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03731c53-a296-4365-9b9a-a2c7750a7996 | Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis is - | Oral Clarithromycin | Oral fluoroquinolone | Oral beta lactam with injectable aminoglycoside | Oral linezolid | 0a
| single | Ans. is 'a' i.e., Oral Clarithromycin * As per the recommendations for empirical antibiotic management oral clarithromycin is the Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis.Empirical Antibotic Treatment of Community-Acquired PneumoniaOutpatientsPreviousuly healthy and no antibiotics in past 3 months* A macrolide (clarithromycin (500 mg PO bid) or azithromycin (500 mg PO once, then 250mg qd) or* Doxycycline (100mg PO bid)Comorbidities or antibiotics in past 3 months: select an alternative from a different class.* A respiratory fluoroquinolone or* A b-lactam .* A b-lactam plus a macrolide Inpatients, ICU* A b-lactam (cefotaxime (1-2 g IV q8h), ceftriaxone (2g IV qd), ampicilin-sulbactam (2g IV 48h)] plus* Azithromycin or a fluoroquinolone (as listed above for inpatients, non-ICU)Special ConcernsIf Pseudomonas is a consideration* An antipneumococal, antipseudomonal b - lactam (piperacilin/tazobactam (4-5 g IV q6h), meropenem (lg IV q8h)] plus either ciprofloxacin (400 mg IV q 12h) or levofloxacin (750mg IV qd)* The above b-lactams plus an aminoglycoside * The above b-lactams plus an aminoglycoside plus an antipneumococcal fluoroquinoloneIf CA-MRSA is a consideration* Add linezolid (600 mg IV q 12h) or vancomycin (lg IV q 12h). | Medicine | Respiratory | [
"clarithromycin",
"linezolid"
] | 154,395 |
6b15963f-56c3-4ba2-9aa7-43182f9e060d | Once weekly administration of which of the following antibiotics has prophylactic activity against bacteremia caused by M. avium complex in AIDS patients? | Azithromycin | Clarithromycin | Isoniazid | Rifabutin | 0a
| single | The regimen used for the treatment of Mycobacterium avium complex in AIDS patients is REC (Rifabutin, ethambutol and clarithromycin). These drugs are given once daily. Clarithromycin can be replaced with azithromycin which is long acting and can be administered once a week. | Pharmacology | Mycobacterial Diseases (TB, Leprosy and MAC) | [
"isoniazid",
"azithromycin",
"clarithromycin"
] | 154,409 |
c5a4762e-895c-4ec6-8263-3cbc0a5f1784 | Which of the following agents is not used in the treatment of Diabetic Macular Edema/Retinopathy? | Ruboxistaurim | Pyridazinoncs | Benfotiamine | Tamoxifen | 3d
| single | Delayed side effects of tamoxifen include infrequent pulmonary emboli or thrombosis, depression, retinopathy, corneal opacities and rare endometrial carcinomas. There have been repeated repos of ophthalmic complications from tamoxifen including irreversible retinopathy with seriously reduced visual acuity, refractile opacities, cystoid macular edema, retinal yellow white dots and keratopathy. Ref: Meyler's Side Effects of Endocrine and Metabolic Drugs By J. K. Aronson - Page 304; Medical toxicology By Richard C. Da - Page 524. | Ophthalmology | null | [
"tamoxifen"
] | 154,414 |
1a1377b6-a447-48de-8166-998020dd476b | Which is the drug of choice for severe preeclampsia? | Labetalol | Metoprolol | A-methyldopa | Nifidipine | 0a
| single | Labetalol is the drug of first choice in severe preeclampsia. The main objective is to reduce the risk of severe hypeension and cerebral haemorrhage. Labetalol is given as 200-400 mg/day in 2 doses | Gynaecology & Obstetrics | Medical, surgical and gynaecological illness complicating pregnancy | [
"methyldopa",
"metoprolol",
"labetalol"
] | 154,426 |
01ace0fb-d9ab-477a-8e17-26b5e2fcbede | Which antibiotic decreases absorption of iron ? | Sulfonamide | Tetracyclines | Erythromycin | Ciprofloxacin | 1b
| single | Ans. is 'b' i.e., Tetracycline Factors facilitating iron absorption - Acid, ascorbic acid (Vit C), amino acids containing SH radical, meat. All these are reducing substances which enhance conversion of Fe" to Fe" and thus improve absorption. Factors impending iron absorption - antacids, alkalies, phosphate (rich in egg yolk), phytates (in maize, wheat), tetracyclines, presence of other food in stomach. | Pharmacology | null | [
"erythromycin",
"ciprofloxacin"
] | 154,440 |
6a7fda63-01d2-42bd-a4cf-604c06f0236c | Drug of choice for whooping cough | Azithromycin | Erythromycin | Rifampicin | Tetracyclin | 1b
| single | null | Social & Preventive Medicine | null | [
"erythromycin",
"azithromycin"
] | 154,459 |
008c9036-a64c-4ca1-b7b6-ff285f3bb2e4 | Pseudomembranous colitis is associated with: | Vancomycin | Lincomycin | Rovamycin | Clindamycin | 3d
| single | Clindamycin | Pharmacology | null | [
"vancomycin",
"clindamycin"
] | 154,468 |
7522e5c7-a03d-4daa-bd97-029aa983900a | An enterococcus (E. faecium) was isolated from a urine specimen (100,000 cfu/mL). Treatment of the patient with ampicillin and gentamicin failed. The most clinically appropriate action is | Do no further clinical workup | Suggest to the laboratory that low colony counts may reflect infection | Determine if fluorescent microscopy is available for the diagnosis of actinomycosis | Consider vancomycin as an alternative drug | 3d
| multi | These questions demonstrate commonly occurring clinical infectious diseases and microbiologic problems. Enterococci may be resistant to ampicillin and gentamicin. Vancomycin would be the drug of choice. However, laboratory results do not always correlate well with clinical response. The National Committee on Clinical Laboratory Standards recommends testing enterococci only for ampicillin and vancomycin. | Microbiology | Bacteria | [
"vancomycin",
"gentamicin",
"ampicillin"
] | 154,470 |
a83e94cf-e44c-45d3-b326-0ad65ab3597d | Which of the following is most common side effect of zidovudine ? | Anemia | Peripheral neuropathy | Lactic acidosis | All | 0a
| multi | null | Pharmacology | null | [
"zidovudine"
] | 154,473 |
89f9ece9-ea72-42e8-9ec2-052c5f0d1d4b | Several weeks following a severe streptococcal sore throat, a 7-year-old boy develops acute glomerulonephritis with edema, hypeension, and hematuria. Which of the following best describes the propeies of the most likely causative organism? | Alpha hemolytic, lysed by optochin | Alpha hemolytic, not lysed by optochin | Beta hemolytic, can grow in 40% bile and 6.5% sodium chloride | Beta hemolytic, inhibited by bacitracin | 3d
| single | The most likely cause of glomerulonephritis following streptococcal sore throat is Streptococcus pyogenes. This is the only species in the Group A streptococci, and is characterized by beta hemolysis and inhibition by the antibiotic bacitracin. Streptococcus pyogenes sore throat can also be followed by rheumatic fever. Streptococcus pneumoniae is an example of an alpha hemolytic streptococcus that is lysed by optochin (1st Choice). Streptococcus mutans is an example of an alpha hemolytic streptococcus that is not lysed by optochin (2nd Choice). Enterococcus faecalis is an example of a beta hemolytic streptococcus that can grow in 40% bile and 6.5% sodium chloride (3rd Choice). | Microbiology | null | [
"bacitracin"
] | 154,478 |
a31a9376-3dad-4b02-9e91-4b5c261a2e8d | A 50-year-old male presented to the ER with acute onset of chest pain which was retrosternal and radiated to the back along with dysphagia, regurgitation and heaburn. Patient gave history of similar episodes of chest pain in the past as well. Barium swallow and esophageal manometric studies were performed. ECG of the patient was normal. Manometry study revealed, 1. Aperistalsis in greater than 30% of the wet swallows with 20% of contractions being simultaneous 2. Amplitudes greater than 30 mm Hg in the distal three fifths of the esophagus Which of the following drugs can be used in the above condition to relieve the symptoms: - | Sildenafil | Botulinum | Octreotide | Terlipressin | 0a
