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c5d3c99f-10cb-4dd9-a082-c3af822058b6 | Following is given in case of pernicious anaemia? | Folic acid | Folinic acid | Methyl cobalamin | epogen | 2c
| single | Ans. C. MethylcobalamineMegaloblastic anaemia is caused due to deficiency of vitamin B-12. it causes degeneration of spinal cord. Methylcobalamine is given (i/m or s/c) for correcting neurological abnormalities. | Pharmacology | Miscellaneous (Pharmacology) | [
"erythropoietin"
] | 58,655 |
2877b31c-26c7-446a-b022-ce70d535b75f | Substantivity of chloraprep remains upto | 4 hours | 8 hours | 12 hours | 16 hours | 2c
| single | null | Dental | null | [
"chlorhexidine"
] | 58,657 |
b85f9baa-5f1c-48c0-aa08-931b31c863f2 | Which of the following production is noted in Cushing's Syndrome | Decrease production of cortisol | Increase production of cortisol | Excessive production of epipen | Excessive production of pitressin | 1b
| single | Cushing syndrome
Cushing syndrome is characterized by an excess production of cortisol.
The most common cause of Cushing syndrome is exogenous hypercortisolism, i.e., administration of exogenous glucocorticoids.
The cause of endogenous hypercortisolism (endogenous Cushing syndrome) are : -
i) ACTH producing pituitary microadenoma →
It is the most common cause of endogenous hypercortisolism and this form of Cushing syndrome is referred to as Cushing disease.
ii) Hypersecretion of cortisol by an adrenal adenoma, carcinoma or nodular hyperplasia.
iii) The secretion of ectopic ACTH by a nonendocrine neoplasm, e.g., small cell carcinoma of the lung. | Pathology | null | [
"epinephrine",
"vasopressin"
] | 58,661 |
d0cfe961-e425-47ae-a6b2-45bac5ff3ad4 | Drugs that can be used in opioid de-addiction are? | catapres | valium | dolophine | All of the above | 3d
| multi | All of the drugs can be used. Methadone is effective orally, more potent ,longer acting and prevents withdrawal symptoms because it is slowly released from tissues. Clonidine a central alpha 2agonist can suppress autonomic.if withdrawal symptoms such as nausea, vomiting, anxiety and diarrhea. Night time sedation with a hypnotic like diazepam is helpful. Ref KD Tripathi 8th ed | Pharmacology | Central Nervous system | [
"methadone",
"diazepam",
"clonidine"
] | 58,692 |
9d3e422b-03ed-41c4-af8c-b915454a946b | Treatment of choice for tropical splenomegaly is : | resochin ' 6 months | lariam ' 3 months | Proguanil | Pyrimethamine + sulphadoxine X 1 month | 2c
| single | Ans. is 'c' Proguanil Tropical splenomegaly is a chronic complication of malaria. Some residents of malaria endemic areas in tropical Asia and Africa exhibit an abnormal immunological response to repeated infections with malaria.In these patients IgM antibodies develop against CD8 and CD5 cells. There is increase ratio of CD4/CD8 cells.These disturbances in immunological process results in splenomegaly. Anaemia and pancytopenia can also occur. | Medicine | Drugs | [
"mefloquine",
"chloroquine"
] | 58,694 |
422f71c8-e1c5-4ef0-9193-83db65c1a9b8 | The drug of choice to control convulsions in eclampsia is: | demerol | valium | Magnesium sulphate | dilantin | 2c
| single | given by i.v. infusion, it has been used for long to control convulsions and to reduce BP in toxaemia of pregnancy. As per WHO, it is the drug of choice for prevention and treatment of seizures in preeclampsia and eclampsia. REF: KD TRIPATHI 8TH ED. | Pharmacology | Central Nervous system | [
"phenytoin",
"pethidine",
"diazepam"
] | 58,700 |
f39a7369-e33d-4734-8d94-a5cc8b35b293 | One of your patients is found to be dyspnoeic. Auscultation of the Lungs revealed bilateral diffuse wheeze. Which drug would you like to use for fastest relief? | serevent | atrovent Bromide | Monteleukast | ventolin | 3d
| single | null | Pharmacology | null | [
"ipratropium",
"salmeterol",
"salbutamol"
] | 58,730 |
1bd88de0-6bfc-4d47-b65c-3f62cf4a26cd | Select the antibiotic most frequently associated with the Gray baby syndrome (SELECT 1 ANTIBIOTIC) | panmycin | Streptomycin | macrobid | chloromycetin | 3d
| single | Fetal exposure to an antibiotic depends on many factors such as gestational age, protein binding, lipid solubility, pH, molecular weight, degree of ionization, and concentration gradient. Some antibiotics are even concentrated in the fetal compartment. Tetracycline is contraindicated in all three trimesters. It has been associated with skeletal abnormalities, staining and hypoplasia of budding fetal teeth, bone hypoplasia, and fatal maternal liver decompensation. Sulfonamides are associated with kernicterus in the newborn. They compete with bilirubin for binding sites on albumin, thereby leaving more bilirubin free for diffusion into tissues. Sulfonamides should be withheld during the last 2 to 6 weeks of pregnancy. With prolonged treatment of tuberculosis (TB) in pregnancy, streptomycin has been associated with fetal hearing loss. Its use is restricted to complicated cases of TB. Nitrofurantoin can cause maternal and fetal hemolytic anemia if glucose- 6-phosphate dehydrogenase deficiency is present. Chloramphenicol is noted for causing the gray baby syndrome. Infants are unable to properly metabolize the drug, which reaches toxic levels in about 4 days and can lead to neonatal death within 1 to 2 days. | Gynaecology & Obstetrics | Fetus & New Born and their Diseases | [
"tetracycline",
"chloramphenicol",
"nitrofurantoin"
] | 58,752 |
da25930a-fbca-4a32-8728-b9ad6b1986d4 | Which of the following potassium sparing diuretics cause renal stones? | carospir | inspra | dyrenium | Amiloride | 2c
| multi | Triamterene is only slightly soluble and may precipitate in the urine, causing kidney stones. Ref: Katzung, 11th edition, Chapter 15. | Pharmacology | null | [
"eplerenone",
"spironolactone",
"triamterene"
] | 58,755 |
fb4728d6-45e8-4979-81d8-b15d794adce5 | All of the following drugs are protease inhibitors except- | viracept | invirase | Abacavir | norvir | 2c
| multi | Ans. is 'c' i.e., Abacavir Antiretroviral drugs a) Nucleoside reverse transcriptase inhibitors (NIs) - Zidovudin, Didanosine, Zalcitabine, Stavudine, Larnivudine, Abacavir. b) Nucleotide reverse transcriptase inhibitor Tenofovir (Katzung I Oth/e) c) Nonucleoside reverse transcriptase inhibitors (NNIS) - Nevirapine, Eirenz, Delavirdine, Etravirine Rilpivirine. d) Protease inhibitors - Ritonavir, Indinavir, Nelfinavir, Saquinavir, amprenavir, Lopinavir, Fosamprenavir, Atazanavir, Darunavir, Tipranavir. e) Fusion inhibitor - Enfuviide, Maraviroc. f) Integrase inhibitors - Roltegravir, Elvitegravir. | Pharmacology | null | [
"nelfinavir",
"ritonavir",
"saquinavir"
] | 58,764 |
8c4e463b-84b7-4bd1-abab-f7ddc889c1c6 | panmycin ointment for mass prophylaxis - | 0.10% | 0.50% | 1& | 5% | 2c
| single | In blanket antibiotic therapy, the regimen is sto apply 1% tetracycline eye ointment twice daily for 5 days in a month for 6 months. Ref: Khurana 7th/e p.72 & 4th/e p.68 | Ophthalmology | Conjunctiva | [
"tetracycline"
] | 58,766 |
35592376-004b-4dcb-b14f-3d955883f11d | Which is the major hormone secreted by the corpus luteum in a lady of reproductive age? | Estrogen | Progesterone | Testosterone | synthroid | 1b
| single | Corpus luteum mainly secretes progesterone and small quantities of estrogen. The follicle that ruptures at the time of ovulation promptly fills with blood and is called corpus hemorragicum. The granulosa and theca cells of the follicle lining begin to proliferate, and the clotted blood is rapidly replaced with yellowish, lipid-rich luteal cells, forming the corpus luteum. Growth of corpus luteum depends upon adequate blood supply and availability of VEGF. If pregnancy occurs, corpus luteum persists and if pregnancy does not occur the corpus luteum begins to degenerate about 4 days before the next menses (24th day of the cycle) and is eventually replaced by scar tissue, forming a corpus albicans. Ref: Ganong's Review of Medical Physiology, 24th Edition, Chapter 22 | Physiology | null | [
"thyroxine"
] | 58,777 |
a91d38b2-0205-466b-8659-403ee7601e19 | The drug that causes fall in elderly patients with postural hypotension is:- | glucophage | minipress | precose | Nor-adrenaline | 1b
| multi | The side effect postural hypotension AkA ''First Dose Hypotension" is observed with drug ending with zosin Prazosin, Terazosin, Doxazosin (d) Acarbose - Inhibition of intestinal absorption of carbohydrate. S/E - flatulence, abdominal discomfo, loose stool. These drugs cause blocking of a1receptors, leading tovasodilation, that can Cause Postural Hypotension. (a)Metformin -Antidiabetic drug which comes under the category of Biguanide. S/E - Abdominal Pain, Anorexia, bloating, nausea, metallic taste mild diarrhea & tiredness. Nor - adrenaline(Press or agent)- stimulates a1 and a2 adrenergic receptors to cause blood vessel contraction, thus increases peripheral vascular resistance and result in increase BP. It acts on b1 adrenergic receptors, causing increase In hea rate and cardiac output. S/E = Transient restlessness, headache, palpitations, Anxiety,tremor. Marked rise in BP leading to cerebral hemorrhage, ventricular tachycardia, angina, MI. | Pharmacology | FMGE 2018 | [
"metformin",
"acarbose",
"prazosin"
] | 58,789 |
76002754-6bc1-49f9-90aa-9e03112f168b | The antimicrobial agent which inhibits the ergosterol biosynthesis is : | extina | Amphotericin B | 5-ancobon | griseofulvic | 0a
| single | null | Pharmacology | null | [
"flucytosine",
"griseofulvin",
"ketoconazole"
] | 58,797 |
42560df5-b1de-4eab-81af-26904ec56ffa | Most commonly used local anesthesia | 1:20,000 xylocaine Hcl | 1:50,000 xylocaine Hcl | 1:10,000 xylocaine Hcl | 1:80,000 xylocaine Hcl | 3d
| single | null | Surgery | null | [
"xylocaine"
] | 58,804 |
718f54d3-cdd2-485c-8945-f764d6d471f2 | Anesthesia agent with least analgesic propey | N20 | fluothane | Ether | Propane | 1b
