrhea. Bronchorrhea,BronchospasmGIT: Hypersalivatioa Nausea and Vomiting, Abdominal pain. Diarrhea,Fecal incontinence. Urinary incontinenceOcular: Miosis, Blurred vision Glands: Increased lacrimation, DiaphoresisNioctinic effectsMuscle fasciculationsCrampingWeaknessDiaphragmatic paralysis Autonomic nicotinic effects(Mild): Tachycardia, Hypertension, Mydriasis and pallorCNS effectsAnxietyEmotional labilityRestlessnessConfusionAtaxiaT remorsSeizuresComa | Medicine | Toxicology | [
"paracetamol",
"atropine"
] | 85,494 |
b89ebbdb-e802-485e-ac1a-6b46bf6cf669 | True regarding EMLA is | Its mixture of 24 mg/g Lidocaine + 25 mg/gm prilocaine used for skin anaesthesia | used as generaL anaesthesia in pediatric use | used for bilateral nerve block | None of the above | 0a
| multi | null | Surgery | null | [
"lidocaine"
] | 85,499 |
1e5d6d6a-48fd-4147-b25d-eadd895562c7 | A 42-year-old woman presents to the emergency depament at 8 PM, mildly somnolent and complaining of the "worst headache of her life," which began at 6 AM on the same day, awakening her. She took acetaminophen (paracetamol) twice during the day, with some relief. At noon she staed to have nausea with vomiting, and by 3 PM she had developed right arm and leg weakness. She denies any head trauma. Which of the following is the most likely diagnosis | Epilepsy | Hypoglycemia | Transient ischemic attack | Subarachnoid hemorrhage | 3d
| single | Spontaneous SAH often is due to aneurysmal rupture. These headaches are described as the worst headache of the patient's life. They frequently are misdiagnosed as migraine or tension headaches or viral illness. The clinical presentation consists of one or more of the following: decreased level of consciousness, increasing headache, or focal motor deficit. Ref:- Harsha Mohan textbook of Pathology | Pathology | Nervous system | [
"tylenol"
] | 85,525 |
fc1d4cef-115d-4250-9e06-fcebecab7c77 | Clonidine has the following attributes except: | Acts on alpha2 adrenergic receptors | Can produce rebound hypeension on abrupt with- drawal | Can Produce CNS stimulation | Inhibits salivation | 2c
| multi | Clonidine is an alpha 2A receptor agonist. clonidine produces sedation due to decreased central sympathetic outflow The adverse effects of Clonidine- sedation, mental depression, dryness of mouth, nose and eyes( secretion is decreased by central action ). The alarming rise of BP, restlessness, nausea, vomiting, tachycardia, anxiety, sweating develop if Clonidine is missed for1-2 days. It is due to the sudden removal of central sympathetic inhibition resulting in a relapse of large quantities of stored CAs and also due to supersensitivity of peripheral adrenergic receptors to CAs that develops due to the chronic reduction of sympathetic tone during Clonidine therapy. From essential of medical pharmacology K D Tripati 7th edition page no 565 | Pharmacology | Autonomic nervous system | [
"clonidine"
] | 85,526 |
7948e9a1-9d21-4ffe-8964-167c67ba6bf0 | Muscle relaxant not to be used in liver failure: | d- Tubocurare | Pancuronium | Suxamethonium | Decamethonium | 1b
| single | Among muscle relaxants metabolism in liver occurs with pancuronium (10-20%), vecuronium (20%) and biliary excretion occurs with rocuronium (40%). vecuronium (30-40%) and pancuronium (10%). So these agents should be avoided in hepatic diseases. Suxamethonium effect is prolonged in only in severe liver failure due to decreased pseudocholinesterase, so is usually acceptable in mild to moderate cases. | Surgery | null | [
"suxamethonium",
"pancuronium"
] | 85,528 |
816998f5-d9fd-4593-9b50-8e1753919a13 | Which drug is not metabolised by acetylation? | INH | Dapsone | Hydralazine | Metoclopramide | 2c
| single | Acetylation is a phase II metabolic reaction. Drugs metabolized by acetylation are Sulfonamides, Hydralazine, Isoniazid, Procainamide. Individuals who are slow acetylators are predisposed to drug-induced autoimmune disorders. Ref: K.D.T 6th Ed Page 25 | Pharmacology | null | [
"hydralazine",
"metoclopramide",
"dapsone"
] | 85,530 |
0563cf97-6407-4797-87fd-211e5e5be12a | Drug of choice for treatment of infestation due to Onchocerca volvolus is: | Albendazole | Ivermectin | Praziquantal | Suramin | 1b
| single | (Ref: KDT 6/e p813, 8140 Ivermectin is used for onchocerca and strongyloides, for all other nematodes, DOC is albendazole and for cestodes and flukes, DOC is praziquantal. | Pharmacology | Other topics and Adverse effects | [
"albendazole",
"ivermectin"
] | 85,553 |
8c59b5ae-f38d-4f22-959a-48b7520c1bb9 | Hemodialysis is used in all except- | Barbiturates | Organophosphates | Salicylates | Theophylline poisoning | 1b
| multi | Hemodialysis is not useful in organophosphate poisoning. | Forensic Medicine | null | [
"theophylline"
] | 85,557 |
05cf57aa-868c-4eba-96a0-db61efd74f6b | Drug of choice for the following condition is (endoscopic view) | Ketoconazole | Clotrimazole | Nystatin | Fluconozole | 3d
| single | The picture shows esophageal candidiasis for which azoles are used.fluconozole is preferred due to better safety profile than ketoconazole .clotrimazole, nystatin is topical antifungal drugsRef: KD Tripathi 6th ed pg 761 | Pharmacology | All India exam | [
"clotrimazole",
"nystatin",
"ketoconazole"
] | 85,561 |
acf7ad71-4bf0-42a9-82e6-b30d05215e75 | Which of the following chemotherapeutic agents is associated with secondary leukemia? | Vinblastine | Paclitaxel | Cisplatin | Bleomycin | 2c
| single | Cisplatin belongs to the group of medicines known as alkylating agents. It is used to treat cancer of the bladder, ovaries, and testicles. It is a platinum coordination complex that is hydrolysed intracellularly to produce a highly reactive moiety which causes cross linking ofDNA. Theoured siteis N&;ofguanineresidue. It can also react with -SH groups in proteins and has radiomimetic propey. It is bound to plasma proteins, enters tissues and is slowly excreted unchanged in urine with a tlh about 72 hrs. Negligible amounts enter brain.Leukemia is cancer of the body&;s blood-forming tissues, including the bone marrow and the lymphatic system. Alkylating agents are chemo drugs that interfere with a cell's DNA in a ceain way. These drugs can sometimes cause AML and MDS. Often MDS develops first, which then progresses to AML. The chemo drugs cisplatin and carboplatin are not an alkylating agents, but they attack cancer cells in much the same way. These drugs seem to increase the risk of leukemia (mainly AML), too, but the risk is not as great as with the alkylating agents. This leukemia is hard to treat and tends to have a poor outcome, much like the leukemia linked to the alkylating agents. The risk of leukemia rises as the amount of drug used gets higher. The risk of developing leukemia increases even more if radiation is given along with cisplatin or carboplatin. REFERENCE:ESSENTIALS OF MEDICAL PHARMACOLOGY(K.D.TRIPATHI,SIXTH EDITION,PAGE NO:827) www.mayoclinic.org | Pharmacology | Chemotherapy | [
"paclitaxel",
"cisplatin"
] | 85,584 |
1bf9ab5d-241c-4f4b-9571-cd4140da6919 | According to Broun "Chemical tourniquet" is: | Adrenaline. | Hyaluronidase | Both | None | 0a
| multi | Adrenaline was discovered by Albel. Broun suggested using adrenaline as a "Chemical tourniquet" to prolong the duration of local anesthetics. | Surgery | null | [
"hyaluronidase"
] | 85,594 |
a2b59c40-2062-424a-b885-88c9875e0df3 | Treatment of choice for coccidioidomycosis is: | Amphotericin | Fluconazole | Flucytosine | Griseofulvin | 0a
| single | Amphotericin B (AMB) It is obtained from Streptomyces nodosus. Chemistry and mechanism of action The polyenes possess a macrocyclic ring, one side of which has several conjugated double bonds and is highly lipophilic, while the other side is hydrophilic with many OH groups. Antifungal spectrum AMB is active against a wide range of yeasts and fungi-Candida albicans, Histoplasma capsulatum, Cryptococcus neoformans, Blastomyces dermatitidis, Coccidioides immitis, Torulopsis, Rhodotorula, Aspergillus, Sporothrix, etc. Dermatophytes are inhibited in vitro, but concentrations of AMB attained in infected skin are low and ineffective. It is fungicidal at high and static at low concentrations. Resistance to AMB during therapy has been rarely noted among Candida in a selected group of leucopenic cancer patients, but it is not a problem in the clinical use of the drug. AMB is also active on various species of Leishmania. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:757,758 | Pharmacology | Chemotherapy | [
"flucytosine",
"fluconazole",
"griseofulvin"
] | 85,595 |
cea65f24-0194-4c29-8e76-1d04fed8871f | In a patient of head injuries with rapidly increasing intracranial tension without hematoma, the drug of choice for initial management would be : | Furosemide | Steroids | 20% Mannitol | Glycine | 2c
| single | Mannitol is an osmotic diuretic indicated for cerebral edema and glaucoma. It is contra-indicated
inactive bleeding in the brain. | Pharmacology | null | [
"furosemide",
"mannitol"
] | 85,601 |
cf3acaa5-b6ae-4276-94c5-77536a12e4d0 | A 59-year old male presents with dimness of near vision. On examination, the media was clear in both the eyes. What would be the next step? | Refraction with near add | Refraction under atropine | Radial keratotomy | Cataract surgery | 0a
