Pharmacolgy Paper-1 (Main), 2020 MBBS Batch ABVMU Lucknow

ATAL BIHARI VAJPAYEE MEDICAL UNIVERSITY, LUCKNOW MBBS IInd PROFESSIONAL EXAMINATION - NOV-2022 SUBJECT: PHARMACOLOGY PAPER-1

TIME: 3 Hrs

Max. Marks: 100

Note: Attempt all questions. Answer PART-A and PART-B in separate answer books. All parts of a question should be answered together.

PART-A

PAPER CODE: 2211130005

Q.1 Long Answer Question (2+3+5+5= 15)

A 37-year-old male visited to neurology OPD with complaints of weakness in limbs after mild exertion. He also complaints that his upper eyelids and lower jaw drop down as the day progresses. On biochemical estimation he was positive with anti-acetylcholine receptor (AChR) antibodies against the Nm receptors. Plasmapheresis helped his condition to become better. Answer the following:

a) Name the possible clinical condition and the cause for weakness.

b) Write drugs used in management of such disease.

c) Discuss the difference between myasthenic and cholinergic crises. Write the management of both.

d) Classify anti-cholinergic drugs and discuss the therapeutic uses and adverse effects of atropine.

Q.2 Short Notes Questions (within 500 words) (5x3=15)

a) Discuss the autonomy of patient.

b) Pharmacotherapy of Migraine.

c) Discuss mechanism of action, uses and adverse effects of phenytoin.

Q.3 Short Answer Questions (within 100 words) (2 x 5=10)

a) Rationale of carbamazepine in management of generalized tonic clonic seizures.

b) Explain why Ethanol is used in the management of Methanol poisoning.

c) Write rational of combining levodopa with carbidopa.

d) Explain why urine is alkalinised in the management of Aspirin toxicity.

e) Loading dose.

Q.4 Multiple Choice Questions (1 x 10=10)

• 1. Which one of the following drugs undergoes zero order kinetics?

  a) Paracetamol b) Phenytoin c) Ranitidine d) Ibuprofen

• 2. Which one of the following drugs gets deposited in retina after long term continuous use?

  a) Thiopentone sodium b) Chloroquine c) Iodine d) Tetracycline

• 3. Which one of the following compounds is the drug of choice to control malignant hyperthermia due to halothane.

  a) Dantrolene sodium b) Calcium gluconate c) Neostigmine d) Physostigmine

• 4. Which one of the following compounds belongs to cholinesterase reactivator group?

  a) Atropine b) Obidoxime c) Rivastigmine d) Galantamine

• 5. Which one of the following compounds belongs to serotonergic agonist group?

  a) Sumatriptan b) Ondansetron c) Cyproheptadine d) Ketanserin

• 6. Which one of the following nonsteroidal anti-inflammatory drugs is derivative of propionic acid?

  a) Paracetamol b) Aspirin c) Ibuprofen d) Piroxicam

• 7. Which one of the following agents is used as antidote for the acute paracetamol poisoning?

  a) Acetylsalicylic acid b) N-acetylcysteine c) Ranitidine d) Ondansetron

• 8. Which one of the following agents inhibits dihydrofolic acid reductase enzyme and used in management of rheumatoid arthritis?

  a) Cyclophosphamide b) Mycophenolate mofetil c) Hydroxychloroquine d) Methotrexate

• 9. Which one of the following is an indication for Rasburitase?

  a) Iron deficiency anemia b) Chronic gout c) Rheumatoid arthritis d) Myasthenia gravis

• 10. Which one of the following agents produces dissociative anesthesia?

  a) Fentanyl b) Thiopentone c) Methohexitone d) Ketamine

Q.1 Long Answer Question (2+3+5+5= 15)

A 27-year-old male visited to his native village during winter season. During early morning he complains of breathlessness and dry cough. His brother gave him dextromethorphan cough suppressant syrup but his condition did not improve. After half an hour the breathlessness further increased and the wheezing were audible during expiration. He was rushed to the nearest primary health care center where on history it was revealed that he had suffered such episodes previously during similar weather conditions. Management by the primary care physician at the right time produced great result with improvement of his condition. Answer the following:

a) Name the possible clinical condition and the cause for cough and breathlessness.

b) Enumerate drugs used in management of this condition.

c) Discuss the management of status asthmaticus. Write mechanism of action of beta 2 agonists as bronchodilators.

d) Discuss the mechanism of action and adverse effects of corticosteroids in Status Asthmaticus.

Q.2 Short Notes Questions (within 500 words) (5x3=15)

a) Discuss the role of Indian medical graduate in health care team management.

b) Discuss mechanism of action and adverse effects of diazepam.

c) Discuss pharmacogenomics and its clinical importance.

Q.3 Short Answer Questions (within 100 words) (2x5=10)

a) Teratogenic drugs.

b) Drugs used in glaucoma.

c) Zero order pharmacokinetics.

d) H1 antihistaminic drugs.

e) Atypical antidepressant drugs.

Q.4 Multiple Choice Questions (1 x 10 = 10)

• 1. Neuroleptanalgesia is produced by the combination of two compounds. One compound is fentanyl. Which one of the following compounds is the second component of this combination?

• a) Droperidol

• b) Domperidone

• c) Dexamethasone

• d) Diazepam

• 2. Which one of the following compounds is benzodiazepine antagonist?

• a) Flumazenil

• b) Melatonin

• c) Chlordiazepoxide

• d) Zaleplon

• 3. Which one of the following drugs is most suitable in management of status epilepticus?

• a) Lorazepam

• b) Carbamazepine

• c) Sodium valproate

• d) Levetiracetam

• 4. Which one of the agents inhibits catechol O methyl transferase enzyme and used in treatment of Parkinsonism disease?

• a) Bromocriptine

• b) Levodopa

• c) Tolcapone

• d) Selegiline

• 5. Which one of the following agents is N-methyl D-aspartate (NMDA) antagonist and used in treatment of Alzheimer's disease?

• a) Piribedil

• b) Ginkgo biloba

• c) Rivastigmine

• d) Memantine

• 6. Which one of the following compounds is used as an antidote in morphine poisoning?

• a) Naloxone

• b) Noscapine

• c) Methadone

• d) Codeine

• 7. Which one of the following agents is considered as antidote in management of acute methanol poisoning?

• a) Disulfiram

• b) Fomepizole

• c) Methadone

• d) Diazepam

• 8. Theophylline produces bronchodilatation in patients with chronic obstructive pulmonary disease. Which one of the following mechanisms is responsible for the therapeutic action of theophylline?

• a) Inhibition of phosphodiesterase

• b) Stimulation of beta 2 receptors

• c) Inhibition of cholinergic receptors

• d) Stimulation of beta 1 receptors

• 9. Which one of the following agents is potassium channel opener?

• a) Nicorandil

• b) Amlodipine

• c) Salbutamol

• d) Isosorbide dinitrate

• 10. Which one of the following compounds is orexin receptor antagonist?

• a) Suvorexant

• b) Methotrexate

• c) Zaleplon

• d) Flumazenil

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