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6e222ead-6f0c-41d7-be16-fb4d6a96b988 | Which of the following patients is most likely to be treated with intravenous glucagon? | A young man who took cocaine and has a blood pressure of 190/110 mm Hg | A middle aged man with type II diabetes who has not taken his regular dose of glipizide for last 4 days | An old man with severe bradycardia and hypotension resulting from ingestion of overdose of atenolol | An old woman with lactic acidosis as a complication of severe infection and shock | 2c
| single | Glucagon : Use in hypoglycemia DOC for beta blocker poisoning A life-threatening adverse cardiac effect of a b antagonist may be overcome directly with isoproterenol or with glucagon (glucagon stimulates the hea glucagon receptors, which are not blocked by b antagonists), but neither of these methods is without hazard. | Pharmacology | Pancreas | [
"glipizide",
"atenolol",
"glucagon"
] | 153,518 |
5a24eb91-6365-482c-a7a0-eac45bd99ee8 | Sympathetic stimulation of nerves innervating the islets of the pancreas will: | Have no effect | Increase secretion of insulin from B cells | Decrease secretion of insulin from B cells | Increase secretion of glucagon from A cells | 3d
| single | The pancreatic islets receive innervation from both the sympathetic and parasympathetic nervous system. Stimulation of the parasympathetic system increases secretion of insulin from the B cells. Stimulation of the sympathetic system increases glucagon secretion from the A cells. Insulin is inhibited by sympathetic stimulation. Ref: Molina P.E. (2013). Chapter 7. Endocrine Pancreas. In P.E. Molina (Ed),Endocrine Physiology, 4e. | Physiology | null | [
"glucagon"
] | 153,523 |
94efad1a-4648-4755-ae8b-969239e32dd7 | All of the following statements regarding Octreotide is TRUE, EXCEPT: | It is a somatostatin analogue | Used in secretory diarrhea in AIDS | Used in carcinoid | An absorbent | 3d
| multi | Octreotide is an octapeptide analog of somatostatin. It acts by inhibiting hormone secretion such as 5HT and other GI peptides. Indications: It is effectively used in treating severe secretory diarrhea brought about by hormone-secreting tumors of the pancreas and the GI tract. It is also used off label in the treatment of secretory diarrhea such as chemotherapy-induced diarrhea, diarrhea associated with HIV and diabetes-associated diarrhea. It is also used in dumping syndrome seen in some patients after gastric surgery and pyloroplasty. In this condition, octreotide inhibits the release of hormones that are responsible for distressing local and systemic effects. Ref: Sharkey K.A., Wallace J.L. (2011). Chapter 46. Treatment of Disorders of Bowel Motility and Water Flux; Anti-Emetics; Agents Used in Biliary and Pancreatic Disease. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | Pharmacology | null | [
"octreotide"
] | 153,532 |
14b06d7f-2076-4373-a7e3-a436e3b19be8 | Multidrug (MDT) regimen under the National Leprosy Eradication Program for treatment of all Multibacillary Leprosy would include:- | Clofazimine, Thiacetazone and Dapsone | Clofazimine, Rifampicin and Dapsone | Ethionamide, Rifampicin and Dapsone | Propionamide, Rifampicin and Dapsone | 1b
| multi | Paucibacillary Multibacillary Lesions <=5 >5 RX 6 months 12 months Follow-up 2 years 5 years Drugs Dapsone, Rifampicin Dapsone, Rifampicin, Clofazimine Now, India may soon adopt "Uniform MDT" regimen in which drugs used will be D + R + CF to all leprosy Patients. | Social & Preventive Medicine | Leprosy, HIV & STDs | [
"clofazimine",
"ethionamide",
"dapsone"
] | 153,538 |
760abe95-2c7b-4235-b12e-0bbe791a220d | A 19-year old male presents with several comedones, papules and pustules on face and trunk. The approp-ilte drug ,*1choice for the patient would be | Topical retinoic acid | Topical retinoic acid + Oral doxycycline | Topical clindamycin | Topical azithromycin | 1b
| single | Ans. b. Topical retinoic acid + Oral doxycycline A I9-year-old male presents with several comedones, papules and pustules on face and trunk. This is a case of inflammatory acne with comedones and appropriate drug of choice for this patient is topical retinoic acid with oral doxycycline. | ENT | null | [
"azithromycin",
"doxycycline",
"clindamycin"
] | 153,548 |
91c4fab4-2e06-4cc8-b371-0aef322052bc | Which of the following anti - glaucoma drug can likely cause black pigmentation on conjunctiva | Adrenaline | Latanoprost | Beta blockers | Pilocarpine | 0a
| single | Adrenaline used in glaucoma can lead to conjunctival pigmentation because of adrenochrome. | Pharmacology | null | [
"pilocarpine",
"latanoprost"
] | 153,550 |
5a87e448-552f-4f1a-a8a7-4f94bbcf79ef | Bosentan is a/an : | Serotonin uptake inhibitor | Endothelin receptor antagonist | Leukotriene modifier | Phosphodiestease inhibitor | 1b
| single | null | Pharmacology | null | [
"bosentan"
] | 153,558 |
39bfc1b4-0b3c-4171-888d-41e933ca5c86 | Anticancer drug causing SIADH as an adverse effect is: | Vincristine | Paclitaxel | Dacarbazine | Cyclophosphamide | 1b
| single | TAXANES Paclitaxel It is a complex diterpin taxane obtained from bark of the Western yew tree, which exes cytotoxic action by a novel mechanism. It enhances polymerization of tubulin: a mechanism opposite to that of vinca alkaloids. The microtubules are stabilized and their depolymerization is prevented. This stability results in inhibition of normal dynamic reorganization of the microtubule network that is essential for vital interphase and mitotic functions. Abnormal arrays or &;bundles&; of microtubules are produced throughout the cell cycle. Cytotoxic action of paclitaxel emphasizes the impoance of tubulin-microtubule dynamic equilibrium. The approved indications of paclitaxel are metastatic ovarian and breast carcinoma after failure of first line chemotherapy and relapse cases. It has also shown efficacy in advanced cases of head and neck cancer, small cell lung cancer, esophageal adenocarcinoma and hormone refractory prostate cancer. The major toxicity is reversible myelosuppression and &;stocking and glove&; neuropathy. Chest pain, ahralgia, myalgia, mucositis and edema can be troublesome.The syndrome of inappropriate ADH secretion is attributed to excessive ADH release. It is defined as less than maximally dilute urine in the presence of plasma hypoosmolality (hyponatremia), without volume depletion or overload, emotional stress, pain, diuretics or other drugs that stimulate ADH secretion. Paclitaxel regimen, cause severe hyponatremia (grade 4) due to documented syndrome of inappropriate antidiuretic hormone secretion (SIADH). ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:826 | Pharmacology | Chemotherapy | [
"paclitaxel",
"vincristine",
"cyclophosphamide"
] | 153,561 |
a429b25b-2e24-457d-a12c-9440f4e0b62e | Inhibition of protein synthesis in translocation steps occurs by | Tetracycline | Erythromycin | Aminoglycosides | Penicillin | 1b
| multi | Reversible Inhibitors in bacteria : These antibiotics are bacteriostatic . Tetracycline bind to the 30S subunit of bacterial ribosome and so inhibit attachment of aminoacyl tRNA to the A site of ribosomes. Chloramphenicol inhibits the peptidyl transeferase acitivity of bacterial ribosomes. Erythromycin (macrolides) and clindamycin prevent the translocation process. REFERENCE : DM.VASUDEVAN.TEXTBOOK ; SEVENTH EDITION ; PAGE NO : 605. | Biochemistry | Metabolism of nucleic acids | [
"erythromycin",
"tetracycline"
] | 153,574 |
1a9070a0-49b6-4717-bc04-0ee66d8fb3dd | Antilipidemic drugs that prevent hypercho- lesterolemia by inhibiting absorption : | Ezetimibe | Statins | Orlistat | Cholestyramine | 0a
| single | Ezetimibe inhibits absorption of cholesterol by binding to transpoer located in intestinal brush border, so decreases delivery of intestinal cholesterol to liver. Orlistat is antiobesity drug, acts as inhibitor of gastric and pancreatic lipase, interfere with digestion and absorption of dietary TG's. Statins act by inhibiting HMG CoA reductase. Cholestyramine acts as a bile acid sequestrant. | Surgery | null | [
"ezetimibe",
"orlistat"
] | 153,581 |
65c2c1a1-2172-4a0b-b746-5856b8283be0 | Antimetabolite drug used for the treatment of gout? | Allopurinol | Zidovudine | Azathioprine | None of the above | 0a
| multi | Synthetic nucleotide used in the treatment of Gout-Alloourinol. | Biochemistry | null | [
"azathioprine",
"allopurinol",
"zidovudine"
] | 153,596 |
12fed86a-3db5-423c-a469-596925d1afa9 | An obese NIDDM patient present with FBS=180 mg% and PPBS=260 mg% Management include-a) Glibenclamideb) Diet therapy+exercisec) Diet therapy+exercise + Metformin
d) Chlorpropamide | ab | bc | bd | cd | 1b
| single | null | Medicine | null | [
"metformin",
"chlorpropamide"
] | 153,604 |
459f6c5c-71a3-487d-8095-25a314394f67 | Which among the following is not an antipsychotic? | Risperidone | Haloperidol | Chlordiazepoxide | Clozapine | 2c
| single | Chlordiazepoxide is a BZD that can be used also an anti anxiety agent. Rest all three given drugs are anti psychotic. Ref: KD Tripathi 8th ed. | Pharmacology | Central Nervous system | [
"chlordiazepoxide",
"clozapine"
] | 153,605 |
8c005186-aeab-4c1f-b112-396013f12742 | For glucose estimation in blood, the mode of transport from a PHC to lab: | Sodium fluoride | EDTA | Citrate | 0.9% saline | 0a
