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|---|---|---|---|---|---|---|---|---|---|---|---|---|
7d9b6800-8202-4ff7-8df9-93b861b87fda
|
Half Life of digoxin is
|
24hrs
|
40hrs
|
48hrs
|
60hrs
| 1b
|
single
|
Ref-KDT 7/e p55 Digoxin and digitoxin are the main digitalis products. Digoxin is absorbed quickly from the gastrointestinal tract with a bioavailability of between 75% and 95%. It is eliminated primarily through kidneys; therefore, it has a half-life of 36-48 hours in patients who have normal kidney function and 3.5-5 days in patients who are anuric. The reference range for digoxin is as follows: 0.8-2 ng/mL (1.2-2 nmol/L) Half-life: 36 hours Toxic level: more than 2 ng/mL
|
Anatomy
|
Other topics and Adverse effects
|
[
"digoxin"
] | 157,322 |
55648f75-9f6c-4349-82b6-bb5c16fef6cb
|
. All of the following statements about the use of spironolactone in CHF are true except
|
It should be administered in low doses to prevent hyperkalemial
|
It affords prognostic benefit in severe hea failure over and above that afforded by ACE inhibitors
|
It helps to overcome the refractoriness to thiazides
|
It affords rapid symptomatic relief in CHF patients
| 3d
|
multi
|
(Ref KDT 6/e p507) Loop diuretics are used to provide rapid symptomatic relief whereas aldosterone antagonists decrease the moality by reversing myocardial remodeling
|
Anatomy
|
Other topics and Adverse effects
|
[
"spironolactone"
] | 157,332 |
4e104b64-82e9-414d-8ebf-c24f8ac476de
|
All of the following drugs can produce hyperuricemia EXCEPT :
|
Ethambutol
|
Pyrazinamide
|
Sulfinpyrazone
|
Hydrochlorothiazide
| 2c
|
multi
| null |
Pharmacology
| null |
[
"ethambutol",
"hydrochlorothiazide"
] | 157,336 |
a8630f17-9f86-4225-b588-4cef27ad2adf
|
A 40 year old man presents to his physician with complaints of substernal pain radiating to his left shoulder, occurring when he is at rest. The pain improves when he gets up and moves around, and responds to sublingual nitroglycerin. This patient's symptoms are thought to be caused by which of the following processes?
|
Coronary aery atherosclerosis
|
Coronary aery embolism
|
Coronary aery spasm
|
Coronary aery thrombosis
| 2c
|
single
|
The pattern of angina described is called Prinzmetal's variant angina, and is believed to be due to coronary aery spasm occurring during rest. Up to 75% of patients with this disorder can be shown to have a fixed obstruction within 1 cm of the site of aerial spasm. Patients with Prinzmetal's angina are often younger than patients with unstable angina secondary to coronary atherosclerosis. The diagnosis may be confirmed by observing a spontaneous coronary aery spasm (or provoking one by administering ergonovine or acetylcholine, or instructing the patient to hyperventilate) during angiography. Atherosclerosis is the cause of typical angina that occurs with exeion. Embolism in the coronary aeries is somewhat unusual, but can occur if a plaque from the aoa breaks off and lodges in a coronary vessel. Thrombosis characteristically produces unstable or crescendo angina with worsening chest pain. Ref: Mohrman D.E., Heller L.J. (2010). Chapter 11. Cardiovascular Function in Pathological Situations. In D.E. Mohrman, L.J. Heller (Eds), Cardiovascular Physiology, 7e.
|
Physiology
| null |
[
"nitroglycerin"
] | 157,353 |
38b2429a-be30-4d5b-9184-7a6d7520c89e
|
Which of the following is not a GnRH agonist?
|
Leuprolide
|
Nafarelin
|
Ganirelix
|
Busurelin
| 2c
|
single
|
GnRH Agonist Drugs Leuprolide Nafarelin Goserelin Buserelin -They are all injectables. -They all have flare up reaction as adverse effect when given in continuous form GnRH Antagonist Drugs Cetrorelix Ganirelix Abarelix Degarelix -Given as injectables -They do not increase the sex hormone
|
Pharmacology
|
Pituitary-Hypothalmic System and Thyroid
|
[
"nafarelin"
] | 157,358 |
97e452ed-ca3f-4608-a970-c1e8860ea047
|
Which of the following is used to treat severe pulmonary hypertension ?
|
Angiotensin I
|
Omapatrilat
|
Bosentan
|
Endothelin
| 2c
|
single
| null |
Pharmacology
| null |
[
"bosentan"
] | 157,361 |
70fcbcb4-3b40-4b4a-90d0-df0e576d98d6
|
Akathisia is treated by
|
Haloperidol
|
Fluoxetine
|
Propranolol
|
Lithium
| 2c
|
single
|
(Refer: Harrison&;s Principles of Internal medicine, 18th edition, pg no - 3544)
|
Pathology
|
All India exam
|
[
"propranolol",
"fluoxetine"
] | 157,374 |
e5c9278c-c17e-4bf8-9b23-cdd53ade6ad1
|
Bisphosphonate-induced osteomalacia is common with
|
Alendronate
|
Pamidronate
|
Zolendronate
|
Etidronate
| 3d
|
single
|
Etidronate is 1st gen bisphosphonate The first generation bisphosphonates, such as etidronate (ETD), a non-nitrogen containing bisphosphonate, displays considerable anti-mineralization activity but is a relatively low-potency inhibitor of osteoclasts. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a condition found in patients who have received intravenous and oral forms of bisphosphonate therapy for various bone-related conditions. it manifests as exposed, nonvital bone involving the maxillofacial structures. it is caused by to dentoalveolar structures that have a limited capacity for bone healing due to the effects of bisphosphonate therapy. REF KD tripathi 8th ed
|
Pharmacology
|
Endocrinology
|
[
"alendronate"
] | 157,412 |
34c947d0-4ac3-45b3-bb8c-6f9309d9c511
|
28 year old female who is a known case of bipolar disorder on lithium therapy is posted for varicose vein repair. What should be done regarding lithium
|
Stop lithium 24 hours prior to surgery
|
Continue lithium till the day of surgery
|
Replace lithium with diazepam
|
None
| 0a
|
multi
|
Lithium has to be stopped 24 hrs prior to surgery.
|
Anaesthesia
| null |
[
"diazepam"
] | 157,413 |
a972059b-c184-4417-bf13-c024580004fb
|
Treatment of choice for LegionnaEUR' aiere's disease is:
|
TC
|
Erythromycin
|
Penicillin
|
Streptomycin
| 1b
|
single
|
Erythromycin
|
Pharmacology
| null |
[
"erythromycin"
] | 157,420 |
25109b14-5144-4ca5-ba3e-cc93c695119c
|
Cough is an adverse reaction seen with intake of
|
Thiazide
|
Nifedipine
|
Enalapril
|
Prazosin
| 2c
|
single
|
Refer kDT 6/e p984 ACE inhibitor cause adverse reaction like cough. The CAPTOPRIL mnemonic can be used to remember the side effects of ACE inhibitors: cough, angioedema, potassium changes, taste change, hyp-O-tension, pregnancy changes, rash, increased renin, and lower angiotensin II. Another side effect is hyperkalemia.
|
Pharmacology
|
Cardiovascular system
|
[
"prazosin",
"nifedipine",
"enalapril"
] | 157,439 |
1bd0a909-0ed4-494d-958f-d3c4760f929f
|
An elderly house wife lost her husband who died suddenly of myocardial infarction couple of years ago. They had been staying alone for almost a decade with infrequent visits from her son and grandchildren. About a week after the death she heard the voice clearly talking to her as he would in a routine manner from the next room. She went to check but saw nothing. Subsequently she often heard his voice conversing with her and she would also discuss her daily matters with him. This however, provoked anxiety and sadness of mood when she would remain preoccupied with thoughts about him. She should be treated with:
|
Clomipramine
|
Alprazolam
|
Electroconvulsive therapy
|
Haloperidol
| 3d
|
single
|
In this case, death happened "couple of years ago". The first time she had auditory hallucinations was after a week of his death and since then it has been happening. Now, in grief "brief hallucinations" can occur however here the hallucinations are often and patient is even discussing the daily matters with the "voice". This clearly shows presence of psychotic symptoms which should be diagnosed separately. Please remember patient can develop all kind of psychiatric disorders like depression, anxiety, PTSD in association with grief and if the symptoms are severe enough, they should receive separate diagnosis. This patient has psychotic symptoms (i.e. hallucinations) and should be treated with an antipsychotic, haloperidol. The treatment depends on symptoms, in case of occasional anxiety, Alprazolam could have been used. In case of significant depressive symptoms antidepressant could have been used, but since the psychotic symptoms are prominent, we must use an antipsychotic.
|
Psychiatry
|
Neurotic, Stress Related and Somatoform Disorders
|
[
"alprazolam",
"clomipramine"
] | 157,442 |
74326026-d6f4-4c64-bc65-9d5654409271
|
Which of the following is a bactericidal drug for Mycobacterium leprae?
|
Ofloxacin
|
Ciprofloxacin
|
Amoxicillin
|
Erythromycin
| 0a
|
single
|
Ans. (A) Ofloxacin(Ref: KDT 7th/e p782)Ofloxacin, pefloxacin, moxifloxacin and sparfloxacin are fluoroquinolones effective against leprosy and fluoroquinolone are bactericidal drugs.
|
Pharmacology
|
Chemotherapy: General Principles
|
[
"erythromycin",
"ciprofloxacin",
"ofloxacin"
] | 157,443 |
5b53e9e0-7aba-4e81-9752-ed837d339489
|
Which of the following doesn't worsen angina?
|
Sumatriptan
|
Oxyfedrine
|
Dipyridamole
|
Thyroxine
| 1b
|
single
|
Ans. is 'b' i.e., Oxyfedrine Drugs that exacerbate Angina o Amphetamines o Alpha blocker o Beta agonists o Beta blockers withdrawal o Dipyridamol o Vasopressin o Ergotamine o Decongestants o Excessive thyroxine o Hydralazine o Methysergide o Minoxidil o Nifedipine o Nicotine and cocaine o Oxytocin o Sumatriptan o Theophylline
|
Pharmacology
| null |
[
"sumatriptan",
"thyroxine"
] | 157,458 |
93793bc4-20d8-4560-8aa0-91c30cbe5166
|
Which of the following is not a contraindication for timolol?