| single | B i.e. Halothane | Anaesthesia | null | [
"halothane"
] | 58,808 |
81c907ae-6689-48b1-afb2-6f19e0c54c08 | Antidote for copper poisoning is: March 2009 | D-cuprimine | Potassium ferrocyanide | BAL | Desferrioxamine | 1b
| single | Ans. B: Potassium ferrocyanide Treatment of copper poisoning: Stomach wash with 1 percent solution of potassium ferrocyanide which acts as an antidote by forming an insoluble cupric ferrocyanide Emetics are contraindicated Demulcent drinks form insoluble albuminate of copper Castor oil Chelation with penicillamine/ EDTA/ BAL | Forensic Medicine | null | [
"penicillamine"
] | 58,811 |
16746670-2daf-4416-bb3c-2b590fa575d0 | All of the following antidiabetic drugs act by enhancing insulin resistance except | byetta | Sitagliptan | Rosiglitazone | prandin | 2c
| multi | Refer KDT 7th /270 Rosiglitaxzone does not act by increasing insulin secretion Rosiglitazone is an oral antihyperglycemic agent that acts primarily by decreasing insulin resistance | Pharmacology | Endocrinology | [
"exenatide",
"repaglinide"
] | 58,820 |
8c30e11c-f711-4c3e-93b6-82b8d4f9d12a | A 35 years old female came with multiple inverted sauce shaped ulcer over the body,sensations was near normal . SSS was positive and lepromin test was negative.How do you treat this patient? | T.Rifampicin 600 mg and T.lamprene 300 mg once in month and T.lamprene 50 mg daily + T. aczone 100 mg daily for 12 months | T.Rifampicin 600 mg and T.lamprene 300 mg once in month and T.lamprene 100 mg daily + T. aczone 1000 mg daily for 12 months | T.Rifampicin 600 mg and T.lamprene 300 mg once in month and T.lamprene 50 mg daily + T. aczone 100 mg daily for 6 months | T.Rifampicin 600 mg and T.lamprene 300 mg once in month and T.lamprene 50 mg daily + T. aczone 100 mg daily for 6 months | 0a
| single | Multiple skin lesions,normal sensation indicating no nerve compresion,SSS :positive suggests of multibacillary leprosy | Dental | null | [
"clofazimine",
"dapsone"
] | 58,821 |
fc28bcf0-7de7-4ca8-8d59-0f4e4f08462d | Which fluoroquinolone is highly active against Mycobacterium leprae and is being used in alternative multidrug therapy regimens: | Norfloxacin | floxin | proquin | Lomefloxacin | 1b
| single | Ofloxacin is highly active against Mycobacterium leprae and is being used in alternative multidrug therapy regimens. As a component of MDT, it has been found to hasten the bacteriological and clinical response. Drugs used for drug resistant leprosy are: Ofloxacin Minocycline Claihromycin | Pharmacology | Mycobacterial Diseases (TB, Leprosy and MAC) | [
"ciprofloxacin",
"ofloxacin"
] | 58,830 |
38652d95-5e12-4dba-937c-0d593967a575 | Gray baby syndrome is caused by - | Penicillin | chloromycetin | Rifampicin | staticin | 1b
| single | Ans. is 'b' i.e., Chloramphenicol o Chloramphenicol causes gray baby syndrome in premature neonates due to blockade of electron transpo in liver, myocardium and skeletal muscle. Remember o Chloramphenical is the most common cause of aplastic anemia. o Tetracyclines are the most common cause of superinfections. | Pharmacology | null | [
"erythromycin",
"chloramphenicol"
] | 58,854 |
3c8a98fe-eb7a-4527-8334-95274f4bcf75 | Wof chemotherapeutic drugs inhibit the polymerization of microtubules but is not associated with causing bone marrow supression | platinol | vincasar | Vinblastine | 5 FU | 1b
| single | Vinca alkaloids Mech of action:- These are mitotic inhibitors, bind to microtubular protein--'tubulin', prevent its polymerization and assembly of microtubules, cause disruption of mitotic spindle and interfere with cytoskeletal function. The chromosomes fail to move apa during mitosis: metaphase arrest occurs. They are cell cycle specific and act in the mitotic phase. Vincristine (oncovin):- Uses:- It is a rapidly acting drug, very useful for inducing remission in childhood acute lymphoblastic leukaemia, but is not good for maintenance therapy. Other indications are acute myeloid leukaemia, Hodgkin's disease, Wilms' tumour, Ewing's sarcoma, neuroblastoma and carcinoma lung. Adverse effects:- peripheral neuropathy and alopecia. It also causes ataxia, nerve palsies, autonomic dysfunction (postural hypotension, paralytic ileus, urinary retention) and seizures. Bone marrow depression is minimal, but syndrome of inappropriate secretion of ADH (SIADH) can occur. Ref:- kd tripathi; pg num:-865 | Pharmacology | Chemotherapy | [
"vincristine",
"cisplatin"
] | 58,859 |
31187706-8b27-4508-aafb-008e1dde82eb | Treatment of acute femoral embolus is- | jantoven | Heparin | Immediate embolectomy | Embolectomy after 5 days bed rest | 2c
| single | null | Surgery | null | [
"warfarin"
] | 58,864 |
72329bab-3cf8-4611-8b8f-3a0653f79155 | A 56-year-old African-American man with COPD comes to the physician for a routine examination. His average diurnal ambulatory blood pressure is 148/92 mmHg. Laboratory studies show creatinine level of 3.2 mg/dL and a potassium level of 5.6 mg/dL.
Which of the following medications would most likely be considered the first-line treatment in this patient? | norvasc | Doxazosin | inderal | Pamipril | 0a
| single | null | Medicine | null | [
"propranolol",
"amlodipine"
] | 58,875 |
7ad6cb6e-d031-4b2b-a28c-893c8ca0e28c | oxoject causes ail EXCEPT: | Milk ejection | Induction of labour | Attaches to VI receptors | Milk production | 3d
| multi | ANSWER: (D) Milk productionREF: Ganongs 22nd ed p- 243, www.ncbi.nlm.nih.gov/pubmed/7922507OXYTOCIN:Oxytocin is a peptide of nine amino acids (a nonapeptide)released by the human posterior pituitary glandActions:Oxytocin has peripheral (hormonal) actions, and also has actions in the brain. Its actions are mediated by specific, high-affinity oxytocin receptors. The oxytocin receptor is a G-protein-coupled receptorActs on myoepithelial cells of the ducts in the breast to squeeze the milk out of areola of iactating breast causing galactokinesis or milk ejection or letting down reflex. Remember milk production is not a function of oxytocinInitiation of labour: it acts on uterine musculature to cause its contraction and initiates labour via positive feed back mechanism. However it's important to note that oxytocin acts on an endometrium primed by estrogen, and progesterone antagonises this function of oxytocin.It also acts on non pregnant uterus to cause sperm transportIt has been found that since the structure of oxytocin is similar to vasopressin it can act on VI receptors in the brain , although the effect is 10 times lesser , hence large doses of oxytocin can cause a state similar to vasopressin excessGiven as syntocinon for induction of labour in intravenous or nasal spray forms. Atosiban a tocolytic is its antagonistThere are three vasopressin receptors. They are ah G protein linked.VIAV1BV2* Acts by phosphatidyl hydrolysis* Located in area postrema, liver, spinal cord* Mediates vasoconstrictor action* Acts by phosphatidyl hydrolysis* Located in anterior pituitary to cause ACTH release* Also called V3 receptors* Neural action* Stimulates adenyl cyclase* Expressed in anterior pituitary and DCT of kidney and liver.* Antidiuretic action* Loss of this causes diabetes insipidus* Now called aquaporins and 5 types have been found aquaporin 1,2,3 found in kidney , aquaporin 4 in brain, and aquaporin 5 in lacrimal and salivary gland | Physiology | Pituitary | [
"oxytocin"
] | 58,881 |
0304a663-3c44-424c-ba06-790dd1bb6502 | Macrocytic anaemia is noted with all of the following except : | dilantin | trexall | Pyrimethamine | proquin | 3d
| multi | null | Pharmacology | null | [
"methotrexate",
"ciprofloxacin",
"phenytoin"
] | 58,899 |
1c3fd1b4-0e1e-46a9-9a58-93e78b35ea11 | All of the following are true about therapy for tuberculosis, except - | 'Flu like syndrome' is usually seen in people taking rifampicin on daily basis | myambutol accumulates in renal failure | Hyperuricemia is a recognized side effect of pyrazinamide | Red-green color impairment is an early sign of myambutol induced optic neuritis | 0a
| multi | Ans. is 'a' i.e.,`Flu like syndrome' is usually seen in people taking rifampicin on daily basis. o Flu like syndrome is not seen with daily dose of Rifampicin. o It results with intermittent dosing Adverse effect of Ethambutol o Ethambutol is relatively non toxic. The main adverse effect of Ethambutol is retrobulbar optic neuritis (unilateral or B/L). This causes:- Loss of visual activity Red-green colour blindness Central scotoma Peripheral vision loss. The changes reverse, if the t/t is stopped promptly if not, the patient may go blind. o Children below 6 years of age are not given ethambutol because children are unable to repo early visual deterioration. o Ethambutol also produces hyperuricemia Ethambutol in renal failure Excretion of ethambutol mainly takes place by kidney, by tubular secretion as well as by glomerular filtration therefore the dose of Ethambutol should be reduced when renal function is impaired. Dose is reduced when creatinine clearance rate is < 50m1/min to prevent drug accumulation and toxicity. Adverse effect of Pyrazinamide o Pyrazinamide produces hyperuricemia, hepatitis, ahralgia, fever, flushing, rashes, loss of diabetes control. Adverse effects of streptomycin Nephrotoxicity, Ototoxicity, Neuromuscular blockade. | Pharmacology | null | [
"ethambutol"
] | 58,910 |
3a312839-be40-4bf2-9107-56bc8fa8d76d | Which of the following drugs inhibits platelet cyclooxygenase reversibly | caverject | Aspirin | advil | orapred | 2c
| single | Alprostadil(PGE1) and predinasolone do not inhibit cause enzyme virus transparent is an Irreversible inhibitor of this enzyme Ref-KDT 6/e p185 | Anatomy | Other topics and Adverse effects | [
"prednisolone",
"ibuprofen",
"alprostadil"
] | 58,933 |