| multi | This is a case of DES (Diffuse esophageal spasm). Normal ECG rules out MI. Diffuse esophageal spasm has a characteristic appearance of multiple simultaneous contractions causing a corkscrew appearance with segmentation. Multiple uncoordinated contractions in the third tracing from the distal esophagus is seen in manometry. Sildenafil, a phosphodiesterase inhibitor, is a smooth muscle relaxant that can lower the LES pressure and spastic contractions of the esophagus. Definitive treatment is myotomy guided by a manometric evidence.n | Unknown | Integrated QBank | [
"sildenafil",
"octreotide"
] | 154,496 |
7d40677f-9576-4706-873f-4d4ced62b9b7 | Adrenal medulla secretes: | Sex hormones | Thyroid stimulating hormones | Epinephrine | Glucocoicoid | 2c
| single | Tyrosine - L-dopa - Dopamine - Noradrenaline - Adrenaline Coversion of Noradrenaline to Adrenaline requires the following enzyme - PNMT: Phenylethanolamine N- methyltransferase PNMT: Not present in sympathetic post ganglionic nerve fibers Therefore, sympathetic post-ganglionic nerve fibers release norepinephrine | Physiology | Endocrine System | [
"epinephrine"
] | 154,505 |
f44e27ff-c5d5-40f5-bacb-82499af7aa5a | Which of the following drugs is not used in Juvenile Myoclonic Epilepsy (JME)? | Topiramate | Zonisamide | Carbamazepine | Valproate | 2c
| single | Juvenile myoclonic epilepsy (JME) is a generalized seizure disorder of unknown cause that appears in early adolescence and is usually characterized by bilateral myoclonic jerks that may be single or repetitive.The myoclonic seizures are most frequent in the morning after awakening and can be provoked by sleep deprivation. Consciousness is preserved unless the myoclonus is especially severe.Carbamazepine useful in focal seizures.Ref: Harrison; 19th edition; Page no: 2544 | Medicine | All India exam | [
"zonisamide",
"topiramate",
"carbamazepine",
"valproate"
] | 154,510 |
fdf6044b-94a1-48c6-ab0a-5aa4674687fa | Minimum dose of tetracycline which will show tooth discoloration and enamel hypoplasia: | 5 mg/kg body weight | 15 mg/kg body weight | 30 mg/kg body weight | 50 mg/kg body weight | 3d
| single | null | Dental | null | [
"tetracycline"
] | 154,520 |
bcda69f9-f7c9-4eca-a002-0b1e4b913e7f | First trimester aboion uses all, except: TN 09 | Mifepristone | Extra-amniotic ethacrydine lactate | Dilatation and evacuation | Suction evacuation | 1b
| multi | Ans. Extra-amniotic ethacrydine lactate | Forensic Medicine | null | [
"mifepristone"
] | 154,524 |
c5917029-03dd-4d02-aee9-38a899a0c946 | Antagonist of benzodiazepine is : | Naltrexone | Flumazenil | Naloxone | N–Acetyl–cysteine | 1b
| single | null | Pharmacology | null | [
"naloxone",
"naltrexone",
"flumazenil"
] | 154,525 |
fa78446a-b54f-4bd7-b9a7-f0bba2ae93c3 | Drug which inhibits the reuptake of norepinephrine into presynaptic membrane is | Cocaine | Lidocaine | Procaine | Botulinum toxin | 0a
| single | Cocaine and TCAs inhibit reuptake of neurotransmitters. | Anatomy | General anatomy | [
"lidocaine",
"procaine"
] | 154,526 |
42de0bc8-5d8f-42b4-8051-b45b8fb2d81b | Drug of choice for cytomegalovirus retinitis in HIV patients is:- | Acyclovir | Ganciclovir | Amantadine | Foscarnet | 1b
| single | Ganciclovir is an analogue of acyclovir which is the most active drugs against CMV. It is activated intracellularly by virus specific thymidine kinase and its triphosphate nucleotide inhibits viral DNA polymerase. CMV retinitis is treated by i.v. infusion of ganciclovir 10 mg/kg/day. This can prevent blindness in AIDS patients. Systemic therapy can be supplemented by intravitreal injection of ganciclovir. | Pharmacology | Anti-Viral Drugs | [
"foscarnet",
"amantadine",
"ganciclovir"
] | 154,530 |
a3e90be8-15be-4179-a318-8a1d90fbb188 | Which muscle relaxant has Maximum duration of action? | Atracurium | Vecuronium | Rocuronium | Doxacurium | 3d
| single | Ans. is 'd' i.e., Doxacurium | Anaesthesia | null | [
"atracurium",
"vecuronium",
"rocuronium"
] | 154,549 |
4ace216b-8baa-4c34-92ae-8b379824e907 | Altered taste sensation is caused by- | Pefloxacin | Rifampicin | Ciprofloxacin | Captopril | 3d
| single | Ans. is 'd' i.e., Captopril Adverse effects of ACE inhibitor Hypotension Cough Angioedma Teratogenecity Acute renal failure Hyperkalemia Rashes, Uicaria Dysguesia Granulocytopenia o Dysguesia is reversible loss or alteration of taste sensations. Cough and angioedema are due to elevated bradykinin, caused by inhibition of bradykinithubstance P metabolism in lungs. | Pharmacology | null | [
"captopril",
"ciprofloxacin"
] | 154,580 |
dc30030e-99f4-4c00-8102-43aa4aa07faf | Drug of choice in methicillin-resistant Staphylococcus aureus - | Ceftriaxone | Ceftazidime | Ampicillin | Vancomycin | 3d
| single | Methicillin resistance in S. aureus is determined by the mecA gene, which encodes for resistance to all b-lactam drugs. If CA-MRSA infection is suspected, either linezolid or vancomycin should be added to the initial empirical regimen. (Harrison's Principles of internal medicine, 20th edition) | Medicine | Infection | [
"vancomycin",
"ceftazidime",
"ampicillin",
"ceftriaxone"
] | 154,588 |
dc2f4e23-621e-4172-9c3f-bb7952f86ac5 | A 25-year-old man presents with acute, painless loss of vision in the right eye. The appearance of the optic nerve of the right eye is hyperemic. Of the entities listed, the most likely cause may include: | Vitamin BI2 deficiency | Ethambutol hydrochloride toxicity | Leber hereditary optic neuropathy (LHON) | Dominant optic atrophy | 2c
| single | Leber hereditary optic neuropathy (LHON) Hereditary, toxic, and nutritional deficiency optic neuropathies commonly present with bilateral, insidious vision loss. In some cases, there can be asymmetry in visual acuity and visual fields. LHON often presents as acute or subacute unilateral vision loss that is followed within several months by vision loss in the fellow eye. The appearance of the optic nerve in LHON is characterized by a triad of circumpapillary telangiectasia, swelling of the nerve fiber layer around the disc, and absence of leakage on fluorescein angiography. LHON should be included in the diagnosis of acute unilateral vision loss from such disorders as optic neuritis and ischemic optic neuropathy. | Surgery | null | [
"ethambutol"
] | 154,592 |
ebba500b-4667-42ee-af82-a31b08ec7e41 | A 40 year old man has megaloblastic anemia and early signs of neurological abnormality. The drug most probably required is : | Folic acid | Iron sulphate | Erythropoietin | Vitamin B12 | 3d
| single | Deficiency of vitamin B12 results in megaloblastic anemia and demyelination. It can cause subacute combined degeneration of spinal cord and peripheral neuritis. | Pharmacology | null | [
"erythropoietin"
] | 154,603 |
d8e35357-c5be-4394-ac9b-c3f217afd2d2 | True statement about Sevoflurane is | It is nephrotoxic at high doses | It has maximum risk of causing convulsions | It is cardiostable | It can cause fulminatnt hepatitis | 0a
| multi | Refer Goodman Gilman 11/e p 360 Sevoflurane is a general anesthetic used by inhalation route It is very good agent for children and asthmatic patients It can produce dose dependent hypotension and decrease in cardiac output It high doses it can release fluoride resulting min Nephrotoxicity | Pharmacology | Anesthesia | [
"sevoflurane"
] | 154,626 |
ea51acab-3541-427f-951d-b75501c76044 | Cause of methaemoglobinemia are all except : | Nitrites | Phenacetin | Sulfonamide | Phenytoin | 3d
| multi | D i.e. Phenytoin | Physiology | null | [
"phenytoin"
] | 154,634 |
9488617f-4af4-41d2-83c6-5691ac1a531e | Most common drug used in Leprosy is: | Dapsone | Clofazimine | Ethionamide | Ofloxacin | 0a
| single | (Dapsone): Ref 709-KDT (752-KDT 6th)Classification of antileprotic drugs1. Sulfone - Dapsone - (DPS)2. Phenazine derivative - clofazimine3. Antitubercular drugs - Rifampin, Ethionamide4. Other antibiotics - Ofloxacin, Minocycline, clarithromycinDAPSONE: - Inhibition of PABA incorporation in to folic acid.* Simplest, oldest, cheapest, most active and most commonly used in leprosy..* RIFAMPIN: - Most important Bactericidial drug in leprosy* Clofazimine: - Dye with leprostatic and anti-inflammatory properties | Pharmacology | Anti Microbial | [