|
Bronchial asthma
|
Anxiety
|
MI
|
Thyrotoxicosis
| 1b
|
single
|
Timolol maleate is a non-selective beta-adrenergic receptor blocking agent. It is contraindicated in patients with bronchial asthma, a history of bronchial asthma, severe chronic obstructive pulmonary disease, thyrotoxicosis, sinus bradycardia, second or third degree atrioventricular block, ove cardiac failure, cardiogenic shock, hypersensitivity to any component of this product.
|
Pharmacology
| null |
[
"timolol"
] | 157,469 |
c8cc7473-338f-4a41-a456-069d5088c760
|
Parathormone has all of the following effects, except
|
Increased bone resorption
|
Increased Ca+2 reabsorption in kidney
|
Increased phosphate reabsorption in kidney J
|
Increased calcitriol synthesis
| 2c
|
multi
|
Parathyroid hormone (PTH), also called parathormone or parathyrin, is a hormone secreted by the parathyroid glands that is impoant in bone remodeling, which is an ongoing process in which bone tissue is alternately resorbed and rebuilt over time.Parathyroid hormone regulates serum calcium through its effects on bone, kidney, and the intestine:In bone, PTH enhances the release of calcium from the large reservoir contained in the bones. Bone resorption is the normal destruction of bone by osteoclasts, which are indirectly stimulated by PTH.In the kidney, Circulating parathyroid hormone influences the reabsorption that occurs in the distal tubules and the renal collecting ducts.PTH reduces the reabsorption of phosphate from the proximal tubule of the kidney.PTH increases the activity of 1-a-hydroxylase enzyme, which conves 25-hydroxycholecalciferol, the major circulating form of inactive vitamin D, into 1,25-dihydroxycholecalciferol, the active form of vitamin D, in the kidney.Ref: Ganong&;s review of medical physiology;24th edition; page no-377
|
Physiology
|
Endocrinology
|
[
"calcitriol"
] | 157,480 |
068e4ab4-a34b-49e6-81f6-8c38d83cc11c
|
By which of the following anticoagulants used in estimating blood glucose, glycolysis is prevented-
|
EDTA
|
Heparin
|
Sodium fluoride
|
Sodium citrate
| 2c
|
single
|
Ans. is 'c' i.e., Sodium Fluoride Fluoride inhibits Enolase, an important enzyme involved in Glycolysis This enzyme catalyzes the following step in glycolysis. Enolase 2 phosphoglycerate > Phosphoenol pyruvate.Inhibition of Enolase causes subsequent inhibition of Glycolysis.This property of Fluoride is utilized when blood is collected in tubes to estimate blood glucose.Fluoride inhibits glycolysis by inhibiting enolase, this will help in correct determination of the glucose level as glycolysis will not be able to affect the level of glucose.
|
Biochemistry
|
Glycolysis
|
[
"edta"
] | 157,485 |
411dc486-32fd-4b65-acc2-bebaf970176f
|
A 25 year old nulliparous woman at 35 weeks' gestation comes to the labor and delivery ward complaining of contractions, a headache, and flashes of light in front of her eyes. Her pregnancy has been uncomplicated except for an episode of first trimester bleeding that completely resolved. She has no medical problems. Her temperature is 37 C (98.6 F), blood pressure is 160/110 mm Hg, pulse is 88/minute, and respirations are 12/minute. Examination shows that her cervix is 2 centimeters dilated and 75% effaced, and that she is contracting every 2 minutes. The fetal hea tracing is in the 140s and reactive. Urinalysis shows 3+ proteinuria. Laboratory values are as follows: leukocytes 9,400/mm3, hematocrit 35%, platelets 101,000/mm3. Aspaate aminotransferase (AST) is 200 U/L, and ALT 300 U/L. Which of the following is the most appropriate next step in management?
|
Administer oxytocin
|
Discharge the patient
|
Encourage ambulation
|
Sta magnesium sulfate
| 3d
|
multi
|
This patient has severe preeclampsia. Preeclampsia is diagnosed on the basis of hypeension, edema, and proteinuria. Severe preeclampsia may be diagnosed when the patient has one of the following: a headache that does not respond to analgesics, visual changes, seizure, very elevated blood pressures, pulmonary edema, elevated liver function tests, severe proteinuria, oliguria, an elevated creatinine, thrombocytopenia, hemolysis, intrauterine growth restriction, or oligohydramnios. The management of severe preeclampsia after 32 weeks is with delivery. Prior to 32 weeks, consideration may be given to expectant management of the patient depending on the clinical circumstances. This patient is at 35 weeks' with headache, visual changes, elevated blood pressures, thrombocytopenia, and elevated liver function tests. She, therefore, needs to be delivered. She appears to already be in labor as she is contracting every two minutes and her cervix is dilated and effaced. At this point, magnesium sulfate should be staed. Magnesium sulfate has consistently been demonstrated to be the most effective medication for seizure prophylaxis in women with preeclampsia. To administer oxytocin would not be necessary for this patient. She appears to already be in labor with contractions every two minutes. To discharge the patient would absolutely be incorrect. Severe preeclampsia need to be delivered or, at the very least, admitted to the hospital. There is no role for discharging a patient home in the management of severe preeclampsia. To encourage ambulation would also be incorrect. Severe preeclampsia should be kept on bed rest. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 34. Pregnancy Hypeension. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
|
Gynaecology & Obstetrics
| null |
[
"oxytocin"
] | 157,486 |
97ad58b7-909a-4495-b3c5-b2862faea188
|
A 38 years old man is posted for extraction of last molar tooth under general anaesthesia as a day care case. He wishes to resume his work after 6 hours. Which of the following induction agent is preferred
|
Thiopentone sodium
|
Ketamine
|
Propofol
|
Diazepam
| 2c
|
single
|
C. i.e. (Propofol) (158 - 60 Lee's synopsis of anesthesia 13th)PROPOFOL - particularly suited for out patient surgery because residual impairment is less marked and incidence of post operative nausea and vomiting* Only agent which are rapidly eliminated are used eg Propofol, alfentanil, remifentanil, N20 Isoflurance,sevoflurane or desflurane* Commercial preparation contains egg extract (lecithin)**Advantage* Fitness to go to work - usually the following day* Fitness to return home - fitness to go out alone* Fitness to walk to the bathroom without feeling faint* The induction dose of propofol in healthy adult is - 1 - 2.5 mg/Kg* Used in Porphyria*** & malignant hyperthermia**Propofol Infusion syndrome - potentially lethal syndrome of metabolic acidosis, acute cardiomyopathy and skeletal myopathy associated with prolonged (>48 hours) high doses (>5m/ kg/h)* Midazolam can be safely uses for day care procedures*** Propofol is the agent of choice for total intravenous anaesthesia (TIVA)
|
Surgery
|
Miscellaneous
|
[
"ketamine",
"diazepam",
"propofol"
] | 157,492 |
18f72940-51dd-4dc3-8079-528a767f16e0
|
Regarding ketamine all are true except
|
Ketamine acts on NMDA receptors in brain
|
Indirectly acting sympathomimetic agent
|
Contraindicated in shock
|
Agent of choice in asthma patients.
| 2c
|
multi
|
Ketamine being sympathomimetic, is agent of choice in shock.
|
Anaesthesia
| null |
[
"ketamine"
] | 157,511 |
1295fcc9-56aa-4d35-ab26-5edd80eab64f
|
Drug used in acute iron poisoning is:
|
BAL
|
Desferrioxamine-B
|
Methylene blue
|
EDTA
| 1b
|
single
|
(Desferrioxamine-B): Ref: 11-30 - PPoisoningTreatments* Iron salt* Iodine* Lead* Hydrocyanic acid* Opium* Paracetamol* Copper sulphate- Gastric lavage, leave dilute NaHCO3 in stomach, Electrolyte correction, desferrioxane - B- Sodium thiosulfate orally, Demulcents- EDTA, Penicillamine- Dicobalt tetracemate, Methylene blue- Methadone- Cysteamine- Potassium ferrocyanide, BAL, Cuprimine Magnesium sulfate
|
Forensic Medicine
|
Toxicology
|
[
"edta"
] | 157,514 |
5b1cd827-1099-4a21-9a84-89d9481a1811
|
A new born with a marked CHD with decreased pulmonary vascularity should be treated with?
|
Digoxin
|
Indomethacin
|
Prostaglandin E1
|
Epinephrine
| 2c
|
single
|
.
|
Pathology
|
All India exam
|
[
"epinephrine",
"digoxin",
"indomethacin"
] | 157,517 |
723c10f1-2c6f-45f9-a8f8-6a5ed8ff9960
|
Oligospermia is a side effect of which of the following drug:
|
Methotrexate
|
D-Penicillamine
|
Lefluonamide
|
Hydroxychloroquine
| 0a
|
single
|
Methotrexate
|
Pharmacology
| null |
[
"methotrexate",
"hydroxychloroquine",
"penicillamine"
] | 157,531 |
bf009ffe-2da6-4cad-9685-64cb54e01034
|
The preferred drug for controlling an acute exacerbation of ulcerative colitis is:
|
Prednisolone
|
Sulfasalazine
|
Mesalazine
|
Vancomycin
| 0a
|
single
|
- Coicosteroids are the mainstay of treatment of acute exacerbation of ulcerative colitis. - so, among the given options prednisolone is best to be used in controlling acute exacerbation of ulcerative colitis
|
Pharmacology
|
Gastro-Intestinal Tract
|
[
"prednisolone",
"sulfasalazine",
"vancomycin",
"mesalazine"
] | 157,532 |
cf639255-3344-4e51-b129-2666f3c07eff
|
In central serous retinopathy –
|
Often shows focal leakage on fluorescein fundus photography
|
A macular hole is a common end result
|
The image perceived by the patient on the affected side in unilateral cases is bigger than on the normal side
|
A dense central scotoma is the most common presentation
| 0a
|
single
|
Fluorescein angiography shows focal leakage of fluorescein in cenral serous retinopathy.
Image of an object is perceived smaller than normal side, i.e., metamorphosia.