7829ed2c-3f61-4e0f-842f-51382a4bed04 | A 30 year old male with NIDDM has a blood pressure of 150/90. His urine examination reveals persistent albuminuria in traces. The most appropriated line of treatment would be - | Non treatment | Regular examination of urine and monitoring of blood sugar | Administering zestril and restriction of sodium | Restriction of sodium only | 2c
| single | Lisinopril is an ACE inhibitor . ACE stands for angiotensin conveing enzyme.Lisinopril is used to treat hypeension in adults and children who are at least 6 years old. It is also used to treat congestive hea failure in adults, or to improve survival after a hea attack . A reduction in dietary salt from the current intake of 9-12 g/day to the recommended level of less than 5-6 g/day will have major beneficial effects on cardiovascular health along with major healthcare cost savings around the world. The World Health Organization (WHO) strongly recommended to reduce dietary salt intake as one of the top priority actions to tackle the global non-communicable disease crisis and has urged member nations to take action to reduce population wide dietary salt intake to decrease the number of deaths from hypeension, cardiovascular disease and stroke . Ref - pubmed.com | Medicine | Endocrinology | [
"lisinopril"
] | 58,938 |
d089d0c0-918e-4052-a518-210b17086db4 | All are side effects of clozaril EXCEPT: | Granulocytopenia | Seizures | Sedation | Extrapyramidal side effects | 3d
| multi | Only weak D2 blocking action, produces few /no extrapyramidal symptoms; tardive dyskinesia is rare and prolactin level does not rise. Ref KD Tripati 8th ed. | Pharmacology | Central Nervous system | [
"clozapine"
] | 58,939 |
250e2865-b6df-4aa0-88d9-83d69b6446ac | A 32 weeks pregnant women presents with mild uterine contraction and on examination her vitals are stable and placenta previa type III is present. Best m/n is: | Bed rest + decadron | Bed rest + adalat and decadron | Bed rest + Sedation | Immediate caesarean section | 1b
| single | At 32 weeks patient is presenting with uterine contraction which is a warning symptom of preterm labour.
Management of patient with placenta previa and preterm labour:
Tocolytic agent: “Uterine contractions are common in patients with placenta previa. Since uterine contractions have the potential to, disrupt the placental attachment and aggravate the bleeding, most obstetricians favor the use of tocolytic agents in the expectant management of patient with placenta previa”.
Most commonly used tocolytics in case of placenta previa.
Nifedipine
Magnesium sulphate
Tocolytics which are not used –
Terbutaline and Ritodrine: They cause tachycardia and make the assessment of patient’s pulse rate unreliable.
Indomethacin: It causes inhibition of platelet cyclo oxygenase system and prolongs the bleeding time.
Besides this - patient should be:
Put on bed rest in left lateral position.
Glucocorticoids are given to hasten lung maturity. | Gynaecology & Obstetrics | null | [
"nifedipine",
"dexamethasone"
] | 58,950 |
db54ac22-8221-4b58-b7c1-4a5e8f8de816 | An 88-year-old white woman with osteoarthritis has noticed mild epigastric discomfort for several weeks. aflaxen has helped her joint symptoms. She has emesis that resembles coffee grounds on three occasions.Select the most likely cause of gastrointestinal blood loss | Mallory-Weiss tear | Aortoenteric fistula | Gastric ulcer | Esophageal varices | 2c
| multi | This patients have acute upper gastrointestinal bleeding, which is often characterized by emesis that looks like red blood or coffee grounds. Nonsteroidal anti-inflammatory drugs (NSAIDs), even over-the-counter brands, are common causes of GI bleeding. Preceding symptoms may be mild before the bleeding occurs. Cotreatment with misoprostol decreases GI bleeding but is expensive. Selective COX-2 inhibitors decrease the incidence of GI bleeding but have been shown to increase cardiovascular events and to carry the same risk of renal dysfunction, edema, and blood pressure elevation as nonselective NSAIDs. | Medicine | G.I.T. | [
"naproxen"
] | 58,958 |
454367c2-4260-40c4-9a04-707e993d2145 | appearex is a Co-enzyme for ? | Transketolase | Dehydrogenase | Oxidase | Carboxylase | 3d
| single | Ans. is 'd i.e., Carboxylase | Biochemistry | null | [
"biotin"
] | 58,970 |
11575a07-bc89-49c3-b79f-0b115c10b61b | Which of the following local anaesthetic should not be alkalinized with soda bicarbonate | Lignocaine | novocaine | exparel | cepacol | 2c
| single | Local anaesthetic drug if dissociated –it wont act on sodium channel.
So drug is kept undissociated by adding soda bicarbonate to maintain pka 7.7→ 8.2
But for bupivacaine soda bicarbonate is not used as it gets precipitated. | Anaesthesia | null | [
"procaine",
"bupivacaine",
"benzocaine"
] | 58,980 |
d8c15424-0ed5-4757-81be-2758b8475def | Minimum Alveolar concentration of fluothane is | 0.74% | 1-2% | 6% | 2% | 0a
| single | Halothane is a potent anesthetic with a MAC of 0.74%. Its blood/gas paition coefficient of 2.4 makes it an agent with moderate induction and recovery time. It is not a good analgesic and its muscle relaxation effect is moderate. | Anaesthesia | General anaesthesia | [
"halothane"
] | 58,994 |
3d462694-f377-4a31-992d-5c4d5292607b | Which of the following antitubercular drug is not hepatotoxic: | nydrazid | Rifampicin | trecator | Streptomycin | 3d
| single | STREPTOMYCIN: It is the oldest aminoglycoside antibiotic obtained from Streptomyces griseus; used extensively in the past, but now practically restricted to treatment of tuberculosis. It is less potent (MICs are higher) than other aminoglycosides Adverse effects: About 1 / 5 patients given streptomycin 1 g BD i.m. experience vestibular disturbances. Auditory disturbances are less common. Streptomycin has the lowest nephrotoxicity among aminoglycosides; probably because it is not concentrated in the renal coex. Hypersensitivity reactions are rare; rashes, eosinophilia,fever and exfoliative dermatitis have been noted. .-\naphylaxis is very rare. Topical use is contraindicated for fear of contact sensitization. Superinfections are not significant. Pain at injection site is common. Paraesthesias and scotoma are occasional. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:722,723 | Pharmacology | Chemotherapy | [
"isoniazid",
"ethionamide"
] | 59,008 |
cdf5b7ae-650b-426f-b4b9-0da63d6e55ae | Haemodialysis is not useful in | lanoxin | Methanol | Lithium | Salicylates | 0a
| single | Dialysis is mainly done for poisoning due to: Methanol Lithium Aspirin Dabigatran Dialysis is not useful in: A- Amphetamines V: Verapamil O- Opioids, OPC I: Imipramine D- Digoxin Dialysis: Diazepam | Pharmacology | Hypeension, Arrhythmias, Dyslipidemia | [
"digoxin"
] | 59,009 |
d4a7d1a3-213a-4944-8abb-a1e35a2b3eba | Sudden withdrawal of which of the following drugs could result in serious adverse cardiovascular changes in a patient taking the drug over a long time: | nardil (MAO inhibitor) | vasotec (ACE inhibitor) | catapres (α2 agonist) | prozac (serotonin reuptake inhibitor) | 2c
| single | null | Pharmacology | null | [
"fluoxetine",
"clonidine",
"phenelzine",
"enalapril"
] | 59,018 |
5e44e9de-8f9f-47a5-b4c8-c6a3f8f250a7 | In cotrimoxazole, sulphamethoxazole and proloprim are in the ratio of- | 2:01 | 1:01 | 5:01 | 1:05 | 2c
| single | Ans. is 'c' i.e., 5 : 1 o Optimal synergy in case of most organism is exhibited at a concentration ratio of Sulphamethoxazole 20: Trimethoprim 1 (This ratio is obtained in plasma when two are given in a dose ratio of 5:1). | Pharmacology | null | [
"trimethoprim"
] | 59,020 |
e6d4766d-00ab-46a0-9d85-296b8febde54 | Drugs Supplied by NACO for prevention of mother to child transmission: | viramune | retrovir | viramune + retrovir | viramune + retrovir + 3tc | 0a
| single | NACO recommendations are for poor settings.Being inexpensive,these have immense potential in developing countries.it is also useful for those who present in labour. NACO recommendations: Nevirapine single dose of 200mg at onset of labour Nevirapine single dose of 2mg/kg to neonate within 3 days of delivery TEXT BOOK OF OBSTETRICS,Sheila Balakrishnan,2nd edition,page no.305 | Gynaecology & Obstetrics | Medical, surgical and gynaecological illness complicating pregnancy | [
"nevirapine",
"zidovudine"
] | 59,023 |
26adf364-b101-4682-a3d4-64fbd3bafad6 | Drug of choice for Choriocarcinoma is- | Nitrosourea | Gemcitabine | trexall | Melphalan | 2c
| single | Ans. is 'c' i.e., Methotrexate o Drug of choice for brain tumors - Nitrosoureas o Drug of choice for pancreatic Ca. - Gemcitabine o Drug of choice for choriocarcinoma - Methotrexate o Drug of choice for multiple myeloma - Melphalan | Unknown | null | [
"methotrexate"
] | 59,026 |
f991efc5-adb6-42ca-b044-c7bf2e3707e9 | Best drug therapy for paranoid schizophrenia in a thinly built 21-years old young male would be- | largactil | Risperidone | Olanzapne | Quetiapne | 2c
| single | Clozapine and olanzapine cause weight gain → suitable drugs for thin built person. | Psychiatry | null | [
"chlorpromazine"
] | 59,044 |
5b0d064c-23e8-42f5-8d7e-05614a063e8f | Regarding oxoject, true statements are: | Acts on myoepithelial cells of breast | Causes contraction of uterus during labour | May cause retention of water | All of these | 3d
| multi | null | Pharmacology | null | [
"oxytocin"
] | 59,052 |
af3f16f4-fbb1-4c3e-b1d0-46eb25a500e9 | Drug of choice for substitution therapy in oramorph dependence - | dolophine | catapres | narcan | Nalmefene | 0a