| multi | Ans. a. Refraction with near add (Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">A 59-year-old male presents with dimness of near vision. On examination, the media was clear in both the eyes. For diminuation of vision this age. one should think for cataract; but in this case, media (cornea/aqueos/lens/vitreous) is clear, so cataract is ruled out. As there is dimness of near only; the next most likely cause would be presbyopia. The treatment for presbyopia is refraction and near addition.PresbyopiaThe term presebyopia means "oldie" and is a vision condition involving the loss of the eye's ability to focus on close objectsQ.Presbyopia is a condition that occurs as a part of normal ageing and is not considered to be an eye diseaseQ.Symptoms are usually noticeable by age 40-45 and continue to develop until the process stabilizes some 10-20 years later.Causes:As individuals age, the lens becomes less flexible and elastic, and the muscles become less powerfulQ.Because these changes result in inadequate adjustment of the lens of the eye for various distances, objects that are close will appear blurry.Major cause: Loss of elasticity of the lens of the eyeQ.Loss of ciliary muscle power, however, is also believed to contribute to the problemQ.Symptoms:Individuals typically have difficulty in reading small print, and may need to hold reading materials at arm's lengthQ.Symptoms include headache and eyestrain when doing close work, blurry vision, and eye fatigueQ.Symptoms may be worse early in the morning or when individuals are fatigued.Dim lighting may also aggravate the problemQ.Diagnosis:Diagnosed during an eye examination conducted by eye specialists, such as optometrists or ophthalmologists.Part of the examination will assess vision while reading by using various strength lenses.Treatment:Presbyopia cannot be cured, but individuals can compensate for it by wearing reading, bifocal, or trifocal eye glassesQ.A convex lensQ is used to make up for the lost automatic focusing power of the eye.Half-glasses can be worn, which leave the top open and uncorrected for distance vision.In addition to glasses, contact lenses have also been found to be useful in the treatment of presbyopia. | Ophthalmology | Types of Errors of Refraction | [
"atropine"
] | 85,624 |
47309c56-e26e-465b-a80a-e1da777d47d6 | Radical cure of Plasmodium vivax is by : | Chloroquine | Tetracycline | Primaquine | Artesunate | 2c
| single | null | Pharmacology | null | [
"tetracycline",
"chloroquine"
] | 85,627 |
572d112f-d64a-47b7-ba6a-d6e82be92d54 | Which of the following anaesthetic agent causes bone marrow supression? | Halothane | Ketamine | Nitrous Oxide | Isoflurane | 2c
| single | Nitrous oxide may cause bone marrow supression by interfering with the production of factors necessary for DNA synthesis. Nitrous oxide has few adverse effects, it is a mild cardiac depressant and pulmonary vasoconstrictor and is relatively contraindicated in patients with pulmonary hypeension. It cause diffusional hypoxia. It inhibits folate metabolism and is contraindicated in pregnancy. It promote expansion of internal gas-filled structures, and is avoided in patients with pneumothorax, pneumocephalus, and vascular air embolism. | Anaesthesia | null | [
"ketamine",
"isoflurane",
"halothane"
] | 85,629 |
21bef25e-8133-4efd-985c-27edcb5ce3ff | Type I diabetes mellitus is initially managed by: March 2010 | Metformin | Sulfonylureas | Meglitinide | None of them | 3d
| multi | Ans. D: None of them Type 1 diabetes mellitus is treated with insulin replacement therapy -- usually by insulin injection or insulin pump, along with attention to dietary management, typically including carbohydrate tracking, and careful monitoring of blood glucose levels. Untreated type 1 diabetes commonly leads to coma, often from diabetic ketoacidosis, which is fatal if untreated. | Pharmacology | null | [
"metformin"
] | 85,638 |
9bdc3da8-2001-4e29-8dcf-97b683ef5ace | Use of Doxycycline hyclate 20 mg. for a period of time forms | Prophylactic antimicrobial therapy | Systemic antimicrobial therapy | Host modulation therapy | Local drug delivery | 2c
| single | null | Dental | null | [
"doxycycline"
] | 85,666 |
05345a21-b17e-422c-a5fb-c323cee319e1 | Verapamil is contraindicated in: | Hypeesion | Complete hea block | Paroxysmal supraventricular tachycardia | Angina pectoris | 1b
| single | Verapamil decreases the force of contraction, decreases hea rate, depresses SA node and slows down AV conduction.so, not used in complete hea block. CCBs and beta blockers have the synergistic effect They are individually or combined contraindicated in complete hea block Beta blockers are also contraindicated in complete hea block. REF.Essentials of Pharmacology KD Tripathi 8th ed. | Pharmacology | Cardiovascular system | [
"verapamil"
] | 85,697 |
b1b9e4a1-fc87-4e88-8de4-8f8fd081d261 | All of the following are used to decrease intracranial pressure, Except : | Frusemide | Mannitol | Steroid | Hyperventilation | 0a
| multi | Answer is A (Furosemide): Although all of the following agents may well be used to decrease intracranial pressure fUrosemide is the answer of exclusion, as Harrisons text mentions all agents except, jitrosemide in the stepwise approach to treatment of elevated Intracranial pressure. Stepwise approach to treatment of elevated intracranial pressure Drain CSF ventriculostomy. Elevate head of bed. Osmotherapy with mannitol. Glucocoicoids (avoid glucocoicoids in head trauma, ischaemic and hemorrhagic stroke). Sedation (e.g. morphine, propofol or midazolam). Hyperventilation Pressor therapy (phenylephrine, dopamine or norepinephrine to maintain adequate mean aerial pressure). Consider second tier therapies for refractory elevated ICP. High dose barbiturate Aggressive hyperventilation Hemicraniotomy | Medicine | null | [
"mannitol"
] | 85,704 |
abba23ae-06fd-402d-b8d5-250e8dcb1a1b | Which of the following is second generation 3 blocker? | Propronolol | Timolol | Nodalol | Atenolol | 3d
| single | Ans. is 'd' i.e., Atenolol | Pharmacology | null | [
"atenolol",
"timolol"
] | 85,717 |
ec44f331-8297-414e-9bfb-9ea5ea59b76d | Antiepileptic drug that can cause folate deficiency anemia is : | Valproate | Phenytoin | Phenobarbitone | Carbamazepine | 1b
| single | null | Pharmacology | null | [
"valproate",
"carbamazepine",
"phenytoin"
] | 85,727 |
b0faef18-0d90-455e-9fbe-fb7f77dc5681 | Which of the following Antihypertensive can cause "SLE like reaction" | Minoxidil | Hydralazine | Diazoxide | Fenoldopam. | 1b
| single | Hydralazine is metabolized by acetylation and it can cause "SLE like reaction".
. | Pharmacology | null | [
"fenoldopam",
"hydralazine"
] | 85,728 |
c450f5c7-6b77-43bb-ab88-40459413d1b2 | Which of the following is not nephrotoxic? | Tobramycin | Kanamycin | Ampicillin | Amphotericin B | 2c
| single | Ans. (C) Ampicillin(Ref: KDT 8/e p772)Aminoglycosides (tobramycin, gentamicin, kanamycin), vancomycin and amphotericin B are highly nephrotoxic agents. | Pharmacology | Chemotherapy: General Principles | [
"ampicillin"
] | 85,740 |
b2ada9eb-2b41-4998-baab-0c8e6cfd83f9 | Which of the following is NOT true about the use of Beta blocker in CHF | These should be staed at very low dose and sowly titrated upwards | Carvedilol is most widely used beta blocker | These are drug of choice in acute decompensated hea failure. | These can reduce moality in CHF patients | 2c
| multi | Ref KDT 6/e p544 Beta blockers are contra-indicated in acute decompensated hea failure. | Anatomy | Other topics and Adverse effects | [
"carvedilol"
] | 85,748 |
a8068e8b-139b-44ec-8f6e-4973a8829372 | True about esmolol is: | It has no intrinsic sympathomimetic activity | It is a cardioselective β–blocker | It can precipitate heart failure | All of these | 3d
| multi | null | Pharmacology | null | [
"esmolol"
] | 85,750 |
c60905be-709a-4c35-aa77-af71da7753f9 | Which among the following drugs is NOT used orally? | Lignocaine | Verapamil | Phenytoin | Quinidine | 0a
| multi | null | Pharmacology | null | [
"phenytoin",
"quinidine",
"verapamil"
] | 85,753 |
c83a2900-dc08-46fe-8716-5303c223915a | Which of the following drugs has been recently approved for treatment of prostate cancer? | Leuprolide | Goserelin | Abarelix | Degarelix | 3d
| single | Ans. (D) Degarelix(Ref: CMDT 2015/1624)Degarelix is a GnRH antagonist, that has recently been approved for advanced prostate cancer.GnRH agonists like leuprolide and goserelin are being used in prostate cancer since many years.Docetaxel is first cytotoxic agent that improve survival in patients with hormone-refractory prostate cancer.Sipulecel-T is an immunotherapy recently approved for prostate cancer.Other drugs for prostate cancer are:CabazitaxelAbirateroneEnzalutamideRadium-223 dichloride | Pharmacology | Chemotherapy: General Principles | [
"goserelin"
] | 85,754 |
4226e1e7-b3be-42d8-bbb8-1138014c2978 | Which of the following antihypertensive agents in most likely to cause an exaggerated response to an injected catecholamine? | Propranolol | Hydralazine | A thiazide diuretic | Gauanethidine | 3d
| single | null | Pharmacology | null | [
"propranolol",
"hydralazine"
] | 85,773 |
8d97ccc2-17a8-4108-8009-3b89aa8bca1c | Morphine is used in the treatment of which one of the following: | Asthma | Kyphoscoliosis | Chronic cor pulmonale | Left ventricular failure | 3d
| single | null | Pharmacology | null | [
"morphine"
] | 85,777 |
aaa8c8b7-5471-4b7e-8a47-00e697929ccd | Which of following can result in secretion of both, insulin and glucagon? | Arginine | Fatty acids | Hypoglycemia | Hyperglycemia | 0a