| single | Ans. A. Sodium fluorideIn glycolysis, (i.e. the pathway in which, glucose is utilized to form energy), 'Enolase' is an enzyme which converts 2- phosphoglycerate to a high energy compound phosphoenolpyruvate.a. This enzyme requires Mg++&Mn++ & is inhibited by fluoride.b. For blood glucose estimation, fluoride is added to the blood to prevent glycolysis by cells, so that the blood glucose is correctly estimated. | Biochemistry | Carbohydrates | [
"edta"
] | 153,609 |
048f642a-e0af-4690-817f-0bf435da755e | The specific antidote for benzodiazepine poisoning is: | Naloxone | Flumazenil | Fomepizole | Pralidoxime | 1b
| single | null | Pharmacology | null | [
"naloxone",
"pralidoxime",
"flumazenil",
"fomepizole"
] | 153,610 |
8145aae9-e0e0-4bdd-9a92-cdba8c4a0dd3 | "Monday disease" is seen with | Calcium channel blockers | Benzodiazepines | Isosorbide Mono nitrate | Chlorpromozine | 2c
| single | Isosorbide Mononitrate is a venodilator, which is associated with Monday disease, where nitrate industry workers gets dizziness & hypotension on Monday, but symptoms disappear by the weekend because of down regulation of enzymes. | Pharmacology | null | [
"isosorbide"
] | 153,624 |
cb4109c5-a1c8-41b7-9dbe-b46010a1f4e1 | Which of the following antifungal drug is developing drug resistance and has not been prescribed for tinea cruris and tinea corporis for the last 2 years? | Griseofulvin | Terbinafine | Itraconazole | Voriconazole | 0a
| single | (a) Griseofulvin,Ref: Katzung, 13th ed., pg. 832 and class="katex">PMC4804599/* Among various options, topical terbinafine for 4 weeks appears to be the treatment of choice for limited disease (tinea corporis/cruris/pedis). For more extensive disease, the choice is less clear. It is also effective orally. Both terbinafine (250-500 mg/day for 2-6 weeks) and itraconazole (100--200 mg/day for 2-4 weeks) appear to be effective. Voriconazole is also an effective drug for these conditions.* Griseofulvin is an oral drug used for tinea infections. It is not effective topically. Because of emergence of resistance over the past few years, griseofulvin has been largely replaced by other antifungal agents like terbinafine and itraconazole.* Luliconazole is an imidazole topical cream recently approved by the FDA and the CDSCO for treatment of interdigital tinea pedis, tinea cruris, and tinea corporis. | Pharmacology | Anti Microbial | [
"terbinafine",
"itraconazole",
"griseofulvin",
"voriconazole"
] | 153,625 |
8aa568aa-a041-4a10-a8f8-a688d73c4fa0 | Most important side effect of ethambutol is : | Hepatotoxicity | Renal toxicity | Peripheral neuropathy | Retrobulbar neuritis | 3d
| single | null | Pharmacology | null | [
"ethambutol"
] | 153,627 |
d9b7327b-503a-48fe-a73a-fa1ca1375010 | Which one of the following insecticides is commonly used for ultra low volume fogging - | Abate | DDT | Paris green | Malathion | 3d
| single | Ans. is 'd' i.e., Malathion o New equipment has been developed to use residual insecticide as space spray by ultra low volume (ULV technique. o Malathions and fenthion are most commonly used. | Social & Preventive Medicine | null | [
"malathion"
] | 153,641 |
e5a79401-abe3-4c8a-8c4f-b74cadf01444 | Which of the following drugs has been found to be useful in acute severe asthma? | Magnesium Sulphate | Anti-leukotrine | Cromolyn Sodium | Cyclosporine | 0a
| single | Ans. (A) Magnesium sulphate(Ref: Harrison 17th/e p1605)Magnesium sulphate by i.v. or inhalational route has been used for the treatment of acute severe asthma. All other drugs mentioned in the options are used for prophylaxis of asthma. | Pharmacology | Asthma | [
"cyclosporine",
"cromolyn"
] | 153,646 |
a22ba2d1-ceb3-4742-a67f-4d8d0e4e2c3e | Drug that is safe in G6PD deficiency: | Primaquine | Acetanilide | Quinidine | Dapsone | 2c
| single | c. Quinidine(Ref: Nelson's 20/e p 2335, Ghai 8/e p 339)Quinidine does not carry risk of hemolysis in persons with G-6-PD deficiency. | Pediatrics | C.V.S. | [
"quinidine",
"dapsone"
] | 153,649 |
ec46b793-2ec3-4fbd-84dd-656c26939749 | Rk39 dip stick kit was found to be positive, the treatment of choice is: | Amphotericin B | Albendazole | Doxycycline | Praziquantel | 0a
| single | Ans. (a) Amphotericin B Ref Paniker 7/e, p 58 RK 39, is a rapid dip stick method for detecting antileishmanial antibodies has been developed using a recombinant leishmanial antigen rk 39 consisting of 39 amino acids conserved in kinesin region of L. infantum. The sensitivity of test is 98% and specificity is 90%. Thus, a positive rk39 test indicates Lishmenial infection Treatment of Leishmaniasis Kala-azar responds better to treatment than visceral leishmaniasis Pentavalent antimonial compound is the drug of choice in most of the endemic region except Bihar, where there is resistance to pentavalent compound Amphotericin B is the first line drug to be used in Bihar Liposomal Amphotericin B: It is the only drug approved by FDA for treatment if visceral leishmaniasis Note: Other impoant Rapid dipstick test: RDT dipsticks for HRP-2 and pLDH: Plasmodium Optimal rapid dipstick test: Plasmodium falciparum > Plasmodium vivax RDT for Fl antigen: Yersinia pestis RDT for 01 and 0139: Rapid detection of Vibrio cholerae serotypes Strep A Rapid Test Dipstick (GIMA): Streptococcus pyogenes is throat swab | Microbiology | null | [
"albendazole",
"doxycycline"
] | 153,653 |
bdf28029-b1a3-4059-974d-dd8f512bc64d | The short acting anticholinesterase drug is: | Edrophonium | Demecarium | Dyflos | Ectothiophate | 0a
| single | null | Pharmacology | null | [
"edrophonium"
] | 153,680 |
de1c9e1b-650c-484f-8cc9-1c3587b05bdc | Treatment of choice in acute congestive glaucoma – | Pilocarpine | Laser iridotomy | Timolol | Trabeculoplasty | 1b
| single | Treatment of choice for PACG is peripheral laser iridotomy. | Ophthalmology | null | [
"pilocarpine",
"timolol"
] | 153,700 |
87cf8a4f-b647-486c-9435-d66201c192aa | Drug that inhibits cell wall synthesis is ? | Tetracyclines | Penicillins | Aminoglycosides | Chloramphenicol | 1b
| multi | null | Pharmacology | null | [
"chloramphenicol"
] | 153,721 |
fa29bd47-6a0f-495b-9887-8c6c716252e4 | Montelukast is ? | Leukotriene antagonist | Potassium channel opener | Smooth muscle relaxant | Anti - inflammatory | 0a
| single | Ans. is 'a' i.e., Leukotriene antagonist Leukotriene antagonists Monteleukast and zafirleucast are cystenyl LT, (cys LT1) receptor antagonists. They are indicated for prophylactic therapy of mild to moderate asthma as alternatives to inhaled glucocoicoids. They are more acceptable in children. They are not used for terminating asthma episodes. They are effective in aspirin induced asthma. They are very safe drugs, produce few side effects like headache and rashes. Eosinophilia, neuropathy and churg-strauss syndrome are other rare side effects. | Pharmacology | null | [
"montelukast"
] | 153,722 |
04022e53-d467-4ded-b6b0-46e81f520a4e | Drug causing malignant hyperthermia: | Cisatracurium | Suxamethonium | Propofol | Thiopentone | 1b
| single | Ans. b. Suxamethonium (Ref: Milier's 7/e p1180-1189, Lee 13/e p352-354, Morgan 4/e p945-950)Suxamethonium is the drug most commonly responsible for causing malignant hyperthermia. | Anaesthesia | Complications Of Anaesthesia | [
"cisatracurium",
"propofol",
"suxamethonium"
] | 153,728 |
55f88cdf-9502-47e6-8505-6009e66c0d0e | All of the following agents are used for emergency contraception, EXCEPT | Combined Pill | Levonorgestrel | Misoprostol | Mifepristone | 2c
| multi | Emergency contraceptive is means of contraception used after act of unprotected intercourse. Misoprostol is a prostaglandin which is an excellent agent for causing early and mid trimester aboions but as an emergency contraceptive it has no role as there is no pregnancy to abo in the first three days of intercourse. Emergency contraceptives IUCD: Can prevent implantation up till 5th day of unprotected inter-course Progesterone only pill: LNG 1.5 mg :can reduce tubal motility , make endometrium 'Out of Phase" for implantation of embryo Combined Pill: the Yuzpe regimen can prevent embryo implantation since the estrogen component makes the endometrium unreceptive. Mifepristone, Antiprogestin, RU 486, prevents implantation Ulipristal acetate: SPRM: Selective progesterone receptor modulator | Gynaecology & Obstetrics | Contraceptives | [
"mifepristone",
"misoprostol"
] | 153,730 |
803de733-55f1-4996-af8e-efcbc9cbd085 | A patient presents with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers in the sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment ? | Intravenous ceftriaxone | Intravenous metronidazole | Intravenous steroids and sulphasalazine | Hydrocoisone enemas | 1b
| single | Ans. is `b' i.e., Intravenous metronidazole Lower gastrointestinal bleeding along with the presence of flask shaped ulcers on sigmoidoscopy confirms the diagnosis of intestinal amoebiasis (Amoebic colitis). Drug therapy for Amoebiasis Asymptomatic carrier (Luminal agents) * lodoquinol * Paromomycin 650 mg t.i.d. for 20 days 500 , '0 day.s. Acute colitis * Metronidazole * plus Luminal agents as above 750 mg PO or IV tid for 5-10 days Amoebic liver abscess * Metronidazole or * Tinidazole or * Ornidazole * plus Luminal agent as above 750 mg PO or IV tid for 5-10 days 2gPO 2 g PO once | Surgery | null | [
"metronidazole",
"ceftriaxone"
] | 153,732 |
eb71b850-01c3-4af8-aade-384a022a7f1f | Group A streptococci is best diagnosed by - | Optochin sensitivity | Bacitracin sensitivity | Catalase negative | Bile solubility | 1b