| single | Ans. is 'a' i.e., Methadone Treatment of morphine or heroin poisoningo Treatment can be divided intoTreatment of toxicity (overdose)o Overdose is a medical emergency, and is treated with opioid antagonist to reverse the complications (respiratory depression) by antagonizing the action on opioid receptors. Intravenous naloxone is the antagonist of choince for morphine (heroin) poisoning. Oral naltrexone is used for maintenance therapy, once acute poisoning has been treated by iv naloxone. Intravenous nalmefene is another specific antagonist.Treatment of dependenceo Treatment of dependence include medically supervised withdrawal and detoxification, followed by maintenance therapy :(a) Detoxificationo Detoxification process include abrupt withdrawal of opioid followed by management of the emergent withdrawal symptoms, i.e., treatment of withdrawal syndrome. Detoxification can be done by any of the following :1 .Substitution of long-acting opioid agonism :- Methadone is the treatment of choice. Because of its agonistic activity on opioid receptors it suppresses withdrawal symptoms. L-alpha-acetyl- methadol/Levomethyl (LAAM) is the other opioid agonist which was used for this purpose. However it is no longer in use because some patients developed prolonged QT intervals (torsades de points).2. Substitution of partial agonist :- Buprenorphine can be used in place of methadone because of its partial agonistic activity on opioid receptor.3.Substitution by a2 agonists :- Clonidine acts as a sympatholytic agent due to its agonistic action on central presynaptic a, receptors which reduce nor-adrenergic activity. Therefore, clonidine reduces the adrenergic withdrawal symptoms. Lofexidine another a2 agonist, is an alternative to clonidine.4. . Clonidine plus naltrexone :- A more rapid detoxification can occur when clonidine is used along with naltrexone. Naltrexone, when given in opioid dependent patient, causes withdrawal symptoms because of its antagonistic action. These can be treated with clonidine. The addition of short acting Benzodiazepine (lorazepam or oxazepam) and NSAIDs, will help relieve withdrawlsymptoms not covered by clonidine. It should be kept in mind that naltrexone should not be used alone for detoxification (to treat withdrawl syptoms) as it precipitates or worsens the withdrawl syndrome.5.Other drugs :- Dextropropoxyphene, diphenoxylate(b) Maintenance therapyo Once detoxification phase is over (i.e., withdrawal symptoms have been managed), the patient is maintained on any of the following drugs to prevent relapse by reducing craving and preventing 'kick' or 'euphoria' produced by opioids (morphine or heroin). Drugs used are1. Methadone :- Reduces craving and 'kick/euphoria ' from morphine or heroin because their opioid receptors are already occupied.2. LAAM and buprenorphine :- Similarly reduce craving.3. Opioid antagonists (naltrexone) :- Naltrexone can be used orally to assist in the rehabilitation of ex-opioid abusers who are fully withdrawn (otherwise it induces an acute withdrawl syndrome). Naltrexone prevents relapse by discouraging substance seeking behavior -If a patient, who is on naltrexone maintenance therapy, takes an opioid, there is no 'kick' or 'euphoria' as opioid receptors are already blocked. Naltrexone can be used with clonidine as in detoxification. | Psychiatry | Opioid-Related Disorders | [
"morphine",
"methadone",
"naloxone",
"clonidine"
] | 59,053 |
f3d3cfa3-a13e-4e1e-b6bd-5583c4c9f33c | atrovent bromide is contraindicated in: | Asthma | Urinary retention | Hypeension | Peptic ulcer | 1b
| single | Ipratropium bromide is an anticholinergic agent which usually promote urinary retention and hence are contraindicated in cases of urinary retention. Although Ipratropium bromide is poorly absorbed into the circulation and its systemic effect (including urinary retention) are not prominent, it should still not be used when urinary retention takes place. Whereas Ipratropium bromide is indicated in cases of Bronchial Asthma, Peptic Ulcer and, Hypeension. Ref: KDT, 6th Edition, Pages 107-110 ; Essentials of Medical Pharmacology By K D Tripathi, 4th Edition, Pages 97, 205 | Pharmacology | null | [
"ipratropium"
] | 59,067 |
57b32854-caae-4746-9f0a-15a0cb047a7c | simulect is a monoclonal antibody against : | IL-2 receptor | CD20 | INF - α | IL-6 | 0a
| single | Basiliximab & Daclizumab are monoclonal antibody against IL-2 receptor (CD25) used as immunosuppresants. | Pharmacology | null | [
"basiliximab"
] | 59,086 |
097ff282-fcbb-4b89-95b8-f2e785160c10 | Which of the following increases cerebral oxygen consumption | diprivan | ketalar | Thiopentone | Alfentanyl | 1b
| single | Ketamine This has been discussed so many times that ketamine increases cerebral oxygen consumption. It increases the intracranial tension too. Thiopentone and propofol decrease cerebral oxygen consumption. Alfentanyl is an opioid and opioids in general reduce cerebral oxygen consumption, cerebral blood flow and intracranial pressure. | Anaesthesia | null | [
"ketamine",
"propofol"
] | 59,102 |
a6a83772-eebd-41fb-9979-ce70ccb9ea26 | Which of the following drug is metabolized by acetylation: | dilantin | nydrazid | ventolin | Haloperidol | 1b
| single | Ans. (b) IsoniazidRef KDT 6th ed. / 25ACETYLATION* Compounds having amino or hydralazine residues are conjugated with the help of N-Acetyl transferase enzyme.# If acetylation is slow- its toxic# Fast acetylation- not effective or effectiveness decreases# Normal acetylation- effective* These drugs are remembered as SHIP drugs:# Sulfonamides (dapsone)# Hydralazine (anti HTN)# Isoniazid (anti TB)# Procainamide (anti-arrhythmic)* NOTE- phenytoin is an anti epileptic drug, which is always confused with procainamide in SHIP drugs. Phenytoin doesn't come under SHIP drugs.* Phenytoin hydroxylation in liver is carried out by cytochrome P 450.* SHIP drugs causes SLE. | Pharmacology | Pharmacokinetics | [
"isoniazid",
"phenytoin",
"salbutamol"
] | 59,104 |
d4f35ac5-f891-4f58-9aa4-95bd607214c3 | Which of the following antimicrobial is not given in pregnancy: September 2011 | Penicillin G | Quinolone | Cephalosporin | staticin | 1b
| single | Ans. B: Quinolone Betalactam antibiotics (penicillins and most of the cephalosporins) are safe during pregnancy Erythromycin base is safe but erythromycin estolate should be avoided Quinolones and fluoroquinolones They are chemotherapeutic bactericidal drugs, eradicating bacteria by interfering with DNA replication. Quinolones inhibit the bacterial DNA gyrase or the topoisomerase II enzyme, thereby inhibiting DNA replication and transcription. Quinolones can enter cells easily porins and, therefore, are often used to treat intracellular pathogens such as Legionella pneumophila and Mycoplasma pneumoniae. For many Gram-negative bacteria, DNA gyrase is the target, whereas topoisomerase IV is the target for many Gram-positive bacteria. Theophylline, nonsteroidal anti-inflammatory drugs and coicosteroids enhance the toxicity of fluoroquinolones. Products containing multivalent cations, such as aluminum- or magnesium-containing antacids and products containing calcium, iron, or zinc, invariably result in marked reduction of oral absorption of fluoroquinolones. Many fluoroquinolones, especially ciprofloxacin, inhibit the cytochrome P450 isoform CYP1A2.This inhibition causes an increased level of, for example, antidepressants such as amitriptyline and imipramine, clozapine (an atypical antipsychotic), caffeine, olanzapine (an atypical antipsychotic). Fluoroquinolones are well tolerated, with most side effects being mild to moderate. Some of the serious adverse effects that occur more commonly with fluoroquinolones than with other antibiotic drug classes include CNS and tendon toxicity.Fluoroquinolones are sometimes associated with an QTc interval prolongation and cardiac arrhythmias, convulsions, tendon rupture, torsade de pointes and hypoglycemia. Moxifloxacin carries a higher risk of QTc prolongation Gatifloxacin has been most frequently linked to disturbed blood sugar levels, although all quinolones carry these risks. Some quinolones were withdrawn from the market because of these adverse events (for example, sparfloxacin was associated with phototoxicity and QTc prolongation, thrombocytopenia and nephritis were seen with tosufloxacin, and hepatotoxicity with trovafloxacin).Fluoroquinolones are considered high-risk antibiotics for the development of Clostridium difficile and MRSA infections. The CNS is an impoant target for fluoroquinolone-mediated neurotoxicity. Moxifloxacin came out worst among the quinolones for causing CNS toxicity. Quinolones are contraindicated if a patient has epilepsy, QT prolongation, pre-existing CNS lesions, CNS inflammation or those who have suffered a stroke.There are safety concerns of fluoroquinolone use during pregnancy and, as a result, are contraindicated except for when no other safe alternative antibiotic exists. They are also contraindicated in children due to the risks of damage to the musculoskeletal system. | Pharmacology | null | [
"erythromycin"
] | 59,107 |
a3b00332-053e-4d72-91c5-0855eb56a7d5 | The following drugs are used for the treatment of type II lepra reaction, except – | lamprene | ['thalomid'] | restasis | Glucocorticoids | 2c
| multi | null | Dental | null | [
"cyclosporine",
"clofazimine",
"thalidomide"
] | 59,115 |
de58cf6b-ab97-48f2-a634-bd1631c85575 | Which of the following art is a fusion inhibitor? | retrovir | Enfuvirtide | viramune | norvir | 1b
| single | (Refer: K. D. Tripathi's Essentials of Medical Pharmacology, 7th edition, pg no:774) | Unknown | null | [
"ritonavir",
"nevirapine",
"zidovudine"
] | 59,141 |
0f858d2b-5bbf-4092-a31a-51a0542e0196 | Digestion of proteins is initiated by: | Amylase | Sucrase | Chymotrypsin | digipepsin | 3d
| single | Enzymes catalyze the digestion of proteins
There are two main classes of proteolytic digestive enzymes (proteases):
Endopeptidases hydrolyze peptide bonds between specific amino acids throughout the molecule. They are the first enzymes to act, yielding a larger number of smaller fragments.