| multi | Ans. a (Arginine) (Ref. Ganong Physiology 22nd/pg. 345-350)FACTORS AFFECTING INSULIN AND GLUCAGON SECRETION# Insulin- Amino Acids# Several amino acids, especially arginine (stimulates insulin secretion)- Fatty Acids (stimulates insulin secretion).- Gastrointestinal Hormones (stimulate insulin secretion).- Action of insulin is opposed by:1. GH2. Glycogen3. Cortisol4. Epinephrine# Glucagon- Amino Acids# As with insulin, arginine is the most potent stimulus for the secretion of glucagon.- Fatty Acids# Decreased circulating fatty acids stimulate glucagon secretion.In direct contrast to insulin, a decrease in blood glucose concentration stimulates glucagon secretion. Therefore, circulating levels of glucagon tend to be highest during periods of starvation (fasting) or prolonged exercise (e.g., running a marathon). During these times, blood glucose concentrations are at their lowest. The ratio of insulin:glucagon concentrations is approximately 1:2.The glucagon brings about changes in the body's metabolism that raise blood glucose concentration back to normal. The alpha cells detect that glucose concentrations are returning to normal and stop secreting glucagon.Again, this is an example of negative feedback control. | Physiology | Endocrinology and Reproduction | [
"glucagon"
] | 85,778 |
f93f0e5c-99ae-49ca-a2fa-7fdea733668a | Which of the following is a prokinetic drug? | Domperidone | Cimetidine | Ondansetron | Hyoscine | 0a
| single | Ans. is 'a' i.e., Domperidone Gastrokinetic (prokinetic drugs) These are the drugs which promote gastrointestinal transit and speed gastric emptying by enhancing coordinated propulsive motility. Prokinetic drugs are - Metoclopramide, Domperidone, Cisapride, Mosapride, Tegaserod, renzapride, prucalopride. Prokinetic drugs can act by ? 5HT4 agonistic activity D2 and 5-HT3 antagonistic activity Both these actions will increase the release of Ach and thereby motility of GIT. | Pharmacology | null | [
"cimetidine"
] | 85,779 |
6119096a-9b2e-48f5-b2cb-2314aa0c23ea | Which drug can cause thyroid dysfunction is? | Amiodarone | Ampicillin | Ibutilide | Acyclovir | 0a
| single | ANSWER: (A) AmiodaroneREF: Goodman and Gillman s 11TH edition, page 1000, CURRENT Medical Diagnosis and treatment Chapter 26. Endocrine DisordersIndirect repeat in June 2010Amiodarone, because of its high iodine content, causes clinically significant Hypothyroidism inabout 8% of patients.ANTITHYROID COMPOUNDSProcess AffectedExamples of InhibitorsActive transport of iodide Complex anionsPerchlorate, Fluoborate, Pertechnetate, ThiocyanateIodination of thyroglobulin ThionamidesPropylthiouracil. Methimazole, Carbimazole Thiocyanate; iodide. Aniline derivatives; sulfonamidesCoupling reactionThionamides; sulfonamidesHormone releaseLithium salts, iodide, lodotyrosineIodothyronine deiodinationNitrotyrosinesPeripheral deiodinationThiouracil derivatives; Amiodarone Oral cholecystographic agentsHormone actionThyroxine analogs; AmiodaroneHormone excretion inactivationInducers of hepatic drug-metabolizing enzymes: phenobarbital, rifampin, carbamazepine, phenytoinBinding in gutCholestyramine | Pharmacology | Adverse Drug Effect | [
"amiodarone",
"ibutilide",
"ampicillin"
] | 152,240 |
bf936984-9678-42bb-bc27-ce51ce138f79 | The drug used in the treatment of cessation of smoking & tobacco addiction | Vareniciline | Acamprosate | Baclofen | Naltrexone | 0a
| single | Vareniciline is a partial agonist at α4 β2 subtype of Nicotine receptor used to treat tobbacco addiction. | Psychiatry | null | [
"naltrexone",
"baclofen"
] | 152,243 |
277d9002-fb4f-4a2e-badd-ebf6f02c2a3b | A 70 year old male known case of a ceain malignancy presents with elevated erythropoietin levels and PCV of 52%. Most likely tumour is | Renal Cell Carcinoma | Medullary thyroid carcinoma | Gastric Carcinoma | Colorectal CA | 0a
| single | Answer- A. Renal Cell CarcinomaErythrocytosis (d/t secretion of erythropoietin by RCC) (but anemia is a more common finding)HypeensionAbnormal liver function (Stauffers syndrome ie non metastatic hepatic dysfunction)HypercalcemiaNeuromyopathyAmyloidosisIncreased ESR (MC paraneoplastic syndrome)DysfibrogenemiaGalactorrhoeaFeminization and masculanization | Surgery | null | [
"erythropoietin"
] | 152,247 |
ae11c621-580a-4bc5-83d5-015b7c5060fc | Neprilysin inhibitor is: | Carperitide | Nesiritide | Sacubitril | Conivaptan | 2c
| single | Ref. KDT. Page. 889
Neprilysin, also known as membrane metallo-endopeptidase (MME)
Sacubitril
Sacubitril's active metabolite, LBQ657 inhibits neprilysin, a neutral endopeptidase that would typically cleave natiuretic peptides, which includes: atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and c-type natriuretic peptide (CNP)
The half life of sacubitril is 1.1 to 3.6 hours
The most common adverse reactions are hypotension, hyperkalemia, cough
Used in combination with valsartan to reduce the risk of cardiovascular events in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction. | Unknown | null | [
"nesiritide"
] | 152,255 |
a126a95e-2f93-4d32-a49c-8a30965a1c81 | Major bacterial enzyme responsible for putrefaction | Hyaluronidase | Lecithinase | Metalloproteinase | Collagenase | 1b
| multi | DECOMPOSITION It involves two processes: (1) Autolysis and (2) Putrefaction. Autolysis: Autolysis is self-digestion of tissues Putrefaction: The disintegration of body tissues after death is known as decomposition. The terms decomposition and putrefaction are used as synonyms. Putrefaction usually follows the disappearance of rigor mois. During hot season, it may commence before rigor mois has completely disappeared from the lower extremities. Mechanism: Organisms enter the tissues sholy after death, mainly from the alimentary canal, and less often through the respiratory tract or through an external skin wound. Multiplication of bacteria begins within 4 hours and peak is reached within 24-30 hours. The fall in the oxygen concentration in the tissues and rise in hydrogen ion concentration after death our bacterial growth and spread throughout the body. Because the protective agencies of the body are absent, the bacteria spread through the blood vessels using the proteins and carbohydrates of the blood as culture media. The chief destructive bacterial agent is Cl. welchii, which causes marked haemolysis, liquefaction of postmoem clots and of fresh thrombi and emboli, disintegration of tissue and gas formation in blood vessels and tissue spaces. Bacteria produce a large variety of enzymes and these breakdown the various tissues of the body. Lecithinase produced by Cl. welchii is most impoant. This hydrolyses the lecithin which is present in all cell membranes including blood cells*, and is responsible for the postmoem haemolysis of blood. Features: The characteristic features of putrefaction are: (1) changes in the colour of the tissues, (2) the evolution of gases in the tissues, and (3) the liquefaction of tissues. The first external sign of putrefaction in a body lying in air is usually a greenish discolouration of the skin over the region of the caecum, which lies fairly superficially, and where the contents of the bowel are more fluid and full of bacteria. Internally, this is seen on the undersurface of the liver, anterior peritoneal surface of right lobe of liver and adipose tissue around gallbladder, where that organ is in contact with the hepatic flexure and transverse colon. The colour results from the conversion of haemoglobin of blood into sulphmethaemoglobin by the hydrogen sulphide formed in the large intestine and escaping into the surrounding tissues. The colour appears in 12 to 18 hours in summer and in one to two days in winter. Ref:- k s narayan reddy; pg num:-164,165 | Forensic Medicine | Death and postmortem changes | [
"collagenase",
"hyaluronidase"
] | 152,266 |
1da01f4f-51fb-424d-a4c9-f0f30ed7db53 | A 65-year-old man with diabetes, on an oral hypoglycemic, presents to the ER with a spos- related right shoulder injury. His hea rate was noted to be irregular and the following ECG was obtained. The best immediate therapy is | Atropine | Observation | Pacemaker | Electrical cardioversion | 1b
| single | This ECG shows Mobitz type I second-degree AV block, also known as Wenckebachphenomenon, characterized by progressive PR interval prolongation prior to block of an atrial impulse. This rhythm generally does not require therapy. It may be seen in normal individuals; other causes include inferior MI and drug intoxications such as from digoxin, beta blockers, or calcium channel blockers. Even in the post-MI setting, it is usually stable, although it has the potential to progress to higher-degree AV block with consequent need for pacemaker. | Surgery | null | [
"atropine"
] | 152,271 |
c31c0aa7-9695-4571-82d5-378fbc67cf67 | The use of levodopa is avoided in which of the following patients? | Alzheimer's disease | Psychosis | Multiple sclerosis | Amyotrophic lateral sclerosis | 1b
| single | Any drug which increase dopamine in brain causes psychosis.Levodopa should be avoided in patient with psychosis Anti parkinsonism drug can cause psychosis Anti Psychotic drug can cause parkinsonism Multiple sclerosis : Interferon b1a and interferon b1b: The immunomodulatory effects of interferon help to diminish the inflammatory responses that lead to demyelination of the axon sheaths. Glatiramer: Glatiramer is a synthetic polypeptide that resembles myelin protein and may act as a decoy to T-cell attack. Natalizumab: Natalizumab is a monoclonal antibody indicated for MS in patients who have failed first-line therapies. | Pharmacology | DNB 2018 | [
"levodopa"
] | 152,272 |
9e1f7b07-e6c7-4664-9916-c4ccfc4f0170 | Testosterone inhibitor is- | Spironolactone | Clomiphene | Bremelanotide | Sildenafil | 0a
| single | Ans. is 'a' i.e., Spironolactone | Pharmacology | null | [
"clomiphene",
"sildenafil",
"spironolactone"
] | 152,274 |
