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fdf3001d-9751-4204-8819-d6a407c2fa23 | Disulfiram acts by | Inhibiting alcohol dehydrogenase | Inhibiting aldehyde dehydrogenase | Both 1 and 2 | None of the above | 1b
| multi | DISULFIRAM is a DETERRANT which acts by blocking acetaldehyde dehydrogenase When acetaldehyde dehydrogenase is blocked there will be increased amount of acetaldehyde that acts on mast cells and results in release of histamine that in turn leads to allergic reaction. Thus when a patient on disulfiram takes alcohol there would be allergic reaction that prevents the patient from using the substance Ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 624 | Psychiatry | Pharmacotherapy in psychiatry | [
"disulfiram"
] | 53,177 |
d7162adf-aef9-41cc-96f2-4a9a4fc0fa39 | Warfarin anticoagulants inhibits following coagulation factors | II, V, VII, IX | II, VII, IX, X | II, V, IX, X | II, IX, X, XIII | 1b
| single | Warfarin inhibits factor II, VII, IX and X. | Pharmacology | null | [
"warfarin"
] | 53,212 |
27eb6c2c-47d9-4c42-94f9-0f152bafb46a | All of the following are strategies to prevent contrast nephropathy, except: | Intravenous Hydration | Use of High Osmolar Contrast Agents | Theophylline administration | Hemodialysis | 1b
| multi | Answer is B (Use of High Osmolar Contrast Agents): Low Osmolar Contrast Media (LOCM) results in substantially less Contrast Induced Nephropathy (CIN) than High Osmolar Contrast Media (HOCM) in patients with preexisting renal dysfunction. The type of contrast medium used is an impoant risk factor for the development of contrast medium induced nephropathy with iso-osmolar contrast media (I0CM) and low-osmolar contrast media (LOCM) being less nephrotoxic than high-osmolar contrast agents in patients with pre-existing renal impairment. Therefore low-osmolar or iso-osmolar nonionic contrast media are recommended in high-risk patients to reduce the risk of contrast medium-induced nephropathy. Note: No benefit has been demonstrated in those without renal dysfunction. Although there is no proven decrease in CIN in normal populations, better tolerability and fewer side effects of LOCM have largely resulted in their supplanting HOCM in routine clinical practice. | Medicine | null | [
"theophylline"
] | 53,231 |
f9944fa8-7350-474a-a56e-25b239a51186 | Free water clearance decreased by ? | Vincristine | Vinblastine | Chlorpropamide | Furosemide | 3d
| single | Furosemide Free water clearance Kidney excretes some solutes in the urine daily. The volume of water in urine, excreted per unit time in excess of that required to excrete the contained solutes isoosmatically with plasma is called free water clearance. Free water clearance is positive dilute urine, negative when concentrated urine is passed and zero when isotonic urine is passed. For example, if 1 lit water is required to excrete the contained solutes per day following three conditions may occur (numerical value are just for example). - If urine output is 1.5 litre than free water clearance will be + (positive) *5 lit/day. - If urine output is 1 litre per day, the free water clearance will be zero. - If urine output is *5 litre per day, the free water clearance will be -- (negative) .5lit/day. Action of diuretics To understand the effect of different diuretics on free water clearance one should know the following facts. The nephron of the kidney is arranged in such a way that some poion of it lies in the coex and some poion of it lies in the medulla. - Pas of nephron in the coex - Proximal convoluted tubule Distal convoluted tubule Thick ascending limb of Henle's loop Coical collecting duct - Pas of nephron in the medulla -9 *Descending thin limb of Henle's loop Ascending thin limb of Henle's loop Medullary collecting duct The coical poion of the nephron are responsible for diluting the urine (i.e., positive free water clearance) The medullary poions of the nephron are responsible for concentrating the urine (i.e.. negative free water clearance) Thus the diuretics which act on both medulla and coex can affect both the positive and negative free water clearance where as diuretics which act on either coex or medulla cannot affect both the negative and positive free water clearance. Furosentide Furosemide is a drug which act on both coex and medulla. It acts on the ascending limb of loop of henle which has both coical and medullary component i.e. the thin ascending pa is situated in the coex and the thicker poion is situated in the medulla. Furosemide acts in the following ways: - In hypovolemia medullary pa of ascending limb concentrate the --) negative free water clearance urine to preserve water --> block negative free water clearance - Furosemide blocks the concentrating ability of the ascending limb pa of medullary pa - In volume overload, coical poion of ascending limb of henle --) positive free water clearance loop dilute the urine to decrease the volume overload - Furosemide blocks this diluting ability as well block positive free water clearance. Thus Furosemide can block positive as well as negative free water clearance. Thiazide diuretics act on DCT and proximal pa of CD, block positive free water clearance but has no effect on negative free water clearance. In hypervolumia DCT dilute the urine to decrease the volume overload -4 positive free water clearance --> blocked by thiazide. As thiazide diuretics no effect on medullary interstitium (in contrast to furosamide) so it does not effect the kidney's ability to concentrate urine during hypovolemia --4 no effect on negative free water. Two more options given in the question block free water clearance Vincristine Vincristine increases the secretion of the hormone A.D.H. Inreased A.D.H blocks free water clearance. Chlorpropamide Chlorpropamide sensitizes the kidney to ADH action. Thus it may impair the free water clearance and in some patients may result in hyponatremia and water intoxication. The impoant point to remember about chlorpropamide is that its action depends on small amount of ADH it won't act in the absence of ADH. Most probably the question should have been framed as "All of the following blocks free water clearance, except" But if you have to choose one answer, go for Furosemide as it will always block free water clearance whereas other drugs will cause them occasionally as their adverse effect. | Pharmacology | null | [
"vincristine",
"furosemide",
"chlorpropamide"
] | 53,238 |
2abb351f-1218-4ecf-828d-32fc3744e2ea | A 25 Year old female is 5 months pregnant and presents to her obstetrician along with her first child. She has not received any prenatal care. She thinks she has gained adequate weight and her pregnancy has been uncomplicated till date. Her past medical history is notable for hypertension for which she is currently taking enalapril.● She is 168 cms (5' 6") tall, weight is 59 kg, B/P = 120/84 mm of hg and fundal ht is 17 cms. Fetal movements are appreciated and FHR = 140/min.● Results of dipstick are negative.Which of the following tests should be preformed: | CVS | Grp B strepto coccal testing | Triple test | USG of fetal kidneys | 3d
| multi | ACE inhibitors are not recommended in pregnancy due to severe fetal malformations and neonatal renal failure, pulm onary hypolplasia and fetal death.So if a female has taken ACE inhibitors in pregnancy, all the above side effects should be ruled out and USG of fetal kidneys should be performed. | Gynaecology & Obstetrics | null | [
"enalapril"
] | 53,242 |
4f51c413-224b-4c5f-9929-2a6d04ddea89 | Peliosis hepatis is caused by all except | Analgesics | Anabolic steroids | OC pills | Danazol | 0a
| multi | Peliosis Hepatis Although sinusoidal dilatation can occur secondary to many liver diseases, peliosis hepatis is an uncommon condition of primary sinusoidal dilatation that results in blockage of blood outflow and may result in massive intraperitoneal haemorrhage. Although exact etiology is not known, peliosis hepatis and another related condition, bacillary angiomatosis (page 413), have been found to occur in HIV-infected patients whose CD4+ T cell counts fall below 100/ml. Oppounistic infection with Baonella henselae in poor hygienic conditions in these cases results in blood-filled cysts in liver paly lined by endothelial cells and having mixed inflammatory cells in a fibromyxoid background. Etiologic association of peliosis hepatis with consumption of anabolic steroids and oral contraceptives has also been suggested and is self-limiting with withdrawal of the offending agent. TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:605 | Pathology | G.I.T | [
"danazol"
] | 53,249 |
71f7c1b5-0298-490f-9180-2f62e8971a82 | Alpha I blocker without any effect on blood pressure is: | Tamsulosin | Prazosin | Doxazosin | Terazosin | 0a
| single | null | Pharmacology | null | [
"prazosin",
"terazosin",
"tamsulosin"
] | 53,254 |
0705f66f-a4ad-4447-a7e4-4c736f50dd41 | DOC for acute organophosphate poisoning is: | Neostigmine | Atropine | Pilocarpine | Tubocurarine | 1b
| single | Atropine
It is highly effective in counteracting the muscarinic symptoms, but higher doses are required to antagonize the central effects. It does not reverse peripheral muscular paralysis which is a nicotinic action.