- Pepsin in the gastric juice catalyzes hydrolysis of peptide bonds adjacent to amino acids with bulky side-chains (aromatic and branched-chain amino acids and methionine).
- Trypsin, Chymotrypsin, and elastase are secreted into the small intestine by the pancreas.
- Trypsin catalyzes hydrolysis of lysine and arginine esters.
- Chymotrypsin catalyzes hydrolysis esters of aromatic amino acids.
- Elastase catalyzes hydrolysis esters of small neutral aliphatic amino acids.
Exopeptidases catalyze the hydrolysis of peptide bonds, one at a time, from the ends of peptides.
- Carboxypeptidases, secreted in the pancreatic juice, release amino acids from the free carboxyl terminal.
- Aminopeptidases, secreted by the intestinal mucosal cells, release amino acids from the amino terminal. Dipeptidases and tripeptidases in the brush border of intestinal mucosal cells catalyze the hydrolysis of di-and tripeptides, which are not substrates for amino-and carboxypeptidases.
Key Concept:
Pepsin in the gastric juice catalyses hydrolysis of peptide bonds adjacent to amino acids with bulky side chains. It is the stomach where digestion of proteins is initiated with the help of pepsin. | Biochemistry | null | [
"pepsin"
] | 59,157 |
4ffcb814-aadf-4255-a1fc-eae1ed8aa5ac | Which of the following anesthetic agent does not cause hypotension on injection? | diprivan | ketalar | fluothane | Thiopentone | 1b
| single | Ketamine, sold under the brand name Ketalar among others, is a medication mainly used for starting and maintaining anesthesia. It induces a trance-like state while providing pain relief, sedation, and memory loss. | Anaesthesia | null | [
"ketamine",
"halothane",
"propofol"
] | 59,164 |
2a8bee2f-11bb-48a3-9e8f-9fef50ac1a42 | Hemolysis in G6PD may be caused by all except | Primaquine | resochin | Pyrimethamine | qualaquin | 0a
| multi | Ref Harrison 19 th ed pg 656 Although it was primaquine (PQ) that led to the discovery of G6PD deficiency, this drug has not been very prominent subsequently, because it is not necessary for the treatment of life-threatening P. falciparum malaria. Today there is a revival of interest in PQ because it is the only effective agent for eliminating the gameto- cytes of P. falciparum (thus preventing fuher transmission) and eliminating the hypnozoites of Plasmodium vivax (thus preventing endogenous relapse). In countries aiming to eliminate malaria, there may be a call for mass administration of PQ; this ought to be associ- ated with G6PD testing. At the other end of the historic spectrum, the latest addition to the list of potentially hemolytic drugs | Anatomy | Haematology | [
"quinine",
"chloroquine"
] | 59,183 |
7e6c207e-7159-4b3f-8a53-29bb19972fed | In the treatment of hypothyroidism, synthroid is preferred over cytomel because of synthroid: | Is faster acting | Has higher affinity for thyroid hormone receptors | Has a longer half life | Can be made more easily by recombinant DNA technology | 2c
| single | Liothyronine (T3) as compared to thyroxine (T4) is:
Fast acting
More potent
Short half-life
An indication of liothyronine includes myxedema coma and for most of the indications, thyroxine is used because it has a long half-life thus can be used less frequently than T3. | Pharmacology | null | [
"thyroxine",
"liothyronine"
] | 59,185 |
38622566-4fdd-418f-b149-9bf82f433eb4 | Theophyline levels in blood are increased by: | Barbiturates | trexall | tagamet | All of the above | 2c
| multi | Cimetidine | Pharmacology | null | [
"cimetidine",
"methotrexate"
] | 59,189 |
2e662bf5-fa80-49be-8561-da04128895e3 | Compared to hydrocortisone, maximum glucocorticoid activity is seen in: | Cortisone | orapred | decadron | medrol | 2c
| single | null | Pharmacology | null | [
"prednisolone",
"methylprednisolone",
"dexamethasone"
] | 59,208 |
8e07cb41-29f1-44e1-9ffe-afeeaecddc92 | Retrograde ejaculation is a characteristic side effect of which psychotropic medication? | Lithium carbonate | nardil | valium | Thioridazine | 3d
| single | Of all the antipsychotic medications, thioridazine is the only one with a strongly recommended dosage ceiling. Dosages exceeding 800 mg daily have been linked to the development of retinitis pigmentosa. Other side effects of thioridazine include ejaculatory inhibition. Although it also produces sedation, a side effect that can be of clinical value in treating agitated psychotic individuals, thioridazine causes fever extrapyramidal side effects than most other neuroleptics. Haloperidol is a widely used butyrophenone antipsychotic that can produce significant extrapyramidal side effects. However, because it is non-sedating and causes little autonomic disturbance, it is effective in low dosages in treating agitation in elderly persons. MAO inhibitors such as phenelzine are used to treat mood disorders.Persons on MAO inhibitor therapy must remain on a diet free of tyramine-containing foods (e.g., aged cheese) to avoid a potentially fatal hypeensive crisis, which can present as severe headache. Lithium carbonate is used in the treatment and prophylaxis of bipolar disorder. The dosage must be adjusted according to blood level. Side effects commonly associated with rising or mildly toxic blood levels include fine tremor of the hands, nausea, anorexia, and diarrhea. Ref: Meyer J.M. (2011). Chapter 16. Pharmacotherapy of Psychosis and Mania. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | Psychiatry | null | [
"phenelzine",
"diazepam"
] | 59,221 |
e8346604-4a53-48fc-bb4f-01879fc5ee8d | All of the following are used in pneumatosis cytoides intestinalis EXCEPT | High flow oxygen | albenza | Metronidazol | azulfidine | 1b
| multi | .PNEUMATOSIS CYSTOIDES INTESTINALIS -* It is transient, thin cysts containing nitrogen in submucosa and subserosa of ileum. * It is due to increased intraluminal pressure, which forces N2 through the layers of the bowel due to hyper-peristalsis. * It is associated with chronic duodenal ulcer, chronic pulmonary disease, bowel obstruction. Treatment * O2 suppo. * Metronidazole. * Cause is treated. ref:SRB&;s manual of surgery ,ed 3,pg no 806 | Surgery | G.I.T | [
"albendazole",
"sulfasalazine"
] | 59,236 |
57eb603f-0f41-442a-a3b9-42eb3422657e | Drugs used in the treatment of pruritus in PBC | Rifampicin | revia | Cholestyramine | All of the above | 3d
| multi | . | Pathology | All India exam | [
"naltrexone"
] | 59,262 |
057037e6-af25-40d3-885a-87e34a9a727e | Long acting dopamine agonist is: | parlodel | Lisuride | dostinex | Apomorphine | 2c
| single | null | Pharmacology | null | [
"cabergoline",
"bromocriptine"
] | 59,263 |
e42769f2-05fe-4da1-8842-9b2dd0a54a18 | Constipation is a possible side effect of drugs taken by the oral route, but it is highly unlikely to occur with the use of | benadryl | colace | phenergan | imodium | 1b
| single | Docusate is a stool-softening laxative that facilitates mixing of oil and water via its surfactant properties. Drugs that have muscarinic blocking effects, like scopolamine and the antihistamines diphenhydramine and promethazine, tend to cause constipation by decreasing GI motility. Loperamide is an opioid derivative, with no analgesic activity, used in the treatment of diarrheal states. | Pharmacology | General Pharmacology | [
"docusate",
"diphenhydramine",
"promethazine",
"loperamide"
] | 59,270 |
43f38f58-7b05-4abe-a0c6-5a3d4a105768 | In which of the following condition ketalar can be used: | Hypovolemia | Myocardial infarction | Hypertension | Head injury | 0a
| single | Ans: a (Hypovolaemia) Ref: Ajay Yadav, 2nd ed, p. 78,139,141Ketamine stimulates sympathetic system causing:TachycardiaHypertensionIV anaesthetic of choice in shock ie good for hypovolaemic patientsIV anaesthetic of choice in asthmaticsCauses dissociative anaesthesia, i.e.. a state of profound analgesia, light sleep, increased muscle tone and emergence deliriumMarked analgesia is a prominent feature and more analgesic than propofol and thiopentanone causes increased muscle tone and myalgia.It is anaesthetic of choice in skin grafting.Dissociative anaesthesia is due to excitation of limbic system and inhibition of thalamus and neocortex.pH of 10% solution is 4IV doseIM doseInfusion rateOral dose- 1 -2 mg/kg of body weight- 6-10 mg/kg- 40 microgram /kg/mt- 6 mg/kgSide effects:Increase all pressures! intracranial, intraocular, blood pressure)Post operative myalgia and myoglobinuriaHallucination and diazepam is used for treatmentIncreased salivation use atropineDrug of choiceHepatic failureRenal failureAnaesthetic agentIsoflurane/ sevofluraneIsoflurane/ sevoflurane/desflurane/ halothaneMuscle relaxantAtracurium /cisatracuriumAtnicuiium/ cisatracurium/ fentanylOpiodFentanylFentanylContraindicationNoneMethoxyflurane/ gallaminc/ enfluraneAnaesthetic of choice in:Cardiac patientsDay care surgeryIntravenous- etomidateAnaesthesia- propofol + alfentanyl + isofluraneInhalation- isofluraneOpiod- alfentanyl > fentanylMR- vecuroniumShock patient- IV ketamineAsthmatic patientNeonates and childrenIntravenous- ketamineInhalation- sevofluraneInhalation- halothaneIntravenous- thiopentoneMR- pancuronium> propofol Neurosurgical operationsAneurysm surgery-Isoflurane + thiopentone / propofolEtomidateElectroconvulsive therapy-Total intravenous anaesthesia-MethohexitoneProporfol -falfentanyl / fentanylPatient susceptible to malignant hyperthermiaControlled hypotensionInduction- propofolIsoflurane Maintenance- nitrous oxide Local anaesthesia-- procainePhaeochromocytomaEnfluraneHaemorrhagic shock- cyclopropaneEpilepticsInduction - thiopentoneMaintainence - isofluraneSkin grafting- ketamine Muscle relaxant causing histamine release (MAST)MivacuriumAtracutiumSuccinylcholineD-Tubocurarine | Anaesthesia | General Anesthesia | [