"clofazimine",
"ethionamide",
"ofloxacin",
"dapsone"
] | 154,636 |
c3201968-f49c-4db9-aa3c-62ace19d331e | Which of the following is least useful in Rx of "Overactive bladder"? | Oxybutynin | Tolterodine | Duloxetine | Darifenacin | 2c
| single | Duloxitin is use in the treatment of stress incontinence. | Surgery | All India exam | [
"oxybutynin",
"duloxetine",
"tolterodine"
] | 154,637 |
c2c5b28d-b0f7-40c7-9c82-a8fb3cf56dab | A young lady presents to your office with compalin of copious vagina discharge, but there is no cervical discharge on per speculum examination. which of the following should be given for the management? | Metronidazole and azithromycin | Metronidazole and doxycycline | Flacon only | Metronidazole and fluconazole | 3d
| single | Metronidazole 200mg 3 doses /day for 7days
A single dose of fluconazole 150mg is very effective. | Gynaecology & Obstetrics | null | [
"metronidazole",
"azithromycin",
"doxycycline",
"fluconazole"
] | 154,638 |
c3b5f937-92a6-4bca-95ff-f2183394706c | A 65-year-old man presents to your clinic after falling several times in the past few months. On examination, his most notable findings are an unstable, wide-based gait and marked retropulsion. He does have bradykinesia with masked facies and dysahria. You find no evidence of cogwheeling or resting tremor. His symptoms do not respond to levodopa/carbidopa. During the next few months, his eye movements are notable for the slowing of veical saccades and fast phases. What is the most likely diagnosis? | L-DOPA resistant PD | Progressive supranuclear gaze palsy | Multiple system atrophy | Foville syndrome | 1b
| multi | Option A - Ruled out as resting tremors are absent & disease is ruled out as it is a ATYPICAL PARKINSONISM disease. Option B- since in the question its mentioned regarding the veical gaze of the patient, it's the most appropriate option. Option C- Ruled out as autonomic insufficiency isn't mentioned in the question. Option D- Manifestation of STROKE related to Pons with VIth nerve palsy. | Medicine | Raised ICP and Brain death | [
"carbidopa",
"levodopa"
] | 154,644 |
851071a2-ce97-49dd-a26e-776601566de3 | Which of the following drugs can cause torsades'de pointers? | Quinidine | Lignocaine | Esmolol | Flecainide | 0a
| single | class 1A agents, class 3 antiarrythymic agents commonly produce torsades de pointes class 1 a- quinidine, disopyramide, procainamide class 1b agents doesnt produce torsades pointes-eg lidocaine, phenytoin, mexiletine, tocainide flecainide is class 1c REF.Essentials of Pharmacology KD Tripathi 8th ed. | Pharmacology | Cardiovascular system | [
"flecainide",
"esmolol",
"quinidine"
] | 154,651 |
e2508ffd-15a6-4f00-a5e7-ae72b3e76c18 | In cirrhotic ascites, which diuretic is preferred? | Furosemide | Acetazolamide | Spironolactone | Any of the above | 2c
| multi | uses of Spironolactone: Cirrhosis edema Aldosterone levels are generally high in cirrhosis. spironolactone is an antagonist for aldosterone. Thus it is paicularly employed in refractory edema caused due to ascites or cirrhoses 2. To counteract K+ loss due to thiazide and loop diuretics. 3. Hypeension: Used only as an adjuvant to thiazide to prevent hypokalaemia; has weak antihypeensive action of its own. 4. CHF: As additional drug to conventional therapy in moderate to severe CHF; can retard disease progression and lower moality ( Essentials of Medical Pharmacology, K.D Tripathi,6 th edition, page 570 ) | Pharmacology | Kidney | [
"spironolactone",
"furosemide",
"acetazolamide"
] | 154,663 |
cde420f3-bed9-43a0-9cc9-0ca287ad119d | Which of the following antimalarial drugs is a slow acting schizonticide? | Artemether | Mefloquine | Pyrimethamine | Quinine | 2c
| single | null | Pharmacology | null | [
"quinine",
"mefloquine"
] | 154,665 |
52a8cf44-d2bb-44b4-a4ea-b6ce626a6383 | Indicate the drug which does not improve lower esophageal sphincter tone or prevent gastroesophageal reflux, but is used as the first line treatment of gastroesophageal reflux disease : | Sodium alginate + aluminium hydroxide gel | Omeprazole | Mosapride | Metoclopramide | 1b
| single | Increasing GI motility with prokinetic drugs (like metoclopramide and mosapride) or
By decreasing gastric acid secretion with PPIs like omeprazole. | Pharmacology | null | [
"metoclopramide",
"omeprazole"
] | 154,671 |
6b881003-232a-436d-aaa8-2d3bec406ae6 | A 7 yr old boy underwent neurosurgery for craniopharyngioma following which pituitary functions were lost. Which of the following hormone should be replaced first ? | Hydrocoisone | Thyroxine | Growth hormone | Prolactin | 0a
| single | Hydrocoisone is a coicosteroid mainly used for anti inflammatory action. It may have lot of side effects due to a neurosurgery. Hence, it should be first replaced after a surgery Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Endocrinology | [
"thyroxine"
] | 154,678 |
3e2c66e8-3180-4cbe-a219-58e471f4546b | Pepsin is a type of | Oxidoreductase | Ligase | Transferase | Hydrolase | 3d
| single | (D) Hydrolase# PEPSIN:> Pepsin is produced by the serous cells of the stomach as pepsinogen, the inactive zymogen or proenzyme.> Pepsin A is the most predominant gastric protease which preferentially cleaves peptide bonds formed by amino groups of phenylalanine or tyrosine or leucine.> Protease or Peptidase or Proteinase: is any enzyme that performs proteolysis; protein catabolism by hydrolysis of peptide bonds.> It break down the bonds by a process - hydrolysis and convert proteins into smaller chains - peptides or even smaller units - amino acids.> Pepsinogen is converted to active pepsin either by autocatalysis, brought about by other pepsin molecules or by gastric HCI (pH < 2).HYDROLASESPhospholipids-PhospholipaseLysophospholipidsLecithin - LysolecithinEnzymes Acting on Peptide Bonds:Exopeptidases-CarboxypeptidaseAiminoacidsEndopeptidase-Aminopeptidases(smallerpeptides)E.g.Pepsin > Removal of a fragment of polypeptide chain (44 amino acids in case of pig enzyme) makes the inactive enzyme active after attaining a proper conformation.> Pepsin is an acid-stable endopeptidase optimally active at a very low pH (2.0).> The active site of the enzyme contains two carboxyl groups, which are maintained at low pH.> Pepsin digestion of proteins results in peptides and a few amino acids which act as stimulants for the release of the hormone cholecystokinin from the duodenum. | Biochemistry | Miscellaneous (Bio-Chemistry) | [
"pepsin"
] | 154,692 |
5974fb01-abf1-47f5-b19d-ac6705dcc527 | Drug used for sympathectomy in experimental animals is ? | Guanethidine | Atropine | Diazoxide | Thebaine | 0a
| single | Ans. is 'a' i.e., Guanethidine Guanethidine is used for experimental sympthectomy. Guanethidine a polar guanidine compound which is taken up into adrenergic nerve endings by active amine transpo and has three impoant facets of action : Displaces NA from storage granules stochiometrically. Inhibits nerve impulse coupled release of NA Engages and blocks NA uptake mechanism at the axonal membrane. It was used for sympathectomy in experimental animal. | Pharmacology | null | [
"atropine"
] | 154,703 |
75b9c9d5-7e91-44b6-afc9-6ae20d2fcccd | Treatment for streptococcal necrotizing fascitis -a) Surgical debridement b) Penicillinc) Clindamycind) Metronidazolee) Vancomycin | ab | bc | acd | abc | 3d
| single | null | Microbiology | null | [
"vancomycin"
] | 154,704 |
a67e6a63-ba49-45fd-bf67-4990cf4dcf9d | Which of the following is not a cardioselective beta blocker: | Acebutol | Atenolol | Pindolol | Metoprolol | 2c
| single | Pindolol | Pharmacology | null | [
"atenolol",
"metoprolol",
"pindolol"
] | 154,709 |
45f784d8-1068-4f75-b41a-1daa3b5cdd7d | Drug causing peptic ulcer are all except: (PGI Nov 2009) | KC1 | Diclofenac | Cyclosporine | Clopidegrel | 2c