All cases of anti-ChE (carbamate or organophosphate) poisoning must be promptly given atropine 2 mg i.v. repeated every 10 min till dryness of mouth or other signs of atropinization appear (upto 200 mg has been administered in a day). Continued treatment with maintenance doses may be required for 1- 2 weeks.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 122,123 | Pharmacology | null | [
"pilocarpine",
"atropine",
"neostigmine"
] | 53,256 |
476d0f96-fb39-45c2-a904-a32a09851ecb | Which set of hormones have nuclear receptor: | Estrogen, Thyroxin & Glucagon | Estrogen, Thyroxin & TSH | Estrogen, TSH & Gonadotropin releasing hormone (GnRH) | Retinoic acid, Thyroxin & Luteinizing hormone (LH) | 3d
| single | D i.e. Testosterone, coisol & Estogen (nearest answer)Nuclear receptors (Steroid receptors) that bind specific ligands (eg estrogen) & alter the rate at which specific genes are transcribed or translate. (Lehninger)Group I hormones eg retinoic acid, estrogen, vitamin D, glucocoicoids etc bind to nuclear receptor (Harper)Glucagon, TSH, GnRH &LH all bind to cell surface receptorsThe steroid hormones (estrogen, progesterone, and coisol for example), retinoic acid and thyroid hormones exe at least pa of their effects by a mechanism fundamentally different from that of other hormones: they act in neucleus to alter gene expression (Lehninger-456) | Physiology | null | [
"glucagon"
] | 53,277 |
f9d53aa0-dd3d-4b66-a9b1-0155070fdd04 | A 75-year-old male patient is accompanied by his wife.The patient's wife is concerned that since staing some new medications for his Parkinson's disease, he has staed acting differently. She repos that since staing the new medication he has staed gambling and making inappropriate sexual comments to the cleaning maid. Which medication is likely to be responsible for this new behaviour? | Levo+Carbidopa | Ropinirole | Bromocriptine | Entacapone | 1b
| single | The presentation of the patient is of disinhibition. Ropinirole is associated with impulse control disorder (pathological gambling and hypersexuality) Option A- (Levodopa + Carbidopa) given for management of Parkinson's disease. it is not associated with disinhibition. Option C- Bromocriptine -Cause Raynaud's phenomenon, doesn't cause any behavioral change. Option D-Entacapone is COMT inhibitor. S/E: mainly nausea, vomitting and dyskinesia | Medicine | Parkinsonism and other movement disorders | [
"carbidopa",
"bromocriptine",
"entacapone",
"ropinirole"
] | 53,282 |
45009073-5ed1-4f17-9ef9-16e909b4d3b2 | Streptococcus all are true except- | Streptodornase cleaves DNA | Streptolysis 0 is active in reduced state | Streptokinase is produced from serotype A,C,K | Pyrogenic toxin A is plasmid mediated | 3d
| multi | Ans. is 'd' i.e., Pyrogenic toxin A is plasmid mediated Three toxin types of streptococcal pyroexotoxin have been identified : A, B and C. Type A and C are coded for bacteriophage genes, while type B gene is chromosomal. Streptolysin '0' is oxygen labile; therefore, it is active in reduced state only Streptokinase is also known as fibrinolysin. It is expressed on all strains of streptococcus pyogenes (including A,C,K). It is expressed close to plasminogen binding site on the bacterial surface, it is activated to plasmin by streptokinase. Deoxyribonucleases (streptodornases) hydrolyze nucleic acids (e.g. DNA). | Microbiology | null | [
"streptokinase"
] | 53,287 |
b024fbe6-0148-426c-8b44-6774980c2cfb | Which drug is the most useful in treating an episode of antipsychotic induced acute dystonia: | Lorazepam | Haloperidol | Promethazine | Phenobarbitone | 2c
| single | null | Pharmacology | null | [
"lorazepam",
"promethazine"
] | 53,301 |
84a8795b-5275-4664-bd97-bfa3fade3970 | An elderly patient presents with hypeension and diabetes, proteinuria without renal failure. Antihypeensive of choice is: | Furosemide | Methyldopa | Enalapril | Propranolol | 2c
| single | Answer is C (Enalapril) ACE inhibitors (Enalapril) are the agents of choice for treatment of hypeension in diabetic patients with proteinuria. Indication Treatment of choice Hypeensive patient with protenuriae ACE inhibitors or Angiolensin Blocker Hypeensive patient with Diabetese ACE inhibitors or Angiotensin Blocker Hypeensive patient with diabetic NephropathvQ - ACE inhibitor or Angiotensin Blocker | Medicine | null | [
"propranolol",
"methyldopa",
"furosemide",
"enalapril"
] | 53,302 |
b723aa15-3196-475f-a0cd-ee768a2225db | A 60-year-old man is referred for evaluation of marked erythrocytosis and splenomegaly. Laboratory studies confirm an elevated red blood cell count and additionally demonstrate a moderate increase in circulating granulocytes and platelets. Oxygen saturation studies are normal, and isotopic studies reveal an increase in total red cell mass. Which of the following is characteristic of this disorder? | Frequent association with thrombosis or hemorrhagic phenomena | Increased erythropoietin concentration | Manifestation of Cushing syndrome | Most often secondary to hypoxia | 0a
| multi | The diagnosis is polycythemia vera (primary polycythemia), one of the myeloproliferative syndromes. The disorder is characterized by prominent erythrocytosis, moderate granulocytosis, and thrombocytosis. Because of hyperviscosity and sludging of blood, there is a frequent association with thrombosis or hemorrhagic phenomena. Marked splenomegaly and decreased erythropoietin are other classic characteristics. | Pathology | Myeloproliferative Disorders | [
"erythropoietin"
] | 53,313 |
6fc91fa1-b35a-483d-9ff1-0cd7eb442335 | Pharmacological closure of patent ductus aeriosus in a premature infant is by administration of ______________ | Aspirin | Estrogen | Ibuprofen | Prednisolone | 2c
| single | PDA treated with PG inhibitors. Ref : Ghai essential of pediatrics, eighth edition, p.no:417 | Pediatrics | C.V.S | [
"prednisolone",
"ibuprofen"
] | 53,320 |
964b8849-aa2d-49cd-8a87-40304a4e4cfa | A patient was on antiepileptics. Hirsutism, coarsening of facial features, gingival hyperophy is noted in the patient. The epileptic could be | Phenytoin | Valproic acid | Ethosuximide | Lamotrigine | 0a
| single | Long-term use of phenytoin is associated with untoward cosmetic effects (e.g., hirsutism, coarsening of facial features, gingival hyperophy) and effects on bone metabolism. Due to these side effects, phenytoin is often avoided in young patients who are likely to require the drug for many years.Ref: Harrison 19e 2552 | Medicine | C.N.S | [
"lamotrigine",
"phenytoin"
] | 53,326 |
f47111ad-3418-4b81-a880-54cd417946a9 | All of the following are m-tor inhibitors except: | Sirolimus | Everolimus | Tacrolimus | Temsirolimus | 2c
| multi | Tacrolimus & cyclosporine are calcineurin inhibitors. | Pharmacology | null | [
"tacrolimus"
] | 53,329 |
5dfeb0d3-ba62-4a49-a166-ef22ef97830b | Tissue schizontocide which prevents relapse of vivax malaria is : | Quinine | Primaquine | Pyrimethamine | Chloroquine | 1b
| single | null | Pharmacology | null | [
"quinine",
"chloroquine"
] | 53,334 |
f2e111d0-8ea5-4be2-910e-fcf12abb7d5b | Mechanism of action of theophylline in Bronchial asthma include all of the following Except - | Phosphodiesterase inhibition | Adenosine receptor antagonism | Increased histone deacetylation | Beta-2 receptor stimulation | 3d
| multi | Ans. is 'd' i.e., Beta-2 receptor stimulationo Pneumonia and CHF (Cardiopulmonary disease) require dose reduction (not increased dose).Theophyllineo Theophylline is one of the three naturally occurring methylated xanthine alkaloids (methyl xanthines) - Caffeine, theophylline and theobromine,o Mechanism of actiona) Inhibition of phosphodiesterase -| degradation of cAMP or cGMP|bronchodilatation - increased intracellular cAMP or cGMP.Blockade of adenosine receptorsRelease of Ca+2 from sarcoplasmic reticulum especially in skeletal and cardiac muscles.Recently it has been found that theophylline at low doses exert antiinflammatory action by activating a nuclear enzyme, histone deacetylase-2.Proposed mechanisms of action of theophyllineo Phosphodiesterase inhibition (Non selective)o Adenosine receptor antagonism (A1 A2)o Increased histone Deacetylase activity (|ed efficacy of corticosteroids)o Inhibition of intracellular calcium releaseo Stimulation of catecholamine releaseo Inhibition of NF - a B translocation into the nucleus (|nuclear translocation)o Mediator inhibition (Prostaglandins, TNF a) | Pharmacology | Asthma | [
"theophylline"
] | 53,338 |
ef591abc-5fce-4e71-aa72-cc301269d80b | A patient has subclinical folate deficiency. Which of the following drug cannot precipitate megaloblastic anemia in this patient? | Alcohol | Metformin | Proguanil | Chloroquine | 3d
| single | Megaloblastic anaemia can be caused by a deficiency of folic acid or vitamin B12. The drugs that can result in a deficiency of folic acid include:
B – B12 and folic acid deficiency
A – Alcohol
T – Trimethoprim
S – Sulfasalazine
M – Metformin
A – Antifolates (Methotrexate, pyrimethamine, proguanil)
N – N2O | Pharmacology | null | [
"metformin",
"chloroquine"
] | 53,340 |
8aefecd1-9e70-4fa7-bd4d-e49d57b6b74a | Drug of choice in an elderly with depression and coronary aery disease is - | Fluoxetine | Dothiepin | Mianserin | Amoxapine | 0a
| single | Ans. is 'a' i.e., Fluoxetine | Pharmacology | null | [
"fluoxetine",
"amoxapine"
] | 53,346 |
44f964a0-1a9a-427c-acee-f1e55ea3ac14 | Beta blockers which can be used in kidney dysfunction are all Except | Celiprolol | Propronolol | Betaxolol | Sotalol | 3d
| multi | Lipid soluble beta blockers like atenolol, sotalol and nadolol are excreted by the kidney, so contraindicated in renal dysfunctionRef: KD.Tripati 6th ed.pg 140 | Pharmacology | Cardiovascular system | [