Common end result is spontaneous healing
Most common presentation is sudden painless loss of vision.
|
Ophthalmology
| null |
[
"fluorescein"
] | 157,543 |
357b2918-c345-4cfb-aea9-f6e59c40c561
|
Which among the following drug is contra–indicated in renal failure ?
|
Pethidine
|
Morphine
|
Fentanyl
|
Atracurium
| 0a
|
single
| null |
Pharmacology
| null |
[
"morphine",
"atracurium",
"pethidine",
"fentanyl"
] | 157,551 |
133e0943-deea-471f-bf69-db7d277cc89b
|
Sustained neutropenia is seen with
|
Vinbalstine
|
Cisplatin
|
Carmustine
|
Cycloohosphamide
| 2c
|
single
|
Refer Goodman Gilman 11/e p1330 KDT 6/e p822. Myrelosuppression leading to neutropenia ,thrombocytopenia and anemia is seen is seen with most of the anticancer drugs The characterstic features of Myelosuprresion produced by carmustine
|
Pharmacology
|
Chemotherapy
|
[
"cisplatin"
] | 157,557 |
286b669b-ee22-4d53-a226-2bc5c04470e7
|
Mycobacterium tuberculosis is said to be Multi - drug resistant if it is resistant to:
|
Isoniazid alone
|
Rifampicin Alone
|
Both Isoniazid and Rifampicin
|
Isoniazid, Rifampicin, Ethambutol
| 2c
|
multi
|
Ans. C. Both Isoniazid and RifampicinM tuberculosis is said to be multidrug resistant if it is resistant to Rifampicin and Isoniazid. And it is known as XDR if it is resistant to Rifampicin, Isoniazid, Fluoroquinolone and one of the three injectable drugs (Amikacin, kanamycin and capreomycin)
|
Pediatrics
|
Infection
|
[
"ethambutol",
"isoniazid"
] | 157,574 |
7fa39100-dca0-445c-9752-860e11c55f81
|
Hypeonic dysfunctional labour is generally characterised by:
|
Rapid cervical dilatation
|
Less pain In labour
|
Responds ourably to oxytocin stimulation
|
Needs adequate pain relief
| 3d
|
multi
|
Hypeonic state of uterus or Imcordinate uterine action : Patient is in agony with unbearable pain referred to back Oxytocin cause fetal tachycardia due to fetal stress Inappropriate dilatation of cervix Uterus is tender and gentle manipulation excites hardening of the uterus with pain. Ref: Dutta Obs 9e pg 337.
|
Gynaecology & Obstetrics
|
Abnormal labor
|
[
"oxytocin"
] | 157,584 |
cbf62cda-fb2f-476c-a9f6-cba1583ef1b9
|
Which of the following drug is cell cycle phase specific?
|
Ifosfamide
|
Bleomycin
|
Cisplatin
|
Chlorambucil
| 1b
|
single
|
Ans. is 'b' i.e., Bleomycin Bleomycin is specific for G2 phase. o Alkylating agents (Ifosfamide, chlorambucil) and platinum compound (cisplatin) are cell cycle nonspecific.
|
Pharmacology
| null |
[
"chlorambucil",
"cisplatin"
] | 157,587 |
ffac3981-2a84-4de1-b63a-8ed991fb23ba
|
A 56-year-old man is brought to the emergency department by his wife because of memory loss and difficulty walking. She has noticed personality changes, truancy from work, and lack of personal care over the past 1 year. On examination he appears unkempt, smells of urine, and is uncooperative. He cannot recall the date or season, and gets angry when asked questions. His answers are often fabricated when checked with his wife. The blood pressure is 150/90 mm Hg, pulse 100/min, and he is diaphoretic and tremulous. His gait is wide based, and motor strength and reflexes are normal. His ocular movements are normal but there is nystagmus on lateral gaze. In the past he has had multiple admissions for alcohol withdrawal. Which of the following is the most appropriate next step in management?
|
prophylactic phenytoin administration
|
prophylactic diazepam administration
|
prophylactic carbamazepine administration
|
calcium administration
| 1b
|
multi
|
Prophylactic administration of diazepam in a withdrawing alcoholic can prevent or reduce severe syndromes such as delirium tremens (DTs). Prophylactic phenytoin, however, is not helpful. A calm, quiet environment with close observation and frequent reassurance is very important. Vitamin administration (especially thiamine) is important, but frequently, severe magnesium depletion slows improvement.
|
Medicine
|
C.N.S.
|
[
"carbamazepine",
"diazepam",
"phenytoin"
] | 157,588 |
18dd3ec6-81c3-431c-a3c8-60cad9f1fc3d
|
The following statements about Bupivacaine are true except
|
Must never be injected into a vein
|
More cardiotoxic than lignocaine
|
0.5 percent is effective for sensory block
|
It produces methaemoglobinemia
| 3d
|
multi
|
Prilocaine is the local anesthetic that produces methemoglobinemia as an adverse effect. All other statements are true. Ref: K D Tripathi; 7th edition; Page no 367
|
Pharmacology
|
Anesthesia
|
[
"bupivacaine"
] | 157,600 |
0d37dcd5-3067-4c88-a9f0-a9f862a9f319
|
Stroke prevention
|
Streptokinase
|
Streptase
|
Warfarin
|
Tissue plasminogen activator
| 2c
|
single
|
(C) Warfarin# MEDICATIONS for TIA/STROKE PREVENTION> Anti-platelet medications:> Anti-platelet medications used to prevent and reduce the risk of stroke include: Aspirin; Aspirin/extended-release dipyridamole; Clopidogrel; Ticlopidine> Aspirin is the most commonly used preventive therapy for patients at risk for stroke. However, at least 10 percent of patients are unable to take aspirin long-term, usually due to stomach problems.> Anticoagulant medication: that is usually prescribed to reduce the risk of stroke is warfarin. Warfarin usually is prescribed in patients with atrial fibrillation and other cardiovascular disorders to reduce the risk of stroke. If you are in the hospital, heparin is an anticoagulant that may be given intravenously. Anticoagulants can also be injected into the skin to prevent clots in the legs. Such clots can form when patients are on bed rest.> Anticoagulants decrease the blood's ability to clot and prevent the formation of additional clots. If you are prescribed an anticoagulant, your follow-up will include frequent blood tests so your response to the medication can be monitored.> Treatment for acute (sudden onset) stroke is the administration of a thrombolytic agent, or "clot buster," including streptokinase or streptase and tissue plasminogen activator (TPA).> These medications can dissolve the blockage within the artery to restore blood flow to the brain. They must be given within the first three hours of the onset of stroke symptoms and are usually given in a hospital where the patient can be closely monitored. The risk, however, is bleeding into the brain, which can worsen the disability. Patients need to be carefully screened and evaluated before and after thrombolytic treatment.
|
Medicine
|
Miscellaneous
|
[
"warfarin",
"streptokinase"
] | 157,612 |
b581f2d3-849d-47c1-8bcb-671688906489
|
Testosterone inhibitors are all except ?
|
Spironolactone
|
Flutamide
|
Finasteride
|
Sildenafil
| 3d
|
multi
|
Ans. is 'd' i.e., Sildenafil
|
Pharmacology
| null |
[
"flutamide",
"spironolactone",
"sildenafil"
] | 157,613 |
87c54909-e9e1-4ad3-89ab-69739055aee9
|
Which of the following drug is a 5HT2c agonist approved for treatment of obesity and causes Serotonin Syndrome as an adverse effect?
|
Lorcaserin
|
Sibutramine
|
Modafinil
|
Rimonabant
| 0a
|
single
|
Lorcaserin: 5HT2c agonist Causes weight loss S/E: Serotonin syndrome Sibutramine: Serotonin and nor-adrenaline reuptake inhibitor Discontinued due to increased risk of stroke Modafinil: used in treatment of Narcolepsy Rimonabant: Inverse agonist of cannabinoid receptor - 1 Causes weight loss Prevents craving of alcohol S/E: psychological problems (withdrawn)
|
Pharmacology
|
Histamine, 5-HT and PGs
|
[
"modafinil",
"lorcaserin"
] | 157,634 |
6384e0f9-b85c-4549-9442-06cc3bd660db
|
Which of the following is true about the WHO analgesic ladder for chronic pain in adults?
|
Analgesics are given 'on demand'
|
Morphine used for severe pain
|
Adjuvants are indicated only for mild pain
|
Non opioid analgesic are given for moderate pain.
| 1b
|
multi
|
The 3 main principles: By the clock: Drugs should be given "around the clock" rather than "on demand". By the mouth: Oral route is preferred. By the ladder: Non-opioids - Mild opioids - Strong opioids. Non opioid analgesic are given for mild pain. Adjuvants can be used for mild, moderate and severe pain
|
Anaesthesia
|
Intravenous Anesthetic Agents
|
[
"morphine"
] | 157,647 |
629570ea-7e9e-4666-85c0-3eb762716960
|
A woman with mitral stenosis but no pulmonary hypertension is in labor at 39 weeks of gestation. She has dyspnea on exertion. Her pulse rate is 80 bpm. There are no basal creps in lungs.The cervix is 4 cm dilated. She is having 1-2 uterine contractions in 10 minutes. Which of the following steps is best avoided in her?
|
Active management of third stage of labor
|
Augmentation of labor with oxytocin
|
Use of epidural analgesia for pain relief
|
Use of ergometrine in third stage of labor
| 3d
|
multi
|
Ans. is d, i.e. Use of ergometrine in third stage of laborUse of Ergometrine/methylergometrine is contraindicated in heart disease patients. Rest all options are correct.
|
Gynaecology & Obstetrics
|
Medical & Surgical Illness Complication Pregnancy
|
[
"oxytocin"
] | 157,649 |
e2ee58c9-38c7-4b5c-9a6c-ae9e510eeca3
|
Drugs which potentiate effect of NMDA at NMDA receptors are all except ?
|
Ketamine
|
Aspaic acid
|
D alanine
|
Homocysteic acid
| 0a
|
multi
|
Ans. is 'a' i.e., Ketamine Ketamine is NMDA receptor blocker so it does not potentiate the NMDA action.
|
Pharmacology
| null |
[
"ketamine"
] | 157,656 |
4828f36d-42e7-41f8-a8a2-90602804e383
|
The neuromuscular blocker that does not need reversal of action by neostigmine at the end of the operation is
|
Pipecuronium
|
d-Tubocurarine
|
Mivacurium
|
Doxacurium
| 2c
|
single
|
Mivacurium:- It is the shoest acting competitive blocker; does not need reversal. Dose and speed of injection related transient cutaneous flushing can occur due to histamine release. Fall in BP is possible, but change in HR is minimal. It is metabolized rapidly by plasma cholinesterases. Prolonged paralysis can occur in pseudocholinesterase deficiency, but this can be reversed by neostigmine. Ref:- kd tripathi; pg num:-354
|
Pharmacology
|
Anesthesia
|
[
"mivacurium",
"neostigmine"
] | 157,671 |
ccdace0a-6521-4247-a947-82699fd2dce4
|
NSAID proposed to be acting inhibition of COX-3 is:
|
Nimesulide
|
Paracetamol
|
Ketorolac
|
Rofecoxib
| 1b
|
single
|
- Paracetamol or acetaminophen has antipyretic and analgesic activities but it lacks anti-inflammatory action. - It is presumed to become inactive by peroxides generated at the site of inflammation therefore, lacks anti- inflammatory action. - Some theories suggest that PCM acts on COX-3 receptors in brain. - A metabolite of paracetamol is assumed to work through vanilloid receptor TRPV-1.