| single | Ans. is 'b' i.e., Bacitracin sensitivity Streptococci are classified according to the type of hemolysis on when cultured on blood Agar namely a, b or v hemolysis. b HemolysisThese streptococci undergo complete hemolysis of sheep red blood cells in agar and therefore shows a clear zone around colonies. Hemolysis is caused by the enzyme hemolysins. a HemolysisIncomplete hemolysis producing greenish discolouration around colonies. g HemolvsisNon hemolysis b hemolytic streptococcibHemolytic streptococci are further classified into lancefied groups (A-H K-V) based on the antigenic carbohydrate in the cell wallGroup A, B, C, D and G are the groups most commonly associated with human infections.Group A streptococci (streptococcus pyogenic) is responsible for a wide range of superficial and deep infections and are further classified according to M protein an antiphagocytic fibrillar molecule that interferes with deposition of complement C3b.Group A streptococci is also classified using bacitracin sensitivity test: - BACITRACIN SENSITIVITY TESTThe bacitracin sensitivity test is useful for the differentiation of B hemolytic Group A streptococci from b hemolytic non Group A streptococciThis is important because most streptococcal diseases are caused by Group A streptococci."Streptococcus A (pyogenes) is bacitracin sensitive while streptococcus agalactiae is bacitracin resistantCAMP TESTThis test is used for the presumptive identification of Group B streptococcus (streptococcus agalactiae) and to differentiate it from streptococcus pyogenes group A.Group B is the only B hemolytic streptococcus which yields a positive CAMP testThis test detects a diffusible heat stable extracellular protein produced by Group B streptococcus that enhances the hemolysis of sheep erythrocytes by staphylococcus aureus.The CAMP factor acts synergistically with the beta hemolysin produced by staphylococcus aureus to induce enhanced hemolysis of sheep or bovine RBL.A known hemolytic strain of S. aureus is streaked in a straight line across the centre of the sheep blood agar plate.The test material is streaked in a straight line perpendicular to staphylococcus aureus streak but without touching it.The plate is incubated at 37deg C for 18-24 hours.A positive test for CAMP factor appears as arrowhead hemolysis between the junction of growth of staphylococcus aureus and Group B streptococcus.There is no enhanced or arrowhead hemolysis if the test isolate is not Group B streptococcus. OPTOCHINTESTOptochin sensitivity test is used to differentiate pneumococcus from other a hemolytic streptococci.a hemolytic streptococci may be pathogens such as streptococcus pneumonia or they may be a part of the flora of the upper respiratory tract i.e. viridans streptococci.Streptococcus pneumonia is sensitive to optochin therefore it does not grow around the optochin disc while bacterias that are optochin resistant will be unaffected.Bile solubility test * Bile solubility test is used to distinguish streptococcus pneumoniae from other d hemolytic streptococci.Bile will selectively lyse colonies of streptococcus pneumoniae while other streptococci are immune to bile's activity.When a bile salt such as deoxycholate is added directly to streptococcus pneumoniae growing on an agar plate or in a broth culture the bacteria will lyse and the area becomes clear. Other 5 hemolytic streptococci are resistant to (not lysed by bile) and will stay viable or turbidClassification of Streptococci | Microbiology | Bacteria | [
"bacitracin"
] | 153,743 |
7d24b4e5-3a3a-4587-b2f1-afe3a9fc4e83 | A person has headache & profuse sweating. On examination his B.P is 200/120 mm Hg. Which of the following shoud not be used -a) Nifedipineb) Phenoxybenozamine c) Methyldopad) Labetalol | ab | abc | bc | bd | 1b
| single | null | Medicine | null | [
"labetalol"
] | 153,749 |
9e621b2e-b9b0-4972-b81c-0603618d405d | A patient with ruptured spleen is taken for laparotomy. His blood pressure is 80/50 and heart rate is 125/min. Induction agent of choice for this patient is: | Sodium Thiopentone | Fentanyl | Ketamine | Halothane | 2c
| single | Ans. (C) Ketamine(Ref: Goodman and Gilman 12th/e p538-539)Ketamine increases all pressures (blood pressure, intracranial tension, intraocular pressure) in the body. It is therefore intravenous anesthetic of choice for shock (increases blood pressure). | Pharmacology | Anaesthesia | [
"ketamine",
"halothane",
"fentanyl"
] | 153,753 |
9ab6c518-d764-4a06-987f-2d540ebbdfc9 | A known alcoholic is brought to the emergency depament by his wife. The person has not consumed alcohol for the past two days due to religious reasons. The person complained of nausea, vomiting and dizziness. On the second day, he developed seizures, that progressed to generalized tonic clonic seizures (GTCs). Which of the following would be the best medication to manage the seizures of the patients? | Sodium valproate | Phenytoin | Diazepam | Clonidine | 2c
| single | Ans. c. DiazepamThe seizures in this patient, is due to alcohol withdrawal. Diazepam would be best medication to manage the seizure ofthe patient.'Long acting benzodiazepines such as chlordiazepoxide and diazepam or sho acting such as lorazepam can be used totreat mild-moderate uncomplicated alcohol withdrawal.'Chlordiazepoxide is preferred over diazepamfor treatment of alcohol withdrawal syndrome. | Psychiatry | null | [
"valproate",
"diazepam",
"phenytoin",
"clonidine"
] | 153,756 |
e8ec18f8-528f-4fe0-a216-caa416cdec02 | Drug of choice for reversal of muscle relaxant after anaerthesia - | Pralidoxine | Neostigmine | Atropine | None | 1b
| multi | Ans. is 'b' i.e., Neostigmine Reversal of neuromuscular blocko Nondepolarising muscle relaxants have antagonistic action on acetylcholineo They act by blocking the action of acetylcholine released at the neuromuscular junction which are then not able to combine with its receptors to generate endplate potential,o The antagonistic action of nondepolarizing muscle relaxant can be overcome by increasing the concentration of acetylcholine at the neuromuscular junction,o This is achieved by administering anticholinesterases to the patiento Anticholinestrases act by inhibiting the action of acetylcholinesterase (an enzyme that degrades acetylcholine by causing its hydrolysis).o Anticholinesterases thus increase the level of acetylcholine at the neuromuscular junction,o Neostigmine also has some additional direct action on cholinergic receptors i.e., it depolarizes motor end plate,o It does not increase the release of ACH. Accumulated ACH acts on prejunctional muscarinic autoreceptors and inhibits the release of ACH. | Pharmacology | D.O.C | [
"atropine",
"neostigmine"
] | 153,757 |
d9ddc65f-f19b-4c79-ae3c-a25942b105b5 | Emergency contraceptive of choice is : | OCP | Danazol | Levonorgestrel | Mifepristone | 2c
| single | Levonorgestrol can be used as a single dose, can be given upto 120hrs following unprotected intercourse and no estrogenic side effects | Gynaecology & Obstetrics | Contraception | [
"danazol",
"mifepristone"
] | 153,781 |
6d0e3175-11b9-418d-8e3d-16b63537a0dc | Choose the false statement regarding Hepatitis G virus -a) Also called GB virusb) Blood born RNA virusc) Mostly infected with C virusd) Responds to Lamivudine | ab | bc | bd | cd | 3d
| multi | null | Microbiology | null | [
"lamivudine"
] | 153,796 |
7963fb9d-51c3-4c67-8525-7612d0061143 | What is the concentration of epinephrine added to local anesthetic solution- | 0.736111111 | 1:10,000 | 1 :200000 | 1.430555556 | 2c
| single | Epinephrine 1:200,000 or 5 microg/ml may be added to local anesthetic solution to produce vasoconstriction. Epinephrine is used along with local anesthetics at a concentration of 5 mg/mL or 1:200,000. At this dose, epinephrine provides adequate vasoconstriction. It is added to local anesthetics to limit systemic absorption and the systemic side effects. It limits the diffusion of the drug away from the site thereby prolongs the duration of block and improves the depth of anesthesia. Epinephrine is also used to detect accidental intraaerial injection of a local anesthetic during the neuraxial block. The classic test dose combines local anesthetic and epinephrine, 3 mL of 1.5% lidocaine with 1:200,000 epinephrine. This epinephrine if injected intraaerially would increase the hea rate by 20% with or without the rise in blood pressure. Use of epinephrine can also enhance analgesia by acting on spinal a2 adrenergic receptors. The extent to which epinephrine prolongs the duration of anesthesia depends on the specific local anesthetic used and the site of injection. It can prolong the block caused by shoer acting agents as compared to longer acting ones. i.e. by adding epinephrine to lidocaine, the duration of the block is prolonged significantly than by the addition of epinephrine to bupivacaine. | Anaesthesia | Cardiopulmonary Cerebral Resuscitation | [
"epinephrine"
] | 153,798 |
fbf4bc64-553a-4347-b86d-6668cf81c40c | Which of the following antimicrobial is effective against an organism producing extended spectrum beta lactamase? | Amoxicillin-Clavulinic acid | Cefepime | Piperacillin-Tazobactam | Ceftriaxone | 2c
| single | Ans. (C) Piperacillin-tazobactam(Ref: Harrison 18th/1247)Organisms producing ESBL-like Klebsiella are resistant to most beta-lactams except carbapenems.ESBL can be inhibited by beta lactamase inhibitors.Amoxicillin is not effective against Klebsiella whereas piperacillin has wide spectrum including Klesiella. | Pharmacology | Chemotherapy: General Principles | [
"ceftriaxone"
] | 153,814 |
868279e0-1fad-4961-8e48-c0b0d67d3b44 | Drug of choice in intractable hiccups is : | Metoclopramide | Fluoxetine | Selegiline | Chlorpromazine | 3d
| single | null | Pharmacology | null | [
"selegiline",
"fluoxetine",