"celiprolol"
] | 53,368 |
192b689b-61af-43f5-ba64-065f016c536d | A 6 month old child is suffering from patent ductus arteriosus (PDA) with congestive cardiac failure. Ligation of ductus arteriosus was decided for surgical management. The most appropriate inhalational anaesthetic agent of choice with minimal haemodynamic alteration for induction of anaesthesia is – | Sevoflurane | Isoflurane | Enflurane | Halothane | 0a
| single | Sevoflurane is the inducing agent of choice in children. | Anaesthesia | null | [
"isoflurane",
"enflurane",
"sevoflurane",
"halothane"
] | 53,369 |
78f0e0bc-0fa4-4965-a158-214984b32f74 | Hotspot in MI is seen in – | Th – 20 | Gallium | Pyrophosphate Tc 99 | Albumin | 2c
| multi | Pyrophosphate accumulates in the damaged myocardium and the area of infarct appears as hot spot. | Radiology | null | [
"gallium"
] | 53,378 |
07b4b656-24c1-4376-9e3f-c02e1a02f918 | A patient with glaucoma is being treated with systemic beta blocker. All of the following can be given to the patient except | Brimonidine | Dorzolamide | Levobunolol | Prostaglandin | 2c
| multi | Ans. c. Levobunolol Brimonidine, dorzolamide and prostaglandin are topical anti-glaucoma drugs. These drugs do not have systemic side effects, while levobunolol (beta-blocker) is systemic anti-glaucoma drug given orally, having systemic side effects. That is why in patients with glaucoma treated with systemic beta blockers, levobunolol may add on the side effects of beta-blockers, hence avoided in the above mentioned patient. Topical Anti-glaucoma Drugs Adrenergic agonist Non-selective: Epinephrine, Dipivefrine Alpha2-selective: Apraclonidine, Brimonidine Adrenergic antagonist Beta--blocker (Non-selective): Timolol, Levobunolol, Caeolol, Metipranolol, Adapralol Betal-blocker: Betaxolol Miotics (direct parasympatomimetics) Pilocarpine, Physostigmine Ecothiophate, Carbachol, Demacarium Prostaglandin analogues Latanoprost Carbonic anhydrase inhibitors Dorzolamide Systemic Antiglaucoma Drugs Carbonic anhydrase inhibitors Acetazolamide Dichlorphenamide Methazolamide Hyperosmotic agents Mannitol Glycerol | Pharmacology | null | [
"brimonidine",
"dorzolamide"
] | 53,384 |
71110ece-2b1e-45f5-b070-6f63153a3265 | Treatment of choice for prinzmetal's angina | Nitroglycerine | CCBs | P-blockers | Prazosin | 0a
| single | Ans. is 'a' i.e., Nitroglycerine Treatment of variant angina Prinzmetal's variant angina is due to spasm of coronary vessels. The drugs which dilate the coronary vessels, are the main treatment of Prinzmental's angina. Drugs are : Nitrates Calcium channel blockers (verapamil, diltiazem) Nitroglycerin is considered the drug of choice for the patient with variant angina. Prazosin a selective a-blocker may also be used because it prevents a mediated vasospasm. ii-blocker's are contraindicated because they cause constriction of coronary aery due to unopposed a mediated vasoconstriction. Prevention of variant angina In contrast Nitrates are not used for the prevention of variant angina because of delevelopment of tolerance. CCBs are the DOC for prevention. | Pharmacology | null | [
"prazosin"
] | 53,394 |
4d89d84a-a4fe-4232-8511-150ac4aa942c | True about midazolam as inducing agent | Increase in BP | Does not produce pain an IV injection | Increase cerebral Oxygen Consumption | Increase peripheral vascular resistance | 1b
| multi | Benzodiazepines display minimal left-ventricular depressant effects, even at general anesthetic doses, except when they are coadministered with opioids (these agents interact to produce myocardial depression and aerial hypotension). Benzodiazepines given alone decrease aerial blood pressure, cardiac output, and peripheral vascular resistance slightly, and sometimes increase hea rate. Benzodiazepines reduce cerebral oxygen consumption, cerebral blood flow, and intracranial pressure but not to the extent the barbiturates do. They are effective in controlling grand mal seizures. Sedative doses often produce anterograde amnesia. The mild muscle-relaxing propey of these drugs is mediated at the spinal cord level. The antianxiety, amnestic, and sedative effects seen at lower doses progress to stupor and unconsciousness at anesthetic doses. Compared with propofol or etomidate, induction with benzodiazepines is associated with a slower rate of loss of consciousness and a longer recovery. Benzodiazepines have no direct analgesic propeies. Intramuscular injections of diazepam are painful and unreliably absorbed. In contrast, midazolam and lorazepam are well absorbed after intramuscular injection, with peak levels achieved in 30 and 90 min, respectively. Ref: Morgan & Mikhail's clinical anesthesiology 6e | Anaesthesia | General anaesthesia | [
"midazolam"
] | 53,403 |
50f4c73a-78b1-4de2-a223-9a08da4712e2 | The antiepilectic drug which does not produce enzyme induction is | Phenobarbitone | Sodium valproate | Phenytoin sodium | Carbamazepine | 1b
| single | The four major enzyme-inducing AEDs (carbamazepine, phenytoin, phenobarbital and primidone) stimulate the metabolism and reduce the serum concentration of most other concurrently administered AEDs, most notably valproic acid , tiagabine , ethosuximide , lamotrigine , topiramate , REF : KD TRIPATHI 8TH ED. | Pharmacology | Central Nervous system | [
"valproate",
"carbamazepine",
"phenytoin"
] | 53,409 |
39186bcd-b445-427c-b55c-ce56ab089df2 | A 30 year old patient on digoxin therapy has developed digitalis toxicity. The plasma digoxin level is 4 ng/ml. Renal function is normal and the plasma t1/2 for digoxin in this patient is 1.6 days. How long should you withhold digoxin in order to reach a safer yet probably therapeutic level of 1 ng/ml? | 1.6 days | 2.4 days | 3.2 days | 4.8 days | 2c
| single | * We want to decrease the plasma concentration of digoxin from 4 ng/ml to 1 ng/ml. * It will take two half lives (From 4 ng/ml to 2 ng/ml in one half life and from 2 ng/ml to 1 ng/ml in second half life). * Thus time required will be 2 x t 1/2 i.e. 2 x 1.6 = 3.2 days. | Pharmacology | Pharmacokinetics | [
"digoxin"
] | 53,414 |
1283faf2-83b0-43e5-ab75-5f763735bb38 | pH and duration of Action of EDTA is | 7.2-7.3 and 15 min | 6.8-6.9 and 12 min | 7.2-7.3 and 12 min | 6.8-6.9 and 15 min | 0a
| single | null | Dental | null | [
"edta"
] | 53,425 |
42ae3640-8171-46b2-8726-4b223acf035f | Proctoscope is sterilised by: | Autoclave | Glutaraldehyde | Formalin | Soap | 1b
| single | Glutaraldehyde | Microbiology | null | [
"glutaraldehyde"
] | 53,428 |
8f3b9024-4d62-4411-81fb-c385aa5ad8a1 | Dantrolene is used in treatment of | Malignant hyperthermia | Neuroleptic malignant syndrome | Thyrotoxicosis-induced hyperthermia | All of the above | 3d
| multi | Ans. d (All of the above) (Ref. Harrison's Internal Medicine 17th edition, p. 121/ Tripathi, p. 347)DANTROLENE# It inhibits Ry R Ca++ channel receptors and thus prevents the release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle.# Uses:OrallyIVReduces spasticityMalignant hyperthermiaIn UML LesionsLeptic malignant syndromeMultiple sclerosisSerotonin syndromeCerebral palsyThyrotoxicosis-induced hyperthermia# Dose of Dantrolene for Hyperthermia - 1-2 mg/kg iv 6 hrly for 24-48 hrs.# Adverse effects:u Muscle weakness, # Diarrhea, # Hepatotoxicity.Neuroleptic malignant syndrome (NMS)-- a s/e of antipsychotic drugs; C/f-rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Treatment:dantrolene, D2 agonists (e.g., bromocriptine).Malignant hyperthermia-- rare, life-threatening hereditary condition in which inhaled anesthetics (except nitrous oxide) and succinylcholine induce fever and severe muscle contractions. Treatment: dantrolene.Also know: other S/e of inhalational anaesthetics: Hepatotoxicity (halothane), nephrotoxicity (methoxyfiurane), proconvuisant (enfturane), expansion of trapped gas in a body cavity (nitrous oxide).Educational Points:DiseaseKey featureHyperthermia-Hypothalamic set point not elevatedMalignant Hyperthermia -Halothane & SchSerotonin Syndrome -SSRI's and when MAO inhibitors or TCA are given | Medicine | Drugs | [
"dantrolene"
] | 53,438 |
31d47fc5-0e57-449e-8683-db03cfc15422 | Which of the following opioid is used by transdermal route in cases of malignancy associated pain - | Fentanyl | Morphine | Codeine | Oxycodone | 0a
| single | Ans. is 'a' i.e., Fentanyl o Fentanyl is opioid analgesic used via transdermal delivery systems in case of chronic pain. | Pharmacology | Anti-Neoplastic Agents | [
"morphine",
"oxycodone",
"fentanyl"
] | 53,443 |
aa7af4c6-7920-4bc4-a41f-a583b5c32667 | Which one of the following provides hemodynamic stability and prolongs survival in congestive hea failure | Lisinopril | Furosemide | Digoxin | Milrinone | 2c
| multi | There are two distinct goals of drug therapy in CHF:(a) Relief of congestive/low output symptoms and restoration of cardiac performance: Inotropic drugs--digoxin, dobutamine/ dopamine, amrinone/milrinone Diuretics--furosemide, thiazides Vasodilators--ACE inhibitors/AT1 antagonists, hydralazine, nitrate, nitroprussideb blocker--Metoprolol, bisoprolol, carvedilol (b) Arrest/reversal of disease progression and prolongation of survival:ACE inhibitors/AT1 antagonists (ARBs)b blockers Aldosterone antagonist--Spironolactone KD TRIPATHI ESSENTIALS OF MEDICAL PHARMACOLOGY 6TH EDITION : pg 519 | Pharmacology | Cardiovascular system | [
"lisinopril",
"digoxin",
"furosemide"
] | 53,444 |
ee7976f0-48fc-414e-b3e0-828e17cd0990 | Galactorrhea my be associated with the use of all the following drugs except - | Methyldopa | Tricyclic antidepressants | Pyridoxine | Phenothiazine | 2c