e481a48d-0403-4f45-9c96-1ae3012dcefa | 36 year old female , asymptomatic but with raised 24-hour urinary coisol level and raised ACTH with suppression in high dose dexamethasone suppression test. MRI of head reveals no enlargement of the pituitary gland. What should be the next step in this case? | MRI to assess the adrenals | CT chest | Inferior petrosal sinus venous sampling | Coicotropin-releasing hormone (CRH) levels | 2c
| multi | This patient most likely has Cushing Syndrome because of positive screening test of 24-hr urinary coisol level. It is a secondary cause of Cushing Syndrome due to elevated ACTH levels. This may be either due to a pituitary adenoma or an ectopic source such as small cell lung cancer. MRI head would reveal any adenoma of pituitary gland but still if inconclusive it should be followed by sampling of inferior petrosal sinus Test for screening or confirmation of Cushing syndrome are: 24 hour urinary free coisol excretion Dexamethasone overnight test (plasma coisol>50nmol/L at 8 am after 1mg dexamethasone tablet given at 11pm night before) Midnight plasma coisol levels>130ng/dl Midnight salivary coisol levels>5mmol/dl Low dose Dexamethasone test ( plasma coisol>50nmol/L after 0.5mg dexamethasone 6hourly for 2 days) | Surgery | Parathyroid and adrenal glands | [
"dexamethasone"
] | 152,277 |
bd60fcf4-bf1f-462f-9870-845116955b87 | Donepezil is used in treatment of: | Alzheimer's dementia | Schzophrenia | Anxiety disorder | Anxiety disorder | 0a
| single | A i.e. Alzheimer's disease | Psychiatry | null | [
"donepezil"
] | 152,278 |
22d09830-ff5c-4e97-bbe0-f4e5278e95d6 | Drug locally used for tracheal stenosis is: | Mitomycin C | Doxorubicin | Bleomycin | Clindamycin | 0a
| multi | Mitomycin C is a mitomycin that is used as a chemotherapeutic agent by viue of its antitumour activity. It is given intravenously to treat upper gastro-intestinal cancers (e.g. esophageal carcinome), anal cancers, and breast, as well as by bladder instillation for superficial bladder tumors. It causes delayed bone marrow toxicity and therefore it is usually administered at 6-weekly intervals. Prolonged use may result in permanent bone-marrow damage. It may also cause lung fibrosis and renal damage. Mitomycin C is highly toxic drug used only in resistant cancers of stomach, cervix, colon, rectum, bladder, etc. It is transformed intracellularly to a form which acts as an alkylating agent and kills cells in G1-M phases. Bone marrow and g.i.t. are the primary targets of toxicity. ESSENTIALS OF MEDICAL PHARMACOLOGY, en.wikipedia.org K.D.TRIPATHI SIXTH EDITION PAGE NO:827 | Pharmacology | Chemotherapy | [
"doxorubicin",
"clindamycin"
] | 152,284 |
377af7e6-49f4-4603-8b2b-cf04e882b76e | 35-year-old man presenting with acute pancreatitis- Ideal fluid of choice | Isotonic crystalloid | Hypertonic crystalloids | Hypotonic crystalloid | Vasopressin | 0a
| multi | Ans. (a) Isotonic CrystalloidRef: Sabiston 20th ed; pg. 1528Management of Acute pancreatitis:* Corner stone of medical management is resuscitation with IV fluids - ISOTONIC CRYSTALLOIDS are given aggressively.* Monitor the adequacy of resuscitation with urine output.* If there is no response to fluid resuscitation - Invasive monitoring to be done using CVP access and Foley catheterization.* MC complication in acute pancreatitis is Hypoxemia due to Acute lung injury and hence maintain Saturation above 95%- Continuous Pulse oximetry monitoring is needed.* Preferred analgesia- morphine narcotics* No proven benefit of giving Antiproteases and Pancreas secretion inhibitors or platelet activation inhibitors (Lexipafant).Nutritional Support in Acute Pancreatitis:* Oral feeding may be difficult because of Ileus, pain and intubation.* 20% of severe acute pancreatitis will develop severe pain on oral feeding.* Enteral or Parenteral must be given though the mortality rate is same in both.* Enteral nutrition has one advantage - less infectious complication.* TPN causes Intestinal Colonization of bacteria, translocation and damage of mucosal defense mechanism.* Hence whenever possible give Enteral (Nasogastric feeding is better as per Bailey and Love page 1225/27th edition)* Prophylactic antibiotics have no role in acute pancreatitis and indicated only for pancreatic abscess, infected necrosis, cholangitis.Additional treatments:* If it is a case of Gallstone pancreatitis caused by Stones in CBD causing Cholangitis, Jaundice- ERCP must be done in 72 hours' time as per Bailey and Love.* Mild Acute Pancreatitis caused by Gallstones - EARLY laparoscopic Cholecystectomy (During same admission) is indicated except in poor performance cases like old age.* Severe Acute pancreatitis caused by Gall stones - conservative treatment for 6 weeks followed by Interval cholecystectomy after 6 weeks is advised. | Surgery | Pancreas | [
"vasopressin"
] | 152,297 |
6fa8430b-80b7-49b5-b216-5bc3913cddba | Treatment for hyperprolactenemia is - | Estrogen | Bromocriptine | GnRh analogue | Cimetidine | 1b
| single | Treatment of hyperprolactinemia depends on the cause of elevated PRL(prolactin) levels. Regardless of the etiology, however, treatment should be aimed at normalizing PRL levels to allete suppressive effects on gonadal function, halt galactorrhea, and preserve bone mineral density. Dopamine agonists are effective for most causes of hyperprolactinemia.Dopamine agonists suppress PRL secretion and synthesis as well as lactotrope cell proliferation. They include bromocriptine(2.5-15mg/day 2-3 times daily), cabergoline(0.25-1mg/week 2 doses/week), quinagolide(0.05-0.15mg/day once daily). Reference : page 2267 Harrison's Principles of Internal Medicine 19th edition ; page 791 Davidson's Principles and practice of Medicine 22nd edition . | Medicine | Endocrinology | [
"cimetidine",
"bromocriptine"
] | 152,298 |
8f990a79-fdf3-407b-bcb5-267cf82fbb22 | MRI is superior in all of the following conditions except | Serial evaluation of liver functions in a 54 years female with metastatic carcinoma breast with doxorubicin chemotherapy | Diagnosis of arrythmogenic right ventricular cardiomyopathy in a 24 years old man who survived recent cardiac arrest. | Diagnosis of aortic coarctation in a 17 years female with hypertension and radio femoral delay on physical examination. | Diagnosis of iron overload cardiomyopathy in a pediatric patient with B-thalassemia major and congestive heart failure. | 0a
| multi | Answer: a) Serial evaluation of liver functions in a 54 years female with metastatic carcinoma breast with doxorubicin chemotherapyCT is preferred than MRI for Serial evaluation of liver functions in a 54 years female with metastatic carcinoma breast with doxorubicin chemotherapy | Radiology | Fundamentals In Radiology | [
"doxorubicin"
] | 152,311 |
3568d301-59d9-4519-af0f-b2a95b29a6f0 | 30 yrs female presented with unilateral breast cancer associated with axillary lymph node enlargement. Modified
radical
mastectomy was done, a further treatment plan will be | Observation and follow-up | doxorubicin based chemotherapy only | doxorubicin based chemotherapy followed by tamoxifen depending on estrogen/progesterone receptor status | Tamoxifen only | 2c
| single | Stage I & II breast cancers (Early invasive breast cancers ) are managed by
1. Primary therapy for local management
2. Adjuvant therapy Primary therapy consists of:
Mastectomy with an assessment of axillary lymph node status (or modified radical mastectomy) or Breast conservation (lumpectomy, wide local excision or quadrantectomy) with an assessment of axillary lymph node status + radiotherapy.
Various trials have found both these methods to be equally effective. Breast conservation is the preferred form of treatment because of cosmetic advantages. However, there are certain contraindications for conservative surgery (described in subsequent question) Management of axillary lymph nodes Earlier dissection of axillary lymph nodes (level I and II) was performed to assess the lymph node status (i.e. presence or absence of occult metastasis). Now Sentinel lymph node biopsy is considered the standard for evaluation of the axillary lymph nodes for metastasis in women who have clinically negative lymph nodes, (the sentinel lymph node is thirst regional lymph node to receive tumor cells that metastasize along the lymphatic pathway from the primary breast cancer). Axillary Lymph node dissection is performed for clinically palpable axillary lymph nodes or metastatic disease detected in sentinel lymph node biopsy. Adjuvant chemotherapy is given to all node-positive cancers node-negative cancers if > 1 cm in size.
Node-negative cancer > .5 cm in size with adverse prognostic factors such as blood vessel or lymph vessel invasion high nuclear grade high histological grade HER 2/neuoverexpression negative hormone receptor status Adjuvant hormone therapy (tamoxifen) is added to all those with estrogen receptor positive tumors. HER-2/neu expression is determined for all patients with newly diagnosed breast cancer and may be used to provide prognostic information in patients with node-negative breast cancer and predict the relative efficacy of various chemotherapy regimens. Trastuzumab is the HER-2/neu-targeted agent that is added to the adjuvant therapy is the tumor shows overexpression of HER-2/neu receptors. Advanced Local-Regional Breast Cancer (Stage III ) (Neoadjuvant chemotherapy + MRM + adjuvant radiation therapy + chemotherapy + antiestrogen therapy)
Here the disease is advanced on the chest wall or in regional lymph nodes (or both), with no evidence of metastasis to distant sites.