"ketamine"
] | 59,283 |
211ad232-b745-4b50-a3dc-51f84645442d | NSAID lacking anti-inflammatory action is: | tylenol | advil | zorvolex sodium | celebrex | 0a
| single | Paracetamol or acetaminophen has antipyretic and analgesic activities but it lacks anti-inflammatory action. It is presumed to become inactive by peroxides generated at the site of inflammation. Some theories suggest that PCM acts on COX-3 receptors. | Pharmacology | NSAIDs, Gout and Rheumatoid Ahritis | [
"diclofenac",
"paracetamol",
"ibuprofen",
"celecoxib"
] | 59,287 |
569a1711-a34e-4b4b-9a5b-36ea55f6a8c9 | Treatment of choice in WPW syndrome patient having an alternate pathway with high-risk propeies? | Vagal maneuver | Catheter ablation | Beta blockers | tambocor | 1b
| single | In Wolff-Parkinson-White patients with preexcitation who have symptoms of arrhythmia are at risk for developing atrial fibrillation and sudden death if they have an alternate pathway (AP) with high-risk propeies. An invasive electrophysiology study is warranted to determine if the AP is high enough risk to warrant potentially curative catheter ablation. Catheter ablation is warranted for recurrent arrhythmias when drugs are ineffective, not tolerated, or not desired by the patient or if the AP is considered high riskHarrison 19e pg: 1483 | Medicine | C.V.S | [
"flecainide"
] | 59,292 |
301dab98-e92b-48a7-b40b-95bbe087f89b | Mode of action of prozac is - | GABA inhibition | Adrenergic neuron blocking agent | Inhibition axonal uptake of 5HT | Alpha adrenergic stimulation | 2c
| single | Ans. is 'c' Inhibit axonal uptake of 5HT Fluoxetine is a tricyclic antidepressant (like imipramine, Amitriptyline)While typically TCA inhibit uptake of both NA and 5HT by neurons.Fluoxetine is selective serotonin reuptake inhibitor (SSRI)Therefore it is devoid of following side effectsAnticholinergic *Sedation*Hypotension*Other SSRIsFluvoxamine*Paroxetine*Also remember mechanism of action of these atypical TCAsTianeptine - It increase rather than inhibit 5-HT uptake *Mianserin - does not inhibit either NA or 5-HT uptake, it blocks presynaptic alpha-2 receptors, increases release and turnover of NA in brain * | Psychiatry | Drugs & Other Biological Methods of Treatment | [
"fluoxetine"
] | 59,329 |
2188c702-1201-4d51-a23d-f79f255f3652 | Drug contraindicated in bilateral renal aery stenosis | Propanolol | Guanethidine | capoten | Amilodipine | 2c
| single | Refer kDT 6/e p 484 Renal aery stenosis is thenarrowing of one of the renal aeries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of therenal aery can impede blood flow to the target kidney, resulting in renovascular hypeension - a secondary type of high blood pressure. Angiotensin-conveing enzyme inhibitors (ACEIs) arecontraindicated in patients withbilateral renal aery stenosis due to risk of azotemia resulting from preferential efferent aeriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II. | Pharmacology | Cardiovascular system | [
"captopril"
] | 59,332 |
8728615c-a67b-42d4-adf1-0d660a282e5f | Which of the following drugs is associated with untoward side effect of renal tubular damage | platinol | Streptozocin | sansert | Cycloohosphamide | 0a
| single | Refer KDT 6/e p827 Cisplatin is a highly emetic and Nephrotoxic agent Streptozocin causes destruction of beta cells of pancreas Methysergide can cause retroperitoneal fibrosis | Pharmacology | Chemotherapy | [
"methysergide",
"cisplatin"
] | 59,346 |
4834cf06-014b-46d5-8b64-85134c52a430 | All of the following are used in organophosphorus poisoning except | protopam | atropen | Activated charcoal | revia | 3d
| multi | Refer kDT 7/e p 110,111 Pharmacologic Treatment Atropine - The endpoint for atropine is dried pulmonary secretions and adequate oxygenation. Tachycardia and mydriasis must not be used to limit or to stop subsequent doses of atropine. The main concern with OP toxicity is respiratory failure from excessive airway secretions. Sta with a 1-2 mg IV bolus, repeat q3-5min prn for desire effects (drying of pulmonary secretions and adequate oxygenation). Consider doubling each subsequent dose for rapid control of patients in severe respiratory distress. An atropine drip titrated to the above endpoints can be initiated until the patient's condition is stabilized. Pralidoxime - Nucleophilic agent that reactivates the phosphorylated AChE by binding to the OP molecule. Used as an antidote to reverse muscle paralysis resulting from OP AChE pesticide poisoning but is not effective once the OP compound has bound AChE irreversibly (aged). Current recommendation is administration within 48 h of OP poisoning. Because it does not significantly relieve depression of respiratory center or decrease muscarinic effects of AChE poisoning, administer atropine concomitantly to block these effects of OP poisoning. Sta with 1-2 g (20-40 mg/kg) IV in 100 mL isotonic sodium chloride over 15-30 min; repeat in 1 h if muscle weakness is not relieved; then repeat q3-8h if signs of poisoning recur; other dosing regimens have been used, including continuous drip. | Pharmacology | Autonomic nervous system | [
"atropine",
"pralidoxime",
"naltrexone"
] | 59,347 |
a314e450-4122-4ce7-87e7-9de1f8d7ddf9 | protopam is ineffective in case of which poisoning: | Organophosphorous | Carbaryl | Both of the above | None of the above | 1b
| multi | Carbaryl | Pharmacology | null | [
"pralidoxime"
] | 59,385 |
816e4cf1-6a0f-4fd5-a421-482a1a207fb9 | After taking some drug for acute attack of migraine, a patient developed nausea and vomiting. He also developed tingling and numbness in the tip of the finger that also turned blue. Which of the following is the most likely drug implicated in causing the above findings | Ergotamine | Aspirin | imitrex | stadol | 0a
| multi | Ergotamine:- Mech of action:- It acts as a paial agonist and antagonist at a adrenergic and all subtypes of 5-HT1 and 5-HT2 receptors. It produces sustained vasoconstriction(leading to Acrocyanosis), visceral smooth muscle contraction, vasomotor centre depression and antagonizes the action of NA and 5-HT on smooth muscles. It is a potent emetic (through CTZ and vomiting centre) and moderately potent oxytocic. At high doses CNS stimulation and paresthesias may be experienced. On chronic exposure (ergot poisoning) vasoconstriction is accompanied by damage to capillary endothelium--thrombosis, vascular stasis and gangrene. Ref:- kd tripathi; pg num:-175,176 | Pharmacology | Autacoids | [
"sumatriptan",
"butorphanol"
] | 59,388 |
ef3dd9e9-66a4-479f-aeed-f4a525f9c1f8 | Wof are anti diabetic agents that acts by increasing insulin sensitivity, and so should be euglycemics | Phenformin | actos | januvia | victoza | 1b
| single | Thiazolidinedione (PPARg agonist) Pioglitazone:- Only one thiazolidinedione Pioglitazone is currently available. Mech of action:- This class of oral antidiabetic drugs are selective agonists for the nuclear peroxisome proliferator-activated receptor g (PPARg) which is expressed mainly in fat cells, but also in muscle and some other cells. It enhances the transcription of several insulin responsive genes. Glitazones tend to reverse insulin resistance by enhancing GLUT4 expression and translocation. Entry of glucose into muscle and fat is improved. Hepatic gluconeo- genesis is also suppressed. Activation of genes regulating fatty acid metabolism and lipogenesis in adipose tissue contributes to the insulin sensitizing action. Lipolysis and plasma fatty acid levels are reduced. Adipocyte turnover and differentiation is accelerated by glitazones. Thus, fatty tissue is a major site of their action. Improved glycaemic control results inlowering of circulating HbA1C and insulin levels in type 2 DM patients. Pioglitazone, in addition, lowers serum triglyceride level and raises HDL level without much change in LDL level, probably because it acts on PPARa as well to induce expression of reverse cholesterol transpoer and some apoproteins. Monotherapy with glitazones is not associated with hypoglycaemic episodes. Ref:- kd tripathi; pg num:-276,277 | Pharmacology | Endocrinology | [