| multi | null | Medicine | null | [
"methyldopa"
] | 53,447 |
1b0aa160-5c5d-40c2-bffb-bb3d5bd6573c | Which of the following can be used in a patient with hepatic as well as renal failure? | Atracurium | Vecuronium | Pancuronium | Mivacurium | 0a
| single | Ans. a (Atracurium) (Ref. KDT 5th ed., 314)The unique feature of atracurium is inactivation in plasma by spontaneous nonenzymatic degradation (Hofmann elimination) in addition to that by cholinesterases. Consequently its duration of action is not altered in patients with hepatic/renal insufficiency or hypodynamic circulation. It is the preferred muscle relaxant for such patients as well as for neonates and the elderly. Hypotension may occur due to histamine release.Cisatracurium, R-Cis enantiomer of atracurium is nearly 4 times more potent, slower in onset, but similar in duration of action. Like atracurium it undergoes Hofmann elimination, but in contrast it is not hydrolysed by plasma cholinesterase. Most importantly, it does not provoke histamine release.Muscle Relaxants (MR)Causes histamine releaseVagolytic propertyContraindicated in renal failureDose to be reduced in Renal failureContraindicated in Biliary obstructioniiiiiD-tubocurarineDoxacuriumAtracuriumMivacuriumPancuroniumVecuroniumRocuroniumGallamineGallamineMetocurineVecuroniumD-tubocurarePancuroniumDoxacuriumVecuroniumRocuronium# Muscle relaxant of choice for rapid sequence intubation is Rocuronium. The rapid onset and intermediate duration of action makes this agent a potential replacement for succinylcholine in conditions where rapid tracheal intubation is indicated.# Vecuronium releases no histamine and has no cardiovascular action except it can cause tachycardia is individuals with hyperthyroid conditions who are sensitized to catecholamines.# Pancuronium does not release very much histamine and it has little effect on the cardiovascular system unless it is administered rapidly. If given rapidly it can increase blood pressure. | Anaesthesia | Muscle Relaxant | [
"atracurium",
"vecuronium",
"mivacurium",
"pancuronium"
] | 53,451 |
91a9f417-229b-4113-bca9-849254a90c4e | Which of the following is the management for postmenopausal women with osteoporosis: | Raloxifene | Tamoxifen | Bisphosphonates | Calcitonin | 2c
| single | DOC for osteoporosis is Bisphosphonates. It's mechanism of action is inhibition of osteoclast. Bisphosphonates are considered as first-line medication for reduction of fracture risk in post-menopausal women*. Calcitonin can also be used for osteoporosis& it acts by inhibiting osteoclast. Raloxifene and tamoxifen are selective estrogen- receptor modulators (SERMs) which is used to reduce the risk of breast cancer in high risk people and also used to prevent and treat osteoporosis in post-menopausal women. But it is less preferred than bisphosphonates. | Orthopaedics | FMGE 2017 | [
"raloxifene",
"tamoxifen"
] | 53,452 |
c58e365d-f4f2-4e12-8d4c-806e9624d3b9 | Which one of the following drugs causes hypomagnesemia by increased excretion? | Frusemide therapy | Cisplatin | Digitalis | Aminoglycosides | 0a
| single | Ans. is 'a' i.e., Frusemide therapy "Loop diuretics cause the abolition of transepithelial potential difference that results in marked increase in excretion of Ca2++ and Mg2++".Loop and thiazide diuretics cause significant urinary loss of magnesium.Magnesium deficiency brought about by diuretics is rarely severe enough to induce the classic picture of neuromuscular irritability. | Pharmacology | Adverse Drug Effect | [
"cisplatin"
] | 53,458 |
3d8ff258-a708-4cc4-80ee-75d9e2cfce3a | A 54–year old obese patient with type 2 diabetes mellitus and a history of alcoholism probably should not receive metformin because it can increase the risk of: | Disulfiram like reaction | Hypoglycemia | Lactic acidosis | Severe hepatic toxicity | 2c
| single | null | Pharmacology | null | [
"disulfiram",
"metformin"
] | 53,461 |
e51341eb-fcfc-4491-9384-34353f08d6f8 | True about Acetazolamide is ? | Decreased GFR | Action similar to sulphonamide | It decreases Na, K, Glucose excretion | It causes metabolic alkalosi | 0a
| multi | Ans. is 'a' i.e., Decreased GFR o Acetazolamide decreases GFR. o Carbonic anhydrase inhibitors increase delivery of solutes to the macula densa by inhibiting proximal reabsorption. o This results in activation of TGF (tubulo-glomerular feedback mechanism), causing increased afferent aeriolar resistance and reduces renal blood flow (RBF) and glomerular filtration rate (GFR). About option 'b' o Dont get confused with option b, with answer of previous question. o Acetazolamide has structural resemblance to sulfonamide, but mechanism of action is different. Acetazolamide acts as diuretic by inhibiting carbonic anhydrase, whereas sulfonamides are primarily antimicrobials and act by inhibiting bacterial folate synthesis. | Pharmacology | null | [
"acetazolamide"
] | 53,488 |
2e8604a3-dd60-45e9-afdf-f858e834c6e3 | An obese patient presented in casualty in an unconscious state. His blood sugar measured 400 mg%, urine tested positive for sugar and ketones; drug most useful in management is: | Glibenclamide | Troglitazone | Insulin | Chlorpropamide | 2c
| single | Answer is C (Insulin) : 'Diabetic ketoacidosis cannot be reveed without insulin' - Harrison The patient in the above question is a definite case of diabetic Ketoacidosis, as suggested by increased blood sugar (Diabetes) and presence of sugar & ketones in urine (ketoacidosis) in an obese (type I) diabetic. Diabetic ketoacidosis cannot be reveed without insulin Remember: Apa from diabetes the only other common ketoacidotic state is alcoholic ketoacidosis. Alcoholic ketoacidosis is invariably associated with hypoglycemia. A plasma glucose estimation usually is required to delineate such patients. Most patients have a plasma glucose, levels of less than 150 mg/dl. Hyperglycemia may occur but is usually mild, & rarely if ever exceeds 300 mg/dl. It is impoant to know this distinction as, in contrast to diabetic acidosis this syndrome is rapidly reversed by the intravenous administration of glucose. | Medicine | null | [
"chlorpropamide"
] | 53,509 |
93079bf9-dc49-4a70-bfc3-f72d5464dd51 | A patient was on treatment with trifluoperazine for some time. He presents with a complaint of hyperthermia, lethargy and sweating. Needed investigations are - | CT Scan brain & hemogram | Hemogram, Electrolyte level and creatinine | ECG, Chest X-ray and hemogram | Hemogram, CPK and renal function test | 3d
| single | Hyperthermia, lethargy and sweating in a patient on antipsychotic (trifluoperazine) suggest the diagnosis of the neuroleptic malignant syndrome.
The rigidity and hyperthermia found in neuroleptic malignant syndrome contribute to muscle damage and necrosis. This can cause:-
Elevated serum creatine kinase (CK) → Serum CK level should be assessed. Assessment of elevated CK level is the most commonly used laboratory investigation for the neuroleptic malignant syndrome.
Elevated blood myoglobin (myoglobinemia) and myoglobinuria which can cause renal failure → renal function test should be done.
Leucocytosis & thrombocytosis → Hemogram should be evaluated. | Psychiatry | null | [
"trifluoperazine"
] | 53,520 |
aa2a0ec7-1390-4881-9cdf-89f780b277f2 | Peripheral neuritis is a complication of | Isoniazid | Ethambutol | Rifampicin | Pyrazinamide | 0a
| single | null | Pharmacology | null | [
"ethambutol",
"isoniazid"
] | 53,530 |
8ff053b9-d11b-44ae-9571-fb0b19f7a263 | Treatment of choice in the cutaneous complication of porphyria is : | I. V dextrose | I. V Haematin | Beta carotene | Calamine | 2c
| single | C. i.e. B carotene | Skin | null | [
"calamine"
] | 53,547 |
0a5da701-a463-47c4-b063-0aac76ec5e5b | A patient lalita present with dry mouth, pupillary dilation and warm skin, the likely drug toxicity is | Organo-phosphorus | Carbamazepine | Lithium | Amytriptyline | 3d
| single | Ans. is 'd' i.e. Amitriptyline Most Tricyclic antidepressants (Imipramine, Amitriptyline) are potent anticholinergics.The symptoms shown by patient are because of anticholinergic effect of Amitriptyline. | Forensic Medicine | Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques | [
"carbamazepine"
] | 53,552 |
a5d8dfaf-a335-4fb4-ad96-a5dad9ec2ae6 | The best drug for control of esophageal bleeding is? | Vasopressin | Octreotide | GnRH | Propranolol | 0a
| single | Ans. is 'a' i.e., Vasopressin Terlipressin (analogue of vesopressin) is considered the vasoactive agent of choice for acute variceal bleeding. Other drugs used are somatostatin and its analog octeride. | Pharmacology | null | [
"propranolol",
"vasopressin",
"octreotide"
] | 53,557 |
9f7c6a24-cada-46f6-a0c7-e2142ffaf355 | Methotrexate is used in all of the follow ing except: | Sickle cell anemia | Psoriasis | Rheumatoid arthritis | Ankylosing spondylitis | 0a