|
Pharmacology
|
NSAIDs, Gout and Rheumatoid Ahritis
|
[
"paracetamol",
"ketorolac"
] | 157,672 |
df0dbe70-7a75-4483-b87a-0ab14e1611fd
|
The following may be used in erectile dysfunction except -
|
Phenylephrine
|
Apomorphine
|
Alprostidil
|
All
| 0a
|
multi
|
Ans. is 'a' i.e., Phenylephrine Drugs used in erectile dysfunction Phosphodiesterase-5 inhibitors (Siledenafil, Todafil, Vardenafil). Alprastadil (Prostaglandin El) Papaverine Androgens Apomorphine
|
Pharmacology
| null |
[
"phenylephrine"
] | 157,698 |
9db63938-1189-4a10-ae4c-dd174e7c4421
|
Cornea veicillata is caused by
|
Erythromycin
|
Amiodarone
|
Timolol
|
Tetracycline
| 1b
|
single
|
Cornea veicillata: *This is a whorl-like opacity in the corneal epithelium seen in patients on long-term treatment with medication such as amiodarone, chloroquine, phenothiazines, and indomethacin. *It is also seen in patients with Fabry disease and its carrier state. *The condition is generally asymptomatic, harmless and reversible on stopping the drug. *The whorl-like pattern shows the direction of migration of corneal epithelial cells. *Occasionally the condition has been known to cause glare and surface discomfo which responds to topical lubricants. Cornea veicillata, also called voex keratopathy or whorl keratopathy, is a condition characterised by corneal deposits at the level of the basal epithelium forming a faint golden-brown whorl pattern. It is seen in Fabry disease or in case of prolonged amiodarone intake Ref- Parson's; 21st edition; Pg No. 214
|
Ophthalmology
|
Cornea and sclera
|
[
"amiodarone",
"erythromycin",
"tetracycline",
"timolol"
] | 157,712 |
455107f5-d693-46dd-bf09-493338fe89a9
|
ICT is raised due to:
|
Ketamine
|
Scoline
|
Halothane
|
Ether
| 0a
|
single
|
A i.e. Ketamine
|
Anaesthesia
| null |
[
"ketamine",
"halothane"
] | 157,717 |
bce76c72-b95f-4b28-9971-fed8e23e30e9
|
Which of the following is not an indication for oxytocin:
|
Spontaneous premature labour
|
Post partum haemorrhage
|
Uterine inertia
|
Breast engorgement due to inefficient milk ejection reflex
| 0a
|
single
|
Ans. (a) Spontaneous premature labour(Ref: KDT 8/e p356)Note: Spotaneous premature labour is an indication for use of tocolytics and not oxytocin.
|
Pharmacology
|
Endocrinology
|
[
"oxytocin"
] | 157,742 |
eea68d36-ee95-4331-a348-4426cb45673f
|
MDR tuberculosis is defined by :
|
Resistance to all first and second line anti-tubercular agents
|
Resistance to any three first line anti-tubercular agents
|
Resistance to all first line and any three classes of second line anti-tubercular agents
|
Resistance to isoniazid and rifampicin
| 3d
|
multi
| null |
Pharmacology
| null |
[
"isoniazid"
] | 157,747 |
a6c70db6-0106-48ab-bc1b-f28de02ecd73
|
Antipsychotic drug induced Parkinsonism is treated by –
|
Anticholinergics
|
Levodopa
|
Selegiline
|
Amantadine
| 0a
|
single
| null |
Pharmacology
| null |
[
"selegiline",
"amantadine",
"levodopa"
] | 157,762 |
545d1ceb-5d14-4b1d-9a20-ccb355cb8f34
|
Zero order kinetics occur in following drug with high doses :
|
Phenytoin and Propranolol
|
Digoxin and Propranolol
|
Amiloride and Probenecid
|
Lithium and Theophylline
| 0a
|
single
|
Ans. is 'a' i.e., Phenytoin and Propranolol
|
Pharmacology
| null |
[
"propranolol",
"theophylline",
"probenecid",
"phenytoin",
"digoxin"
] | 157,766 |
9f9905fb-335e-454c-89fc-48f0de3ef59c
|
DOC for rapid cycling MDP
|
Li
|
Valproate
|
Calcium Channel Blocker
|
All
| 1b
|
multi
|
B i.e. Valproate
|
Psychiatry
| null |
[
"valproate"
] | 157,774 |
8b42306c-b9a7-4f3a-9bbf-7e2e11f0ec8d
|
Which of the following antidepressants causes sedation and pain relief?
|
Venalafaxine
|
Desipramine
|
Amitriptyline
|
Imipramine
| 2c
|
single
|
Ans. c (Amitriptyline) (Ref. Harrison 18th/ p 74. Table 11-1; Table 371-3)Painful conditions that respond to tricyclic antidepressants# Postherpetic neuralgia# Diabetic neuropathy# Pension headache# Migraine headache# Rheumatoid arthritis# Chronic low back pain# Central post-stroke pain# CancerAntidepressantsClass/AgentsMechanismSide effects and CommentsTricyclic antidepressants (TCAs)(amitriptyline, Imipramine, nortriptyine desipramine)Block reuptake of NE and 5HT# Anticholinergic# Alpha blockage# Sedation# Seizure threshold# Overdose: triad ("3 Cs"): coma, convulsions# Drug interactions: do not mix with SSRIs and MAOIs: potentially fatalHeterocylics(amoxopine, bupropion, maprotiline trazodone, mirtazapine, nefazodone venlafaxine)Mechanism varies# Trazodone causes priapism, sedation# Amoxapine causes EPS (also dopamine receptor blocker)# Maprotiline, amoxapine, seizures, cardiotoxicity# Nefazodone, venlafaxine: P450 inhibitors# Bupropion used in smoking cessationSelective serotonin reuptake inhibitors (SSRIs) (fluoxetine, sertraline, citalopram, fluvoxamine, paroxetine)Block reuptake of 5HT# Anxiety, agitation, insomnia# Nausea# Sexual dysfunction# Serotonin syndrome (muscle rigidity, hyperthermia, myoclonus, ANS instability), seizures occurs with TCADs, MAOIs, meperidine, dextromethorphanMAO inhibitors (MAOIs)(phenelzine, tranylcypromine, isocarboxazid)Interferes with metabolism of NE and 5HT by blocking monoamine oxide (MAO) types A and B# Orthostatic hypotention, weight gain# Hypertensive crisis if patient consumes food with tyramine and other indirect-acting sympathomimetics# Serotonin syndrome when combined with SSRIs
|
Psychiatry
|
Pharmacotherapy In Psychiatry
|
[
"imipramine",
"amitriptyline",
"desipramine"
] | 157,783 |
6f8190ea-d729-4f6a-823d-50531bec16f9
|
A 78-year-old woman is treated for depression with nortriptyline. Which of the following is the most common side effect of nortriptyline?
|
impaired cardiac contractility
|
heart block
|
weight loss
|
anticholinergic side effects
| 3d
|
single
|
Antihistamine side effects (sedation) and anticholinergic side effects (dry mouth, constipation, urinary hesitancy, blurred vision) are the most common side effects. Orthostasis is probably the most common serious side effect and is difficult to manage. Severe cardiac toxicity is uncommon and diarrhea and weight loss are associated with SSRI antidepressants.
|
Medicine
|
Drugs
|
[
"nortriptyline"
] | 157,788 |
c258a0e1-016b-43f9-9678-0300a97192da
|
Drug not used in treatment of alcohol dependence: NIMHANS 08; PGI 09, 11; TN 08; AI 11; AIIMS 14
|
Diazepam
|
Disulfiram
|
Acamprosate
|
Naltrexone
| 0a
|
single
|
Ans. Diazepam
|
Forensic Medicine
| null |
[
"disulfiram",
"naltrexone",
"diazepam"
] | 157,791 |
9791e4b2-302c-4587-b412-18e27442049f
|
Directly acting cholinergic drug is/are:
|
Pilocarpine.
|
Bethanechol.
|
Methacholine.
|
All of the above.
| 3d
|
multi
|
Directly acting
Ach
Pilocarpine
Bethanechol
Methacholine
Carbachol
|
Pharmacology
| null |
[
"pilocarpine",
"bethanechol"
] | 157,793 |
31a711ad-32be-4cb2-b54b-2d55108a84ae
|
Dineshbhali Shah suffering from AIDS is on Zidovudine, lamivudine and Indnavir therapy. He develops pulmonary tuberculosis for which treatment is to be staed. Which of the following should be avoided in him?
|
Rifampicin
|
INH
|
Ethambutol
|
Pyrazinamide
| 0a
|
single
|
Ans. is 'a' i.e., Rifampicin Rifampicin induces metabolism of ritonavir, indinavir and saquinavir, thus it should not be used with these drugs. Rifabutin can be used.
|
Pharmacology
| null |
[
"lamivudine",
"ethambutol",
"zidovudine"
] | 157,809 |
0439be4e-4bed-41b2-b4eb-35af1199f0bf
|
A 32 week pregnant female presented with labor pain. She was given tocolytics. Which of the following is a tocolytic agent?
|
Prazocin
|
Ritodrine
|
Yohimbine
|
Propranolol
| 1b
|
single
|
Betamimetics include ritodrine, terbutaline, albuterol, fenoterol, hexoprenaline, isoxsuprine, metaproterenol, nylidrin, orciprenaline, and salbutamol, they have been used extensively as tocolytic agents. Ritodrine, isoxsuprine and terbutaline are the beta-2 receptor agonists most commonly used. Also know: Other agents used as tocolytic agents are calcium channel blockers, prostaglandin synthase inhibitors, magnesium sulfate, nitric oxide donor and oxytocin receptor antagonists. Ref: Management of High-Risk Pregnancy: A Practical Approach By S. S. Trivedi, Manju Puri, M.D., 2011, Page 81, 82; Danfoh's Obstetrics and Gynecology 10th Edition, Page 175-178.
|
Pharmacology
| null |
[
"yohimbine",
"propranolol"
] | 157,828 |
02c99c11-6830-43f9-acd5-61c03bd39081
|
The following statement is not true about the use of clonidine in treatment of hypeension
|
Reduction in Central sympathetic outflow
|
Increase in LDL cholesterol on prolonged use
|
Sedation and xerostomia are the common side effects
|
It can be combined with vasodilators
| 1b
|
multi
|
Clonidine is a selective alpha 2 agonist the acts by decreasing Central sympathetic outflow. Vasodilators can increase in reflex increase in renin release. This can be prevented by combining the vasodilators with clonidine or beta blockers. Sedation and dry mouth are the prominent adverse side effects of clonidine and Alpha methyldopa. These drugs LDL decrease and HDL increase cholesterol. Refer kDT 6/e p546
|
Pharmacology
|
Cardiovascular system
|
[
"clonidine"
] | 157,838 |
411bb9a5-b9cb-4ed9-956f-c658986d9cf7
|
Over expression of InhA gene can lead to cross resistance of Isoniazid with:
|
Rifampicin
|
Ethambutol
|
Ethionamide
|
PAS
| 2c
|
single
|
InhA gene overexpression can lead to cross resistance of Isoniazid with Ethionamide.