"metoclopramide",
"chlorpromazine"
] | 153,833 |
cbb071cd-818c-4e9e-9385-c5aab9c58b67 | Aqueous flow is increased by ? | Timolol | Latanoprost | Atropine | Dorzolamide | 1b
| single | Ans. is 'b' i.e., Latanoprost | Ophthalmology | null | [
"dorzolamide",
"latanoprost",
"atropine",
"timolol"
] | 153,839 |
a2578af3-ae63-4c1b-b5ec-2784055891c2 | All are used for mangement for hypernatremia except | 5% dextrose in water | N/2 in 5% dextrose | Nil by mouth | Indomethacin | 2c
| multi | Ans. is `c' i.e., Nil by mouth T/T of Hypernatremia :? As hypernatremia develops, water moves out from I.C.F. to E.C.F. to maintain equal osmolality inside and outside the cell. So the intracellular fluid decreases. To compensate for this the brain cells generates idiogenic osmoles to increase the intracellular osmolality and prevent the loss of brain water. This mechanism is not instantaneous and is most prominent when hypernatremia has developed gradually. If the hypernatremia is corrected rapidly by administration of fluids, the E.C.F. osmolality lowers rapidly, and now the I. C.F becomes hyperosmotic in comparison to the E.C.F. So, now there is movement of water from serum into the brain cells to equalize the osmolality in the two compament. This results in brain swelling and most commonly it manifests as seizures in infants. (This is clinically similar to hyponatremia) Because of the dangers of ovely rapid correction, hypernatremia should not be corrected rapidly. The goal is to decrease the serum sodium by less than 12-10 mEq/L even, 24 hr, at a rate of 0.5-10 mEq/h. In patients with chronic hypernatremia (hypernatremia that has been present for longer than 48 hours). The treatment regimen is 5 percent dextrose in water, intravenously At a rate of (1.35 mL/hour x patient's weight in kg), or About 70 mL per hour in a 50 kg patient and 100 mL per hour in a 70 kg patient. The goal of this regimen is to lower the serum sodium by a maximum of 10 meq/L in a 24-hour period (0.4 meq/ L/hour). In patients with known acute hypernatremia (hypernatremia that has been present for 48 hours or less). The treatment regimen is (see 'Initial fluid repletion regimen' above) :- 5 percent dextrose in water, intravenously, at a rate of 3 to 6 mL/kg per hour The serum sodium and blood glucose should be monitored every one to two hours until the serum sodium is lowered below 145 meq/L. Once the serum sodium concentration has reached 145 meq/L, the rate of infusion is reduced to 1 mL/kg/hour and continued until normonatremia (140 meq/L) is restored. The goal of this regimen is to lower the serum sodium by 1 to 2 meq/L per hour and to restore normonatremia in less than 24 hours. Patients with diabetes insipidus will also require desmopressin therapy, which is discussed elsewhere. Hyperglycemia may develop with rapid infusions of 5 percent dextrose; to avoid increased water losses from glycosuria, a slower rate of infusion or a change to 2.5 percent dextrose in water may be required after several hours. Risk of correctionof hypernatremia. The treatment goal for chronic hypernatremia is designed to lower the serum sodium by 10 meq/L in 24 hours (12 meq/L in 24 hours is considered the maximum safe limit, 10 meq/L in 24 hours is chosen to increase to safety | Medicine | null | [
"indomethacin"
] | 153,847 |
ae604146-2536-460f-bdf9-574032c32fa3 | All about warfarin are true EXCEPT? | Half-life is 36 hours | Crosses placenta | Contraindicated in hepatic failure | Inhibits all vitamin K dependent clotting factors | 2c
| multi | Ans. is 'c' i.e., Contraindicated in hepatic failure o Liver disease requires dose reduction, but is not a contraindication. Effect of liver disease on warfarin o In liver diseases the dose of oral anticoagulats needs to be decreased because in liver disease the hepatic synthesis of clotting factors is reduced. o Thus there is already a deficiency of clotting factors (i.e. there is preexisting anticoagulant state). o Administration of warfarin is this state increases the risk of bleeding. About other options o Warfarin is an indirectly acting anticoagulant, i.e. it inhibits vitamin K which in turn inhibits coagulation factors. o T1/2 of warfarin is 36 hrs. o Warfarin can cross placenta and cause fetal warfarin syndrome. Therefore it is contraindicated pregnancy. Patient is switched to heparin from warfarin during pregnancy. | Pharmacology | null | [
"warfarin"
] | 153,872 |
ede3470b-6042-43d2-939a-ebe8add20815 | Active substance in Dakins skin dressing agent used in burns is ? | Mafenide acetate | Silver sulfadiazine | Sodium hypochlorite | Nystatin | 2c
| single | Ans. is 'c' i.e., Sodium hypochlorite | Surgery | null | [
"nystatin"
] | 153,874 |
7e25c218-c643-461a-bc0a-c25e4a253002 | Safest transplantation approach in liver disease- | Directly transplanting embryonic stem cell in the liver | Transplanting donor hepatocytes into liver | Transplanting mesenchymal stem cell from adipose tissue to liver | Injecting erythropoietin into body | 2c
| single | Answer- C. Transplanting mesenchymal stem cell from adipose tissue to liverToday, autologous (from the patient) adipose tissue stem cell are the only stem cells that have been used clinically for treating liver disease.Many trials have shown that patients with liver cirrhosis have benefitted from autologous adipose tissue derived mesenchymal stem cells | Medicine | null | [
"erythropoietin"
] | 153,879 |
255b3a76-63e2-46ae-bb15-b72a731f1e47 | The fastest acting schizontocidal drug among the following is : | Artemether | Mefloquine | Chloroquine | Proguanil | 0a
| single | null | Pharmacology | null | [
"chloroquine",
"mefloquine"
] | 153,887 |
da5797fd-232d-434e-9979-11cc44d0cdf1 | The binding of epinephrine or glucagon to the corresponding membrane receptor has which of the following effects on glycogen metabolism? | The net synthesis of glycogen is increased. | Glycogen phosphorylase is activated, while glycogen synthase is inactivated. | Glycogen phosphorylase is inactivated, while glycogen synthase is activated. | Both glycogen synthase and phosphorylase are activated. | 1b
| multi | Both epinephrine and glucagons result in activities which serve to increase (maintain) blood glucose. Activation of glycogen phosphorylase will result in glycogen degradation, ultimately providing a source of glucose. Glycogen synthase inhibition results in decreased synthesis of glycogen. | Biochemistry | null | [
"epinephrine",
"glucagon"
] | 153,894 |
fe2c8c20-c89a-4c06-b6f8-6af53c23f2ce | In anterior uveitis with secondary glaucoma, all mydriatics can be given, except | Pilocarpine | Homatropine | Epinephrine | Tropicamide | 0a
| multi | A i.e. Pilocarpine In inflamatory glaucoma (glaucoma with uveitis) pilocarpine (miotic) & prostaglandin analogue e.g. latanoprost are contraindicated Q because - Pilocarpine 1/t development of posterior synechiae Prostaglandin analogue enhance breakdown of aqueous barrier and exacerbate cystoid macular edema. | Ophthalmology | null | [
"pilocarpine",
"epinephrine",
"tropicamide"
] | 153,899 |
42a061ca-177b-4b6c-8934-c063f788489d | Infliximab is : | IgG1 chimeric monoclonal antibody against TNF α | IgG1 fully human monoclonal antibody against TNF α | P75 TNF receptor fusion protein | none | 0a
| multi | null | Pharmacology | null | [
"infliximab"
] | 153,900 |
4759e72c-1e18-4880-b8d2-4405700b0bf6 | which of the following antimicrobials should not be given to a 4C asthmatic patient managed on theophylline therapy ? | ERYTHROMYCIN | CEFOTIXIME | COTRIMOXAZOLE | AMOXICILLIN | 0a
| single | THEOPHYLLIN + ERYTHROMYCIN = QT PROLONGATION REF : KD TRIPATHI 8TH ED | Pharmacology | All India exam | [
"theophylline",
"erythromycin"
] | 153,904 |
cf90099e-a8fe-458e-a1ab-4b74ced83075 | Zero order kinetic is shown by all EXCEPT: | High dose salicylates | Phenytoin | Ethanol | Methotrexate | 3d
| multi | null | Pharmacology | null | [
"methotrexate",
"phenytoin"
] | 153,917 |
0b54f50e-a750-4d78-a0d6-2cac1368b1ee | If a diabetic patient being treated with an oral hypoglycemic agent, develops dilutional hyponatremia-which one of the following could be responsible for this effect - | Chlorpropamide | Tolazamide | Glyburide | Glimepiride | 0a
| single | Ans. is 'a' i.e., Chlorpropamide o Cholorpropamide causes cholestasis, dilutional hyponatremia, intolerance to alcohol (disulfiram like reaction). | Pharmacology | null | [
"chlorpropamide"
] | 153,919 |
df2de93d-a380-444f-bebe-2e91a85b82f6 | A 35 year old man presents with Acute Pancreatitis. The ideal fluid of choice in the initial management is | Isotonic crystalloid | Hypertonic | Hypotonic | Vasopressin | 0a