| multi | Ans. a. Sickle cell anemia (Ref: Katzung l1/e p631-632; KDT 7/e p210, 863, 882, 6/e p203, 841]Methotrexate is not used in sickle cell anemia."Methotrexate is now considered the first line DMA RD agent for most patients with Rheumatoid arthritis. The anti- inflammatory effect of methotrexate in rheumatoid arthritis appears to be related at least in part to interruption of adenosine and possible effect on TNF pathways."Which DMARD should be the drag of first choice remains controversial and trials have failed to demonstrate a consistent advantage ofone over the other? Despite this, methotrexate has emerged as the DMARD of choice especially in individuals with risk factors for the development of bone erosions or persistent synovitis of >3 months duration because of its relatively rapidity of actiont its capacity to effect sustained improvement with ongoing therapy and the higher level of patient retention on therapy""Methotrexate is a folate antagonist, it causes reduction in cells reproductive abilities. Methotrexate affects cells, which divides quickly. In psoriasis cells divide more than usual. Methotrexate binds to these cells and inhibits enzymes involved in rapid growth of skin cells. It is commonly used to stop the progression ofpsoriatic arthritis and less commonly used in the treatment of severe psoriasis with no arthritis component Methotrexate is an effective antipsoriasis agent. It is especially useful in acute generalized pustular psoriasis, psoriatic erythroderma, psoriatic arthritis and extensive chronic plaque psoriasis.Methotrexate although widely used has not been shown benefit in ankylosing spondylitis. There is not enough evidence to be certain of the benefit and harms of methotrexatefor ankylosing spondylitis amhnore research is needed. In ankylosing spondylitis the use of methotrexate is not recommended for the axial manifestations. The drug may have some efficacy- in the peripheral involvement. For this disease there is lack of clinical trials and most of the trials did not show efficacy on the axial symptoms of the disease. | Pharmacology | Anti-Neoplastic Agents | [
"methotrexate"
] | 53,564 |
86f8d454-d949-4f8d-8d26-3eabcfeaa624 | Drug of choice in scabies | Permethrin | Ivermectin | Albendazole | Flucanazole | 0a
| single | (A) Permethrin # Creams and lotions for Scabies:> Two most widely used treatments for scabies are permethrin cream and malathion lotion. Permethrin is usually recommended first, and malathion lotion is used if the permethrin cream proves ineffective.> Both medications contain insecticides that kill the scabies mite. | Skin | Miscellaneous | [
"ivermectin",
"albendazole"
] | 53,589 |
9dd8a668-2d89-4f2a-8467-ae1d03d0733d | A child presents with bladder exstrophy and chronic renal failure. The muscle relaxant of choice to be used during surgery of exstrophy in this child is | Pancuronium | Rocuronium | Mivacurium | Atracurium | 3d
| single | Atracurium:- A bisquaternary competitive blocker and shoer acting: reversal is mostly not required. The unique feature of atracurium is inactivation in plasma by spontaneous non- enzymatic degradation (Hofmann elimination) in addition to that by cholinesterases. Consequently its duration of action is not altered in patients with hepatic/renal insufficiency or hypodynamic circulation. It is the preferred muscle relaxant for liver/kidney disease patients as well as for neonates and the elderly. Hypotension may occur due to dose dependent histamine release. Ref:- kd tripathi; pg num:-353,354 | Pharmacology | Anesthesia | [
"atracurium",
"mivacurium",
"rocuronium",
"pancuronium"
] | 53,595 |
b18f2aaf-d6f1-45cf-8607-a50f0ec71782 | A patient of closed angle Glaucoma the treatment of choice in other eye is | Acetolazimide | Laser iridotomy | Pilocarpine | Timolol eye drop | 1b
| single | B i.e. Laser iridotomy | Ophthalmology | null | [
"pilocarpine",
"timolol"
] | 53,600 |
eeb40d3c-05c2-4f72-bd64-1f6dde3b4c17 | Which of the following statement about phenytoin is true ? | It follows zero order kinetics | It is not teratogenic | It is excreted unchanged in urine | It does not induce microsomal enzymes | 0a
| multi | null | Pharmacology | null | [
"phenytoin"
] | 53,606 |
07f3ac1f-dc4a-4cc9-ba96-f23e24c9a18b | Visual field monitoring is impoant before staing? | Vigabatrin | Topiramate | Valproic acid | Carbamazepine | 0a
| single | Ans. is 'a' i.e., Vigabatrin o Vigabatrin is an irreversible inhibitor of GABA transaminase, thus increases GABAergic activity. It is the DOC for infantile spasms (previously ACTH was DOC). It can result in irreversible visual field defects due to retinal atrophy. Therefore visual field monitoring is impoant. | Pharmacology | null | [
"topiramate",
"carbamazepine",
"vigabatrin"
] | 53,632 |
08bbb20f-251e-44c5-a4bf-be4d500aea96 | Hunter syndrome is due to deficiency of - | Beta galactosidase | Sphingomyelinase | Iduronate Sulfatase | Hyaluronidase | 2c
| single | Ans. is 'c' i.e., Induronate Sulfatase DiseaseDeficiencyInheritanceGM1 gangliosidosesBeta galactosidaseARMucopolySaccharidosesMPS I-Hurler syndromea-L-iduronidaseARMPS II-Hunter syndromeIduronate sulfataseXRMPS IIISanfilippo syndrome AHeparan sulfamidaseARSanfilippo syndrome BN-acetylglucosaminidaseSanfilippo syndrome CAcetyl-CoA: alphaglucosaminide acetyltransferaseSanfilippo syndrome DN-acetylglucosamine-6-sulfataseMPS IVMorquio syndrome AGalactose-6-sulfate sulfataseARMorquio syndrome BBeta-galactosidaseMPS VI - Maroteaux-Lamy syndromeN-acetylgalactosamine-4-sulfataseARMPS VII - Sly syndromeb-glucuronidaseARMPS IX - Natowicz syndromeHyaluronidaseAR | Biochemistry | Phospholipids, Glycolipids and their disorders | [
"hyaluronidase"
] | 53,633 |
294a6fe8-9b4f-417e-a8fb-317d2ff142db | All of the following can cause visual adverse effects except : | Ethambutol | Rifampicin | Chloroquine | Digoxin | 1b
| multi | null | Pharmacology | null | [
"ethambutol",
"digoxin",
"chloroquine"
] | 53,649 |
0809a016-3711-4e41-9c55-b61782af7846 | Probenecid interacts with ? | Streptomycin | Ampicillin | Vancomycin | Erythromycin | 1b
| single | Ans. is 'b' i.e., Ampicillin Interactions of probenecid Probenecid inhibits urinary excretion of penicillins, cephalosporins, methotrexate, sulfonamides and indomethacin. It inhibits biliary excretion of rifampicin. Salicylates block uricosuric action of probenecid. Probenecid inhibits tubular secretion of nitrofurantoin. Pyrazinamide and ethambutol may interfere with uricosuric action of probenecid. Note : Ampicillin is a penicillin. | Pharmacology | null | [
"vancomycin",
"probenecid",
"erythromycin",
"ampicillin"
] | 53,665 |
5cdd3443-7467-4079-88bb-e92909b263e2 | Hepatitis with cholestatic jaundice occurs most frequently as an adverse reaction to the following preparation of erythromycin : | Erythromycin base | Erythromycin stearate | Erythromycin estolate | Erythromycin ethyl succinate | 2c
| single | null | Pharmacology | null | [
"erythromycin"
] | 53,669 |
1380495f-1e06-4c12-a350-cb4c0571ef7a | Derivative of morphine used for diarrhea is: | Oxymorphine | Diphenoxylate | Pethidine | Codeine | 1b
| single | null | Pharmacology | null | [
"morphine",
"pethidine"
] | 53,676 |
b4d10457-cb1d-4a9d-a17b-e55f3da1d16c | A 2-year-old child has a fever, stiff neck, and is irritable. Gram stain smear of spinal fluid reveals gram-negative, small pleomorphic coccobacillary organisms. What is the most appropriate procedure to follow in order to reach an etiological diagnosis? | Culture the spinal fluid in chocolate agar, and identify the organism by growth factors | Culture the spinal fluid in mannitol-salt agar | Perform a catalase test of the isolated organism | Perform a coagulase test with the isolate | 0a
| multi | Meningitis caused by H. influenzae cannot be distinguished on clinical grounds from that caused by pneumococci or meningococci. The symptoms described are typical for all three organisms. H. influenzae is a small, gram-negative rod with a polysaccharide capsule. It is able to grow on laboratory media if two factors are added. Heme (factor X) and NAD (factor V) provide for energy production. Use of the conjugate vaccine (type b polysaccharide) reduces the disease incidence more than 90%. Pneumococci are gram-positive diplococci, and meningococci are gram-negative diplococci, which grow on blood agar and chocolate agar with no X and V factors needed, respectively. Salt-mannitol agar is used to distinguish S. aureus from other oral flora. Streptococci do not produce catalase while many other organisms do. Coagulase production is another test to identify S. aureus. Commercial kits are available for immunologic detection of H. influenzae antigens in spinal fluids, but currently none are available to measure specific antibody in CSF. | Microbiology | Bacteria | [
"mannitol"
] | 53,682 |
940bb138-a015-4c5e-a76e-4ea9363b0376 | All of the following therapies may be required in a 1–hour-old infant with severe birth asphyxia except – | Glucose | Dexamethasone | Calcium gluconate | Normal saline | 1b
| multi | Corticosteroids should not be used' - Paediatrics for doctors - Frankshann & John Vince
Management Protocol
The management protocol of babies with asphyxia :
Oxygen. In the absence of continuous oxygen saturation monitoring, it is reasonable to give nasopharyngeal oxygen (0.5 litre/min) until the baby recovers. If monitoring is available, oxygen is given as appropriate.
Thermal control. Baby's body temperature should be kept in the normal range of 36.5-37.2°C (sometimes the babies become hyperpyrexic).
Correction of shock, If peripheral perfusion is poor, it is reasonable to give 20 ml/kg of normal saline initially. If perfusion remains poor, the use of dopamine should be considered.
Fluid balance. Give IV fluids at 2/3 maintenance. Use 10% dextrose.
Monitor blood glucose with dextrostix and do not let it fall below 2.2 mmol (explains glucose administration)
Prevent/control convulsions. In less severely affected babies, phenobarbitone should be given when there is anyuspicion of actual or impending convulsions (phenobarbitone loading dose 20 mg/kg IM or 10mg/kg slowly IV, then 5 mg/kg daily orally).
Treat hvpocalcaemia if it occurs (or more practically, if the baby has uncontrollable fitting with anormal dextrostix).
(explains calcium gluconate administration)
Notes:
Corticosteroids should not be used, and although many paediatricians use mannitol, there is no evidence for its effectiveness.