KatA gene mutation : Severe form of Isoniazid resistance.
|
Pharmacology
| null |
[
"ethambutol",
"isoniazid",
"ethionamide"
] | 157,839 |
6eaf44cc-a8e0-45f8-becc-537a09afe783
|
Aboion at 11 weeks of pregnancy can be done by: AP 10; Jharkhand 11; JIPMER 15; COMEDK 14
|
Suction evacuation
|
Hypeonic saline
|
Ethacrydine lactate
|
Oxytocin
| 0a
|
single
|
Ans. Suction evacuation
|
Forensic Medicine
| null |
[
"oxytocin"
] | 157,854 |
f89d835b-c621-4541-9af5-b242bd0435dc
|
K+ secretion from the loop of Henle is decreased by
|
Furosemide
|
Thiazide
|
Spironolactone
|
Acetazolamide
| 2c
|
single
|
Potassium-sparing diuretics act in the collecting tubule to inhibit Na+ reabsorption and K+ excretion. Spironolactone is a synthetic steroid that antagonizes aldosterone at intracellular cytoplasmic receptor sites. The spironolactone-receptor complex is inactive. That is, it prevents translocation of the receptor complex into the nucleus of the target cell and, therefore, it cannot bind to DNA. This results in a failure to produce proteins that are normally synthesized in response to aldosterone. These mediator proteins normally stimulate the Na+/K+-exchange sites of the collecting tubule. Thus, a lack of mediator proteins prevents Na+ reabsorption and, therefore, K+ and H+ secretion.Ref: Lippincott's Illustrated Reviews: Pharmacology, 5th edition, Page No: 286
|
Physiology
|
Renal physiology
|
[
"spironolactone",
"furosemide",
"acetazolamide"
] | 157,867 |
2fb46650-2f28-4e51-a904-e0f4c2a9dc64
|
Drug used to treat extrapyramidal syndrome due to phenothiazines:
|
Diphenhydramine
|
Benzhexol
|
Clonidine
|
Promethazine
| 1b
|
single
| null |
Pharmacology
| null |
[
"diphenhydramine",
"promethazine",
"clonidine"
] | 157,874 |
2f25272e-fad2-4c27-88b0-ad4dc9280b90
|
All of the following lower intracranial pressure except?
|
Mann itol
|
Furosemide
|
Coicosteroids
|
Hyperventilation
| 1b
|
multi
|
Ans is 'b' i.e. Furosemide
|
Surgery
| null |
[
"furosemide"
] | 157,876 |
54a8e50c-5b3f-4839-ba33-3cf36a9aed76
|
A 22 year old female, Neeta presented to you with complaints of headache and vomiting since 2 months. She is having amenorrhea but urine pregnancy test is negative. She also complained of secretion of milk from the breasts. A provisional diagnosis of hyper prolactinemia was made and MRI was suggested. MRI confirmed the presence of a large pituitary adenoma. Neeta was advised surgery, however, she is not willing to undergo surgery. Which of the following medications is most likely to be prescribed?
|
Sumatriptan
|
Bromocriptine
|
Ergotamine
|
Allopurinol
| 1b
|
multi
|
Ans. (B) Bromocriptine(Ref: KK Sharma 2/e p550, KDT 8/e p24)Bromocriptine is a D2 agonist and is useful in hyperprolactinemia by its action to inhibit the release of prolactin.
|
Pharmacology
|
Endocrinology
|
[
"allopurinol",
"bromocriptine",
"sumatriptan"
] | 157,878 |
cc4e2e37-6c85-4e1c-a63f-56c38733af34
|
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
|
Answer is option 1 - insulin. Presence of sugar & ketone bodies in urine and hyperglycemia suggests diabetic ketoacidosis. Treatment of choice for diabetic ketoacidosis is insulin Ref Harrison 17 /p2073
|
Medicine
|
Endocrinology
|
[
"glipizide",
"metformin"
] | 157,897 |
c81581d9-1d49-4eef-94e7-5996bd88102d
|
ATT most commonly implicated in causing peripheral neuropathy is:
|
Rifampicin
|
Pyrazinamide
|
INH
|
Ethambutol
| 2c
|
single
|
Isoniazid (lsonicotinic acid hydrazide, H) Isoniazid is the antitubercular drug parexcellence, and an essential component of all antitubercular regimens, unless the patient is not able to tolerate it or bacilli are resistant. lt is primarily tuberculocidal. Fast multiplying organisms are rapidly killed, but quiescent ones are only inhibited. It acts on extracellular as well as on intracellular TB (bacilli present within macrophages); is equally active in acidic and alkaline medium. It is one of the cheapest antitubercular drugs. However, most atypical mycobacteria are not inhibited by INH. The most plausible mechanism of action of INH is inhibition of synthesis of mycolic acids which are unique fatty acid component of mycobacterial cell wall. This may explain the high selectivity of INH for mycobacteria (it is not active against any other microorganism). The lipid content of mycobacteria exposed to INH is reduced. A gene labelled inh A which encodes for a fatty acid synthase enzyme is the target of INH action. Adverse effects INH is well tolerated by most patients. Peripheral neuritis and a variety of neurological manifestations (paresthesias, numbness, mental disturbances, rarely convulsions) are the most impoant dose-dependent toxic effects. These are due to interference with utilization of pyridoxine and its increased excretion in urine Pyridoxine given prophylactically (10 mg / day) prevents the neurotoxicity even with higher doses, but routine use is not mandatory. INH neurotoxicity is treated by pyridoxine lOO mg/day. Hepatitis, a major adverse effect of iNH, is rare in children, but more common in older people and in alcoholics. It is due to dose-related damage to liver cells and is reversible on stopping the drug. Other side effects are rashes, fever, acne and ahralgia. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:740,741
|
Pharmacology
|
Chemotherapy
|
[
"ethambutol"
] | 157,899 |
181fceea-d83f-4b3f-89ec-161a709c4b2f
|
A patient of Chronic Renal Failure with GFR <40 ml/min/m2 is now suffering from Pulmonary TB. Which of the following drug does not require a dose reduction ?
|
Ethambutol
|
Isoniazid
|
Rifampicin
|
Streptomycin
| 2c
|
single
|
Mnemonic : BILE EXCRETED ANTI-MICROBIAL AGENTS: CEF - CEFoperazone, CEFtriaxone R - Rifampacin E- Erythromycin N - Nafacillin A - Ampicilllin L - Lincosamides (Clindamycin) DISEASE - Doxycycline Rifampicin: Its metabolised by liver and excreted the bile.Therefore its dose need not be reduced in a patient with Chronic Renal Failure. Ethambutol and Streptomycin are mainly excreted through the kidney,so they require a dosage modification in Renal Failure.
|
Pharmacology
|
Mycobacterial Diseases (TB, Leprosy and MAC)
|
[
"ethambutol",
"isoniazid"
] | 157,906 |
8ecc8475-a04a-49fe-8919-f6b964ee9a95
|
T 1/2 of oxytocin is -
|
1 - 2 minutes
|
3 - 4 minutes
|
15-20 minutes
|
25 - 30 minutes
| 1b
|
single
|
Ans. is 'b' i.e., 3-4 minutes o Oxytocin has a half life of 3-4 minutes and duration of action of approximately 20 minutes.Oxytocino Oxytocin is a nonapeptide.o It is secreted by posterior pituitary along with vasopressin (ADH).o Both oxytocin and ADH are synthesized within the nerve cell bodies in supraoptic and paraventricular nuclei of hypothalamus; are transported down the axon and stored in the nerve endings within the neurohypophysiso They are stored in separate neurones as complexes with their specific binding proteins (Neurophysin). Its major actions are :1. Uterus# It increases the force and frequency of uterine contraction. Estrogens sensitize the uterus to oxytocin, while progestins decrease the sensitivity.# The increased contractility is restricted to the fundus and body, lower segment is not contracted, may even be relaxed at term.# Excessive uterine contraction prior to labor may cause fetal distress, placental abruption or uterine rupture.2. Breast# Oxytocin contracts myoepithelium of mammary alveoli and forces milk into bigger sinusuids - Milk ejection or milk letdown reflex.3. CVS# Higher doses cause vasodilation - Brief fall in BP., reflex tachycardia and flushing. The umblicle vessels are constricted oxytocin may help their clossure at birth.4. Kidney# Oxytocin in high doses exerts ADH like action - water retention can occur.o Oxytocin is used in -i) Induction of labourii) Uterine inertiaiii) Post-partum hemorrhageiv) Breast engorgementv) Oxytocin challenge test.
|
Gynaecology & Obstetrics
|
Induction of Labour
|
[
"oxytocin"
] | 157,953 |
3450b6c8-8bf0-4601-ad76-9533dbd1431e
|
The half-life of Digoxin is
|
24hours
|
40hours
|
48hours
|
60hours
| 1b
|
single
|
Digoxin is not extensively metabolized in humans; almost two-thirds is excreted unchanged by the kidneys. Its renal clearance is propoional to creatinine clearance, and the half-life is 36-40 hours in patients with normal renal functionReference: Katzung Pharmacology; 13th edition; Chapter 13; Drugs Used in Hea Failure
|
Pharmacology
|
Cardiovascular system
|
[
"digoxin"
] | 157,956 |
7835467c-e4c5-4c6d-88ee-4b438330d771
|
A patient is suffering from atherosclerosis, which of the following drug is most effective for the prevention of stroke in this patient
|
Warfarin
|
Heparin
|
Aspirin
|
Digoxin
| 2c
|
single
|
Antiplatelet drugs are used for the prophylaxis of arterial thrombotic conditions like stroke and MI.