Such patients are recognized to be at significant risk for the development of subsequent metastases, and treatment addresses the risk for both local and systemic relapse. In an effort to provide optimal local-regional disease-free survival as well as distant disease-free survival for these women, surgery is integrated with radiation therapy and chemotherapy.
Neoadjuvant chemotherapy (administration of therapeutic agents prior to the main treatment) should be considered in the initial management of all patients with locally advanced stage III breast cancer. Surgical therapy for women with stage III disease is usually a modified radical mastectomy, followed by adjuvant radiation therapy and chemotherapy. Antiestrogen therapy (tamoxifen) is added for hormone receptor-positive tumors.
Chemotherapy is used to maximize distant disease-free survival, whereas radiation therapy is used to maximize local-regional disease-free survival.
In selected patients with stage IIIA cancer, neoadjuvant (preoperative) chemotherapy can reduce the size of primary cancer and permit breast-conserving surgery.
Distant Metastases (Stage IV ) (mainly palliative treatment) Treatment for stage IV breast cancer is not curative but may prolong survival and enhance a woman’s quality of life.
Hormonal therapies that are associated with minimal toxicity are preferred to cytotoxic chemotherapy.
Appropriate candidates for initial hormonal therapy include women with hormone receptor-positive cancers; women with bone or soft tissue metastases only; and women with limited and asymptomatic visceral metastases.
Systemic chemotherapy is indicated for women with hormone receptor-negative cancers, symptomatic visceral metastases, and hormone-refractory metastases. Bisphosphonates, which may be given in addition to chemotherapy or hormone therapy, should be considered in women with bone metastases. About Adjuvant Therapy, Adjuvant therapy is the use of systemic therapy (chemotherapy or/and hormone therapy) in patients who have received local therapy but are at risk of relapse.
The objective is to eliminate the occult metastasis responsible for late recurrences while they are microscopic and theoretically most vulnerable to anticancer agents. Adjuvant chemotherapy is given to all node-positive cancers node-negative cancers if > 1 cm in size node-negative cancer > .5 cm in size with adverse prognostic factors such as blood vessel or lymph vessel invasion high nuclear grade high histological grade HER 2/neuover expression negative hormone receptor status Adjuvant hormone therapy (tamoxifen) is added to all those with estrogen receptor positive.
The use of chemotherapy in postmenopausal women is controversial. In postmenopausal women, chemotherapy is frequently used upto age 70 yrs, if she can tolerate it. In older women, chemotherapy is performed less frequently.
In estrogen-positive tumors, in postmenopausal women, antiestrogen (tamoxifen / aromatase inhibitors)
Therapy is the preferred form of adjuvant systemic treatment. Neoadjuvant chemotherapy it involves the administration of adjuvant therapy before primary therapy (surgery & radiation therapy) it has shown to down-stage the tumor. Previously CMF (cyclophosphamide, methotrexate & 5 - fluorouracil) was the chemotherapeutic regimen of choice. “CMF is no longer considered adequate adjuvant chemotherapy and modem regimens include an anthracycline (doxorubicin or epirubicin) and the newer agents such as the taxanes (paclitaxel and docetaxel)”- Bailey and Love 25/e p844 Anti-HER-2/neu antibody therapy.
(Trastuzumab) HER-2/neu expression for all newly diagnosed patients with breast cancer is now recommended. Trastuzumab is added to the chemotherapy for tumors overexpressing HER-2/neu receptors (Trastuzumab is added along with taxanes). | Surgery | null | [
"adriamycin",
"tamoxifen"
] | 152,312 |
6192567d-e244-4b3f-b9e7-a1e81f78735f | NOT TRUE regarding sevoflurane | MAC is higher than isoflurane | Blood gas coefficient is higher than desflurane | Potency more than cardio depressant than isoflurane | Sevoflurane is less cardio depressant than isoflurane | 3d
| multi | D i.e., Sevoflurane is less cardiodepressant than isoflurane Sevoflurane is inhalational agent of choice for inductioin of anesthesia in pediatric patients and adults, because of rapid onset of action & nonpengency Q Desflurane & isoflurane are more pungent and are associated with more coughing breath holding & laryngeal spasm during inhalational inudction, so not used as first choiceQ. Methoryflurane is highly nephrotoxic, so not preferred. Sevoflurane is not recommended in closed circuit because there is chance of production of a toxic metabolic product compound A, Q (an olefin) in closed circuit. - Unlike isoflurane & desflurane, both of which lead to tachycaridia, sevoflurane has minimal effect on hea rate. Sevoflurane can cause direct myocardial depression ( calcium channels) and produce dose dependent depression of cardiac output, & reduction in systemic vascular resistance similar to that seen in isoflurane | Anaesthesia | null | [
"isoflurane",
"sevoflurane",
"desflurane"
] | 152,314 |
fa14b34d-47d5-4155-bcf5-f6c97d8b7539 | Bronchial hyperplasia may be caused by all except? | Smoking | Theophylline | Prematurity | Allergy | 1b
| multi | Answer is B (Theophylline): Theophylline relaxes the tone of bronchial smooth muscles, thereby causing bronchodilation It may he used in the treatment of bronchial hyperplasia, it ceainly does not contribute to bronchial hyperplasia. Smoking and other irritants cause the hyperophy of mucus glandsQ within the brochial wall, and contributes to narrowing of bronchioles by a variety of factors. Prematurity may be associated with bronchopulmonary dysplasiaQ and bronchial hyperplasiae | Medicine | null | [
"theophylline"
] | 152,325 |
10c7ef1a-a6a9-4d62-b373-7fd8e9fa6c9e | Which of the following drugs can cause gynaecomastia? | Digoxin | Ketoconazole | Spironolactone | All of the above | 3d
| multi | Drugs causing gynaecomastia : Digoxin,Ketoconazole,Spironolactone,Cimetidine,Estrogen. | Pharmacology | null | [
"digoxin",
"spironolactone",
"ketoconazole"
] | 152,329 |
1c0d7013-5daa-4dd0-9fff-f43848ce0d4f | Drug of choice for nephrogenic diabetes insipidus is:- | Mannitol | Spironolactone | Thiazides | Demeclocycline | 2c
| single | Diabetes insipidus Central Nephrogenic Desmopressin (DOC) Thiazides (DOC) (As endogenous ADH is already present that is not able to work, so there is no point in giving ADH(desmopressin)) | Pharmacology | Kidney | [
"spironolactone",
"mannitol",
"demeclocycline"
] | 152,332 |
3cd6a818-7604-46b9-90f3-2f48556fce50 | Which of the following drugs is not an antifungal agent? | Ciclopirox olamine | Ketoconazole | Undecylenic acid | Clofazimine | 3d
| single | Ketoconazole, Undecylenic acid and Ciclopirox olamine are Anti Fungal drugs. While Clofazimine is a antimycobacterial drug. Ref: KDT, 6th Edition, Pages 752, 757; Antituberculosis Chemotherapy, Volume, Page 169; Lippincott's Illustrated Reviews: Pharmacology, 4th Edition, Page 399; Basic and Clinical Pharmacology By Katzung, 10th Edition, Pages 772, 779 | Pharmacology | null | [
"clofazimine",
"ketoconazole"
] | 152,333 |
c383272e-a8b8-4df5-9719-609a02a07256 | A person has severe pain & swelling in great toe.True statements are -a) Allopurinol used in acute control of goutb) Colchicine acts slowlyc) Colchicine cause gastrointestinal disturbancesd) High serum uric acid level may be not presente) Joint fluid aspiration is done for investigation | abd | acd | bde | cde | 3d
| multi | "Serum uric acid levels can be normal or low at the time of acute attack. This limits the value of serum uric acid determination for the diagnosis of gout. Nevertheless, serum urate levels are almost always elevated at some time & are important to use to follow the course of hyperuricemic therapy". — Harrison 17th /e 2166
Colchicine is the fastest acting drug. However it is reserved for the patients in which NSAIDs are condraindicated, because colchicine can cause gastrointestinal disturbances.