Babies with severe asphyxia may appear to settle relatively quickly after the resuscitation - but there is likely to be a deterioration after 6-12 hours or so as cerebral oedema develops. | Pediatrics | null | [
"dexamethasone"
] | 53,687 |
cbbfc0d2-9bee-481e-b2a6-9551ce3f77ad | Mydriatic used in 3 years old child for refraction is – | 1% Atropine drops | 1% Atropine ointment | 1% Homatropine drops | 1% Tropicamide drops | 1b
| single | Atropine 1% ointment → < 5 years of age
Homatropine 2% drop → 5 - 20 years
Cyclopentolate 1% drop → 5- 20 years
Tropicamide 5%,10% drop → 5- 20 years | Ophthalmology | null | [
"atropine",
"tropicamide"
] | 53,688 |
a5ed3b30-49a5-426c-847b-a599f095db12 | A 35-year-old alcoholic has presented with 2 episodes of hematemesis. On examination his pulse rate is 100/min with BP of 90/60 mm Hg. Per abdomen examination shows spleen palpable 3 cm below costal margin. Which is true about this patient? | Elevated CRP and Low C3 | Most common site of bleeding is First part of duodenum | Urgent Elective intubation of patient | The increased portal vein pressure should be lowered with octreotide | 3d
| multi | Ans. D The increased pressure of portal vein pressure should be lowered with octreotideRef: CMDT2019 pg. 627* The presence of splenomegaly with hematemesis points to etiology of portal hypertension. Hence after stabilization of patients with fluids, octreotide should be started to lower the pressure in portal vein.* The leading cause of hematemesis is peptic ulcer disease but this patient is having portal hypertension leading to vomiting of blood. | Physiology | Heart, Circulation, and Blood | [
"octreotide"
] | 53,703 |
39f693c4-feca-42b0-a575-2ac99bea6a86 | Propofol causes pain on injection. True is all except | It is kallikerein pathway mediated | It is due to 1-2% egg lecithin component as it causes crystalization in the veins | Can be reduced by adding 1% lignocaine in the syringe | Use of larger veins decreases the incidence | 1b
| multi | All phenols irritate skin and mucous membrane. Thus, propofol being an alkylphenol is expected to cause pain in spite of the fact that it is almost isotonic. Pain on propofol injection has also been described as angialgia by some meaning that the pain is due to vascular involvement. Pain on propofol injectionis immediate as well as delayed after 10-20 s. The immediate pain is due to irritation of vein endothelium whereas delayed pain is due to the release of mediators such a kininogen from kinin cascade. | Anaesthesia | Intravenous Anesthetic Agents | [
"propofol"
] | 53,707 |
191cb5a9-8542-4056-9df2-fcc3a42be2ab | Which of the following hypnotic drugs facilitates the inhibitory actionsof GABA but lacks anticonvulsant or muscle relaxing propeies and has minimal effect on sleep architecture? | Buspirone | Diazepam | Phenobarbital | Zaleplon | 3d
| single | Zolpidem, zaleplon and zopiclone are agonists at BZD receptors. These are hypnotic drugs that lack muscle relaxant and anticonvulsant actions. These have negligible effect on REM sleep and do not affect sleep architecture. | Pharmacology | Sedative-Hypnotics and Parkinsonism | [
"diazepam",
"phenobarbital"
] | 53,711 |
dfb03073-5cfa-4b34-a81c-9d617352f32b | Which of the following anticancer drugs are competitive inhibitors of tyrosine kinase? | Imatinib and Sunitnib | Letrozole | Bicalutamide | Fulvestrant | 0a
| single | null | Pharmacology | null | [
"fulvestrant",
"imatinib",
"letrozole"
] | 53,713 |
d156b420-90cb-4b43-8dc2-657d6d1cb0ac | A 52-year-old man comes with jaundice and extrapyramidal symptoms. On ophthalmic examination, the below finding is noted. The treatment is: | BAL | Penicillamine | Calcium edetate | Desferrioxamine | 1b
| single | Ans. (B). PenicillamineThe picture shows KF ring in eye, a feature of wilsons disease.KF ring: Brownish-yellow ring visible around the corneo-scleral junction (limbus).Consists of copper deposits in Descemet's membrane, extending into the trabecular meshwork.Sign of Wilson's disease.Oral Pencillamine is the drug of choice.Tirentine is the alternate drug. | Forensic Medicine | Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques | [
"penicillamine"
] | 53,724 |
3fcefce5-eb43-4a32-a6ad-582a1642a4b4 | Which of the following antibiotic can cause cholestatic jaundice | Erythromycin | Isoniazid | Amikacin | Azithromycin | 0a
| single | Antibiotics like Erythromycin, Nitrofurantoin, Flucloxacillin can lead to cholestatic jaundics. | Pharmacology | null | [
"amikacin",
"erythromycin",
"azithromycin",
"isoniazid"
] | 53,742 |
ac4c06a7-1a5b-4030-bd92-26233a223dcb | A 2 yr old child is brought to emergency at 3 am with fever, barking cough and stridor only while crying. The child was able to drink normally. On examination, respiratory rate is 36/min and temperature is 39.6C. What will be your next step | Racemic epinephrine nebulisation | Dexamethasone | Nasal wash for influenza or respiratory syncytial virus | Antibiotics and blood culture | 1b
| multi | Dexamethasone The child is suffering from croup. Croup is the most common form of acute upper respiratory tract obstruction. It is also called laryngotracheobronchitis which is the viral infection of the glottic and subglottic region. Clinical features:? Most patients initially have an upper respiratory tract infection with some combination of rhinorrhoea, pharyngitis and mild cough and low grade fever for 1-3 days. After this upper airway obstruction becomes apparent. The child then develops the characteristic barking cough, hoarseness and inspiratory stridor. Symptoms are characteristically worse at night and often recur with decreasing intensity for several days and resolve completely within a week. Agitation and crying greatly aggravates the signs and symptoms. The child may prefer to sit up in bed or be held upright. Croup is a disease of the upper airway and alveolar gas exchange is usually normal. It is a clinical diagnosis and does not require a radiograph of the neck. Radiographs of the neck may show the typical subglottic narrowing or "steeple sign" of croup on the posteroanterior view. Croup Mild disease Occasional barking cough No stridor at rest Mild or nonexistent suprasternal or subcostal retractions Moderate disease Frequent cough Audible stridor at rest Visible retractions Little distress or agitation Severe disease Frequent cough Prominent inspiratory (and occasionally, expiratory) stridor Conspicuous retractions Decreased entry on auscultations Treatment of Croup Cornerstone of treatment Glucocoicoids Nebulized epinephrine Glucocoicoids are useful in -- Mild - Moderate and - Severe croup Dexamethasone is the most effective coicosteroid Nebulized epinephrine Useful in Moderate to severe distress (works by adrenergic stimulation, which causes constriction of the precapillary aerioles, thereby decreasing capillary hydrostatic pressure. This leads to fluid resorption from the interstitium and improvement in laryngeal mucosal edema). Antibiotics are not indicated cool mist (used earlier) Heliox (mixture of oxygen and helium. It has low viscosity and low specific gravity which allow for greater laminar airflow through the respiratory tract. Complete blood counts and culture - Is of no use in croup because it is a clinical diagnosis, this would be helpful in case of acute epiglotitis but not croup. Nasal washing for influenza & respiratory syncitial virus - Is not required since the time we would get the repo the condition would have been taken care off. | Pediatrics | null | [
"epinephrine",
"dexamethasone"
] | 53,746 |
581c9a8d-2025-44cc-a28d-454233583f20 | Drug inhibiting granulocyte migration is:- | Montelukast | Cromoglycate | Colchicine | Felbamate | 2c
| single | Colchicine : used for the treatment of acute gouty attack. Binds to tubulin, a microtubular protein, causing it's depolymerization. This disrupts cellular function such as inability of granulocyte, thus deceasing their migration into affected area. Fuhermore, colchicine block cell division by binding to mitotic spindle. Montelukast/ Zafirlukast : Blocks leukotriene receptor. Felbamate : Broad spectrum of anticonvulsant action with multiple mechanism including blocking of voltage depended sodium channel, blocking calcium channel and potentiating GABA action. It is reserved for use in refractory epilepsies paicularly Lennox- Gastaut Syndrome because of the risk of aplastic anemia and hepatic failure. Sodium cromoglycate :- Inhibit degranulation of mast cell (Mast cell Stabilizer). | Pharmacology | NEET 2019 | [
"colchicine",
"montelukast"
] | 53,747 |
e2359ab6-2df9-4a4d-b1d1-16156697ffbc | A 65-year-old gentleman is having tremors, rigidity and reduced mobility. He is likely to be benefited by | Bromocriptine | Alpha-methyldopa | Reserpine | Acyclovir | 0a
| single | Symptoms suggestive of Parkinson's disease Treatment modality are : 1)levodopa + carbidopa 2)Bromocriptine(dopamine receptor agonist) 3)MAOI-B inhibitor : selegiline and rasagiline 4)COMT inhibitors : Entacapone and tolcapone 5)Amantadine 6) Anticholinergic : benzhexol 7)Surgery 8)Physiotherapy, occupational therapy and speech therapy. Reference : Harrison20th edition pg 2567 | Medicine | C.N.S | [
"methyldopa",
"bromocriptine"
] | 53,780 |
afdc6123-3e41-40b7-b988-64875d21ea50 | XDR-TB is defined as Resistance to: | INH plus rifampicin | Fluoroquinolones plus INH plus amikacin | Fluoroquinolones plus rifampicin plus kanamycin | Fluoroquinolones plus INH plus rifampicin plus amikacin | 3d
| single | Ans. is. 'd' i. e., Fluoroquinolones plus INH plus rifampicin plus amikacin | Microbiology | null | [
"amikacin"
] | 53,788 |
b9e74c05-ab72-4b85-a080-a4fc5dc3fe34 | Which of the following `statins' has the longest half life ? | Cerivastatin | Rosuvastatin | Atorvastatin | Simvastatin | 1b
| single | Ans. is 'b' i.e., Rosuvastatin | Pharmacology | null | [
"atorvastatin",
"rosuvastatin",
"simvastatin"
] | 53,802 |
5a0a5420-1c6e-49d5-80fe-b40e644e0abb | All are true statements about anticancer drugs except? | Vincristine is a marrow sparing anticancer drug | Irinotecan is a topoisomerase II inhibitor | L-asparaginase can cause acute pancreatitis | Anthracyclines cause cardiotoxicity | 1b
| multi | Anthracyclines cause cardiotoxicity, prevented by dexrazoxane Bleomycin causes pulmonary fibrosis L-asparaginase cause allergy, acute pancreatitis Vincristine, vinblastine causes peripheral neuropathy & SIADH. But it is marrow sparing. Irinotecan is a topoisomerase I inhibitor used for colorectal carcinoma Topoisomerase II inhibitors are Etoposide, doxorubicin, Daunorubicin & anthracyclines. | Pharmacology | Cytotoxic Anticancer Drugs | [
"vincristine"
] | 53,826 |
bd63a0ba-e66e-46be-a1fd-23c30026a016 | Dobutamine causes - | Increased cardiac output | Marked increase in hea rate | Increased total peripheral resistance | Marked increase in BP | 0a
| single | Ans. is 'a' i.e., Increased cardiac output o Only prominent action of dobutamine is in increase in force of cardiac contraction and cardiac output without significant change in hea rate, peripheral resistance and BP. o In comparison to dopamine, dobutamine :? i) Does not cause renal or mesentric vasodilation. ii) Does not cause coronary vasoconstriction (no effect on alpha receptors). iii) Does not cause release of endogenous norepinephrine and does not precipitate arrythmia. If has an effect on peripheral resistance , always decreases it (Dopamine can increase or decrease peripheral resistance depending on the dose). | Pharmacology | null | [
"dobutamine"
] | 53,843 |
13b11c3e-44e8-414d-af14-cdb358ba6419 | Methadone is used in the management of opioid addiction because- | Its analgesic activity is less than that of morphine | It is an opioid receptor antagonist | It is not addictive | It is longer acting and causes milder withdrawal symptoms | 3d
| single | Ans. is 'd' i.e., It is longer acting and causes milder withdrawal symptoms | Pharmacology | null | [
"morphine",
"methadone"
] | 53,860 |
5ec4799b-e2d3-4e7d-a888-87809799feae | Apixaban is: | Antithrombin inhibitor | Direct Xa inhibitor | Platelet activator | Clotting Factor XII | 1b
| single | Ref. KDT. Page. 617
Apixaban is an oral, direct, and highly selective factor Xa (FXa) inhibitor (of both free and prothrombinase-bound FXa independently of antithrombin III) for the prevention and treatment of thromboembolic diseases
Apixaban prolongs clotting tests such as prothrombin time (PT), INR, and activated partial thromboplastin time (aptt)
Apixaban is absorbed in the stomach and small intestine
87% plasma protein bound.