Atrial fibrillation increases the risk of thromboembolism and can result in stroke
|
Pharmacology
| null |
[
"digoxin",
"warfarin"
] | 157,969 |
a7872ab4-2470-47e1-a673-1c5f6510db4d
|
True statement regarding neuraxial opioids for labor and delivery is
|
Opioids should never be used as a sole agent
|
Most common side effect is fetal bradycardia
|
Intrathecal morphine is associated with quick peak in concentration and early onset maternal respiratory depression
|
Systemic absorption is similar to intramuscular
| 3d
|
multi
|
Most common side effect of opioids is pruritis. Since epidural space contains extensive vascular plexus systemic absorption is similar to intramuscular injection.
|
Anaesthesia
| null |
[
"morphine"
] | 157,976 |
a45c1748-853b-4d32-a788-c709526e08c7
|
Mechanism of action of zileuton:
|
Inhibit prostaglandin synthesis
|
Inhibit COX
|
Inhibit LOX
|
Inhibit mast cells
| 2c
|
single
|
Ans. C. Inhibit LOXArachidonic acid is acted upon by two enzyme-COX and LOX. Lox converts it into leukotrienes and Cox into prostaglandin. Zileuton is the inhibitor of LOX enzyme and it is used in treatment of asthma.
|
Pharmacology
|
Prostaglandins
|
[
"zileuton"
] | 157,988 |
dcc8d435-9126-437c-ba9f-db3df94ff1c0
|
Which antidiabetic drug is used both for type I & H DM -
|
Sulphonylureas
|
Metformin
|
Acarbose
|
Pramlinitide
| 3d
|
multi
|
Ans. is 'd' i.e., Pramlinitide
|
Pharmacology
| null |
[
"metformin",
"acarbose"
] | 158,001 |
c5abc644-bdb8-4638-8e1a-d2ae336b2f41
|
Oral medication used in the treatment of scabies –
|
Albendazole
|
Metronidazole
|
Ketoconazole
|
Ivermectin
| 3d
|
single
|
Ivermectin is the only oral drug, available for scabies treatment.
|
Dental
| null |
[
"albendazole",
"metronidazole",
"ivermectin",
"ketoconazole"
] | 158,006 |
bb4d67e1-25a3-45ec-9f9b-5813dc028994
|
Which of the following drugs can cause "Churg Strauss syndrome"
|
Omalizumab
|
Theophylline
|
Montelukast
|
Zileuton
| 2c
|
single
|
Montelukast and Zafirlukast are leukotriene receptor antagonists used in bronchial asthma, which can lead to “Churg strauss syndrome” characterized by vasculitis and eosinophilia.
|
Pharmacology
| null |
[
"zileuton",
"theophylline",
"omalizumab",
"montelukast"
] | 158,009 |
4de05eb4-1f6a-4b6b-9bd0-1ec07fb42fcf
|
Which of the following is a plasma expander similar to the albumin, has a molecular weight of 30,000 and causes less hypersensitivity reactions but should be used with caution?
|
Hydroxy ethyl starch (HES)
|
Dextran
|
Polygeline
|
Polypyrrolidone
| 2c
|
single
|
Ans. c. Polygeline Polygeline is a plasma expander similar to the albumin, has a molecular weight of 30,000 and causes less hypersensitivity reactions but should be used with caution. Polygeline Polypeptide with average MW 30,000Q Exes oncotic pressure similar to albuminQ Not antigenic, hypersensitivity reactions are rareQ but should be watched for. Does not interfere with grouping and cross matching of bloodQ Remains stable for three years. It is not metabolized in the body; excreted slowly by the kidney. Expansion of plasma volume lasts for 12 hours. It is more expensive than dextran It can also be used for priming of hea-lung and dialysis machines
|
Pharmacology
| null |
[
"dextran"
] | 158,011 |
dfc85fb4-c9f8-42ed-91e2-dda042ea8414
|
β-blockers with intrinsic sympathomimetic properties a) Propranolol b) Oxprenolol c) Pindolol d) Esmolol e) Butoxamine
|
ab
|
ae
|
ad
|
bc
| 3d
|
single
| null |
Pharmacology
| null |
[
"propranolol",
"esmolol",
"pindolol"
] | 158,014 |
7999d060-9068-4ebe-919b-e8d382ddb69a
|
Drugs used in GTCS is/are: a) Ethosuximide b) Sodium–valproate c) Lamotrigine d) Propofol
|
bc
|
ab
|
ad
|
cd
| 0a
|
single
| null |
Pharmacology
| null |
[
"valproate",
"lamotrigine",
"propofol"
] | 158,019 |
e287f404-2aa4-4125-89e3-f9d200a3b8eb
|
Clomiphene citrate, apa from ovulation induction, can be tried for which of the following disorders?
|
Oligospermia
|
Erectile dysfunction
|
Asherman's syndrome
|
Carcinoma endometrium
| 0a
|
single
|
Clomiphene is thought to have effects on the hypothalamic axis which promotes gonadotropin release. Gonadotropin stimulates pituitary LH & FSH secretion which helps in testosterone production and hence in spermatogenesis. The drug is staed at a dose of 25mg daily dose to increase the FSH. Usually given for a period of 3 months, the spermatogenesis cycle length. This regime is an 'OFF-Label" use in practice since its not yet universally accepted. However, its a frequent therapy given prior to going in for more elaborate and expensive treatment by IVF.
|
Gynaecology & Obstetrics
|
Infeility (Eggs'plantation!)
|
[
"clomiphene"
] | 158,023 |
91924bd5-55f8-422a-a911-38cc955f8d70
|
Biotin is a coenzyme for:
|
Pyruvate dehydrogenase
|
Pyruvate carboxylase
|
PEP carboxylase
|
Glutamate pyruvate transaminase
| 1b
|
single
|
Ans. B. Pyruvate carboxylaseBiotin is required as a co-enzyme of carboxylation reactions. Pyruvate carboxylase converts pyruvate to oxaloacetate.
|
Biochemistry
|
Vitamins and Minerals
|
[
"biotin"
] | 158,031 |
eca1ffd6-046d-48e6-8cf2-72a3523729c7
|
Which of the cephalosporin is used in pseudomonas aeruginosa:?
|
Cefadroxil
|
Cefuroxime
|
Ceftazidime
|
Cefotaxime
| 2c
|
single
|
Ans. C. Ceftazidime4 and 5 generations of cephalosporins can be given for pseudomonas infection. Only ceftazidime and cefoperazone are the third generation drugs given as antipseudomonal agents.
|
Pharmacology
|
Anti Microbial
|
[
"cefotaxime",
"ceftazidime"
] | 158,049 |
f3d4aa07-91fd-43eb-a8c0-cac1b37543e1
|
Which of the following is a pro kinetic drug-
|
Domperidone
|
Cimetidine
|
Ondansetron
|
Hyoscine
| 0a
|
single
|
Ans. is 'a' i.e., Domperidone Gastrokinetk (prokinetic drugs)o These are the drugs which promote gastrointestinal transit and speed gastric emptying by enhancing coordinated propulsive motility.o Prokinetic drugs are - Metoclopramide, Domperidone, Cisapride, Mosapride, Tegaserod, renzapride, prucatopride.Pathophysiology of gastrokinetic drugs:o Acetylcholine is the major neurotransmitter in the GIT which is responsible for the peristaltic movement,o Its secretion is affected by other neurotransmitter also -1. Activation of prejunctional excitatory 5-HT, receptors increases the release of Ach.2. Activation of prejunctional inhibitory D2 and 5-HT. receptors inhibits the release of Ach.o So, prokinetic drugs can act by -1. 5HT4 agonistic activity2. D2 and 5-HT3 antagonistic activityo Both these action will increase the release of Ach and there by motility of GIT.
|
Pharmacology
|
Anti-Emetic
|
[
"cimetidine"
] | 158,057 |
2e7ea542-7266-4e5d-a747-9b60b7385357
|
Which of the following drugs have no role in opioid detoxification?
|
Naloxone
|
Methadone
|
Buprenorphine
|
Clonidine
| 0a
|
single
|
Naloxone is an opioid antagonist which is used in opiod toxicity. It has no role is opioid detoxification. Opioid detoxification DOC -methadone, buprenorphine, dextropropoxyphene (long acting opioids) - Clonidine / lofexidine can also be used NALOXONE is an opioid receptor antagonist and used in case of opioid overdose; NOT in OPOID DETOXIFICATION
|
Psychiatry
|
Substance Related and Addictive Disorders
|
[
"naloxone",
"methadone",
"clonidine"
] | 158,068 |
e719e1b7-70b0-4a29-9749-4de9c6aff3b2
|
Which of the following acts as cofactor after it&;s modification?
|
Vit-C
|
Pantothenic acid
|
Biotin
|
Zinc
| 1b
|
single
|
The functions of pantothenic acid are exeed through coenzyme A or CoA (A for acetylation). Coenzyme A is a central molecule involved in all the metabolisms (carbohydrate, lipid and protein). Coenzyme A may be regarded as a coenzyme of metabolic integration since acetyl CoA is a central molecule for a wide variety of biochemical reactions ref Satyanarayana 4th ed page 149
|
Biochemistry
|
vitamins
|
[
"biotin"
] | 158,077 |
294dd972-2170-43e9-84bf-7a5c153634a8
|
Which of the following is false about Hemolytic Anemias
|
Jaundice is the main clinical sign
|
Shortend red cell life span
|
Increased Recticulocyte count
|
Decreased erythropoietin levels
| 3d
|
multi
|
Elevated erythropoietin leves are seen in Hemolytic anemias.