Allopurinol and uricosuric drugs (sulfinpyrazone, probenacid) are not effective in acute gout because they will not relieve symptoms as they don't have anti-inflammatory property. | Orthopaedics | null | [
"allopurinol",
"colchicine"
] | 152,339 |
6a0d455b-5e50-49c3-8fda-1701eb4aa580 | Awakening from a single bolus dose in rapid from Propofol due to;- | Redistribution | Excretion | Biotransformation | D- Methylation | 0a
| single | It is redistributed from the brain to tissues which are less perfused like muscles, resulting in rapid recovery within 20 minutes. All intravenous anaesthetic agent undergo rapid redistribution. Thus awakening from Thiopentone, Propofal, Etomidate, ketamine is very fast. | Anaesthesia | Intravenous Anesthetic Agents | [
"propofol"
] | 152,340 |
bd99e979-7faa-45e9-aecc-6ca3f25bac20 | Radio opaque stone is | Uric acid stone | Triamterene | Struvite | All of the above | 2c
| multi | Radio opaque stones - Cystine, struvite, calcium oxalate, calcium phosphate. | Radiology | null | [
"triamterene"
] | 152,342 |
ada77952-7573-43fc-893a-62a19eb33c9e | This antihistaminic drug can cause cardiac arrhythmia at a high dose by blocking cardiac K+ channels. It is most likely to be : | Levocetirizine | Fexofenadine | Astemizole | Loratadine | 2c
| single | null | Pharmacology | null | [
"fexofenadine",
"loratadine"
] | 60,963 |
8e4aa36e-cb55-4fa8-8c85-bc78c948b266 | Which of the following does not contribute to digoxin toxicity ? | Hyperkalemia | Hypercalcemia | Renal failure | Hypomagnesemia | 0a
| single | null | Pharmacology | null | [
"digoxin"
] | 60,975 |
5e90584c-220a-4ced-8870-a4abc11e27b7 | A 59 year old man with severe myxomatous mitral regurgitation is asymptomatic, with a left ventricular ejection fraction of 45% and an end systolic diameter index of 2.9 cm/m2. The most appropriate t/t is | Mitral valve repair or replacement | No treatment | ACE inhibitor therapy | Digoxin and diuretic therapy | 0a
| single | null | Medicine | null | [
"digoxin"
] | 60,976 |
3a520842-4855-4b63-9773-309c319a3cbf | In making your decision to treat with procainamide, which of the following statements would be relevant? | Procainamide may worsen or precipitate hypehyroidism | Procainamide is not effective for atrial arrhythmias | Procainamide prolongs the effective refractory period in atrial and ventricular cells | Procainamide commonly induces thrombocytopenia | 2c
| multi | Procainamide prolongs the effective refractory period in atrial and ventricular cells. Ref: KDT, tth Edition, Page 511,512 Procainamide prolongs refractory period by blocking sodium channels and by prolonging the AP. All of the other statements are false. | Surgery | null | [
"procainamide"
] | 60,982 |
bc580844-2ade-4a38-b481-700ea49bfa92 | Which is the most common dose related side effect of Salbutamol? | Nervousness | Palpitations | Restlessness | Tremors | 3d
| single | The most common dose related side effect of salbutamol is tremors. Palpitations, restlessness, nervousness, throat irritation and ankle edema are also seen. | Pharmacology | null | [
"salbutamol"
] | 60,991 |
62b4c19f-359d-4c29-8ffe-11e667193ac5 | Umbrella configuration on fluorescein angiography is seen in | Retinitis pigmentosa | Rhegmatous retinal detachment | Central serous retinopathy | Eale's disease | 2c
| single | Fundus fluorescein angiography helps in confirming the diagnosis. Two patterns are seen:_ Ink-blot pattern: It consists of a small hyperfluorescent spot which gradually increases in size._ Smoke-stack pattern: It consists of a small hyperfluorescent spot which ascends veically like a smoke-stack and gradually spreads laterally to take a mushroom or umbrella configuration.Ref: Khurana; 4th edition; Pg.No. 272 | Ophthalmology | Vitreous and retina | [
"fluorescein"
] | 60,992 |
62777be4-4267-4f29-bae3-e5c660539f2c | A patient with AIDS and a CD4 cell count of 100/ul , has a persistent fever and Weight Loss associated with invasive pulmonary disease due to M avium complex. Optimal management of this case requires | Select an antibiotic regimen based on drug susceptibility of the cultured organism | Sta treatment with isoniazide and rifampicin | Treat the patient with clarithromycin,ethambutol and rifabutin | Treat with trimethoprim sulfamethoxazole | 2c
| single | Ref-KDT 6/e p750 Mycobacterium avium complex infection is treated with combination of rifabutin,ethambu eth and clarithromycin | Anatomy | Other topics and Adverse effects | [
"ethambutol",
"clarithromycin",
"trimethoprim"
] | 60,997 |
a85683c6-a189-400c-ba69-2c1d6f3053c2 | Following statements are true regarding mycetoma except: | Mycetoma is a neglected tropical disease | Eumycetoma has no acceptable treatment at present | Actinomycetoma is treated with courses of antibiotics, which usually include co-trimoxazole and amikacin | Recurrence in patients with Eumycetoma is uncommon | 3d
| multi | Eumycetoma has no acceptable treatment at present; antifungals such as ketoconazole and itraconazole have been used but are unable to eradicate the fungus, need to be given for long periods and are expensive. Amputations and recurrences in patients with Eumycetoma are common. | Microbiology | Mycology | [
"amikacin"
] | 60,999 |
b6c2b95a-aea7-4c81-bbfb-821302c85bf1 | Bradycardia is common after injection of | Midazolam | Succinylcholine | Dopamine | Isoprenaline | 1b
| single | Succinylchole is the only muscle relaxant, which stimulates vague nerve - BRADYCARDIA.(attenuates tachycardia and hypeension) This effect is more predominant in the pediatric age group. Therefore, I. V. Atropine is given prior to the first dose of scholine in the children and prior to the second dose in the adults. Ref.morgan 5th/e | Anaesthesia | Muscle relaxants | [
"midazolam"
] | 61,012 |
40b3d946-e50f-47bc-8f54-39fd67459623 | A 70-year-old man has isolated systolic hypertension. On examination, his blood pressure is 170/80 mm Hg, heart and lungs are normal. He has no other medical conditions.For patient with high blood pressure, select the most appropriate medication | thiazides | spironolactone | clonidine | prazosin | 0a
| single | Thiazides seem to work particularly well in Blacks and the elderly. Younger individuals and Whites respond well to beta-blockers, ACE inhibitors, and calcium channel antagonists. Isolated systolic hypertension is a common occurrence in the elderly. It is due to arteriosclerosis of the large arteries. Treatment of isolated systolic hypertension with low-dose thiazides results in lower stroke rates and death. The goal for treatment is a blood pressure of 140/90 mm Hg. | Medicine | C.V.S. | [
"prazosin",
"spironolactone",
"clonidine"
] | 61,018 |
d8184724-f9f0-4412-871d-3aaa4fb8bddb | Intra-aerial injection of thiopentone. All true except:- | Intra-aerial thiopentone can form crystals in aerioles & capillaries and cause intense vasoconstriction | It should be treated promptly with papaverine and lidocaine | Treatment of choice is stellate ganglion block | Heparinization can also be done | 2c
| multi | If other measures fail then we can go for stellate ganglion block. Intra-aerial injection may cause acute, severe extremity ischaemia and gangrene. The degree of injury is related to the concentration of the drug. Treatment: Theneedle should not be removedand saline is administered the same needle so as to dilute the drug Administering heparinto prevent thrombosis aery dilators can be used Brachial plexus block or stellate ganglion blockto relieve vasospasm | Anaesthesia | Intravenous Anesthetic Agents | [
"lidocaine",
"papaverine"
] | 61,021 |
a139ff46-00ca-407c-8113-3622b5eeebaa | Which of the following to stimulate glucose utilization: | Insulin | Growth hormones | Corticosteroids | Glucagon | 0a
| single | (Insulin): Ref: 548-RS 7'h, 309-LPInsulin increases utilization of glucose for providing energy which takes place in muscle, liver and many other tissues. Insulin enhances glycolysis t because it induces the synthesis of key enzyme phosphofrnctokinase and also "pyruvate kinase" (511-RS)Biological effect of Insulin* | Glucose uptake* | Gluconeogenesis* | Glycogen synthesis* | Glycogenolysis* | Protein synthesis* | Lipolysis* | Fat synthesis* Altered gene expression | Biochemistry | Carbohydrates | [
"glucagon"
] | 61,024 |
b6a9cd4d-955e-4b0b-aa75-c17ba3d28fae | A 25-year-old female, complained of lumps felt in axilla and in the supra-clavicular region. She self-examined and then went to a Surgeon. X-ray was done. USG guided biopsy was done. HPE examination revealed the diagnosis. Flow cytometry revealed CD15 AND CD30 positive. She was staed on chemotherapy. After some time, patient complained of skin lesions. Which of the following drug is responsible for above manifestation? | Daunorubicin | Bleomycin | Capecitabine | Cyclophosphamide | 1b
| multi | This is a case of Hodgkin's lymphoma. Chest X-RAY shows mediastinal lymphadenopathy. HPE image shows the classical Reed-Sternberg cells The lesion depicts long streaks of hyper pigmentation on the back known as FLAGELLATE DERMATITIS; characteristic side effect of BLEOMYCIN DRUG SIDE-EFFECT Bleomycin FLAGELLATE DERMATITIS Pulmonary fibrosis Daunorubicin Dilated cardiomyopathy Capecitabine Hand and foot syndrome Cyclophosphamide Hemorrhagic cystitis Methotrexate Liver fibrosis. | Anatomy | Integrated QBank | [
"capecitabine",
"cyclophosphamide"
] | 61,036 |