"sitagliptin",
"pioglitazone",
"liraglutide"
] | 59,402 |
529d656f-d8a4-4e65-b913-efe488e44457 | The following patient on trexall, steroids and NSAIDs for past 4 months has had no retardation of disease progression. What is the next rational step in management? | Sta monotherapy with anti-TNF alpha drugs | Continue trexall and steroids at higher dose | Stop oral trexall and sta parenteral trexall | Add azulfidine | 3d
| multi | Z-line deformity, ulnar detion: RHEUMATOID AHRITIS Option A: Combination with Methotrexate, cannot be given alone. Option B: Steroids are not proved to reduce the occurrence of R.A nowadays. Steroids may lead to increase of Cushing syndrome Option C: Parenteral treatment is not recommended Combination therapy where appropriate; (3) individualization of therapy in an attempt to maximize response and minimize side effects; and (4) achieving, whenever possible, remission of clinical disease activity. A considerable amount of evidence suppos this intensive treatment approach. As mentioned earlier, methotrexate is the DMADRD of the first choice for initial treatment of moderate to severe RA. Failure to achieve adequate improvement with methotrexate therapy calls for a change in DMARD therapy, usually a transition to an effective combination regimen. Effective combination include: methotrexate, sulfasalazine, and hydroxychloroquine (oral triple therapy); methotrexate and leflunomide; and methotrexate plus a biological. The combination of methotrexate and an anti-TNF agent, for example, has been shown in randomized, controlled trails to be superior to methotrexate alone not only reducing signs and symptoms of disease, but also for retarding the progression of structural joint damage. | Medicine | NEET 2019 | [
"methotrexate",
"sulfasalazine"
] | 59,410 |
86cea17b-6b3f-4cc8-9278-4f2632f7678c | A 55 year old cardiac patient who was on long-term treatment comes for follow up visit. The physician observes the following finding on ophthalmological examination. Which drug prescribed by the physician would most probably be responsible for this? | lanoxin | isoptin | cordarone | inderal | 2c
| single | The image shows "voex keratopathy". Here, there is a whorl-like pattern of epithelial deposits in the cornea. Causes:Drugs-Amiodarone, Chloroquine, Phenothiazines, Indomethacin Fabry's disease and its carrier stateThe whorl-like pattern shows the direction of migration of corneal epithelial cells. | Microbiology | All India exam | [
"amiodarone",
"digoxin",
"propranolol",
"verapamil"
] | 59,411 |
feb6d223-c84a-4167-968d-ecc8dc389eca | Which of the following is NOT an amide - | Lignocaine | novocaine | carbocaine | rectacaine | 1b
| single | Ans. is 'b' i.e., Procaine Local Anaesthetics|||AmidesEstersLidocaineBupivacaineDibucaine (cinchocain)PrilocaineRopivacaineCocaineProcaineChloroprocaineTetracaine (Amethocain)BenzocaineAdvantages of amides over esters:o Produces more intense and longer lasting anaesthesiao Cause less hypersensitivity reactionso Produce longer lasting anaesthesia as they are not hydrolysed by esterasesRemembero Amide LAs bind to a1 acid glycoprotein, while ester LAs do not bind to plasma protein.o Ester LAs can antagonize the action of sulfonamide due to PABA residue. | Anaesthesia | Miscellaneous (Local and Regional Anesthesia) | [
"mepivacaine",
"procaine",
"dibucaine"
] | 59,423 |
92d1805f-33ee-438f-943f-bb169aa89ff4 | Which one of the following is not a cause for hyperkalemia : | lanoxin | Potassium sparing diuretic | Renin angiotensin system blockers | restasis | 0a
| single | null | Pharmacology | null | [
"digoxin",
"cyclosporine"
] | 59,425 |
d40c0641-15b4-4a93-ae4f-e7efa01be195 | The best approach to prevent cholera epidemic in a community is | Mass chemoprophylaxis with panmycin | Vaccination of all individuals | Health education | Safe water and sanitation | 2c
| multi | • Pattenkoffer advocated for improving local sanitary conditions as ‘the best way to prevent or stop cholera epidemics.’
• Robert Koch believed that quarantine and disinfection can only prevent cholera. | Social & Preventive Medicine | null | [
"tetracycline"
] | 59,426 |
e7f270f3-698d-4f72-b59c-ccdfa89a3d0c | Which of the following drugs cause oligospermia? | Leflunomide | D-Penidillamine | trexall | azulfidine | 3d
| single | It is a compound of sulfapyridine and S-amino salicylic acid (5-ASA); has anti-inflammatory activity and is primarily used in ulcerative colitis. Sulfapyridine split off in the colon by bacterial action and absorbed systemically appears to be the active moiety. Generation of superoxide radicals and cytokine elaboration by inflammatory cells may be suppressed. Efficacy of sulfasalazine in RA is modest and side effects are few, but neutropenia/thrombocytopenia occurs in about 10% patients and hepatitis is possible. It is used as a second line drug for milder cases. Free radicles can cause oligospermia Dose: 1-3 g/day in 2-3 divided doses ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION; KD TRIPATHI; PAGE NO 211 | Pharmacology | Autacoids | [
"methotrexate",
"sulfasalazine"
] | 59,437 |
3972ba9a-afe3-487d-973a-6cb768d4b423 | Which of the following is longest acting ocular Beta blocker | blocadren | Betaxolol | Caiolol | betaloc | 1b
| single | Ref-KDT 6/e p145 Betaxolol is a cardioselective Beta blocker useful in glaucoma. It is longer acting than timolol. Another non selective Beta blocker used topically for the treatment of glaucoma is levobunolol | Anatomy | Other topics and Adverse effects | [
"metoprolol",
"timolol"
] | 59,449 |
f8629855-c1b1-4339-8da6-55f16a9e2f0c | All of the following can aggravate Myasthenia gravis except | imuran | d-Tubocurarine | panmycin | Aminoglycoside | 0a
| multi | Essentials of medical pharmacology, seventh edition, page no 864, Answer is option 1, Azathioprine This antipurine acts by getting conveed to 6-MP,but has more prominent immunosuppresant action. It mainly supresses cell mediated iimmunity and is mainly used in autoimmune diseases like rheumatoid ahritis, myasthenia gravis, ulcerative collitis etc. | Pharmacology | Anesthesia | [
"azathioprine",
"tetracycline"
] | 59,461 |
0f9244f6-c2b7-4753-b276-190e27738213 | 45 year old woman is posted for elective incisional hernia repair. On reviewing her history, she is known hypertensive patient for the past 10 years on regular capoten. What is your concern for the patient | Stopping capoten a day before surgery | Continue the medication till the day of surgery | Stop a week priorly and start on norvasc | Stop capoten a week before surgery and give when necessary. | 1b
| single | Antihypertensive medications need not be stopped prior to surgery. | Anaesthesia | null | [
"captopril",
"amlodipine"
] | 59,464 |
1b600a86-057a-4bfe-aabb-d0fdb1c3732f | Side effects of nydrazid are all EXCEPT ? | Hepatitis | Optic neuritis | Peripheral Neuropathy | Thrombocytopenia | 3d
| multi | Ans. is 'd' i.e., Thrombocytopenia Adverse effects of INH -Peripheral neuritis (most common), hepatitis, optic neuritis & atrophy, seizure, ataxia, muscle twitching, toxic encephalopathy, psychoses, rashes, fever, ahralgia, acne, lupus like syndrome, hemolytic anemia in G6PD deficiency. Note: Most common antitubercular drug which is implicated in causing peripheral neuropathy is INH. | Pharmacology | null | [
"isoniazid"
] | 59,472 |
61cfde90-71e8-45d8-b8bd-9067480af53e | Which of the following agents is not used to provide induced hypotension during surgery? | brevibloc | apresoline | Mephentermine | Sodium nitropress | 2c
| single | Mephenteramine is an indirect acting sympathomimetic drug. It is used to treat the hypotension induced by ganglion blockers or spinal anaesthesia. Therefore not used to induce hypotension. Esmolol, hydralazine and sodium nitroprusside are commonly used agents to provide induced hypotension during surgery. Cerebral blood flow remains constant in an intact brain over a mean aerial blood pressure range 50-150mmHg. Induced hypotension is employed to reduce blood loss. Ref: Textbook of Neurosurgery By Prakash Narain Tandon, Volume 1, Page 927; Medical Toxicology By Richard C. Da, 3rd Edition, Page 551. | Anaesthesia | null | [
"nitroprusside",
"hydralazine",
"esmolol"
] | 59,489 |
6fbc613c-66ad-43c7-8a4f-10b05b33b259 | DOC for Bacterial vaginosis in a pregnant female: | cleocin | flagyl | staticin | diflucan | 1b