|
Medicine
| null |
[
"erythropoietin"
] | 158,094 |
413c94d0-e4ad-46d9-a406-18ade6c244d1
|
All of the following are indications of Intravenous Iron Administration, except-
|
Intermittent Gastrointestinal blood loss
|
Iron malabsorption
|
Inability to Tolerate oral Iron
|
Patients on Erythropoietin Therapy
| 3d
|
multi
|
Ans. is D Patients on Erythropoietin Therapy o Intravenous iron therapy is indicated in excessive continuing blood loss whose level of continued bleeding usually gastrointestinal or menstrual exceeds the ability of the gastrointestinal tract to absorb iron. Indications for parenteral iron supplementation o Inability to tolerate oral iron o Excessive continuing blood loss o Inflammatory bowel disease o Chronic kidney disease o Cancer patients o Heart failure
|
Unknown
| null |
[
"erythropoietin"
] | 158,095 |
a9a04416-32c3-4966-8ef0-2ca5f7818126
|
Drug of choice for Absence attacks is
|
Phenytoin
|
Primidone
|
Ethosuximide
|
Phenobarbitone
| 2c
|
single
|
- DOC for Absent seizures: Typical - Ethosuximide Atypical & in India - Sodium valproate If nothing is mentioned in question then DOC is Ethosuximide Drug of choice for: Focal seizures : oxcarbamazepine and carbamazepine; Juvenile myoclonic epilepsy: valproate and lamotrigine; Lennox-Gastaut syndrome: clobazam, valproate, topiramate, lamotrigine, and, most recently, as add on, rufinamide Infantile spasms: adrenocoicotropic hormone (ACTH).
|
Pediatrics
|
Epilepsy
|
[
"primidone",
"phenytoin"
] | 158,098 |
d1f36008-8a32-4d9f-abd4-cf3e937c0463
|
All of the following agents are used for prophylaxis of migraine, Except:
|
Propanalol
|
Valproate
|
Topiramate
|
Ethosuxamide
| 3d
|
multi
|
Ethosuximide is not used in the prophylaxis of migraine. It is used only in the treatment of absence seizures. Betablockers, calcium channel blockers, TCA, valproate and topiramate are used in migraine prophylaxis. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 15; Current Management in Child Neurology By Bernard L Maria, Page 70, 71.
|
Pharmacology
| null |
[
"valproate",
"topiramate"
] | 158,102 |
118c2e6c-fec6-4b89-8c8d-e22b11fe4a01
|
A pregnant woman with the recent onset of urinary frequency, urgency and dysuria, and evidence of bacteriuria should be treated with
|
Ciprofloxacin
|
Norfloxacin
|
Trimethoprim-sulfamethoxazole
|
Cephalexin
| 3d
|
single
|
Tetracyclines may cause staining of fetal teeth when given during pregnancy. Trimethoprim-sulfamethoxazole may cause neonatal jaundice when administered late in pregnancy because sulfonamides may displace bilirubin from plasma proteins. Fluoroquinolones, such as ciprofloxacin and norfloxacin, are best avoided in pregnancy because of their potential to cause ahropathy in the fetus caused by damage to cailage. The 13-lactam antibiotics, including penicillin's such as ampicillin and various oral cephalosporin's, may be safely administered to pregnant women. First- or second-generation cephalosporins are usually preferred because of their antimicrobial spectrum..
|
Pharmacology
|
All India exam
|
[
"cephalexin",
"ciprofloxacin",
"trimethoprim"
] | 158,103 |
fcf694a3-36ab-43f7-8df5-89336fbed47d
|
Gynecomastia is an adverse effect of all of the following drugs except:
|
Spironolactone
|
Finasteride
|
Coisol
|
Cimetidine
| 2c
|
multi
|
ESSENTIAL of MEDICAL PHARMOCOLOGY SIXTH EDITION -KD TRIPATHI Page:298 Adverse effect of coisol: 1.Cushing habitus 2.Fragile skin, purple striae-typically on thighs and lower abdomen, easv bruising, telangiectasis, hirsutism. Cutaneous atro- phy occurs with topical use also. 3. Hyperglycaemia, may be glycosuria, preci- pitation of diabetes. -!. Muscular weakness: proximal (shoulder, arm, pelvis, thigh) myopathy occurs occa- sionally-withdraw coicoids. 5. Susceptibility to infection: this is nonspeci- fic; latent tuberculosis may flare; oppou- nistic infections with low grade pathogens (Candida, etc.). 6. Delayed healing: of wounds and surgical incisions. 7. Peptic ulceration: risk is doubled; bleeding and silent perforation of ulcers may occur. Dyspeptic symptoms are frequent with high dose therapy. 8. Osteoporosis: Specially involving veebrae and other flat spongy bones. Compression fractures of veebrae and spontaneous frac- ture of long bones can occur, especially in the elderly. Radiological evidence of osteo- porosis is an indication for withdrawal of coicoid therapy. Coicosteroid induced osteoporosis can be prevented/ arrested by calcium supplements + vit D, bisphospho- nates and by estrogen/ androgen replace- ment therapy in females I males respectively. Avascular necrosis of head of femur, humerous, or knee joint is an occasional abrupt onset complication of high dose coicosteroid therapy. 9. Posterior subcapsular cataract may deve- lop after several years of use, especially in children. 10. Glaucoma: may develop in susceptible individuals after prolonged topical therapy. 11. Growth retardation: in children occurs even with small doses if given for long periods. Large doses do inhibit GH secretion, but this may in addition be a direct cellular effect of coicoids. Sectic- 12. Foetal abnormalities: . Fragile skin, purple striae-typically on thighs and lower abdomen, easv bruising, telangiectasis, hirsutism. Cutaneous atro- phy occurs with topical use also. 3. Hyperglycaemia, may be glycosuria, preci- pitation of diabetes. -!. Muscular weakness: proximal (shoulder, arm, pelvis, thigh) myopathy occurs occa- sionally-withdraw coicoids. 5. Susceptibility to infection: this is nonspeci- fic; latent tuberculosis may flare; oppou- nistic infections with low grade pathogens (Candida, etc.). 6. Delayed healing: of wounds and surgical incisions. 7. Peptic ulceration: risk is doubled; bleeding and silent perforation of ulcers may occur. Dyspeptic symptoms are frequent with high dose therapy. 8. Osteoporosis: Specially involving veebrae and other flat spongy bones. Compression fractures of veebrae and spontaneous frac- ture of long bones can occur, especially in the elderly. Radiological evidence of osteo- porosis is an indication for withdrawal of coicoid therapy. Coicosteroid induced osteoporosis can be prevented/ arrested by calcium supplements + vit D, bisphospho- nates and by estrogen/ androgen replace- ment therapy in females I males respectively. Avascular necrosis of head of femur, humerous, or knee joint is an occasional abrupt onset complication of high dose coicosteroid therapy. 9. Posterior subcapsular cataract may deve- lop after several years of use, especially in children. 10. Glaucoma: may develop in susceptible individuals after prolonged topical therapy. 11. Growth retardation: in children occurs even with small doses if given for long periods. Large doses do inhibit GH secretion, but this may in addition be a direct cellular effect of coicoids. Sectic- 12. Foetal abnormalities 13.psychiastric disturbance etc
|
Pharmacology
|
Other topics and Adverse effects
|
[
"cimetidine",
"spironolactone"
] | 158,109 |
e9c54552-2cf1-4e1f-ae27-c3c54961c01c
|
Maximum histamine is released by
|
d Tubocurarine
|
Succinycholine
|
Pancronium
|
Gallamine
| 0a
|
multi
|
Tubocurarine is a toxic alkaloid historically known for its use as an arrow poison.
In the mid-1900s, it was used in conjunction with an anesthetic to provide skeletal muscle relaxation during surgery or mechanical ventilation.
|
Anaesthesia
| null |
[
"gallamine"
] | 158,113 |
c9a00c98-4133-427b-9ec6-631fe53fffc3
|
A case of 35 week pregnancy with Hydramnios and marked respiratory distress is best treated by:
|
Intravenous furosemide
|
Saline infusion
|
Amniocentesis
|
Aificial rupture of membranes
| 3d
|
single
|
For rapidly increasing hydramnios where the patient has acute respiratory distress and overall discomfo, management is done by decompressing the amniotic sac by amniocentesis, but this conservation is best done till 34 weeks. Beyond 34 weeks, when pulmonary maturity is achieved, then an induction of labour with a 'controlled' ARM would be a prudent step. it is done under controlled conditions as sudden decompression of the fetus leading to placental abruption.
|
Gynaecology & Obstetrics
|
Amniotic Fluid Dynamics
|
[
"furosemide"
] | 158,115 |
24acdf21-ff3d-4f67-be52-2f2050a09caa
|
Naltrexone is used in opioid dependence to:
|
Prevent respiratory depression
|
Treat withdrawal symptoms
|
Prevent relapse
|
Treatment of opioid overdose
| 2c
|
single
|
Naltrexone a long acting opioid antagonist competitively block the opioid receptor and blocks the effects of opioids. Regular dosing of naltrexone prevents patients from experiencing the effect of opioids thereby preventing relapse. Opioid antagonists are used in the treatment of opioid dependence in 3 ways: To reverse an opioid overdose To prevent relapse by blocking opioids from producing their effect at opioid receptors To identify those with opioid dependence by inducing withdrawal symptoms to provide evidence of opioid dependence. Ref: Cambridge Textbook of Effective Treatments in Psychiatry by Peter Tyrer, Page 386
|
Psychiatry
| null |
[
"naltrexone"
] | 158,125 |
942f038a-9851-40d2-b67a-a143237254a0
|
Among the following 5HT3 antagonist is ?
|
Cisapride
|
Ondansetron
|
Clozapine
|
Buspirone
| 1b
|
single
|
Ans. is 'b' i.e., Ondansetron o Stimulation of 5-HT3 receptor is responsible for vomiting induced by anticancer drugs. 5-HT3 receptor antagonists (ondansetron, granisetron and tropisetron) are DOCs for chemotherapy induced vomiting.
|
Pharmacology
| null |
[
"clozapine"
] | 158,132 |
320cc26c-1ec1-4cd6-a058-eeb2381acc25
|
True regarding acetazolamide is
|
Irreversible inhibitor of carbonic anhydrase
|
Structural resemblance to sulfonamides
|
It decrease so potassium excretion
|
It cause metabolic alkalosis
| 1b
|
multi
|
Acetazolamide is non-competitive but reversible inhibitor of carbonic anhydrase It is a sulfonamide derivative It causes hypokalemia and metabolic acidosis.