3bf80e53-0061-476b-981f-c4df6c4d9894 | A 72–year–old patient with Parkinsonism presents with swollen feet. They are red, tender and very painful. You could clear up these symptoms within a few days if you tell the patient to stop taking : | Amantadine | Benztropine | Bromocriptine | Levodopa | 0a
| single | null | Pharmacology | null | [
"benztropine",
"amantadine",
"bromocriptine",
"levodopa"
] | 61,042 |
706a5338-0652-4953-80fe-bb0f9bad418f | The antibiotic of choice of peussis is - | Ampicillin | Gentamicin | Erythromycin | Penicillin | 2c
| single | Ans. is 'c' i.e., Erythromycin Treatment of peussis DOC ----> Macrolides (Erythromycin, Azithromycin, Clarithromycin) Alternative ----> Cotrimoxazole | Pediatrics | null | [
"erythromycin",
"gentamicin",
"ampicillin"
] | 61,057 |
60639782-edaf-4db0-b580-ea941bf39f0b | Ibutilide acts by | Blockade of Na+ current | Interference with the action of catecholamines at the b-adrenergic receptor | Delay of repolarization due to inhibition of K+ current | Interference with calcium conductance | 1b
| single | Ibutilide is a class III antiarrhythmic drug.The classes of antiarrhythmic action are:- Class I, Local anaesthetic effect due to blockade of Na+ currentClass I antiarrhythmics have been fuher subdivided based on the kinetics and potency of Na+ channel bindingClass Ia agents (quinidine, procainamide) are those with moderate potency and intermediate kinetics;Class Ib agents (lidocaine, mexiletine) are those with low potency and rapid kinetics; and Class Ic drugs (flecainide, propafenone) are those with high potency and the slowest kinetics.Class II: Interference with the action of catecholamines at the b-adrenergic receptor (Atenolol, Propranolol, Esmolol, Metoprolol)Class III: Delay of repolarization due to inhibition of K+ current or activation of depolarizing current (Amiodarone, Sotalol, Ibutilide, Dofetilide)Class IV: Interference with calcium conductance (Diltiazem, Verapamil)Harrison 19e pg: 273e-6 | Medicine | All India exam | [
"ibutilide"
] | 61,060 |
a7a93232-c77e-443f-b500-6b0dfe667d65 | Penicillinase resistant penicillin is- | Methicillin | Ampicillin | Carbenicillin | Ticarcillin | 0a
| single | Ans. is 'a' i.e., Methicillin | Pharmacology | null | [
"ampicillin"
] | 61,072 |
addcf57c-035e-40dd-8ea6-1d0b7bea4c6d | The drug of choice for prophylaxis of motion sickness is:- | Promethazine | Ondansetron | Metoclopramide | Domperidone | 0a
| single | (Best Drug)Doc for prophylaxis of motion sickness - Hyoscine (scopolamine) If hyoscine is not given in the option, then the answer would be first generation Antihistaminics. First generation Antihistaminics can cross the blood brain barrier and also have strong Anti-cholinergic propeies. First generation Antihistaminics - Promethazine | Pharmacology | Histamine, 5-HT and PGs | [
"metoclopramide",
"promethazine"
] | 61,096 |
4867991f-d3d2-478b-bd51-25e546bd8212 | Anaesthetic having epileptogenic potential is | Desflurane | Sevoflurane | Ether | Halothane | 1b
| single | Sevoflurane Enflurane Isoflurane Have epileptic potentials Refer Katzung 11/e p 432L | Pharmacology | Anesthesia | [
"halothane",
"sevoflurane",
"desflurane"
] | 61,097 |
9ebc3ebf-b59e-4c6a-8894-833eb1a6ca92 | Which of the following is a bactericidal drug against Mycobacterium leprae? | Erythromycin | Ofloxacin | Cotrimoxazole | Amoxicillin | 1b
| single | Answer- B. OfloxacinOfloxacin Over 99.9% bacilli were found to be killed by 22 daily doses of ofloxacin monotherapy | Pharmacology | null | [
"erythromycin",
"ofloxacin"
] | 61,104 |
cd50190f-124a-49d5-a6d8-2825f06a70c6 | Which of these is a new oral drug used in treatment of chronic Hepatitis C? | Interferon alpha | Ledipasvir | Oseltamivir | Lamivudine | 1b
| single | Ans. b. Ledipasvir (Ref: Harrison 19/ep2049, I8fe p2556.tLedipasvir is an inhibitor of the hepatitis C virus NS5A protein. Ledipasvir is most commonly used in combination with sofosbuvir for treatment in chronic hepatitis C genotype l patients." Ledipasvir is an inhibitor of the hepatitis C virus NS5A protein. Sofosbuvir, on the other hand, is metabolized to the active uridine analog triphosphate, which acts as a RNA chain terminator when incorporated into the RNA via the NS5B polymerase. ''LedipasvirLedipasvir is an inhibitor of the hepatitis C virus NS5A proteinQ.The ledipasvir/sofosbuvir combination is a direct-acting antiviral agent that interferes with HCV replication and can be used to treat patients with genotypes 1a or 1b without PEG-interferon or ribavirin.On October 10, 2014 the FDA approved the combination product Icdipasvir/sofosbuvir called Harvoni.Mechanism of Action:Ledipasvir inhibits an important viral phosphoprotein, NS5A, which is involved in viral replication, assembly & secretionClinical Uses:Ledipasvir is most commonly used in combination with sofosbuvir for treatment in chronic hepatitis C genotype1 patientsQ.Side-effects:MC side effects: Fatigue & headacheAntiviral Therapy in Hepatitis CIndications for Antiviral Therapy in Hepatitis CDetectable HCV RNA (with or without elevated ALT)Portal/bridging fibrosis or moderate to severe hepatitis on liver biopsyInitial Recommended Treatment depends on the Type of Hepatitis C virusGenotypeRecommended TreatmentHCV genotype 1a* 12 weeks of ledipasvir & sofosbuvir OR 12 -24 weeks of paritaprevir, ombitasvir, dasabuvir & ribavirinHCV genotype 1b* 12 weeks of ledipasvir & sofosbuvir OR 12 weeks of paritaprevir, ombitasvir & dasabuvirHCV genotype 2* 12 to 16 weeks of sofosbuvir & ribavirinHCV genotype 3* 12 weeks of sofosbuvir, ribavirin & pegylated interferonHCV genotype 4* 12 weeks of ledipasvir & sofosbuvir OR paritaprevir, ritonavir, ombitasvir & ribavirin, OR* 24 weeks of sofosbuvir & ribavirinHCV genotype 5 or 6* Sofosbuvir & ledipasvir | Medicine | Hepatitis | [
"lamivudine",
"oseltamivir"
] | 61,115 |
eee6f723-2ece-4c63-8c2c-e0bfb03ec2a4 | A child with acute myeloid leukemia presents with hyperleukocytosis. Treatment includes all of the following EXCEPT: | IV fluid | Allopurinol | Alkalinization | Immediately sta induction chemotherapy | 3d
| multi | Hyperleukocytosis: - Leukocyte count > 100,000/uL - It is medical emergency most commonly seen with AML or CML in blast crisis - There is sludging of blasts in microcirculation - obstruction of small vessels especially in brain & lungs - Treatment: IV fluids (hydration) Alkalinization Allopurinol (to prevent tumor lysis syndrome) Hydroxyurea (for leukoreduction) - Induction chemotherapy- initiated only after leukoreduction, as it carries a high-risk of acute tumor lysis syndrome | Pediatrics | Neoplastic disorders of WBCs | [
"allopurinol"
] | 61,133 |
f8ecb9d1-2c01-456d-ac93-bde1aa12cfea | Treatment of choice for scorpion bite: | Anti-venin | Insulin | Steroids | Atropine | 0a
| single | (Ref: KDT, 6th ed. pg. 2748)General time guidelines for the disappearance of symptoms after anti-venom administration are as follows:# Centruroides anti-venom: Severe neurologic symptoms reverse in 15-30 min. Mild-to-moderate neurologic symptoms reverse in 45-90 min.# Non-Centruroides anti venom: In the first hour, local pain abates. In 6-12 hours, agitation, sweating, and hyperglycemia abate. In 6-24 hours, cardiorespiratory symptoms abate.Insulin administration in scorpion envenomation animal experiments has helped the vital organs to use metabolic substrates more efficiently, thus preventing venom- induced multiorgan failure, especially cardiopulmonary failure. Unfortunately, no human studies have been conducted.The use of steroids to decrease shock and edema is of unproven benefit.Atropine for symptomatic bradycardia.RememberScorpion venom is composed of neurotoxin cardiotoxin, nephrotoxin, hemolytic toxin, phosphodiesterases, phospholipases, hyaluronidases, glycosaminoglycans, histamine, serotonin, tryptophan, and cytokine releasers.Hence the clinical effects of envenomation are neuromuscular, neuro-autonomic, or local tissue effects.The main targets of scorpion venom are voltage- dependent ion channels, of which sodium channels are mainly affected.Alpha blocker like Prazosin can also be used for this purpose. | Pharmacology | A.N.S. | [
"atropine"
] | 61,135 |
4c9a2c12-7134-413b-bb58-7ed929a9916c | Drugs causing macular toxicity when given intravitreally? | Gentamycin | Vancomycin | Dexamethasone | Ceftazidime | 0a
| multi | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 445)Intravitreal aminoglycosides (gentamycin, amikacin) are a repoed cause of macular toxicityAminoglycosides induced macular toxicity is thought to be paially due to the gravity-induced settling of drugs on the macula in the supine positionThis may result in a higher concentration of drug locally at the macula. | Ophthalmology | Miscellaneous | [
"ceftazidime",
"dexamethasone",
"vancomycin"
] | 61,148 |
c838a217-9d0e-4d49-a66e-eb80ffd3a161 | All of the following are used in the initial management of acute life threatening cardiognenic pulmonary edema, except - | Digoxin | Morphine | Furosemide | Positive Pressure Ventilation | 0a
| multi | null | Medicine | null | [
"morphine",
"digoxin",
"furosemide"
] | 61,151 |
f9026854-8cee-412f-8a03-a8cc44773788 | Niacin deficiency occurs in all except- | Prolonged antibiotic use | Hanup's disease | Carcinoid syndrome | Isoniazid use | 3d
| multi | isoniazid act as chemical antagonist to pyridoxine causing pyridoxine deficiency Ref Harrison 20th edition pg 78 | Medicine | Nutrition | [
"isoniazid"
] | 61,155 |
e3fc0621-422f-4fed-8489-5a6039d85d31 | Which of the following causes lupus like features- | Hydralazine | Amphetamines | Clozapine | Esmolol | 0a