| multi | (A) Isotonic crystalloid[?]INITIAL MANAGEMENT:oCrystalloids: Ringer's lactate or Normal saline.oWhile crystalloids appear to be the Ideal Choice based on expert opinion & the guidelines/recommendations from America, Italy & Japan.oThese recommendations are not based on high - level evidence in patients with acute pancreatitis.ADVANTAGES & DISADVANTAGES OF DIFFERENT FLUID TYPES IN RESUSCITATIONFluid TypeAdvantagesDisadvantagesIsotonic crystalloids (lactated Ringer's solution, 0.9% sodium chloride, Normosol-R, Plasmalyte A)*. Los cost*. Necessary in dehydration*. Widely available*. Large volumes needed*. Longer time to resuscitate*. Require more technical staff (E.g., Placement of multiple, large-guage IV catheters)*. Risk of hypothermia*. Risk of interstitial edema*. Risk of hemodilution*. Risk of re-bleedingHypertonic saline*. Low cost*. Small volumes needed for rapid resuscitation*. Minimizes risks of interstitial edema*. Beneficial neurological effects; decreases intracranial pressure*. Immunomodulatory effects*. Beneficial cardiac effects*. Short acting when used alone*. Transient hypernatremia*. Hypotension, bronchoconstricction, or arrhythmias with rapid administration*. Risk of volume overload*. Possible phlebitis*. HyperosmolarSynthetic colloids (6% hetastarch, 10% pentastarch, 6% dextran 70)*. Smaller volumes needed for rapid resuscitation compared with crystalloids*. Minimizes risks of interstitial edema*. Longer duration of effect*. Increases COP*. Less hemodilution*. Higher cost*. Risk of volume overload*. Exacerbation of coagulopathies*. Risk of allergic reactions*. Edema with vasculitis*. Interference with cross-matchingHemoglobin-based oxygencarrier (Oxyglobin)*. Increases COP*. Increases oxygen delivery*. Eliminates need to cross-match*. 2 year shelf life*. Higher cost*. Risk of volume overload*. Possible risk of anaphylaxis with multiple uses*. Inability to measure certain blood values after useoAggressive hydration, defined as 250-500 per hour of isotonic crystalloid solution should be provided to all patients, unless cardiovascular, renal or other related co-morbid factors exist.oEarly aggressive intravenous hydration is most beneficial during the first 12-24 hr, and may have little benefit beyond this time period.oIn a patient with severe volume depletion, manifest as hypotension & tachycardia, more rapid repletion (bolus) may be needed. | Medicine | Fluid & Electrolyte | [
"vasopressin"
] | 153,922 |
64d6c543-22c3-49c2-9b93-e100259d85ca | b2 agonist with a long duration of action is | Salbutamol | Terbutaline | Salmeterol | Albuterol | 2c
| single | A new generation of long-acting b2- selective agonists includes salmeterol (a paial agonist) and formoterol (a full agonist). Both drugs are potent selective b2 agonists that achieve their long duration of action (12 hours or more) as a result of high lipid solubility. These drugs appear to interact with inhaled coicosteroids to improve asthma control. Because they have no anti-inflammatory action, they are not recommended as monotherapy for asthma. An ultra-long-acting b agonist, indacaterol, is currently approved in Europe. It needs to be taken only once a day but is used only for the treatment of chronic obstructive pulmonary disease (COPD). Data on its efficacy and safety in the management of asthma are lacking. Reference: Katzung Pharmacology; 13th edition; Chapter 20; Drugs Used in Asthma | Pharmacology | Cardiovascular system | [
"salmeterol",
"terbutaline",
"salbutamol"
] | 153,936 |
fc80f152-e452-49e0-a5a2-2d361fda62d2 | A 22 yr old female, Neeta presented to you with complaints if headache and vomiting since 2 months b. She is having amenorrhea but urine pregnancy test is negative. She also complained big secretion big milk from the breasts. A provision diagnosis of hyper prolactinemia was made and MRI was suggested. MRI confimed the presence of large Pituatory Adenoma Neeta was advised surgery however she is not willing to undergoe surgery. Which of the following medications is most likely to be prescribed | Sumatriptan. | Bromocriptine | Ergotamine | Allopurinol | 1b
| multi | Refer KK Sharma 2/e p 550 Bromocriptine is a D2 agonist and is useful in hyoerprolactinemia by its action to inhibit the release of prolactin. | Pharmacology | Endocrinology | [
"allopurinol",
"bromocriptine",
"sumatriptan"
] | 153,942 |
e9afe148-f203-4c4c-b43f-03f7512f1618 | Agent of first choice in an acute attack of Prinzmetals angina is - | Diltiazem | Nitrates | Propranolol | Verapamil | 1b
| single | null | Medicine | null | [
"propranolol",
"diltiazem",
"verapamil"
] | 153,948 |
e9117bb4-1567-4861-9c40-d8aeab82eb45 | A 45-year-old Nobel Prize-winner in chemistry has recently been the recipient of a heart transplant. Patient education has included both verbal and written descriptions of the potential cardiovascular effects of pharmacologic agents. Which one of the following drugs is least likely to cause tachycardia in this patient? | Amphetamine | Dobutamine | Epinephrine | Isoproterenol | 0a
| multi | This question is to remind you that indirect-acting sympathomimetics require innervation of the effector organ to exert effects. In this case, amphetamine would not be effective because the transplanted heart lacks sympathetic innervation; thus, there is no "mobile pool" of NE capable of being released by a drug. However, transplanted hearts retain receptors, including those (b1 ) responsive to direct-acting sympathomimetics. Heart transplants are not responsive to AChE inhibitors because they, too, are indirect acting and require vagal innervation to exert effects on the heart. | Pharmacology | C.V.S | [
"epinephrine",
"dobutamine"
] | 153,957 |
a5c3e7e3-7ccf-449e-aa54-197d87234b7f | Anti-hypeensive drug contraindicated in pregnancy is? | Enalapril | Cardio selective Beta blockers | Methyl dopa | Hydralazine | 0a
| single | Enalapril REF: KDT ed p. 553 Also asked in June 2008 (OBG), December 2008 (pharm) Anti-hypeensive to be avoided in pregnancy Anti-hypeensive to be given in pregnancy * ACE-I , AT-1 blockers ( absolutely c/i) * Hydralazine * Diuretics * Methyl dopa * Non selective beta blockers * Dihydropyridine CCBs * Sodium nitroprusside * Cardioselective beta blockers and those with intrinsic sympathomimetic activities * Prazosine and clonidine | Pharmacology | null | [
"hydralazine",
"enalapril"
] | 153,980 |
1bab79a8-4a43-4797-908f-465749dd4891 | 40 year old male patient presents to the Emergency depament with central chest pain for 2 hours. The ECG shows ST segment depression and cardiac troponins are elevated. Patient has a positive history of previous PCI 3 months back. He is administered Aspirin, Clopidogrel, Nitrates and LMWH, in the Emergency Depament and shifted to the coronary are unit. The best recommended course of fuher action should include. | Immediate Revascularization with Thrombolytics | Early Revascularization with PCI | Continue conservative management and monitoring of cardiac enzymes and ECG | Continue conservation management and plan for delayed Revascularization procedure after patient is discharged | 1b
| single | Answer is B (Early Revascularization with PCI) The patient presenting as a case of NSTE M I to the emergency depament. The presence of elevated cardiac troponins and history of previous PCI place the patient into a high 'risk category'. The Patient in question is th 10 a 'high risk' patient with NSTEMI Such patients are candidates for early invasive management with PCl/CABG. | Medicine | null | [
"clopidogrel"
] | 153,985 |
bf295bbe-3223-4366-a8f1-d9c3db1a1986 | Atropine is useful in organophosphate poisoning because it - | Reactivates acetylcholinesterase | Competes with acetylcholine release | Binds with both nicotinic and muscarinic acetylcholine receptors | Is a competitive antagonist of acetylcholine | 3d
| multi | Ans. is 'd' i.e., Is a competitive antagonist of acetylcholine o Atropine acts as competitive antagonist at muscarinic receptors. It has no activity on nicotinic receptors and has nothing to do with Ach release. | Pharmacology | null | [
"atropine"
] | 153,988 |
2adb2ec5-f423-436a-af8f-8ca28444e90d | Regarding the synthesis of triacylglycerol in adipose tissue, all of the following are true except | Synthesis from Dihydroxyacetone phosphate | Enzyme Glycerol kinase plays an important role | Enzyme Glycerol 3 phosphate dehydrogenase plays an important role | Phosphatidate is hydrolyzed | 1b
| multi | null | Biochemistry | null | [
"dihydroxyacetone"
] | 153,992 |
26bf22a0-66cb-4046-a082-f04a6d7adcb0 | Which of the following drugs used in osteoporosis acts both by decreasing the resorption of bone as well as inducing new bone formation? | Teriparatide | Ibandronate | Strontium ranelate | Calcitonin | 2c
| multi | Strontium ranelate appears to block differentiation of osteoclasts while promoting their apoptosis, thus inhibiting bone resorption. At the same time, strontium ranelate appears to promote bone formation. Unlike bisphosphonates, denosumab, or teriparatide, this drug increases bone formation markers while inhibiting bone resorption markers. Calcitonin inhibits osteoclastic bone resorption. Although bone formation is not impaired at first after calcitonin administration, with time both formation and resorption of bone are reduced. Ref: Bikle D.D. (2012). Chapter 42. Agents that Affect Bone Mineral Homeostasis. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e. | Pharmacology | null | [
"teriparatide"
] | 153,994 |
850002ca-0299-4fe3-9e81-6f25f1bac4bf | Late onset hemorrhagic cystitis after bone marrow transplanatation is caused by: | Cyclophosphamide | Ifosfamide | Adeno virus | Cytomegalo virus | 2c
| single | After bone marrow transplantation (BMT), early-onset hemorrhagic cystitis is related to drugs in the treatment regimen (e.g., cyclophosphamide, ifosfamide), and late-onset hemorrhagic cystitis is usually due to the polyoma virus BKV or adenovirus type 11. Ref: Harrisons principles of internal medicine, 18th edition, Page: 2275. | Medicine | null | [
"cyclophosphamide"
] | 154,011 |
1a54ce81-0fbe-4171-a02f-fd9182344736 | A child presents with hepatomegaly and hypoglycemia. There is no improvement in blood sugar even after administration of epinephrine. What is the likely diagnosis – | Von girke's disease | Anderson's disease | Pompe's disease | Mc Ardle's disease | 0a
| single | Amongst the given options only Von Gierke's disease presents with hepatomegaly and hypoglycemia.