| multi | Ans: C (Cyclosporine) Drug Causing Peptic UlcerIngestion of NSAIDs (including aspirin) is the main cause' of gastric and duodenal ulcers that are not associated with H. pylori infection."Diclofenac :Gastric ulceration & bleeding are less common"- K.D.T. 6th/193The isoenzymes cyclo-oxygenase-1 and cyclo-oxygenase-2 are largely responsible for the mucosal protective and antiinflammatory effects respectively of NSAIDs. Therefore newer NSAIDs, such as celecoxih and rofecoxih. that are highly selective for cyclo-oxygenase-2, control inflammation with 'ess risk*--' of causing ulcers.The use of alternative medications such as paracetamol is the best way to prevent NSAID-associated ulcers'1. NSAIDs are now generally avoided in non-inflammatory conditions such as osteoarthritis. When NSAIDs are required a cyclo- oxygenase-2-selective drug is preferred.If an ulcerogenic NSAID has to be continued in a patient at risk then ulcer prophylaxis is indicated. Proton pump inhibitors and misoprostol are both effective in healing and preventing NSAID-associated ulcers. The former are generally preferred because they have fewer side-effects: misoprostol in particular tends to cause diarrhoeaTable (Harrison): Causes of Ulcers Not Caused by HelicobacterPylori and NSAIDsPathogenesis of Non-Hp and Non-NSAIDInfection Cytomegalovirus Herpes simplex virus Hel i cobacter heil manniDrug/Toxin Bisphosphonates Chemotherapy Clopidogrel Q Crack cocaine GlucocorticoidsQ (when combined with NSAIDs) Mycophenolate mofetilQ Potassium chloride0 Miscellaneous Basophilia in myeloproliferative disease Duodenal obstruction (e.g., annular pancreas) Infiltrating disease Ischemia Radiation therapy Sarcoidosis Crohn's disease Idiopathic hypersecretory state | Pharmacology | Adverse Drug Effect | [
"cyclosporine",
"diclofenac"
] | 154,716 |
00287ac9-894b-4040-82b0-3d3cf00461b2 | Periportal fatty infiltration of the liver is seen with- | Alcoholism | Viral hepatitis | Malnutrition | Tetracycline | 2c
| single | Causes of periportal fatty infiltration
Low protein diet
Total parenteral nutrition
Langerhans cell histiocytosis. | Pathology | null | [
"tetracycline"
] | 154,724 |
d435d0ca-d9e2-48c0-a4ee-a6135502ad85 | Which drug has least extrapyramidal symptoms? | Aripiprazole | Loxapine | Fluphenazine | Chlorpromazine | 0a
| single | (Ref: KDT 8th ed. pg. 467)* Among given choice, least risk of EPS among atypicals is: ARIPIPRAZOLE.* Typicals always has high EPS. | Pharmacology | C.N.S | [
"fluphenazine",
"chlorpromazine",
"aripiprazole"
] | 154,733 |
027fa9d0-0e6a-4519-9854-d61b3b3f49a1 | Gynaecomastia may be associated with administration of- | Ranitidine | Cimetidine | Terfenadine | Omeprazole | 1b
| single | Ans. is 'b' i.e., Cimetidine Cimetidine (but not other H2blockers) o Has anti-androgenic action (by displacing DHT from receptor) o Increases plasma prolactin levels --> Galactorrhea in female o Inhibits degradation of Estradiol by liver. Therefore it cause gyaenecomastia, loss of libido, impotence & temporary decrease in sperm count. Other adverse effects of cimetidine o CNS effects --> confusional state (Delirium), restlessness, convulsions, coma, headache, dizziness, hallucination. o Bowel upset, rashes, dry mouth. o Bolus i.v. injection can cause histamine release --> arrhythmias and cardiac arrest. o Transient elevation of plasma aminotransferases. o Cimetidine inhibits several cytochrome P-450 isoenzymes --> inhibits metabolism of many drugs. | Pharmacology | null | [
"cimetidine",
"ranitidine",
"omeprazole"
] | 154,748 |
71472b0a-ada2-4336-8f84-7452f7a846ba | Least diffusion coefficient is for : | Isoflurane | Enflurane | Halothane | N20 | 3d
| single | D i.e N20 | Anaesthesia | null | [
"enflurane",
"isoflurane",
"halothane"
] | 154,750 |
a2ac093e-9b81-4c13-9c20-9948ffa93b60 | Which of the following is not a pharmacological propey of Repaglinide? | Insulin Secretagogues | Reduces insulin resistance | Causes less hypoglycemia than sulfonylureas | Effectively reduced postprandial hyperglycemia | 1b
| single | Repaglinide: the first member of the group, was approved for clinical use in 1998. These drugs modulate B cell insulin release by regula ng potassium efflux through the potassium channels. It should be taken just before each meal in doses of 0.25-4 mg; hypoglycemia is a risk if the meal is delayed or skipped or contains inadequate carbohydrate. | Pathology | All India exam | [
"repaglinide"
] | 154,755 |
12ccf10c-6594-4fb4-8422-27ba831fc4ca | Which of the following drugs is a direct inhibitor of clotting factor Xa? | Apixaban | Argatroban | Fondaparinux | Aspirin | 0a
| single | All the drugs ending with XA BAN are direct Xa inhibitor XaBlocker Impoant ones are :- (1) Rivaroxaban (2) Apixaban (3) Edoxaban (4) Betrixaban (b) Argatroban - Direct thrombin inhibitors. (synthetic non-peptide compound which binds reversibly to the catalytic site of thrombin but not to the substrate recognition site)Argatroban uses ---- Tx of Thrombosis and for PCI(PCI = Per cutaneous Intervention) in HIT patients (HIT= Heparin induced thrombocytopenia ) (c) Fondaparinux - Indirect thrombin inhitor. (Penta-saccharidewith specitic sequence that binds to AT -III with high affinity inducing an irreversible conformational change to selectively in actively factor Xawithout binding thrombin) Fondaparinux use - prophylaxis and Tx of DVT &PE(Pulmonary Embolism) as well as ACS (Acute coronary syndrome) (d)Aspirin - Thromboxane synthesis inhibitor Aspirin use - CAD (Coronary Aery Disease), Stroke. | Pharmacology | FMGE 2018 | [
"fondaparinux",
"apixaban"
] | 154,761 |
49cc3f73-df06-46ff-b008-f891b4e05b61 | Bone marrow depression is seen with chronic administration of - | Isoflurane | N2O | Ether | Halothane | 1b
| single | Ans. is 'b' i.e., N2O Nitrous oxide N2Oo It is colourless, odourless, heavier than air, nonirritating and noninflammable gas.o It is also called laughing gas.o MAC is 105% (least potent) - even pure N2O at 1 atmospheric pressure can not produce adequate anaesthesia.o It has good analgesic but poor muscle relaxant activity.o It is supplied under pressure in blue coloured steel cyclinders.o It has very low blood solubility - induction is quick and smooth with rapid recovery.o Second gas effect and diffusion hypoxia occur with N2O only.o N2O is generally used as a carrier and adjuvant to other anaesthetics - A mixture of 70% N2O + 25 - 30% O2 + 0[?]2 - 2% another potent anaesthetic is employed for most of the surgical procedures.o Entonox is a mixture of 50% N2O and 50% O2.o It has little effect on respiration, heart and BP.o It can cause bone marrow depression and vit B12 deficiency.o N2O is the only anaesthetic reported to produce hematologic toxicity and neurotoxicity with long term administration.o Both toxicides are the result of the interaction of N2O with vit B12.o Complete bone marrow failure can be expected after several days of continuous exposure.o Bone marrow changes are preventable by pretreating patients with large doses of folinic acid.o Other manifestations of vit B12 deficiency eg. megaloblastic anemia, subacute combined degeneration of cord may also occur.o Methemoglobinemia and laryngospasm may occur.o It is contraindicated in patients with air cavities like pneumothorax, pneumoperitoneum and volvulus - expansion and increase in pressure occur. | Anaesthesia | Complications Of Anaesthesia | [
"isoflurane",
"halothane"
] | 154,765 |
7c2d6218-1915-45af-890f-c270d2f8f894 | All are used to shrink fibroids EXCEPT: | Estrogen | Danazol | Mifepristone | GnRH analogue | 0a
| multi | (Estrogen) (345-46-Shaw's 13th) (323-S14th)* Estrogen are used to control the bleeding not the shrinkage tumours:Medical treatment of Fibroids* Iron therapy for anaemia* Drugs used to control menorrhagia* RU 486 (Mifepristone) Dannazol, Gn Rh analogues (depot leuprolide or nafarelin) used to reduce the size of the tumour upto 50 - 80% | Gynaecology & Obstetrics | Miscellaneous (Gynae) | [