Apixaban mainly undergoes o-demethylation and hydroxylation to metabolites
Grapefruit juice may increase apixaban serum concentration.
St. John's wort will likely decrease apixaban serum concentration | Unknown | null | [
"apixaban"
] | 53,864 |
2c6e8613-70ba-4040-9c81-16800a1098b3 | DOC for Extrapulmonary cryptococcal infection without CNS involvement is | Amphotericin B | Flucytosine | Azoles | Fluconazole | 3d
| single | Cryptococcal infection with meningitis: DOC IS Amphotericin B with flucytosine,Extrapulmonary without CNS involvement: DOC is fluconazole Ref: Harrison 18th ed/.Pg 1650. | Pharmacology | Antibiotics | [
"flucytosine",
"fluconazole"
] | 53,871 |
eb67065c-749d-4f4a-a0ca-e32bcf0bb39d | Drug of choice for diphtheria carrier is: | Penicillin | Erythromycin | Procaine penicillin | Tetracycline | 1b
| single | Ans. is 'b' Erythromycin Drug of choice for diptheria carrier is erythromycin. | Medicine | Bacteriology | [
"erythromycin",
"procaine",
"tetracycline"
] | 53,876 |
0d25619f-4a13-4096-a2ee-243790304519 | Atropine is drug of choice in | Chorioretinitis | Lens induced glaucoma | Iridocyclitis | Close angle glaucoma | 2c
| single | C i.e. Iridocyclitis Steroid > Atropine is drug of choice for acute iridocyclitis (anterior uveitis).Q Atropine is contraindicated in glucomas where as pilocarpine is contraindicated in anterior uveitis. Q | Ophthalmology | null | [
"atropine"
] | 53,880 |
9e167709-7f18-4e54-8330-562388fc58a5 | First line of Rx of osteoporosis in postmenopausal women | Estrogen | Bisphosphonates | Raloxifene | Ullipsistal | 1b
| single | REF : SHAW GYNECOLOGY REF REF : | Gynaecology & Obstetrics | All India exam | [
"raloxifene"
] | 53,899 |
1b062578-4da5-456c-b671-497bdb2ebc3c | Following is true about iron dextran except ? | It is parenteral iron preparation | It can be given either iv or im | It binds to transferrin | It is not excreted | 2c
| multi | Ans. is 'c' i.e., It binds to trnasferrin | Pharmacology | null | [
"dextran"
] | 53,901 |
4ab487bb-25f2-480c-a38c-2a251f164e5b | Omalizumab is a monoclonal antibody used for the treatment of: | Digitalis toxicity | bronchial asthma | Rheumatoid ahritis | Breast carcinoma | 1b
| single | (Ref: KDT 6/e p226) Omalizumab is a monoclonal antibody against IgE. It is useful for the management of bronchial asthma. | Pharmacology | Other topics and Adverse effects | [
"omalizumab"
] | 53,904 |
746e22c6-846e-459c-a21b-1250c78e4dae | Which is associated with nonalcoholic steatohepatitis ? | Amiodarone therapy | Thin body habitus | Phenytoin sodium therapy | Right hemicolectomy | 0a
| single | NAFLD is strongly associated with overweight/obesity and insulin resistance. Other causes are: * Hepatitis C (paicularly genotype 3) * Inborn errors of metabolism (Galactosemia, Glycogen storage disease, Hereditary fructose intolerance, Homocystinuria ..etc) * Medications (Cytotoxic and cytostatic drugs, Metals, Amiodarone, Oestrogen, Tamoxifen, Glucocoicoids, Highly active antiretroviral therapy..etc) * Inflammatory bowel disease * Lipodystrophy * Bacterial overgrowth * Starvation * Parenteral nutrition * Surgical procedures (Biliopancreatic diversion, Extensive small-bowel resection, Gastric bypass, Jejunoileal bypass) * Reye's syndrome * Acute fatty liver of pregnancy * HELLP syndrome ref : Harrison 20th ed pg: 2056 | Medicine | G.I.T | [
"amiodarone",
"phenytoin"
] | 53,929 |
59dd9b02-47f9-40d3-ac65-d0896e3aea0a | Which intravenous anaesthetic agent has high incidence of pychomimetic reactions during early recovery period- | Ketamine | Thiopentone | Propofol | Etomidate | 0a
| single | Ketamine has been associated with emergence reaction/delirium incidence of which ranges from 3% to 100%. Emergence reactions seen with ketamine include vivid dreaming, extracorporeal experiences (sense of floating out of the body), and illusions (misinterpretation of a real, external sensory experience) during emergence from anesthesia. These are usually associated with excitement, confusion, euphoria, and fear. Emergence reaction can be reduced by the use of benzodiazepines. | Anaesthesia | Intravenous Anesthetic Agents | [
"etomidate",
"ketamine",
"propofol"
] | 53,938 |
8656397f-6dcc-4c6b-abbb-b6bc4c442388 | The following are used for treatment of postoperative nausea and vomiting following squint surgery in children except – | Ketamine | Ondansetron | Propofol | Dexamethasone | 0a
| multi | null | Anaesthesia | null | [
"ketamine",
"dexamethasone",
"propofol"
] | 53,939 |
7a4ffcd3-5af5-470e-9180-b01e6b525a7e | Ceftriaxone is : | IInd generation short acting cephalosporin | Has activity against beta lactamase producing bacteria | IVth generation long acting cephalosporin | Illrd generation long acting cephalosporin | 3d
| single | null | Pharmacology | null | [
"ceftriaxone"
] | 53,943 |
befbc0d4-e024-4253-9cf8-770efad68c96 | DOC for a pregnant woman in 2nd trimester with pustular psoriasis is - | Prednisolone | Dapsone | Acitretin | Methotrexate | 0a
| single | systemic coicosteroids- contraindicated in psoriasis as they cause flareup of disease on cessation of therapy only indication of systemic coicosteroids is erythrodermic psoriasis , generalised pustular psoriasis and pustular psoriasis of pregnancy(impetigo herpetiformis). they are life saving in acute types. other drug that is used in pustular psoriasis of pregnancy is cyclosporine. IADVL textbook of dermatology, page1054. | Dental | Papulosquamous disorders | [
"prednisolone",
"methotrexate",
"acitretin",
"dapsone"
] | 53,946 |
be8b6cfa-dcba-4939-90ef-a55991eab413 | As per WHO protocol ATT drug C/l in pregnancy: | Rifampicin | Pyrazinamide | Ethambutol | Streptomycin | 3d
| single | Ans: D (Streptomycin) T.B Treatment during pregnancy Park 21st/175"During pregnancy, streptomycin can cause permanent deafness in the baby, so ethambutol should be used instead of streptomycin. Isonsazid, rifampicin, pyrazinamide & ethambutol are safe to use. Second-line drugs such as fluoroquinolones, ethionamide PS protionamide are teratogenic & should not he used"T.B Treament during pregnancy1 KDT6th/ 748-49"The WHO & British Thoracic Society consider H, R & Z to be safe to the foetus & recommended the standard 6 month (2HRZ+4HR) regimen for pregnant women with T.B. Ethambutol can be added during late but not early pregnancy Streptomycin is contraindicated" | Pharmacology | Anti Microbial | [
"ethambutol"
] | 53,959 |
ca2d135d-93b1-4125-9e98-6e3f848f471e | The treatment of choice of fellow eye of acute angle closure glaucoma is | Pilocarpine | Nd:YAG laser iridotomy | Peripheral iridectomy | Careful follow up | 1b
| single | B i.e. Nd: YAG Laser iridotomy | Ophthalmology | null | [
"pilocarpine"
] | 53,966 |
11a6ee3b-13e3-45b4-913f-054e0d9ea677 | Resistance to Methotrexate develops due to? | Rapid Cancer cell multiplication | Deficiency of thymidylate kinase | Deficiency of thymidylate synthetase | Increased production of dihydrofolate reductase | 3d
| single | Ans. is 'd' i.e., Increased production of dihydrofolate reductase Methotrexate resistanceo Methotrexate resistance may be due to any of the following mechanismDefective transport into cellsProduction of altered form ofDHFR that have decreased affinity for methotrexateIncreased concentrations of intracellular DHFR through gene amplification or altered gene regulationDecreased ability to synthesize methotrexate polyglutamatesIncreased expression o f a drug efflux transporter of the MRP (multidrug resistance protein) classDrugMost common mechanism of resistanceo Beta lactamsInactivating enzyme (Beta lactamase)o TetracyclinesEfflux pump (decreased concentration in the cell)o ChloramphenicolInactivating enzyme (acetyl transferase)o MacralidesDecreased permeability or efflux pumpo FluoroquinolonesAltered DNA gyrase with reduced affinityo AminoglycosidesInactivating enzyme | Pharmacology | Anti-Neoplastic Agents | [
"methotrexate"
] | 53,971 |
21feaeae-e25a-4e64-b963-427555e0d3f6 | After undergoing repair of a left indirect inguinal hernia, a 72-year-old obese man is admitted to the emergency department with severe retrosternal pain of 1-hours duration. The pain radiates to the medial aspect of the left hand. The ECG shows Q waves and an elevated ST-segment. A diagnosis of acute MI is established 1 hour after admission. Immediate management should include which of the following? | Thrombolytic therapy with tissue plasminogen activator (tPA) | Vitamin K | Ampicillin, 2 mg tid PO | Hydrochlorothiazide, 50 mg/d | 0a