"A diagnosis of type I glycogen storage disease (Von Gierke's disease) should be suspected whenever there is hepatomegaly with hypoglycemia that is unresponsive to glucagon or epinephrine". | Pediatrics | null | [
"epinephrine"
] | 154,015 |
7d286fbe-ffae-4413-bfdb-6f4d3e8cf994 | The second gas effect is | Displacement of N20 by Oxygen | Displacement of oxygen by N20 | Removal of oxygen by N20 from alveoli during recovery from general anaesthesia | Facilitation of inhalation of Halothane by N20 | 3d
| single | null | Anaesthesia | null | [
"halothane"
] | 154,050 |
426cecc5-9086-4d76-86c4-2ab0200c7935 | All are true about Hvpothalamus-pituitary-Adnnal axis except | CRH stimulates zona fasiculata leading to increased cortrisol production | CRH & Vasopressin are released from neurosecretory nerve terminals at the median eminence | Cortisol produced in the adrenal cortex will negatively feedback | Epinephrine and norepinephrine will positively feed- back to the pituitary | 0a
| multi | (A) CRH stimulates zona fasiculata leading to increased cortisol production.# KEY ELEMENTS OF THE HPA AXIS are:> Paraventricular nucleus of the hypothalamus, contains neuroendocrine neurons that synthesize and secrete vasopressin & corticotropin-releasing hormone (CRH).> These two peptides regulate: Anterior lobe of the pituitary gland. In particular, CRH and vasopressin stimulate the secretion of adrenocorticotropic hormone (ACTH), once known as corticotropin. ACTH in turn acts on: Adrenal cortex, which produces glucocorticoid hormones (mainly cortisol in humans) in response to stimulation by ACTH. Glucocorticoids in turn act back on the hypo- thalamus and pituitary (to suppress CRH and ACTH production) in a negative feedback cycle.> CRH & Vasopressin are released from neurosecretory nerve terminals at the median eminence.> CRH is transported to the anterior pituitary through the portal blood vessel system of the hypophyseal stalk & vasopressin is transported by axonal trans- port to the posterior pituitary gland.> CRH and vasopressin act synergistically to stimulate the secretion of stored ACTH from corticotrope cells.> ACTH is transported by the blood to the adrenal cortex of the adrenal gland, and it rapidly stimulates biosynthesis of corticosteroids such as cortisol from cholesterol.> Cortisol is a major stress hormone and has effects on many tissues in the body, including the brain. In the brain, cortisol acts on two types of receptor - mineralocorticoid receptors and glucocorticoid receptors, and these are expressed by many different types of neurons. One important target of glucocorticoids is the hypothalamus, which is a major controlling centre of the HPA axis.> Vasopressin can be thought of as "water conservation hormone" and is also known as "antidiuretic hormone." It is released when the body is dehydrated and has potent water-conserving effects on the kidney. It is also a potent vasoconstrictor.# Important to the function of the HPA axis are some of the feedback loops: Cortisol produced in the adrenal cortex will negatively feedback to inhibit both the hypothalamus and the pituitary gland. Reduces the secretion of CRH and vasopressin, and also directly reduces the cleavage of propiomelanocortin (POMC) into ACTH and b-endorphins. Epinephrine and norepinephrine (E/NE) are produced by the adrenal medulla through sympathetic stimulation and the local effects of cortisol (upregulation enzymes to make E/NE). E/NE will positively feedback to the pituitary and increase the breakdown of POMCs into ACTH and b-endorphins. | Physiology | Nervous System | [
"epinephrine",
"vasopressin"
] | 154,056 |
f76fc912-e037-445b-a9e4-d6e882d3678a | Which one of the antitubercular drug may precipitate gout : | Pyrazinamide | Rifampicin | Streptomycin | Isoniazid | 0a
| single | null | Pharmacology | null | [
"isoniazid"
] | 154,066 |
95c0cfd2-8662-4a88-bcb0-9f8b01201ad4 | Furosemide acts by inhibiting - | Na+-K+-2Cl- pump | Na+-Cl- pump | Carbonic anhydrase | Epithelial Na+ channels | 0a
| single | Ans. is 'a' i.e., Na+-K+-2C1- pump o The major site of action is thick ascending limb of loop of Henle where they inhibit Na+K+2Cl'.o Has been explained in previous sessions | Pharmacology | Diuretic | [
"furosemide"
] | 154,082 |
41da1e95-adc1-47d6-b904-cb8a6548fe04 | Anti HER 2/ neu antibody is: | Bevacizumab | Trastuzumab | Rituximab | Abciximab | 1b
| single | The determination of tumor HER-2/neu expression for all newly diagnosed patients with breast cancer is now recommended. It is used for prognostic purposes in node-negative patients to assist in the selection of adjuvant chemotherapy because response rates appear to be better with doxorubicin-based adjuvant chemotherapy in patients with tumors that overexpress HER-2/neu, and as baseline information in case the patient develops recurrent disease that may benefit from anti-HER-2/neu therapy (trastuzumab). Patients with tumors that overexpress HER-2/neu may benefit if trastuzumab is added to paclitaxel chemotherapy. Cardiotoxicity may develop if trastuzumab is delivered concurrently with doxorubicin-based chemotherapy. Ref: Schwaz's principle of surgery 9th edition, chapter 17. | Surgery | null | [
"abciximab",
"rituximab"
] | 154,083 |
15d8d025-10c9-4932-9c8a-d01c69c721c5 | Which of the following drug is commonly responsible for ohostatic hypotension: March 2010 | Clonidine | Hydralazine | Captoprils | Prazosin | 3d
| single | Ans. D: Prazosin Side effects of prazosin include ohostatic hypotension, syncope, and nasal congestion. The ohostatic hypotension and syncope are associated with the body's poor ability to control blood pressure without active alpha-adrenergic receptors. Patients on prazosin should be told not to stand up too quickly, since their poor baroreflex may cause them to faint as all their blood rushes to their feet. The nasal congestion is due to dilation of vessels in the nasal mucosa. One phenomenon associated with prazosin is known as the "first dose response", in which the side effects of the drug, especially ohostatic hypotension and fainting, are especially pronounced after the first dose. Another common side effect of prazosin (and doxazosin) is priapism. | Pharmacology | null | [
"prazosin",
"hydralazine",
"clonidine"
] | 154,087 |
4b3044f8-cfc9-484f-b83f-78d05c129b63 | A person presents with pneumonia. His sputum was sent for culture. The bacterium obtained was gram positive cocci in chains and alpha haemolytic colonies on sheep agar. Which of the following will help in confirming the diagnosis? | Novobiocin | Optochin | Bacitracin | Oxacillin | 1b
| single | Ans. b. Optochin (Ref: Ananthanarayan 8/e p205-206)Gram-positive cocci with alpha hemolytic colonies on sheep agar are Streptococcus viridians and Streptococcus pneumoniae. They can be further differentiated on basis of optochin sensitivity, Streptococcus viridians-optochin resistant or Streptococcus pneumonia-optochin sensitive. Streptococci ViridansStreptococcus pneumoniaeBile solubilityInsolubleQSolubleQFermentation of inulinNot a fermenterQFermenter with acid productionQSensitivity to optochinNot sensitiveQSensitiveQPathogenicity to miceNonpathogenicQPathogenicQQuel lung testNegativeQPositiveQ | Microbiology | Streptococci | [
"bacitracin",
"novobiocin"
] | 154,115 |
cac38c07-5344-4b8c-b986-f7de1f20e64a | Zileuton, a 5-lipooxigenase inhibitor, acts by which of the following mechanisms? | LT C4 synthesis inhibitor | D4 synthesis inhibitor | LT B4 synthesis inhibitor | All of the above | 3d
| multi | Ans. d (All of the above) (Ref. KDT, Pharmacology, 6th ed. 175, 223)ZILEUTON# 5-Lipoxygenase inhibitor and blocks LTC4, LTD4 as well as LTB4 Synthesis# Duration of action - Short 3-4 hrs# Adverse effect - Hepatotoxicity.MONTELEUKAST, ZAFIRLUKAST# Cys LT1 receptor antagonist used in asthma prophylaxis# Side effects:- Eosinophilia, Neuropathy, Churg-Strauss disease | Pharmacology | Asthma | [
"zileuton"
] | 154,127 |
3e7b575d-f30f-481c-975a-0d6b3a40445a | Most common agent associated with agranulocytosis is: | Steroids | Alkylating agents | Paracetamol | Endotoxemia | 1b
| single | Ans. b. Alkylating agentsRef: Harrison 19th e/P 417Most common cause of agranulocytosis is iatrogenic, i.e. drug induced.Most common drugs causing agranulocytosis are anticancer drugs which inhibit cell cycle like alkylating agents and antimetabolites like methotrexate, 5-FU and 6-MP. | Pharmacology | Anti-Cancer | [
"paracetamol"
] | 154,134 |
224f0abc-fb5d-484d-90a1-9a5570995509 | Acute anginal attack can be terminated by: September 2007 | Nitroglycerin | Digoxin | Lignocaine | Verapamil | 0a
| single | Ans. A: Nitroglycerin Absorption of Nitrates is most rapid and complete through the mucous membrane.For this reason, nitroglycerin is the most commonly administered sublingually. Their mechanism of action is systemic venodilation with concomitant reduction in LV end diastolic volume and pressure, thereby reducing myocardial wall tension and oxygen requirements. Complications are a pulsating feeling in the head, postural dizziness. | Medicine | null | [
"nitroglycerin",
"digoxin",
"verapamil"
] | 154,146 |
64c86057-76ce-473e-99dd-b6a071736866 | Discolouration of the teeth seen in following intake | Tetracyclines | Chloramphenicol | Minocycline | Lymecycline | 0a
| single | [A) (Tetracycline) (672 - KDT 5th) (714-KDT 6th)* Tetracyclines have chelating property. Calcium- tetracycline chelate gets deposited in developing teeth and bone Given from mid pregnancy to 5 months to extra uterine life the decidous teeth are affected brown discolouration of teeth, more susceptible to carries. Tetracyclines gives between 3 months to 6 years of age affect permanent anterior dentition. Repeated course are more damaging* Prevention of discolouration of permanent front teeth requires that tetracyclines be avoided from the last 2months of pregnancy to 4 years and of other teeth to 8 years of age (or 12 years if the third molar are valued)* Prolonged tetracyclines therapy can also stain the finger nails at all ages. | Pharmacology | Anti Microbial | [
"minocycline",
"chloramphenicol"
] | 154,151 |
2e797f75-1b22-4e57-8f5c-3fa2a8fa9370 | A child with schizophrenia was on medications. Suddenly he developed neck stiffness and spasm. Best treatment of such a case is? | Benzatropine | Lorazepam | Diphenhydramine | Propranolol | 0a
| single | Ans. (a) BenzatropineRef. Handbook of psychiatric drug therapy by Lawrence A. Labbate, Maurizio favay Jerrold F. Rosenbaum, George W. Arana 6th ed. /37y Medical toxicology edited by Richard C. Dart 3th ed. /869) | Psychiatry | Schizophreniform Disorder | [
"propranolol",
"lorazepam",
"diphenhydramine"
] | 154,160 |
1359ed08-ab85-4fa8-928b-60d0822747e9 | All of the following drugs causes hirsutism except: | Phenytoin | Flutamide | Norethindrone | Danazol | 1b