"danazol",
"mifepristone"
] | 154,781 |
9de7b613-5c19-4846-878e-d7dd15f6e94b | Indicate the drug which does not improve lower esophageal sphincter tone or prevent gastroesophageal reflux, but is used as the first line treatment of gastroesophageal reflux disease: | Sodium alginate+aluminium hydroxide gel | Omeprazole | Mosapride | Metoclopramid | 1b
| single | (Ref: KDT 6/e p648) Treatment of GERD can be acomplished by Increasing GI motility with prokinetic drugs (like metoclopramide and mosapride) or By decreasing gastric acid secretion with PPIs like omeprazole. | Pharmacology | Other topics and Adverse effects | [
"omeprazole"
] | 154,794 |
3f034882-6b9b-4ecd-855e-8dee610936c7 | Emergence Delirium is characteristic of ? | Midazolam | Ketamine | Thiopentone | Opioids | 1b
| single | Ans. is 'b' i.e., Ketamine o Ketamine produces emergence reaction during awakening from anaesthesia --> vivid dreaming, illusions, extracorporeal experiences, excitment, confusion, fear and euphoria --> contraindicated in psychiatric illness like schizophrenia. | Pharmacology | null | [
"ketamine",
"midazolam"
] | 154,804 |
49885cd2-df24-4697-a610-a2d677cd77b8 | Which of the following increases during surgical stress? | Coisol | Glucagon | Insulin | Gastrin | 0a
| single | Stress hormones such as coisol and norepinephrine are released by the body in situations that are interpreted as being potentially dangerous. The hormone regulating system is known as the endocrine system. Coisol is believed to affect the metabolic system and norepinephrine is believed to play a role in ADHD as well as depression and hypeension.Glucagon, a peptide hormone secreted by the pancreas, raises blood glucose levels. Its effect is opposite that of insulin, which lowers blood glucose levels.Insulin is a peptide hormone, produced by beta cells of the pancreas, and is central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, skeletal muscles, and fat tissue to absorb glucose from the blood. In the liver and skeletal muscles, glucose is stored as glycogen, and in fat cells (adipocytes) it is stored as triglycerides.In humans, gastrin is a peptide hormone that stimulates secretion of gastric acid (HCl) by the parietal cells of the stomach and aids in gastric motility. It is released by G cells in the antrum of the stomach (the poion of the stomach adjacent the pyloric valve), duodenum, and the pancreas.Ref: Ganong&;s review of medical physiology;24th edition; page no-362 | Physiology | Endocrinology | [
"glucagon"
] | 154,808 |
b6f6344c-eb41-47c5-9589-d1d7d2b75a64 | Misoprostol is an analogue of: | PGE1 | PGE2 | PGF2 | PGI2 | 0a
| single | null | Pharmacology | null | [
"misoprostol"
] | 154,811 |
efa912fc-d135-4e06-83a0-719b5480b863 | Which anaesthetic gas is contraindicated in the presence of pneumothorax ? | Halothane | Isoflurane | Nitrous oxide | Chloroform | 2c
| single | null | Anaesthesia | null | [
"isoflurane",
"halothane"
] | 154,818 |
6ff422a1-73c9-4453-b82e-33451639c0f4 | All of the following can cause SLE–like syndrome except: | Isoniazid | Penicillin | Hydralazine | Sulphonamide | 1b
| multi | null | Pharmacology | null | [
"hydralazine",
"isoniazid"
] | 154,828 |
7db17906-e8f4-462b-81a1-5e3fdc422c1f | A child was diagnosed as a case of pauci–immune crescentic glomerulonephritis. The treatment to be given in this child is – | Prednisolone + Cyclophosphamide | Methylprednisolone | Cyclophosphamide | Immumoglobins | 0a
| single | Panel-immune glomerulonephritis
Pauci-immune glomerulonephritis is defined as the lack of anti-GBM antibodies or immune complex.
It is a type of rapidly progressive glomerulonephritis.
Causes are :-
Idiopathic renal-limited crescentic glomerulonephritis (ANCA associated).
Microscopic PAN
Microscopic polyangitis
Wegner's gramdomatosis
It is treated aggressively with glucocorticoids with or without cyclophosphamide or azathioprine | Pediatrics | null | [
"cyclophosphamide",
"prednisolone",
"methylprednisolone"
] | 154,848 |
60a90f4e-fb83-4c32-ae2b-497ee4b58ad6 | Antimitotic drugs of plant source is/are? | Vincristine | Isotretinoin | Bleomycine | Methotraxate | 0a
| single | Ans. is 'a' i.e., Vincristine | Pharmacology | null | [
"isotretinoin",
"vincristine"
] | 154,858 |
2380afde-689e-49bf-9141-7f2e35b157d6 | In the treatment of severe bradycardia, all of the following can be the best modality of treatment except- | Atropine | Pacing | Isoproterenol | Diltiazem | 3d
| multi | atropine,pacing,isoproterenol can be used to increase hea rate in bradycardia diltiazem is a calcium channel blocker used to reduce hea rate Ref Harrison 20th edition pg 1456 | Medicine | C.V.S | [
"diltiazem",
"atropine"
] | 154,867 |
300b7c29-d46b-4746-a108-b022a3feefe8 | Induction agent of choice in day care surgery is : | Ketamine | Propofol | Methohexitone | Thiopentone sodium | 1b
| single | null | Pharmacology | null | [
"ketamine",
"propofol"
] | 154,877 |
7353f819-6bb7-42d7-b04c-8c47947c2c8d | Which of the following is a monoclonal antibody against IL-5 | Omalizumab | Mepolizumab | Tocilizumab | Alemtuzumab | 1b
| single | Mepolizumab & Reslizumab are monoclonal antibodies against IL-5 used in bronchial asthma, which act by inhibiting recruitment of esinophils. | Pharmacology | null | [
"omalizumab",
"tocilizumab",
"mepolizumab"
] | 154,894 |
4bf5e2a4-b20f-4004-85d0-c96b4fcc3189 | Which one of the following drugs should be avoided in Wolff-Parkinson-White (WPW) Syndrome ? | Digoxin | Adenosine | Procainamide | Amiodarone | 0a
| single | null | Medicine | null | [
"amiodarone",
"digoxin",
"procainamide"
] | 154,895 |
8691a81f-70ec-4627-bed5-60bc642571cd | A 37-year-old woman presents with complaints of severe heartburn with or without meals. She has a history of hypertension, which has been treated with captopril. She also has a history of Raynaud disease, multiple facial telangiectasias, and very taut skin on the dorsum of both hands. She has failed to obtain relief for her heartburn with large doses of antacids, or omeprazole. Esophageal manometry is ordered. Most likely results of this test is ? | Decreased esophageal peristalsis and decreased LES pressure | Decreased esophageal peristalsis and increased LES pressure | Increased esophageal peristalsis and decreased LES pressure | Increased esophageal peristalsis and increased LES pressure | 0a
| multi | This patient has the classic presentation of gastroesophageal reflux disease (GERD) in association with scleroderma. These patients have the deposition of collagen in the body of the esophagus, as well as the lower esophageal sphincter (LES). This results in the typical pattern of decreased esophageal peristalsis and the reduced ability of the LES to maintain its high pressures between swallowing. These patients are therefore at risk for severe GERD and subsequent complications of peptic stricture and Barrett's esophagus. Although there is no corrective therapy to improve esophageal motility or increase LES pressure, aggressive treatment is generally aimed at reducing acid production with the use of high doses of proton pump inhibitors. Nevertheless, many of these patients develop the long-term consequences of GERD. Achalasia, in which impaired esophageal peristalsis is often accompanied by a lack of lower esophageal sphincter relaxation. | Unknown | null | [
"captopril",
"omeprazole"
] | 154,896 |
ca08ee13-d968-48f4-89da-16781b58edfb | Treatment of choice for prophylaxis in patients with repeated episodes of bipolar illness: March 2004 | Lithium | Valproate | A + B | None of the above | 2c
| multi | Ans. C i.e. A + B Ref: Kumar and Clark's | Psychiatry | null | [
"valproate"
] | 154,903 |
1294ba95-dae2-466b-96d1-c3ea02941fd6 | Drug of choice for a child with first episode nephrotic syndrome is? | Cyclophosphamide | Prednisolone | Mycophenolate | Cyclosporine | 1b