| single | Thrombolytic therapy intravenously with streptokinase, urokinase, or tPA is indicated in most patients with MI presenting early for treatment. This therapy, however, is effective only if initiated within 6 hours after the onset of pain in patients with acute MI. These drugs are fibrinogenolytic, and aspirin and heparin are frequently included in the anticoagulant protocol. Reperfusion rates of 60% can be anticipated; reocclusion rates of 15% usually occur. Vitamin K is not indicated, because it would increase the coagulability of blood. If a diuretic, such as hydrochlorothiazide, 25-50 mg/d is indicated to treat milder hypertension, hypokalemia must be avoided. | Surgery | Heart & Pericardium | [
"ampicillin",
"hydrochlorothiazide"
] | 53,973 |
42e2c8ac-ee7f-4540-8d77-bed2d7eb0130 | A child was taken for CECT Chest and contrast was injected : the child had swelling which gradually increased. There is numbness. There is a pain on passive extension of fingers. He is not allowing you to touch the arm. Pulse was present. What will you do? | High Dose Prednisolone | Arterial Thrombectomy | Immediate Fasciotomy | Antihistamines / Anticoagulants | 2c
| multi | The child is having Compartment syndrome due to extravasation of contrast. This is a medical emergency and immedicate fasciotomy needs to be done to prevent tissue necrosis. | Radiology | null | [
"prednisolone"
] | 53,974 |
2ce972bb-7b5e-467a-a408-f10399bc9cc4 | A 45 yr old male presents with fever, cough, and anorexia. Sputum is positive for AFB. He is staed on isoniazid, rifampicin, pyrazinamide and ethambutol. What is the reason for administering multidrug therapy in tuberculosis? | To broaden antimicrobial spectrum | To delay development of resistance | To prevent toxin release from the organism | To reduce toxicity | 1b
| single | The reason for administering muti-drug therapy in tuberculosis is to prevent develompment of resistance. Resistance to individual drugs in Mycobacterium tuberculosis occurs by spontaneous point mutations that occur at a low but predictable rate (10 to 10 ). The development of drug-resistant tuberculosis (TB) is almost invariably the result of monotherapy, i.e., the failure of the health care provider to prescribe at least 2 drugs to which the tubercle bacilli are susceptible. Hence, multi-drug therapy is recommended for tuberculosis. Common point mutations in M.tuberculosis which cause drug resistance Rifampin : rpoB gene Isoniazid : katG gene & inhA Pyrazinamide : pncA gene Ethambutol : embB gene Aminoglycosides : rrs gene fluoroquinolones : gyrA-gyrB genes Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | Microbiology | Bacteriology | [
"ethambutol",
"isoniazid"
] | 53,992 |
cb230989-d36c-4d72-9a23-f2f5f94cddee | Tec 6 vaporizer is used with......... | Halothane | Desflurane | Isoflurane | Trielene | 1b
| single | The most common such vaporizer is the Ohmeda Tec 6, designed specifically for use with desflurane. Desflurane has two physical propeies, making it unsuitable for use with a conventional vaporizer. First, it has a very high SVP (88.5 kPa at 20degC). A conventional vaporizer would require high fresh gas flows to dilute it to within clinically useful concentrations, making it uneconomical. Secondly, it has a low boiling point (23.5degC). At room temperature, it will intermittently boil resulting in large fluctuations in agent delivery. When boiling, there will be excessive agent delivery; however, it will then cool due to a large loss of latent heat of vaporization, resulting in an exponential decrease in SVP and under-delivery of agent. The Ohmeda Tec 6 overcomes these problems by using an electrical filament that heats the desflurane to 39degC, raising its SVP to 194 kPa, that is, nearly 2 atm. In addition to providing a stable SVP, this high pressure removes the need for a pressurized carrier gas--instead, the fresh or diluent gas is entirely separate from the vaporizing chamber | Anaesthesia | Inhalational Anesthetic Agents | [
"desflurane",
"isoflurane",
"halothane"
] | 54,000 |
7957f568-3120-47a0-97ba-133ae203f532 | The most likely hormone increased in a middle aged female with a mass in sella turcica is: | Prolactin | Thyroxine | Estrogen | ADH | 0a
| single | Answer is A (Prolactin): The pituitary gland sits cradled within the sella turcica. The most common cause of a mass in the sella turcica is a Pituitary adenoma. The most frequent type of hyper-functioning pituitary adenomas are Prolactinomas that account for approximately 30 percent of all clinically recognized pituitary adenomas. Elevated levels of Prolactin are characteristic findings 'Hyperprolactinemia is the most common pituitary hormone hypersecretion syndrome in both men and women. Prolactin secreting pituitary adenomas (Prolactinomas) are the most common cause' - Harrison | Medicine | null | [
"thyroxine"
] | 54,005 |
05deb6ff-4c71-4a8d-8f36-15aaf6e5e636 | The drug NOT used in acute asthma is- | Salbutamol | Ipratropium | Monteleukast | Hydrocoisone | 2c
| single | Ans. is 'c' i.e., Monteleukast Monteleukast and zafirleukast are indicated for prophylactic therapy of mild to moderate asthma as an alternative to inhaled coicosteroids. However they are not used to terminate acute attack of asthma. | Pharmacology | null | [
"ipratropium",
"salbutamol"
] | 54,008 |
09a0a71c-c440-4c8d-9e85-9e13ba7ce25a | Drug of choice for the treatment of peptic ulcer caused due to chronic use of NSAIDs is: | Pirenzepine | Loxatidine | Misoprostol | Esomeprazole | 3d
| single | Proton pump inhibitors: are DOC for :-- PUD of any reason- GERD- Zollinger Ellison Syndrome Misoprostol is specific drug for NSAIDs induced peptic ulcer. | Pharmacology | Gastro-Intestinal Tract | [
"misoprostol",
"pirenzepine"
] | 54,042 |
3b227f91-3a90-4688-a493-61e381f98b51 | Which one of the following is effective in the treatment of brucellosis - | Rifampicin | Amphotericin | Ketoconazole | Pencillin | 0a
| single | null | Medicine | null | [
"ketoconazole"
] | 54,058 |
6d884508-450a-45ea-974f-2ea035942a34 | Which of the following drug inhibits the enzyme 11-beta- hydroxylase responsible for coisol synthesis:- | Thiopentone | Propofol | Etomidate | Ketamine | 2c
| single | Etomidate Inhibits the activity of II-B- hydroxylase an enzyme necessary for the synthesis of coisol, aldosterone ,17- hydroxyl-progesterone and coicosterone. Associated with adrenocoical suppressionwhich canlast for 72 hours. Inhibits the enzyme 11b-hydroxylase, - decreased biosynthesis of coisol and mineralocoicoid and increases the formation 11-deoxycoicosterone. More potent inhibitor of steroid synthesis than as a sedative-hypnotic as the concentration which produces adrenocoical suppression(10 ng/mL)is much lower than that needed for hypnosis (>200 ng/mL). | Anaesthesia | Intravenous Anesthetic Agents | [
"etomidate",
"ketamine",
"propofol"
] | 54,083 |
6487b92e-77b3-4118-a212-0f19bdb35efa | Benzodiazepine overdose in a patient presenting with coma, is treated by: March 2010 | Protamine | Flumazenil | Coumarin | Midazolam | 1b
| single | Ans. B: Flumazenil Decontamination - Gastric lavage is not recommended but may be considered if the presence of a lethal co-ingestant is suspected and the patient presents within 1 hour of ingestion. - Single-dose activated charcoal is recommended for GI decontamination in patients with protected airway who present within 4 hours of ingestion. Respiratory depression may be treated with assisted ventilation. Flumazenil - Flumazenil is a competitive BZD receptor antagonist and should be used cautiously because it has potential to precipitate BZD withdrawal in chronic users, resulting in seizures. - Flumazenil administration is contraindicated in mixed overdoses (e.g., TCAs) because BZD reversal can precipitate seizures and cardiac arrhythmias. - Ideal indication for flumazenil use is isolated BZD overdose, paicularly if overdose is iatrogenic in nature. | Psychiatry | null | [
"flumazenil",
"midazolam"
] | 54,099 |
2dd073de-e9ba-4777-989e-4f10664ebec9 | All are true regarding pseudomembranous colitis, except | It is caused by clostridium difficile | The organism is a normal commensal of gut | It is due to production of phospholipase A | It is treated by vancomycin | 2c
| multi | Clostridium difficile causes acute colitis with bloody diarrhea and pseudomembranous colitis. A common cause of nosocomial diarrhea. The disease follows the use of broad-spectrum antibiotics to which it is resistant. Exotoxin A and B involved in the pathogenesis. It is not a normal commensal, it is an oppounistic organism. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 270 | Microbiology | Bacteriology | [
"vancomycin"
] | 54,127 |
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