| single | Ans. is 'a' i.e., Hydralazine Drugs inducing ANA and SLE :o Antiarrhythmics : Procainamide, disopyramide, propafenomeo Anti-hypertensives : hydralazine, methyldopao ACE inhibitorso Beta-blockerso Antithyroid-propylthiouracilo Antipsycbotics - chlorpromazine. lithiumo Anti-convulsauts : carbamazepine, phenytoino Antibiotic :Isoniazid, minocycline, macrodantino Antirheumatic : sulfasalazineo Diuretics : Hydroclorothiazideo Statins : Lovastatin, simvastatino Biologies : IFN, TNF-a inhibitors | Pharmacology | Adverse Drug Effect | [
"hydralazine",
"clozapine",
"esmolol"
] | 61,157 |
e87802d6-2a8c-4df4-9775-150a477a19a8 | Pulmonary fibrosis is side effect associated with the use of : | Actinomycin | Bleomycin | Doxorubicin | Mithramycin | 1b
| single | null | Pharmacology | null | [
"doxorubicin"
] | 61,168 |
e6a67d4d-9cd2-4290-b670-6d38cb435e98 | Dobutamine acts on all of the following receptors except | β1 | β2 | D1 | α1 | 2c
| multi | Dobutamine has no action on Dopamine receptors. | Pharmacology | null | [
"dobutamine"
] | 61,169 |
469ca4c9-9d7e-4faa-889b-14102b28e99f | MDR TB is defined as- | Resistance to INH and Ethambutol | Resistance to Rifampicin and Ethambutol | Resistance to Pyrazinamide and Rifampicin | Resistance to INH and Rifampicin | 3d
| single | Ans. is 'd' i.e., Resistance to INH and Rifampicin Treatment of multidrug resistance (MDR) TBo MDR-TB is defined as resistance to at least both INH and rifampicin. Previously it was classified as Category IV under DOTS (DOTS-PLUS).o The treatment is given in two phases, the intestive phase (IP) and the continuation phase (CP). The total duration of treatment for regimen for MDR-TB is 24-27 months, depending on the IP duration,o Treatment regimen comprises :-Intensive phase (6-9 months) : Six drugs : Kanamycin (Km), levofloxacin (Lvx), ethionamide (Eto), pyrazinamide (Z), ethambuto! (E), and cycloserine (Cs).Continuation phase (18 months): Four drugs : Levofloxaxcin, ethionamide, ethambuto! and cycloserine,o Total duration of treatment is 24-27 months.Treatment of extensive drug resistance (XDR) TBo XDR-TB is defined as resistance to any fluoroquinolone and at least one of the following three second-line drugs (capreomycin, kanamycin, amikacin), in addition to multidrug resistance,o The Regimen for XDR-TB would be of 24-30 months duration, with 6-12 months Intensive Phase (IP) and 18 months Continuation Phase (CP),o Regimen is :-intensive phase (6-12 months) : Seven drugs : Capreomycin, PAS. moxifloxacin, high dose INH, clofazimine, Linezolid, amoxyclav.Continuation phase (18 months) : Six drugs : PAS, moxifloxacin, high dose INH, clofazimine, linezolid, amoxyclav. | Microbiology | Mycobacteria | [
"ethambutol"
] | 61,172 |
36b1c8dd-880b-483f-a6cc-782ce67ba3e9 | Which of the drugs must be available in labour room while giving narcotics for pain? | Fentanyl | Naloxone | Pheniramine | Morphine | 1b
| single | In a labour room when opoid narcotics are being given to reverse the respiratory depression induced by them, Naloxone should be available. It is given to the mother 0.4 mg IV in labour. Ref: Datta Obs 9e pg 479. | Anatomy | General obstetrics | [
"naloxone",
"morphine",
"fentanyl"
] | 61,174 |
818deb42-0686-4062-b376-ed78dab2f0c5 | Steroid receptor superfamily is present in : | Vitamin D3 | Insulin | Glucagon | All | 0a
| multi | A i.e. Vitamin D3 | Physiology | null | [
"glucagon"
] | 61,176 |
c0861b9d-9c9e-49a3-9b82-4d93abce5ee1 | A 57-year-old man with MI is admitted in cardiac emergency. Which of the following drug might cause unexpected results based on CYP2C19 genotype of patient? | Prasugrel | Clopidogrel | Warfarin | Ticagrelor | 1b
| single | CYP 2C19 shows pharmacogenetic variations. Some people are poor metabolizers and others extensive metabolizers Clopidogrel, a platelet inhibitor, is a prodrug that is metabolized by CYP2C19 to active form. Poor metabolizers cause inadequate platelet inhibition, Extensive metabolizers may result in bleeding. Prasugrel, warfarin and ticagrelor do not require CYP 2C19 activation. | Pharmacology | Pharmacokinetics | [
"clopidogrel",
"warfarin",
"ticagrelor",
"prasugrel"
] | 61,180 |
dbe53531-f8de-4687-98e9-2d864c1158d4 | Which among the following is the drug of choice for Clostridium difficile-induced colitis - | Gentamicin | Ciprofloxacin | Metronidazole | Linezolid | 2c
| single | null | Medicine | null | [
"metronidazole",
"gentamicin",
"ciprofloxacin",
"linezolid"
] | 61,189 |
f3946115-8754-447b-a0e8-090903844018 | Which of the following agents is recommended for medical treatment of variceal bleed: | Octreotide | Desmopressin | Vasopressin | Nitroglycerine | 0a
| single | Ans. (a) Octreotide* DOC in management of Acute Variceal Bleed- Octreotide* Terlipressin is released in sustained manner - may also be used to control variceal bleeding (better than Vasopressin) | Surgery | Liver | [
"desmopressin",
"vasopressin",
"octreotide"
] | 61,196 |
ed531026-7cc8-4087-bc94-e0c3977f74b8 | All the following are true regarding HIV transmission, from mother to infant, except: | Nevirapine prophylaxis is used for the prevention of veical transmission | Zidovudine should be given to both pregnant women and infants | Emergency CS increases the chance of transmission | Avoid breast feeding | 2c
| multi | In the sho course prophylactic antiretroviral (ARV) regimens Nevirapine is given to mother at the onset of labour and within 72 hours to child cesarean section decreases the transmission of HIV. | Gynaecology & Obstetrics | null | [
"nevirapine",
"zidovudine"
] | 61,205 |
4dce23c7-582e-4d73-9b01-9c166aa47350 | In chlamydial cervicitis drug of choice is : | Tetracycline | Septran | Chlomphenicol | Erythromycin | 0a
| single | Tetracycline | Gynaecology & Obstetrics | null | [
"erythromycin",
"tetracycline"
] | 61,207 |
11fd7f39-f259-4a6b-be9f-fe7669a85564 | Gp2b3A inhibitors are all except ? | Abciximab | Eptifibatide | Tirofiban | Prasugrel | 3d
| multi | Ans. is 'd' i.e., Prasugrel Glycoproteins lib / 111a inhibitors The platelet glycoprotein mediates platelet aggregation binding of adhesive proteins such as fibrinogen and Von Willebrand factor. GP IIb / Ina inhibitors, inhibit platelet aggregation by blocking GPIlb / Ma. They are more complete inhibitors than either aspirin or clopidogrel / ticlopidinejj because they inhibit final pathway in platelet aggregation (whether it is mediated by ADP or TXA2), while aspirin blocks only TXA2 pathway and clopidogrel blocks only ADP pathway. Drugs are ? Abciximab - A humanized monoclonal antibody against GP IIb / 111a. Eptifibatide Tirofiban - Competitive inhibitors of GP I1b/IIIa Lamifiban In addition to inhibiting Gp lib / Ilia receptor, abciximab also inhibits ayP3 receptor (which binds vitronectin) and a.132 (a leukocyte integerin). This action is responsible for anti-inflammatory and antiproliferative propeies of abciximab. | Pharmacology | null | [
"eptifibatide",
"abciximab",
"tirofiban",
"prasugrel"
] | 61,216 |
d5c59a0f-0dfc-41b6-8b7b-42e8b31e69f4 | Which of the following drug is to be discontinued on the day of surgery - | Atenolol | Amlodipine | Metformin | Statin | 2c
| single | Ans. is 'C' i.e., Metformin o Metformin needs to be stopped at least 48 hours before surgery for the fear of lactic acidosis. o Other drugs that need to be discontinued before surgery. o OCP ---> 4 weeks before surgery o Irreversible MAO inhibitor ----> 2 weeks before surgery. o Reversible MAO inhibitor --> A day before surgery. o Lithium ---> 2 days before surgery. | Pharmacology | null | [
"atenolol",
"metformin",
"amlodipine"
] | 61,223 |
1212d005-5005-43dd-8e2e-3438afcefce7 | Drug of choice for hyperhidrosis is | Phenylephrine | Atropine | Darifenacin | Trospium | 2c
| single | Darifenacin is considered as drug of choice for hyperhidrosis-excess sweating as it blocks m3 receptors on sweat glands Ref: KDT 6th ed pg 118 | Pharmacology | Autonomic nervous system | [
"trospium",
"atropine",
"phenylephrine"
] | 61,224 |
54e04e1e-3b10-49cf-be75-065ff91c4aaa | Which of the following is true regarding enalapril treatment in patients of essential hypeension? | Decreased angiotensin II concentration in the blood | Decreased concentration of renin in the blood | Decreases sodium and increases potassium in the urine | All of the above | 0a
| multi | Enalapril is an Angiotensin conveing enzyme inhibitor- concentration of Angiotensin II in the blood will decrease.Enalapril may offer ceain advantages over captopril:1.) More potent2.) Its absorption is not affected by food.3.) Onset of action is slower (due to need for conversion to active metabolite), less liable to cause abrupt first dose hypotension.4.) Has a longer duration of action: most hypeensives can be treated with single daily dose.5.) Rashes and loss of taste are probably less frequent. | Pharmacology | Hypeension, Arrhythmias, Dyslipidemia | [
"enalapril"
] | 61,228 |
ab626f5d-1207-4743-b25f-6672d89785c5 | Stavudine (stavudine) is prescribed to a client with human immunodeficiency virus seropositive. The nurse observes which of the following most closely while the client is taking the medication? | Orientation. | Gag reflex. | Appetite. | Gait. | 3d
| single | One of the most serious side effects of Stavudine (Zerit) is peripheral neuropathy so the nurse should monitor the client’s gait while taking this medication.
Options A, B, and C are not related to the use of the medication. | Medicine | null | [
"stavudine",
"zerit"
] | 61,250 |
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