| single | Drug of choice for a child with first episode nephrotic syndrome is oral prednisolone. Drug of choice for steroid dependent nephrotic syndrome is Levamisole, Steroid resistant Nephrotic syndrome are calcineurin inhibitors like Cyclosporine and Tacrolimus. | Pediatrics | Nephritic & Nephrotic Syndrome | [
"cyclophosphamide",
"cyclosporine",
"prednisolone"
] | 154,904 |
6f17b679-e7d1-4c35-b3a9-66f71e3ab255 | Drug of choice for attention deficit disorder with hyperactivity is: September 2009 | Chlorpromazine | Clonidine | Imipramine | Methylphenidate | 3d
| single | Ans. D: Methylphenidate Attention-Deficit Hyperactivity Disorder/ ADHD/ AD/ HD is a neurobehavioral developmental disorder. It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms staing before seven years of age. ADHD is the most commonly studied and diagnosed psychiatric disorder in children, affecting about 3% to 5% of children globally. Stimulant medication are the most commonly prescribed medications for ADHD. The most common stimulant medications are the chain subsitituted amphetamine methylphenidate (currently, the drug of choice), dextroamphetamine and dexamohetamine. Atomoxetine, a norepinephrine reuptake inhibitor, may be an alternative for children who do not respond to stimulants. | Psychiatry | null | [
"chlorpromazine",
"imipramine",
"methylphenidate",
"clonidine"
] | 154,939 |
9265bbfb-9616-4de2-b2b0-2c43ef45387a | A 30 weeks pregnant multigravida was found to have high BP, proteinuria and pedal edema. The antihypeensive can be used to control BP in this patient is: | Guanethidine | Labetalol | Atenolol | Captopril | 1b
| single | Labetalol is an alpha1-adrenergic blocker and a nonselective beta-adrenergic blocker and it is safe during pregnancy. The beta-blockade/alpha-blockade ratio is 7:1. It appears to lack teratogenicity and crosses the placenta in small amounts. Methyldopa, labetalol, or nifedipine are first-line antihypeensive agents in pregnancy. Among them, methyldopa is the first-line antihypeensive agent in pregnancy. Other antihypeensive medications used in pregnancy include metoprolol, prazosin, minoxidil, hydralazine, thiazide diuretics, and clonidine. Ref: Miller D.A. (2013). Chapter 26. Hypeension in Pregnancy. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. | Gynaecology & Obstetrics | null | [
"atenolol",
"captopril",
"labetalol"
] | 154,942 |
0d33134b-6d10-4e95-b9eb-130be1d39da5 | Strongest stimulus of lactation is by : | Metoclopramide | Post paum hemorrhage | Bromocripti ne | Suckling | 3d
| single | Suckling | Gynaecology & Obstetrics | null | [
"metoclopramide"
] | 154,948 |
3d974e42-d610-4a9b-8f70-edf5c1c4cd65 | Features of liver damage are all except | Decreased factor VII levels | Raised prothrombin time | Conjugated as well as unconjugated hyperbilirubinemia | Decreased erythropoietin production | 3d
| multi | Ans. d (Decreased erythropoietin production). (Ref. Harrison's 18,h/Ch. 301., Robbins 6th/846, 1667)SIGNS OF LIVER FAILURE:# Intermediate metabolism of amino acids and carbohydrates# Synthesis and degradation of proteins and glycoproteins# Metabolism and degradation of drugs and hormones# Restriction of lipid and cholesterol metabolism# Coagulation factor# Bile, bile salts and impaired metabolism. | Medicine | G.I.T. | [
"erythropoietin"
] | 154,953 |
b92c2758-e30f-484f-b7f2-f086afa7533b | Following are features of morphine withdrawl, except: | Piloerection | Insomnia | Discharge from nose | Constipation | 3d
| multi | Constipation | Psychiatry | null | [
"morphine"
] | 154,965 |
68163ab9-795b-403d-aed3-c89e3b82cbd6 | Most potent analgesic: | COX-2 inhibitor | Remifentanil | Morphine | Sufentanil | 3d
| single | Ref: Goodman & Gillman 13th ed. P 376* Fentanyl citrate and sufentanil citrate are congeners of fentanyl and are considered as potent analgesics* After systemic delivery:# Fentanyl is about 100 times more potent than morphine# Sufentanil is about 1000 times more potent than morphine* Time to peak analgesic effect after IV administration: 5 minutes* These drugs are well known to be used as epidural analgesic. | Pharmacology | Endocrinology | [
"morphine",
"sufentanil",
"remifentanil"
] | 154,984 |
abda6ac9-fa74-4a35-b75e-dedeb0c56673 | A female patient with a mechanical heart valve who is taking warfarin informs you that she hopes to get pregnant in the near future. What advice do you give her regarding her antithrombotic medication during the anticipated pregnancy? | Continue with warfarin until the third trimester. | She should replace warfarin with aspirin at analgesic doses. | Discontinue all medications that affect the blood. | Replace warfarin with heparin. | 3d
| multi | Discontinuance of warfarin is appropriate during pregnancy because it is a known teratogen that causes bone dysmorphogenesis. The patient will need continued protection against thrombus formation, and heparin (or a related low molecular weight compound) is usually advised, despite the fact that the drug will require parenteral administration and can cause thrombocytopenia. | Pharmacology | Anti-Cancer | [
"warfarin"
] | 154,998 |
5d739a5a-3864-4e86-b99b-d1d9f687f1a1 | mood stabilzer used in the management of trigeminal neuralgia is | carbamezepine | valproate | lamotrigine | lithium | 0a
| single | Carbamazepine - USES - TRIGEMINAL NEURALGIA - TEMPORAL LOBE EPILEPSY - SECOND LINE MOOD STABILIZER Ref.Kaplon and Sadock, synopsis of psychitry, 11 th edition, pg no.935 | Anatomy | Pharmacotherapy in psychiatry | [
"valproate",
"lamotrigine"
] | 155,012 |
c653ec61-c176-4b1c-952a-142d9ec20846 | Alpha 1 blocker used for BHP is: | Tamsolusin | Prazosin | Oxazosin | Dolazoline | 0a
| single | Tamsolusin | Pharmacology | null | [
"prazosin"
] | 155,014 |
c8b63608-1954-4ae1-8ab6-5ebedbb95f3c | Bronze baby syndrome is caused by: | Phototherapy | Phenobarbitone | Hemosiderosis | Chloramphenicol | 0a
| single | Bronze baby syndrome: is a dark, grayish brown skin discoloration mainly seen in infants with elevated conjugated bilirubin, as an adverse effect of phototherapy | Pediatrics | Neonatal Jaundice | [
"chloramphenicol"
] | 155,036 |
644a2452-0ffb-456c-843d-1e0f210183b6 | Oxalate crystals in urine is seen in: (PGI Dec 2006) | Ethylene glycol poison | Di glycol poison | Alcohol | Indinavir | 0a
| single | Ans: A (Ethylene glycol poisoning) Ethylene Glycol Poisoning# Ingestion of ethylene glycol (commonly used in antifreeze) leads to a metabolic acidosis and severe damage to the central nervous system, heart, lungs, and kidneys. The increased AG and osmolar gap are attributable to ethylene glycol and its metabolites, oxalic acid, glycolic acid, and other organic acids. Lactic acid production increases secondary to inhibition of the tricarboxylic add cycle and altered intracellular redox state.# Diagnosis is facilitated by recognizing oxalate crystals in the urine(r) the presence of an osmolar gap in serum, and a high-AG acidosis. If anti freeze containing a fluorescent dye is ingested, a Wood's lamp applied to the urine may be revealing. Treatment should not be delayed while awaiting measurement of ethylene glycol le%rels in this setting | Medicine | Toxicology | [
"indinavir"
] | 155,054 |
92b573b9-f22d-45ff-8bc7-8fdd4e124978 | A 48-year-old male presented to OPD with complaints of generalized swelling over face and legs. Lab repos show moderately increased albuminuria. He gives history of HTN and T2DM for 15 years which is improperly controlled. He is staed on cA preparations,which of following drug should not be prescribed to this patient? | Dolutegravir | Lamivudine | Emtricitabine | Tenofovir | 3d
| single | Albuminuria in presence of T2DM And HTN is pointing towards renal dysfunction Tenofovir disoproxil fumarate (TDF, commonly termed 'tenofovir') is the antiretroviral most commonly implicated in antiretroviral-induced nephrotoxicity. It is mainly metabolized and excreted by kidneys, therefore avoided in patients with renal dysfunction | Medicine | viral infection | [