| multi | Phenytoin has various adverse effects like hirsutism, hyperglycemia, osteomalacia, gum hyperplasia etc Norethindrone a progestin derivative has various adverse effects like breast enlargement, hirsutism, and hyperglycemia. Danazol is an antiandrogen with side effects like hirsutism, amenorrhea etc Flutamide is androgen receptor antagonist. Hirsutism occurs due to excess testosterone like effects .so this effect is not seen with antiandrogen like flutamide. ESSENTIAL of medical PHARMACOLOGY SEVENTH EDITION-KD TRIPATHI Page:413,414,301,858,318 | Pharmacology | Other topics and Adverse effects | [
"danazol",
"flutamide",
"phenytoin"
] | 154,164 |
c50a55ed-e16d-4962-a3d9-914519eac95f | All of the following drugs are used in alcohol de-addiction except? | Naltrexone | Acamprostate | Disulfiram | Opioids | 3d
| multi | ALCOHOL DE-ADDICATION Benzodiazepines (chlordiazepoxide and diazepam) are given to prevent withdrawal. These are long acting CNS depressants and can be withdrawn gradually. Naltrexone is an opioid antagonist that can be used to reduce alcohol craving. Acamprosate is an NMDA antagonist that can be used for maintenance therapy of alcohol abstinence. Disulfiram can be used in psychologically dependent persons who are motivated to quit alcohol. It is contraindicated in physically dependent individuals. Disulfiram produces severe distressing symptoms. Topiramate and ondansetron can also decrease alcohol craving. | Pharmacology | CNS | [
"disulfiram",
"naltrexone"
] | 154,170 |
3215a0be-052e-4c6f-aada-78a6979791b9 | which of the following antidepressent is used for smoking sessation | bupropion | miazapine | trazadone | clomipramine | 0a
| single | NDRI * IMPOANCE Anti-depressant which does not deal with serotonin neurotransmission Also called as Zyban * MECHANISM Prevents reuptake of nor adrenaline and dopamine * DRUGS Bupropion * USE ADHD SMOKING CESSATION HYPOACTIVE SEXUAL DESIRE DISORDER * SIDE EFFECTS seizures ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 954 | Psychiatry | Pharmacotherapy in psychiatry | [
"bupropion",
"clomipramine"
] | 154,176 |
8150c661-3faf-423b-888e-9daa5b7792db | A middle aged man presented with pain in back, lack of interest in recreational activities, low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucinations. He did not suffer from any chronic medical illness. There was no family history of psychiatric illness. Routine investigations including haemogram, renal function tests, liver function tests electrocadiogram did not reveal any abnormality. This patient should be treated with - | Haloperidol | Sertraline | Alprazolam | Olanzapine | 1b
| multi | This patient has (for 2 months)
i) Lack of interest
ii) Low mood
iii) Loss of energy / fatigue (lethargy)
iv) Decreased sleep
v) Decreased appetite
Diagnosis is major depression → Antidepressant should be given. Amongst the given options only sertaline is antidepressant. | Psychiatry | null | [
"alprazolam",
"sertraline",
"olanzapine"
] | 154,181 |
7aac9909-c3f8-44b8-b636-4079b8eea6f5 | A 50 year old man with a history of smoking, hypeension, and chronic exeional angina develops several daily episodes of chest pain at rest compatible with cardiac ischemia. The patient is hospitalized. All the following would be pa of an appropriate management plan except - | Intravenous heparin | Aspirin | Intravenous nitroglycerin | Lidocaine by bolus infusion | 3d
| multi | Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:188-190 Management 1. Bed-rest 2. Nasal O2 3. Morphine given in an intravenous form (< 1 mg per minute) to a maximum dose of 10-15 mg. It acts as a pulmonary venodilator and also as an analgesic to allete anxiety 4. Nitrates may be given sublingually for rapid action of relief of pain by coronary vasodilation. It also helps to reduce the preload of the hea, being a predominant venodilator. If pain persists after administration of sublingual nitrates, IV infusion of nitroglycerine may be given, provided the systolic BP is maintained above 100 mm Hg 5. Aspirin is given orally in the dose ranging from 100 to 300 mg 6. Thrombolytic therapy (Streptokinase, Urokinase, Tissue plasminogen activator) may be given and is paicularly useful if given within 6 hrs of onset of Comparison of Anterior and Inferior Wall Myocardial Infarction Features Anterior MI Inferior MI 1. Extent of necrosis Large Small 2. Extent of coronary atherosclerosis Small Large 3. Complications a. Ventricular septal rupture Apical, easily repaired Basal, difficult to repair b. Aneurysm Common Uncommon c. Free wall rupture Uncommon Rare d. Mural thrombus Common Uncommon e. Hea blocks Uncommon Common f. Bundle branch blocks Common Uncommon 4. Prognosis Worse than that of inferior MI Better than that of anterior MI 5. Diagnosis a. Symptoms Gastrointestinal symptoms unusual Gastrointestinal symptoms (nausea, vomiting, hiccough) common b. Physical examination Tachycardia; hypotension uncommon. Bradycardia; hypotension common. Jugular venous distention less Jugular venous distention common. common than with inferior MI. 20% have S3 50% have S3 c. ECG Features of anterior wall MI Features of inferior wall MI d. Echocardiogram Abnormal left ventricular wall Abnormal left ventricular wall motion motion is anterior in location. is inferior in location. Right ventricular No abnormal right ventricular abnormal wall motion present in wall motion approximately one-third of patients. symptoms, but may be given upto 12 hrs after onset of symptoms. Ideal--door to needle time 30 min. 7. Heparin may be given in a dose of 5000 U, 12 hourly, subcutaneously, as prophylaxis against development of deep vein thrombosis and 12,500 U, 12 hourly, subcutaneously, as prophylaxis against development of mural thrombus or extension of the coronary thrombus, for a period of 7-10 days 8. b-blockers are staed immediately, or after two weeks and given for a minimum duration of two years, if there is no contraindication for their use, as these agents (atenolol, metoprolol, propranolol) help in reducing morbidity and moality significantly. b-blockers can be given even if the ejection fraction as determined by Echo is < 40%, but calcium channel blockers must be avoided 9. ACE inhibitors help in cardiac remodelling and reduce morbidity and moality 10. Treatment of the associated complications as and when they arise 11. Advice patient to stop smoking 12. Control of associated risk factors (systemic hypeension, diabetes mellitus, hyperlipidaemia) 13. Rehabilitation If the patient is stable and no complications: Sit in a chair - 2nd day Walk to toilet - 3rd day Return home - 7th day Back to work - 6th week Driving (LMV) - 6 weeks Intercourse - 8 weeks Air travel - 8 weeks 14. Surgery (coronary angioplasty, coronary aery bypass grafting) if medical management fails or if there is severe compromise of coronary circulation. 15. Drug eluting stents - Many drugs have been considered for drug eluting stents. The main drugs used are paclitaxel (Taxol), sirolimus and their derivatives (tacrolimus, everolimus). These stents have lower rates of restenosis. They act by inhibiting neointimal hyperplasia (antiproliferative action). 16. Assessment of ischaemic burden: A sub-maximal stress testing is done at the end of first week and a maximal exercise stress test at the end of 6 weeks. Stress testing aids in assessing the patient's ischaemic burden and planning fuher line of management. 17. Alternate therapies: * Transmyocardial laser revascularisation by percutaneous technique * Enhanced external counterpulsation to decrease the frequency of angina * Spinal cord stimulation ( C7-T1 - epidural space electrode) to improve anginal symptoms | Medicine | C.V.S | [
"nitroglycerin",
"lidocaine"
] | 154,188 |
0e9645f1-2cc2-4a9a-a408-36fabe74e99a | All except one can cross blood brain barrier | Neostigmine | Atropine | Lignocaine | Physostigmine | 0a
| multi | Neostigmine being quaternary amine , is highly ionised and does not cross blood brain barrier. | Anaesthesia | null | [
"atropine",
"neostigmine",
"physostigmine"
] | 154,201 |
c2c60fd4-2d3d-489d-97ce-0f0246e054f8 | Furosemide causes all except - | Hyperuricemia | Ototoxicity | Hypercalcemia | Hypokalemia | 2c
| multi | Ans. is `C' i.e., Hypercalcemia Coniolications of high ceiling (furosamidel diuretics o Hypokalemia (M. C) o Hyperuricemia o GI disturbances o Acute saline depletion o Hypocalcemia o Mental disturbances o Dilutional hyponatremia o Hyperglycemia o Allergic manifestations o Alkolosis o Hyperlipidemia o Hearing loss (ototoxicity) o Hypomagnesemia Thiazides also have same complications except o Thiazides cause hypercalcemia o Thiazides may aggravate renal insufficiency. o Thiazides do not cause ototoxicity. Remember o Hypokalemia is less common with loop diuretics than with thiazides. o Hypokalemia is prevented and treated by | Pharmacology | null | [
"furosemide"
] | 154,215 |
286e13cd-f42b-41c2-a222-590c71212264 | Activity of all local anaesthetic solutions is affected by pH of the tissue or infection except: | Propoxycaine | Benzocaine | Lidocaine | None of the above | 1b
| multi | As benzocaine has no charge | Surgery | null | [
"lidocaine",
"benzocaine"
] | 154,223 |
fc94b5f1-0d09-469b-97b7-eb196292f2d8 | A 60 year old male a sudden fall in toilet. His BP was 90/50 mm Hg and pulse was 100/min. His relatives repoed that his stool was black/dark in colour. Fuher careful history revealed that he is a known case of hypeension and coronary aery disease and was regularly taking aspirin, atenolol and sorbitrate. The most likely diagnosis is- | Gastric ulcer with bleeding | Acute myocardial infarction with cardiogenic shock | Acute cerebrovascular accident | Pulmonary embolism | 0a
| multi | Peptic ulcers may be in the stomach, the small intestine just below the stomach, or the food pipe above the stomach. Sometimes, peptic ulcers can bleed (known as bleeding ulcers). More severe bleeding, known as hemorrhaging, can be life-threatening. Infections and some medications can cause bleeding ulcers Ref Davidson 23rd edition pg 683 | Medicine | C.V.S | [
"atenolol"
] | 154,225 |
c1f612e2-3e6a-4b05-a9a3-c388e6e84fde | An example of covalent drug receptor interaction: | Noradrenaline binding to β1 adrenergic receptor | Acetylcholine binding to muscarinic receptor | Prazosin binding to α1 adrenergic receptor | Phenoxybenzamine binding to alpha adrenergic receptor | 3d
| single | Phenoxybenamine is an irreversible (covalent) antagonist at alpha receptors. All other drugs mentioned are reversibly interacting with their receptors. | Pharmacology | null | [
"phenoxybenzamine",
"prazosin"
] | 154,226 |
4276f143-e010-4e13-bbcf-1bc9ee184aba | Which of the following anti inflammatory drug is a COX- 2 inhibitor: | Aspirin | Ketoprofen | Rofecoxib | Sulidec | 2c
| single | null | Pharmacology | null | [
"ketoprofen"
] | 154,247 |
690ce7aa-4013-461e-a314-d54bde38a25f | Which of the following drug releases Nitric oxide | Hydralazine | Aminophylline | Amrinone | Sildenaphil sulphate | 0a