|
Pharmacology
|
Endocrinology
|
[
"acetazolamide"
] | 158,135 |
cbf87ced-f75b-4fa4-96b9-cd45af54cd36
|
All of the following are true about Clostridium perfringens, EXCEPT:
|
It is the commonest cause of gas gangrene
|
Serologic tests are not useful
|
The food poisoning spores of Clostridium perfringens are heat resistant
|
The major enzyme secreted is hyaluronidase
| 3d
|
multi
|
Clostridium perfringens causes approximately 80% of cases of gas gangrene. All types of C perfringens produce the alpha toxin, a necrotizing, hemolytic exotoxin that is a lecithinase. The spores of some C perfringens strains are often paicularly heat-resistant and can withstand temperatures of 100degC for an hour or more. Smears of tissue and exudate samples show large gram-positive rods. C. perfringens colonies exhibit a double zone of hemolysis on blood agar. Egg yolk agar is used to demonstrate the presence of the lecithinase. Serologic tests are not useful. Ref: Brooks G.F. (2013). Chapter 21. Infections Caused by Anaerobic Bacteria. In G.F. Brooks (Ed), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.
|
Microbiology
| null |
[
"hyaluronidase"
] | 158,172 |
865287aa-231a-409c-98fa-0bf4e8fd200e
|
Amino acid required for formation of thyroxine?
|
Tryptophan
|
Tyrosine
|
Glutamine
|
Cysteine
| 1b
|
single
|
Ans. is 'b i.e., Tyrosine The term thyroid hormone denotes both thyroxine (7'4) and triodothyronine (T3). Both T4 and T3 are iodine derivatives of thyronine. Thyronine is a condensation product of two molecules of amino acid tyrosine. Thyroxine is 3, 5, 3', 5' - tetraiodothyronine and T3 is 3, 5, 3 '-triiodothyronine. Thyroid hormones are synthesized and stored in the thyroid follicles as apa of thyroglobulin molecule.
|
Biochemistry
| null |
[
"thyroxine"
] | 158,173 |
2c518c8d-b58b-4384-b42e-a3a5244a0add
|
Which of the following drugs is hydrolyzed by a plasma esterase that is abnormally low in activity in about 1 in every 2500 humans?
|
Ethanol
|
Rifampicin
|
Cimetidine
|
Succinylcholine
| 3d
|
multi
|
* SCh is the shoest acting muscle relaxant due to its metabolism by pseudocholinesterase. * Some patients contain an atypical pseudocholinesterase (which has abnormally low activity) and are susceptible to develop apnea with the use of this drug.
|
Pharmacology
|
Anaesthesia
|
[
"cimetidine"
] | 158,193 |
7f0ad5c5-4546-4535-a6da-91cc111b64a5
|
Which beta blocker has anti oxidant property?
|
Celiprolol
|
Carvedilol
|
Betaxolol
|
Propanolol
| 1b
|
single
|
Ref: Goodman and Gillman, Pharmacological Basis of Therapeutics, 11th editionExplanation:"In addition to the classical non-subtype selective and hi-selective adrenergic receptor antagonists, there also are a series of drugs that possess vasodilators actions. These effects are produced through a variety of mechanisms including a l adrenergic receptor blockade flabetalol, carvedilol, bucindolol, bevantolol, nipradilol), increased production of NO (celiprolol, nebivolol, carteolol, bopindolol and nipradolol), b2-agonist properties (celiprolol, carteolol and bopindolol), Ca2+ entry blockade icarvedilol, betaxolol and bevantolol), opening of K+ channels (tilisolol), or antioxidant action (carvedilol). " Ref: Goodman and GillmanThird-Generation b Receptor Antagonists with Additional Cardiovascular ActionsNitric oxide productionb2 receptor agonisma1 receptor antagonismCa2+ entry blockadeK+ channel openingAntioxidantactivity* Celiprolol* Nebivolol* Carteolol* Bopindolol* Nipradilol* Celiprolol* Carteolol* Bopindolol* Carvedilol* Bucindotol* Bevantolol* Nipradilol* Labetalol* Carvedilol* Betaxolol* Bevantolol* Tilisolol* Carvedilol
|
Pharmacology
|
Anti-Hypertensive
|
[
"celiprolol",
"carvedilol"
] | 158,214 |
8d289468-6f8f-4a61-9600-45a4f685d2e5
|
Monday disease is seen with exposure to?
|
Verapamil
|
Nitroglycerine
|
Benzodiazepines
|
Propranolol
| 1b
|
single
|
MONDAY DISEASE: Workers in nitroglycerin (NTG) manufacturing facilities, can develop headaches and postural weakness initially. After constant exposure through the week they develop tolerance to the effects of NTG. Over the weekend, the workers lose the tolerance (Nitrate free interval), and when they are re-exposed on Monday, there is exaggerated vasodilation, which produces a tachycardia, dizziness, and a headache,
|
Pharmacology
|
Hypeension, Arrhythmias, Dyslipidemia
|
[
"propranolol",
"verapamil"
] | 158,244 |
c2daee74-e902-416f-aa6d-ed2074bc936e
|
Methotrexate resistance is due to:
|
Depletion of folate
|
Overproduction of DHFRase
|
Overproduction of thymidylate kinase
|
Decreased DHFRase
| 1b
|
single
|
Ans. (B) Overproduction of DHFRase(Ref: Goodman and Gilman, 11th/e p1336)Mechanisms of methotrexate resistanceImpaired transport of methotrexate into cellsProduction of altered forms of DHFR that have decreased affinity for the inhibitorIncreased concentrations of intracellular DHFR through gene amplification or altered gene regulationDecreased ability to synthesize methotrexate polyglutamatesIncreased expression of a drug efflux transporter, of the MRP (multidrug resistance protein) class.
|
Pharmacology
|
Chemotherapy: General Principles
|
[
"methotrexate"
] | 158,248 |
ac2100a7-e207-4865-90f8-fc78ea534a79
|
Dose of which of the following muscle relaxant has to be calculated on the basis of total body weight of an obese person rather than its ideal weight
|
Atracurium
|
Vecuronium
|
Pancuronium
|
Rocuronium
| 0a
|
single
|
Ans. a. Atracurium
|
Anaesthesia
| null |
[
"atracurium",
"vecuronium",
"rocuronium",
"pancuronium"
] | 158,257 |
667cea8d-f188-443b-8313-3a34e4713e0c
|
Drug possessing highest efficacy to increase plasma HDL is?
|
Ezetimibe
|
Nicotinic acid
|
Gemfibrosil
|
Rosuvastatin
| 1b
|
single
|
Ans. b (Nicotinic acid) (Ref. Harrison's medicine 17th ed., Table 350-6)Statins, fibrates, and bile acid sequestrants have modest effects (5-10%), and there is no effect on HDL cholesterol with ezetimibe or omega-3 fatty acids. Nicotinic acid is the only currently available drug with predictableHDL cholesterol-raising properties. Nicotinic acid effectively raises HDL and can be used in patients with diabetes,but high doses (>2 g/d) may worsen glycemic control and increase insulin resistance.MANAGEMENT OF LOW HDL-C# Severely reduced plasma levels of HDL-C (<20 mg/dL) accompanied by triglycerides <400 mg/dL usually indicate the presence of a genetic disorder, such as a mutation in apoA-I, LCAT deficiency, or Tangier disease.# HDL-C levels <20 mg/dL are common in the setting of severe hypertriglyceridemia, in which case the primary focus should be on the management of the triglycerides.# HDL-C levels <20 mg/dL also occur in individuals using anabolic steroids.# The presence of an isolated low plasma level of HDL-C in a patient with a borderline plasma level of LDL-C should prompt consideration of LDL-lowering drug therapy in high-risk individuals.# Statins increase plasma levels of HDL-C only modestly (~5-10%).# Fibrates also have only a modest effect on plasma HDL-C levels (increasing levels ~5-15%), except in patients with coexisting hypertriglyceridemia, where they can be more effective.# Niacin is the most effective available HDL-C-raising therapeutic agent and can be associated with increases in plasma HDL-C by up to -30%.Lipid-lowering agentsDrugEffect on LDL "Bad cholesterol"Effect on HDL "Good cholesterol"Effect on triglyceridesMechanisms of actionSide effects/ problemsHMG-CoA reductase inhibitors (lovastain, pravastatin, simvastain, atorvastain, rosuvastain)|||||Inhibit conversion of HMG-CoA to mevalonate, a cholesterol precursorHepatotoxicity (| LFTs), rhabdomyolysis (esp. when used with fibrates and niacin)Niacin (vitamin B3)|||||Inhibits lipolysis in adipose tissue; reduces hepatic VLDL synthesisRed, flushed face, which is | by aspirin or long-term use Hyperglycemia (acanthosis nigricans) Hyperuricemia (exacerbates gout)Bile acid resins (cholestyramine, dostipol, colesevelam)||Slightly |Slightly |Prevent intestinal reabsorption of bile acids; liver must use cholesterol to make morePatients hate it - tastes bad and causes GI discomfort, | absorption of fat-soluble vitamins Cholesterol gallstonesCholesterol absorption blockers (ezetimibe)||----Prevent cholesterol absorption at small intestine brush borderRare - LFTs, diarrheaFibrates (gemfibrozil, clofibrate, bezafibrate, fenofibrate)||||||Upregulate LPL - | TG clearance Activates PPAR-a to induce HDL synthesisMyositis (| risk with concurrent statins), hepatotoxicity (| LFTs), cholesterol gallstones (esp. with cone current bile acid resins)Educational point:NICOTINIC ACID (NIACIN)# Recently a receptor for nicotinic acid called GPR109A was discovered; it is expressed in adipocytes and, when activated, suppresses the release of NEFA by adipose.# Niacin reduces plasma triglyceride and LDL-C levels and raises the plasma concentration of HDL-C.# Niacin is also the only currently available lipid-lowering drug that significantly reduces plasma levels of Lp(a).# Niacin is a safe and effective lipid-lowering agent.Side-effects# The most frequent side effect of niacin is cutaneous flushing.# Mild elevations in transaminases occur in up to 15% of patients treated.# Niacin potentiates the effect of warfarin.# Acanthosis nigricans, a dark-colored coarse skin lesion, and maculopathy are infrequent side effects of niacin.Contraindications# Peptic ulcer disease# Precipitate gouty attacks.# Can raise fasting plasma glucose levels.
|
Pharmacology
|
Hypolipidemic
|
[
"ezetimibe",
"rosuvastatin"
] | 158,279 |
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