"lamivudine",
"dolutegravir",
"emtricitabine"
] | 155,066 |
449d128b-e935-4c62-a958-45501729944c | A 28 year old Raji was HbsAg positive during her first pregnancy 8 years ago. She was asymptomatic and had regular check ups with a Hepatologist. Rani is now 32 weeks pregnant with the following lab parameters : LFT Normal, HbsAg Positive, HbeAg Negative, HBV DNA 90,000 copies/ml. Her first child was given hepatitis B immunoglobulin and Vaccination soon after bih and the child is HBsAg negative. Which of the following statement is true about the current scenario? | Very high risk of hepatitis B transmission to the baby | Entecavir is safe in pregnancy and should be staed as early as possible to mother | Antiviral therapy against hepatitis B is contraindicated in pregnancy | The patient can be monitored without antivirals and the baby should be given immunoglobulin and active immunisation soon after delivery | 3d
| multi | The patient can be monitored without antivirals and the baby should be given immunoglobulin and active immunisation soon after delivery | Medicine | null | [
"entecavir"
] | 155,076 |
5bf3aa0c-328c-4450-b0df-c6910e3798c1 | Regarding sulpha group of drugs all the below statements are true, except: | Sulfonamide may cause Kernicterus in newborn | Sulfonamides are used in Norcardia infections | Crystalluria can occur with sulfonamide | Sulfasalazine is absorbed well from GIT | 3d
| multi | Sulfasalazine is usaually absorbed from the small intestines. Only 10% of drug is absorbed remaining excreted unaltered in bowel. Hence, this drug acts locally in the intestine of patient with inflammatory bowel disease. Ref: Paul Beringer (2006), Chapter 90, "Antiinfectives", In the book, "Remington: The Science and Practice of Pharmacy", Lippincott Williams and Wilkins, USA, Page 1631 ; KD Tripathi, 5th Edition, Pages 186, 643 ; Katzung 9th Edition, Page 591 | Pharmacology | null | [
"sulfasalazine"
] | 155,079 |
fd9b2009-a6e4-4479-b9c0-7e0fc3530ae3 | Which of the following local anesthetic is a vasoconstrictor | Lidocaine | Procaine | Bupivacaine | Ropivacaine | 3d
| single | null | Surgery | null | [
"lidocaine",
"ropivacaine",
"bupivacaine",
"procaine"
] | 155,086 |
dfdb9eca-d73d-4d45-a382-fb677cdee025 | A 53-year-old man presents to Casualty with severe chest pain. He has a history of angina. ECG shows ST elevation of 4 mm in leads V1 and V4 Thrombolysis has been done but pain and ECG findings are persisting 90 minutes after start of thrombolysis. What is the best management of this patient? | Rescue PCI | Primary PCI | Delayed PCI | IV Abciximab | 0a
| single | Ans. A Rescue PCIRef: CMDT 2019 pg. 386The patient is having failure of thrombolysis. In case of failure of thrombolysis, rescue PCI is performed. Primary PCI is done for STEMI. Delayed PCI is done for NSTEMI and hence are ruled out. | Physiology | Nervous System | [
"abciximab"
] | 155,100 |
4d08b1ed-f5c3-4d60-8c24-d363697d7d66 | Which amide local anaesthetic causes allergy | Lignocaine | Articane | Benzocaine | Prilocaine | 1b
| multi | Articane is the only amide local anaesthetic agent metabolised by pseudocholinesterase, produces PABA thus causing allergy. | Anaesthesia | null | [
"benzocaine"
] | 155,104 |
df0a364e-028c-440e-b61c-b8fb79d37919 | ICATIBANT IS A ? | bradykinin B 1 antagonist | bradykinin B 2 antagonist | bradykinin B 3 antagonist | histamine receptor H3 antagonist | 1b
| single | Icatibant, New Bradykinin-Receptor Antagonist, in HAE Icatibant (Firazyr, Shire) synthetic selective decapeptide bradykinin B2 receptor competitive antagonist contains 5 non-natural amino acids to enhance resistance to peptidases Icatibant administered sc injection as single 30 mg peak concentration within 30 minutes, ref : kd tripathi 8th ed | Pharmacology | All India exam | [
"icatibant"
] | 155,130 |
2bdf52c0-327e-4e2f-acea-73648a2a8c1d | A 55-year-old woman was admitted to the intensive care unit with severe lobar pneumonia and septic shock. She remained hypoxemic despite intubation, a high fraction of inspired oxygen, and positive end-expiratory pressure (PEEP). When PEEP was increased further, she paradoxically became more hypoxemic and her blood pressure and central venous hemoglobin saturation fell. What would be your approach | Keep PEEP at the highest and give adrenaline | Initiate dobutamine and reduce PEEP to 5cm H2O | Increase PEEP further | Increase FiO2 | 1b
| multi | High levels of PEEP can decrease cardiac output and tissue oxygen delivery with subsequent decreases in mixed and central venous oxygen content that contribute to impaired arterial oxygenation in patients with increased shunt fractions. So in this patient give dobutamine to correct hypotension and reduce PEEP so as to increase oxygenation. | Anaesthesia | null | [
"dobutamine"
] | 155,143 |
31065b71-cacd-4766-ab02-9f93e0807b23 | Which of the following drugs is contra-indicated in acute intermittent porphyria? | Thiopentone | Midazolam | Propofol | Etomidate | 0a
| single | Barbiturates are contra-indicated in acute intermittent porphyria. Ref: KD Tripathi 8th ed. | Pharmacology | Central Nervous system | [
"etomidate",
"midazolam",
"propofol"
] | 155,151 |
0c2166d9-c644-4cf9-a1c5-6e1e653af19b | A 32-year old male with no past medical history is brought to the emergency department after being injured in a bomb blast. On examination he is suspected to have a splenic injury and is supposed to undergo an emergency laparotomy. Which of the following is the ideal anaesthetic agent of choice ? | Remifentanil | Morphine | Etomidate | Halothane | 2c
| single | Inducing agents of choice patients with hypotension are Ketamine and Etomidate :-
(1) If the patient is hypertensive at the time of induction → Etomidate is preferable.
(2) If the patient is normotensive or mild hypotensive → Either of two can be used.
(3) If the patient is severely hypotensive → Ketamine is preferred. | Anaesthesia | null | [
"morphine",
"halothane",
"remifentanil",
"etomidate"
] | 155,164 |
8c4c66f9-8ca5-4af1-bf76-162954c50674 | Delta cells of pancreas secretes | Glucagon | Insulin | Somatostatin | Pancreatic polypeptide | 2c
| single | Ans. (c) Somatostatin | Physiology | Pancreas | [
"glucagon"
] | 155,182 |
687f89a2-ab71-4b49-a2bc-99ac61e19de5 | Which of the following pair of drugs are metabolized by same Cytochrome enzyme | Omeprazole and Clopidogrel | Phenytoin and Tacrolimus | Paracetamol and Warfarin | Omeprazole and Warfarin | 0a
| single | Both are metabolized by CYP2C19. | Pharmacology | null | [
"clopidogrel",
"tacrolimus",
"omeprazole",
"paracetamol",
"phenytoin",
"warfarin"
] | 155,187 |
0092c918-83ea-4e0d-acf1-64bbcfc74021 | Which of the following medications should be used for pheochromocytoma associated hypeension after phenoxybenzamine is staed? | Amlodipine | Propranolol | Nifedipine | Diltiazem | 1b
| single | Option B- in order to control tremors and palpitation complaints in the patient For Pheochromocytoma : (a+b) =Ideal management recommended protocol (b+a) = C/I | Medicine | Disorders of Adrenal Gland | [
"propranolol",
"diltiazem",
"amlodipine",
"phenoxybenzamine",
"nifedipine"
] | 155,188 |
7d1f1e2f-423f-4aab-be37-c69f837211cc | Amphotericin B (Fungizone) IV is given to a client with aspergillosis, a fungal infection. In order to prevent its side effects, the nurse anticipate administering which of the following prior, except? | Hydrocortisone. | Ketoconazole. | Diphenhydramine. | Meperidine. | 1b
| multi | Azole antifungals (eg, ketoconazole) decreases the effectiveness of amphotericin b.
Options A and C: Fever, shaking, chills, flushing, loss of appetite, dizziness, nausea, vomiting, headache, shortness of breath, or fast breathing may occur 1 to 3 hours after the infusion is started. Medications such as acetaminophen, diphenhydramine, corticosteroids such as hydrocortisone) may be necessary to prevent these side effects.