| multi | Hydralazine is used with or without other medications to treat high blood pressure. Lowering high blood pressure helps prevent strokes, hea attacks, and kidney problems.Hydralazine is called a vasodilator. It works by relaxing blood vessels so blood can flow through the body more easily. Hydralazine may induce aeriolar vasodilation by preventing oxidation of nitric oxide and thereby lowering blood pressure. | Pharmacology | Anesthesia | [
"hydralazine"
] | 154,249 |
fe50f378-6a8d-4b6a-8ad2-e11792760d77 | A 27 year old man with epilepsy presents with complaints of persistent lethargy and occasional feelings of intoxication, although he does not consume alcohol. The patient is currently taking phenobarbital for the long-term management of tonic-clonic seizures. In addition, he was recently staed on a medication for the treatment of gastroesophageal reflux disease. Which of the following agents was he most likely prescribed? | Cimetidine | Famotidine | Lansoprazole | Ranitidine | 0a
| single | Cimetidine is an H2-receptor antagonist indicated for the sho-term and maintenance treatment of duodenal and gastric ulceration, as well as gastroesophageal reflux disease. One of the primary disadvantages of using this agent, with respect to other H2-receptor antagonists famotidine and ranitidine, is that it is a relatively potent hepatic enzyme inhibitor. Therefore, this medication is likely to decrease the metabolism of other hepatically metabolized medications, such as phenobarbital. When the metabolism of a medication is decreased, the blood levels will increase, leading to an extension of the therapeutic effect and/or toxicity. Phenobarbital is a barbiturate indicated for the treatment of tonic-clonic seizures and status epilepticus. When the blood concentration of this medication increases, lethargy and feelings of intoxication may occur. Lansoprazole is a gastric acid proton-pump inhibitor indicated for the sho-term and maintenance treatment of duodenal and gastric ulceration, as well as gastroesophageal reflux disease. This agent does not affect hepatic enzymes. Ref: McQuaid K.R. (2012). Chapter 62. Drugs Used in the Treatment of Gastrointestinal Diseases. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds),Basic & Clinical Pharmacology, 12e. | Pharmacology | null | [
"cimetidine",
"ranitidine",
"phenobarbital",
"famotidine",
"lansoprazole"
] | 154,252 |
e4759190-12aa-4f52-a24c-f9d2232c5314 | Which one of the following drugs inhibits bacterial protein synthesis, preventing the translocation step via its interaction with the 50S ribosomal subunit? | Clindamycin | Gentamicin | Chloramphenicol | Imipenem | 0a
| multi | Clindamycin has a mechanism of action similar to, if not identical with, erythromycin and related macrolides. They bind to rRNA bases on the 50S subunit to prevent translocation of peptidyl-mRNA from the acceptor to the donor site. Chloramphenicol also binds to the 50S subunit but interferes with the activity of peptidyltransferase. Gentamicin and tetracyclines bind to the 30S ribosomal subunit. Imipenem is a cell-wall synthesis inhibitor, acting similarly to beta-lactams. | Pharmacology | Anti Microbial | [
"gentamicin",
"chloramphenicol",
"clindamycin"
] | 154,260 |
caa63a04-b88a-4381-ba06-34a103518971 | Which of the following drugs is useful in prophylaxis of migraine ? | Propranolol | Sumatriptan | Domperidone | Ergotamine | 0a
| single | Ans. is 'a' i.e., Propranolol | Pharmacology | null | [
"propranolol",
"sumatriptan"
] | 154,287 |
e7f37c60-8d14-489e-857f-adc9f77c4c4e | Bulls eye retinopathy is seen in toxicity of: (Repeat) | Chloroquine | Mefloquine | Primaquine | Quinine | 0a
| single | Ans A (Chloroquine) Ref: CMDT, 2013. pg 197Explanation:Adverse Effects of ChloroquineOcular- Irreversible retinal damage,CNS- Seizures. Tinnitus, Nerve deafnessGIT- Anorexia, nausea, vomitingSkin pigmentation | Medicine | Drugs | [
"quinine",
"mefloquine",
"chloroquine"
] | 154,289 |
0cf0a220-b092-43a9-9991-c6cc08835997 | which of the following SSRi is used in the management of pathological emotions | Escitalopram | paroxetine | clomipramine | fluoxetine | 0a
| single | SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955 | Psychiatry | Pharmacotherapy in psychiatry | [
"escitalopram",
"fluoxetine",
"paroxetine",
"clomipramine"
] | 154,311 |
3a22bb1d-91a8-40a3-976e-7846401e6f4d | A lady presented with creamy white vaginal discharge with fishy odor, drug of choice is: | Doxycycline | Ofloxacine | Metronidazole | Clindamycin | 2c
| single | Ans. is c, i.e. MetronidazoleRef: Shaw 15th/ed, p131; CGDT 10th/ed, p670; William's Gynae 1st/ed, p51Creamy white discharge with fishy odor is characteristic of bacterial vaginosis (M/C cause Gardnerella)Drug of choice for management of bacterial vaginosis/Gardnerella vaginitis is --Metronidazole:Dose - 500mg oral metronidazole is given twice daily for 7 daysAlternatively, metronidazole gel (can be applied once daily for 5 days or clindamycin cream (2%) at bedtime for 5 days.Note: Treatment of male sexual partner is not required in bacterial vaginosisQ.In pregnancy:* Bacterial vaginosis is associated with preterm birth and premature rupture of membranes.* Treatment is reserved for symptomatic women who usually complain of fishy odor.* DOC - Metronidazole (oral) in the 2nd and the 3rd trimester.Unfortunately, treatment does not reduce preterm birth and routine screening is not recommended. | Gynaecology & Obstetrics | Sexually Transmitted Disease in the Female | [
"metronidazole",
"doxycycline",
"clindamycin"
] | 154,314 |
1aedc7eb-6769-4e92-9324-cdc550f32331 | A 50 year old man has presented with pain in back, lack of interest in recreational activities, low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucinations. He did not suffer from any chronic medical illness. There was no fami-ly history of psychiatric illness. Routine investigations including haemogram, renal function tests, liver function tests, electroca-rdiogram did not reveal any abnormality. This patient should be treated with: | Haloparidol | Seraline | Alprazolam | Olanzapine | 1b
| multi | B i.e. Seraline | Psychiatry | null | [
"alprazolam",
"olanzapine"
] | 154,344 |
84c46bf2-bc0a-451c-9b07-200903c9923b | A 20 year old male presents with acute respiratory distress and tachypoea. His B.P. is 90/60. Loud P2 is +nt. True about his condition | D-dimer assay should be done | S wave in lead 1 and Q wave in lead 3 of ECG is seen | Streptokinase hold be given | All | 3d
| multi | The patient is presenting with dyspnea and tachpnea;dyspnoea with hypotension(BP:90/60 mmHg) indicates a massive pulmonary embolism.He is also presenting with a classic sign of PE,i.e.,an accentuated pulmonic component of the second hea sound.The most sensitive test for PE is D-dimer ELISA assay which rises due to the breakdown of fibrin by plasmin.The most frequently cited abnormality in ECG,in addition to sinus tachycardia ,is the S1Q3T3 sign-an S wave in lead I,a Q wave in lead III,and an inveed T wave in lead III.This finding is relatively specific.The gold standard test for PE is CT pulmonary angiography.On confirming the diagnosis ,primary therapy consisting of clot dissolution with thrombolytics like tPA/streptokinase or removal of PE by embolectomy is done.Anticoagulation with heparin and warfarin or placement of an inferior vena caval filter constitutes secondary prevention. Reference:Harrison's medicine-18th edition,page no:2172-2177. | Medicine | Respiratory system | [
"streptokinase"
] | 154,354 |
013619b3-4e9a-48da-a26b-df6f6be00947 | Carboxylases requires | Vitamin B12 | Folic acid | Niacin | Biotin | 3d
| single | Pyruvate in the cytoplasm enters the mitochondria. Then, carboxylation of pyruvate to oxaloacetate is catalyzed by a mitochondrial enzyme, pyruvate carboxylase. It needs the co-enzymes biotin and ATP.Ref: DM Vasudevan, page no: 103 | Biochemistry | Enzymes | [
"biotin"
] | 154,357 |
9b86123c-6636-40ba-a9d9-eb3775ed683b | Eutectic mixture of local anesthetic (EMLA) cream is - | Bupivacaine 2.0% + Prilocaine 2.5% | Lidocaine 2.5% + Prilocaine 2.5% | Lidocaine 2.5% + Prilocaine 5% | Bupivacaine 0.5% + Lidocaine 2.5% | 1b
| single | Ans-B | Unknown | null | [
"lidocaine",
"bupivacaine"
] | 154,369 |
3e94e2de-1d3c-4774-a376-abb681db6879 | All of the following can cause SLE-like syndrome except | Isoniazid | Penicillin | Hydralazine | Sulphonamide | 1b
| multi | Hydralazine, procainamide, sulphonamide, isoniazid- causes SLE like syndrome Also, these drugs undergo acetylation Ref: KD Tripathi 8th ed | Pharmacology | General pharmacology | [
"hydralazine",
"isoniazid"
] | 154,383 |
3a41a181-baf8-4d20-8cc1-eb45d7e1911d | Most potent estrogen is - | Estrone (El) | Estradiol (E2) | Estriol(E3) | Etisterone enanthate | 1b
| single | Ans. is 'b' i.e., Estradiol (E2) Estrogeno Natural oestrogens are Cl 8 steroids, the main source of which are the theca and granulosa cells of the Graafian follicles and corpus luteum, while the adrenal cortex is the secondary source of supply.o Oestrogen is secreted as oestradiol. It is bound to albumin (30%) and sex-hormone-binding globulin (SHBG, 69%), and only 1% is biologically active.o It acts by binding to cytoplasmic receptors in the cells.o It is inactivated by the liver and excreted as conjugates of oestrone, oestradiol and oestriol in the urine and bile (85% in urine, 10% in faeces).o Estradiol is ten times more potent than estrone, which is ten times more potent than estriol. Thus potency of estroogens is as follows:Estradiol > estrone > estriol.Major estrogen during:o Reproductive age group - estradiolo Post menopausal period - estroneo Pregnancy - estriol | Gynaecology & Obstetrics | Endocrine Control of the Menstrual Cycle | [
"estriol"
] | 154,385 |
b2f04f13-0f1c-4b7d-9341-8dd447198242 | Which of the following should not be used in the ROSACEA? | Isoetretin | Metronidazole | Steroids | Benzoyl peroxide | 2c
| single | ROSACEA is a Vascular disorder predominantly affecting flush areas of face manifesting as erythema and telangiectasia, punctuated with episodes of inflammation during the episodes of inflammation papules, pustules and swelling develop. It has a chronic course. Treatment: a. Oral tetracyclines are drug of choice. b. Topical erythromycin and benzoyl peroxide are also helpful. c. Topical metronidazole is also effective. oral doxycycline and minocycline can also be given. d. The role of topical steroids is limited. e. With halogenated steroids rebound phenomenon and perioral dermatitis is known to occur. Hence their use is not justified. f. Isotretinoin can be used if no response to above drugs. The use of the topical steroid should be limited to the condition. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) does not necessary prevent steroid induced rosacea. Similar conditions have been seen with both Elidel and Protopic, possibly from immunosuppression and Demodex or bacterial growth. Ref Robbins 9 e pg 456 | Pathology | All India exam | [
"metronidazole"
] | 154,394 |
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