Option D: Meperidine (25 to 50 mg IV) has been shown in some patients to decrease the duration of shaking chills and fever that may accompany the infusion of amphotericin B. | Medicine | null | [
"diphenhydramine",
"ketoconazole"
] | 155,192 |
a04d5ed2-9c9b-47bb-9e2e-ee7d95c3f1e8 | All of the following are true about "Imiquimod" EXCEPT: | Direct antiviral activity | Indirect antiviral activity | Antitumor activity | It release cytokines | 0a
| multi | IMIQUIMOD: Mechanism of Action An unknown mechanism in treating actinic keratosis and external genital was; immune response modifier, stimulates the release of inflammatory cytokines and proliferation/migration of immune cells No direct antiviral activity Absorption Appears to be dependent on the area of application rather than the amount applied Peak plasma concentration (Aldara): 0.1-3.5 ng/mL Peak plasma concentration (Zyclara): 0.323 ng/mL Elimination Excretion: Urine USES: Actinic Keratosis Indicated for topical treatment of clinically typical, nonhyperkeratotic, nonhyperophic actinic keratoses on the face or scalp in immunocompetent adults Zyclara 2.5% or 3.75%: Apply qDay to the skin of affected area (either entire face or balding scalp) for two 2-week treatment cycles separated by 2-week no-treatment period Aldara 5%: Apply 2 times a week for 16 weeks to one defined treatment area (contiguous area <25 cm2); examples of dosing schedules include Monday and Thursday or Tuesday and Friday Superficial Basal Cell Carcinoma Target tumor should have maximum <2 cm diameter and be located on trunk (excluding anogenital skin), neck, or extremities (excluding hands and feet); treatment area should include 1 cm margin of skin around tumor Aldara 5%: Apply 5 times a week for 6 weeks to biopsy-confirmed superficial basal cell carcinoma and include 1 cm margin of skin around tumor External Genital Was Indicated for the treatment of external genital and perianal was/condyloma acuminata Zyclara 3.75%: Apply a thin film to the entire treatment area and rub in until the cream is no longer visible; may wash with mild soap and water after 8 hours of application; use 1 packet or 1 full actuation of the pump Aldara 5%: Apply 3 times a week until total clearance of was or for a maximum of 16 weeks; examples of application schedules are Monday, Wednesday, Friday or Tuesday, Thursday, Saturday; use 1 packet only for each application Bladder Cancer (Orphan) Orphan designation for the treatment of carcinoma in situ of the urinary bladder. Adverse Effects >10% Application site reaction (33%) UI (15%) Erythema (54-61%) Erosion (29-31%) Excoriation/flaking (18-25%) Edema (12-17%) Itching (20%) 1-10% Sinusitis (7%) Burning (6%) Headache (5%) Carcinoma squamous (4%) Diarrhea (3%) Bleeding (3%) Stinging (3%) Pain (3%) Eczema (2%) Induration (2%) Tenderness (2%) Irritation (2%) Back pain (1%) Fatigue (1%) Atrial fibrillation (1%) REF KD Tripathi 8th ed | Pharmacology | Immunomodulators | [
"imiquimod"
] | 155,214 |
1b81e59f-0bb4-412e-9b1e-b6267bfd6bf2 | Best uterine relaxation is seen with – | Chloroform | Nitrous oxide | Ether | Halothane | 3d
| single | All fluorinated inhalational agents (including halothane) can cause uterine relaxation. Traditionally, Halothane is considered as to posseses maximum uterine relaxant property. | Anaesthesia | null | [
"halothane"
] | 155,218 |
175791c5-c987-45dd-838e-d01765b25045 | Cholinergic drugs such as pilocarpine are routinely used to treat glaucoma. What is their mechanism of action in the eye that accounts for this ophthalmologic use? | Reduction in the formation of aqueous humor | Blockade of adrenergic receptors to potentiate cholinergic effects | Alkalinization of aqueous humor | Improved drainage of aqueous humor | 3d
| single | Like other cholinergics with muscarinic action, pilocarpine improves the drainage of aqueous humor from the anterior chamber angle of the eye. The cholinomimetic effect results in contraction of the ciliary body and causes a change in its position. This altered position increases flow of aqueous humor through the trabecular network and into the canal of Schlemm, thus decreasing the intraocular pressure of glaucoma. Ref: Brown J.H., Laiken N. (2011). Chapter 9. Muscarinic Receptor Agonists and Antagonists. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | Ophthalmology | null | [
"pilocarpine"
] | 155,245 |
99c767c2-bde7-4e08-9e54-ec93630332d8 | Drug of choice in delirium tremens is - | Diazepalm | Phenytoin | Chlordiazepoxide | Morphine | 2c
| single | Chlordiazepoxide is preferred over diazepam. | Psychiatry | null | [
"morphine",
"chlordiazepoxide",
"phenytoin"
] | 155,258 |
4a892906-a105-424d-b963-549152241d63 | Which one of the following drugs can reduce the efficacy of low dose oral contraceptive pill : | Penicillin | Tetracycline | Ampicillin | Rifampicin | 3d
| single | Rifampicin | Gynaecology & Obstetrics | null | [
"tetracycline",
"ampicillin"
] | 155,260 |
e29c2837-ae3d-4e9b-ab1e-d1e1462f5358 | Drug of choice for generalized anxiety ? | 3-blocker | Alprazolam | Buspirone | Phenytoin | 1b
| single | Ans. is 'b' i.e., Alprazolam Treatment of generalized anxiety Benzodiazepines are the drug of choice. Drugs in this group are diazepam, Lorazepam, Alprazolam, Oxazepam, chlordiazepoxide. Other drugs used are buspirone; TCA (amptriptyline, imipramine, clomipramine, desipramine); SSRIs (Fluoxetine, Sealine, Paroxetine, Citalopram); SNRIs (Venalafaxine), 13-blockers. Anticonvulsants with GABAergic propeies may also be effective against anxiety, e.g., Gabapentin, Oxcarbazepine, Tiagabine, pregabalin, and Valproate (divalporex). | Psychiatry | null | [
"alprazolam",
"phenytoin"
] | 155,271 |
e14f1a88-4afe-4ebd-ac48-02d55dc3b087 | Drug not having any role in Acute Asthma is: | Ipratropium | Steroid | Salbutamol | Sodium Chromoglycate | 3d
| single | Sodium Chromoglycate Sodium Chromoglycate | Pharmacology | null | [
"ipratropium",
"salbutamol"
] | 155,280 |
718cc486-4e8a-4400-92f1-c479a4be7c1b | Drug of choice for cystitis ? | Amoxicillin | Chloramphenicol | Cotrimoxazole | Ciprofloxacin | 3d
| single | Ans. is 'd' i.e., Ciprofloxacin Fluroquinolones form the first line of drugs to be used against cystits. Ciprofloxacin is a fluoroquinolone and so the most appropriate answer. | Pharmacology | null | [
"ciprofloxacin",
"chloramphenicol"
] | 155,283 |
753f7e8b-b92b-462c-8134-d4eab3a3e55d | Treatment for multiple sclerosis | Interferon alpha | Interferon beta | Infliximab | Interferon gamma | 1b
| single | Beta interferons. These medications are among the most commonly prescribed medications to treat MS. They are injected under the skin or into muscle and can reduce the frequency and severity of relapses Interferon alpha is used to treat various cancers (e.g., leukemia, melanoma, AIDS-related Kaposi's sarcoma). It is also used to treat virus infections Interferon-g 1b is approved by the U.S. Food and Drug Administration to treat chronic granulomatous disease and osteoporosis This medication is used to treat ceain types of ahritis (rheumatoid ahritis, ahritis of the spine, psoriatic ahritis), ceain bowel diseases (Crohn's disease, ulcerative colitis), and a ceain severe skin disease (chronic plaque psoriasis). Ref Harrison20th edition pg 2345 | Medicine | C.N.S | [
"infliximab"
] | 155,297 |
d5e36578-bfe7-4155-a7d7-1ab91a0244a7 | Coronary steal phenomenon is seen with: | Dipyridamole | Diltiazem | Propranolol | Verapamil | 0a
| single | There are two types of vessels in coronary circulaton –
1. Larger conducting arteries which run epicardially and send perforating branches.
2. Smaller resistance arterioles - These are perforating branches of conducting arteries. These arterioles supply blood to the endocardium.
During ischemia, adenosine (a local mediator) causes dilatation of resistance arterioles in the ischemic area only, the tone of resistance vessels of the nonischemic area does not change → the increased flow to the ischemic area.
Dipyridamole is a powerful coronary dilator; increases total coronary flow by preventing uptake and degradation of adenosine.
It dilates resistance vessels in the nonischemic zone as well → Diverts the already reduced blood flow away from ischemic zone - Coronary steal phenomenon.
It has no effect on larger conducting vessels (contrast nitrates which dilate larger conducting vessels and cause redistribution of blood towards ischemic zone).
Dipyridamole inhibits platelet aggregation by increasing cAMP (by inhibiting phosphodiesterase) which potentiates PGI and interferes with aggregation.
It is not useful as an antianginal drug (due to coronary steal phenomenon), but can be used for prophylaxis of coronary and cerebral thrombosis in post-MI and post-stroke patients as well as to prevent thrombosis in patients with a prosthetic heart valve. | Pharmacology | null | [
"propranolol",
"diltiazem",
"verapamil"
] | 155,301 |
e4db8a6b-f808-46f8-8507-5d0b31789591 | Patient was given chloroquine & doxycycline for 7 days. Patient&;s fever decreases in 4 days but , peripheral smear showed occasional gametocytes of plasmodium falciparum. This type of drug resistance is - | R1 type | R2 type | R3 type | R4 type | 1b
| single | Types of Drug Resistance In defining criteria for resistance to the aminoquinolineantimalarial drugs, the WHO has described three grades of resistance following treatment (Low grade) R1 : Recrudescence of infection between 7 and 28 days of completing treatment following initial resolution of symptoms and parasite clearance. (High grade) R2 : Reduction of parasitaemia by > 75% at 48 hours but failure to clear parasites<br />within 7 days. R3 : Parasitaemia does not fall by >75% within 48 hours. (www.slideshare.net) | Social & Preventive Medicine | Communicable diseases | [
"chloroquine",
"doxycycline"
] | 155,302 |
f470bc50-f939-4f1b-8a5e-22457c0639e8 | Granulomatous hepatitis may be seen with : | Carbamazepine | Allopurinol | Phenylbutazone | All of the above | 3d
| multi | Answer is D (All of the above) Granulomatous Hepatitis has been implicated with the following drugs: PhenyIbutazoneQ Sulfimamides.Q INHQ AllopurinolQ QuinidineQ CarbamazepineQ | Medicine | null | [
"allopurinol",
"carbamazepine"
] | 155,311 |
468888e8-7c81-48b1-8753-1e1447a73081 | A patient with HIV infection complains of rapidly progressive painless visual loss.Fundus shows exudates and haemorrhage especially along blood vessels. In this case, the treatment of choice would be- | Amphotericin B | Pentamidine | Acyclovir | Ganciclovir | 3d
| multi | null | Medicine | null | [
"ganciclovir",
"pentamidine"
] | 155,320 |
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