| single | Ans. (B) MetronidazoleMetronidazole, tinidazole and clindamycin are preferred antibiotics for treatment of bacterial vaginosis; however the single best drug of choice is metronidazole.First lineSecond line* Metronidazole (DOC) 500 mg orally BD for 7 days* Metronidazole gel 0.75% 5 gm intravaginally once a day for 5 days* Clindamycin cream 2% 5 gm intravaginally once a day for 7 days* Tinidazole 2 gm orally OD FOR 2 days* Tinidazole 1 gm orally OD for 5 days* Clindamycin 300 mg orally BD for 7 days* Clindamycin ovules 100 mg OD intravaginally for 3 daysExtra MileInfectious Vulvovaginitis Bacterial vaginosisCandidiasisTrichomonas vaginitisComplaintOrder increased after intercourse and/or mensesNote: No inflammation-hence no itchingItching, burning, dischargeFrothy discharge, odor, dysuria, pruritis, spottingMC organismAlteration of vaginal flora; lactobacilli decrease whereas coccobacilli and Gardnerella increaseCandida albicans > Candida galbrata > Candida tropicalisTrichomonas vaginalisMCOverall: Most common vaginitisM/C vaginitis in:* Pregnancy, diabetes* Immunocompromised* OCP users, steroid users, antibiotic users DischargeThin, gray or white adherent, often increasedWhite, curdy "Cottage cheese" dischargeInflammation "Strawberry cervix" Yellow-green foul smelling dischargeKOH "whiff test"+-+-Vaginal pH>4.5<4.5>4.5 (5-6)Gold standard investigation Gram stain: on gram staining Nugent scoring is done-The Nugent score is calculated by assessing the presence of lactobacillus (Gram +ve rods-scored as 0 to 4), Gardnerella vaginalis (scored as 0 to 4) and mobilincus (Gram variable rods-scored as 0-2) A score of >=7 is consistent with bacterial vaginosisCulture on sabouraud'smedium or NickersonmediumCulture on --Feinberg Whittington media or Diamond mediaT/t = Non pregnant femalesMetronidazole (500 mg BD x 7 days) orClindamycinAzole group of antifungals Like fluconazole/miconazole which can be applied topically or given orally (150 mg, single dose)Metronidazole(2 gm single dose oral)Pregnancy = DOCMetronidazole (250 mg TDS x 7 days)To be avoided in first trimesterTopical azole antifungalsTo be avoided in first trimesterMetronidazole(250 mg TDS x 7 days)Simultaneous treatment of male partnerNot needed as BV is not an STDIf partner has symptoms then treatment neededAlways done as Trichomonas vaginalis is an STDMicroscopic findingsSaline wet prep'Clue cells', bacterial clumps10% KOH solution wet prep Pseudohyphae and bud seenSaline wet prepMotile pear-shaped trichomonadsVulvovaginitis | Gynaecology & Obstetrics | Pharmacotherapeutic in Obstetrics | [
"metronidazole",
"fluconazole",
"erythromycin",
"clindamycin"
] | 59,498 |
ed0ac8b7-2bd9-4f63-9330-66cd1247e60e | Agents used for anaesthesia are generally metabolized by liver and eliminated by kidney. Which of the following anaesthetic agent is NOT metabolized by body? | N2O | flaxedil | ultane | fluothane | 0a
| multi | Nitrous oxide (N2O; laughing gas) is the only inorganic anesthetic gas in clinical use. There is no change with blood pressure, hea rate, systemic vascular resistance, and cardiac output. Respiratory tidal volume decreases but respiratory rate is increased. By increasing CBF and cerebral blood volume, nitrous oxide produces a mild elevation of intracranial pressure. Nitrous oxide also increases cerebral oxygen consumption (CMRO2). Nitrous oxide appears to decrease renal blood flow by increasing renal vascular resistance. This leads to a drop in glomerular filtration rate and urinary output. During emergence, almost all nitrous oxide is eliminated by exhalation. Ref: Morgan, Jr. G.E., Mikhail M.S., Murray M.J. (2006). Chapter 7. Inhalation Anesthetics. In G.E. Morgan, Jr., M.S. Mikhail, M.J. Murray (Eds), Clinical Anesthesiology, 4e. | Anaesthesia | null | [
"sevoflurane",
"halothane",
"gallamine"
] | 59,534 |
82811ce4-d4fa-4ce2-b5cc-78f6b8770261 | A 50 year old man with advanced tuberculosis has developed signs of severe acute adrenal insufficiency. The patient should be treated immediately with a combination of: | Aldosterone and fludrocoisone | kenalog and decadron | Coisol and fludrocoisone | decadron and metopirone | 2c
| single | Patient should be given both mineralocoicoids as well as glucocoicoid. - Aldosterone and Fludrocoisone both are mineralocoicoids. -Highest mineralocoicoid activity is seen with Aldosterone - Triamcinolone and Dexamethasone both are glucocoicoids. - Coisol is glucocoicoid and Fludrocoisone is a mineralocoicoid. - Dexamethasone is a glucocoicoid whereas Metyrapone is anti-glucocoiocid. | Pharmacology | Adrenal | [
"triamcinolone",
"metyrapone",
"dexamethasone"
] | 59,548 |
05a2eb67-5270-4248-9af2-647e96b36202 | A 75 years female patient with fracture neck of femur 1 month hack, presents with 2 days history of altered sensorium & decreased urine output. Urea is 140 mg/dl, creatinine is 2 mg/dl, Ca is 15.5 mg/dl. All of will be useful in immediate treatment except | Give NS | lasix | Hemodialysis | Bisphosphonates | 1b
| multi | Furosemide Initial therapy of severe hypercalcemia includes the simultaneous administration of saline, calcitonin and a biphosphonate. Isotonic saline Isotonic saline corrects possible volume depletion due to hypercal- cemia induced urinary salt wasting and in some cases vomiting. Hypovolemia exacerbates hypercalcemia by impairing the renal clearance of calcium. - The rate of saline infusion depends upon several factors including the severity of hypercalcemia, the age of the patient and the presence of comorhid conditions paicularly underlying cardiac or renal disease. - A reasonable regimen in the absence of edema is the administration of isotonic saline at an initial rate of 200-300 ml/h that is then adjusted to maintain the urine output at 100-150 ml/h, - Saline therapy requires careful monitoring since it can lead to fluid overload in patients who cannot excrete the administered salt because of impaired renal function which can be induced by hypercalcemia or hea failure. - The saline infusion should be stopped in patients who develop edema and a loop diuretic may be necessary. Saline therapy rarely normalizes the serum calcium concentration in patients with more than mild hypercalcemia. Saline therapy beyond that necessary to restore euvolemia has fallen out of our for two reasons: - The availability of drugs such as biphosphonates and calcitonin that inhibit bone resorption which is primarily responsible .for hypercalcemia. - The requirement for careful monitoring because of potential fluid and electrolyte complications resulting .from a massive saline infusion and furosemide induced diuresis such as hypokalemia, hypomagnesemia and volume depletion if the diuretic induced losses are not replaced. Furosemide in hypercalcemia In the past administration of loop diuretic was initiated routinely once fluid repletion had been achieved to fuher increase urinary calcium excretion. - However this practice was based upon an approach that involved intensive administration of furosemide (80-100 mg every one to two hours) with aggressive fluid hydration. - In the patients with hypercalcemia receiving saline hydration, routinely using a loop diuretic is not suggested. However in individuals with renal insufficiency or hea failure, careful monitoring and judicious use of loop diuretics may be required to prevent. fluid overload. - In the absence of renal failure or hea failure, loop diuretic therapy to directly increase calcium excretion is not recommended because of potential complications and the availability of drugs that inhibit bone resorption. William's Endocrinology on I.V. furosemide in hypercalcemia Use of furosemide or other potent loop diuretics to promote calciuresis can exacerbate extracellular volume depletion if used too early in the course of treatment. In the light of availability of highly effective alternatives for the therapy of hypercalcemia such drugs probably are best avoided except in circumstances in which rigorous hydration fails to improve severe hypercalcemia or might ppt precipitase C.H. F.. In any case prolonged use of saline induced dieresis without early introduction of an effective antiresorptive agent is ill advised and ultimately futile. Concurrent treatment with biphosphonates with or without calcitonin is typically required to treat moderate to severe hypercalcemia. Calcitonin Pharmacological doses of serum calcitonin reduce the serum calcium concentration by increasing renal calcium excretion and, more impoantly by decreasing bone resorption interference with osteoclast maturation. - Calcitonin is relatively safe and nontoxic although a relatively weak agent, it works rapidly, lowering the serum calciwn concentration by maximum of 1-2 mg/dl beginning within, four to six hours. Thus it is useful in combination with hydration .for the initial management of severe hypercalcemia. The efficacy of calcitonin is limited to the first 48 hours even with repeated doses, indicating the development of tachyphylaxis, perhaps due to receptor downregulation. - Because of its limited duration of effect, calcitonin is most beneficial in symptomatic patients with calcium >14 mg/L when combined with hydration and biphosphonates. Calcitonin and hydration provide a rapid reduction in serum calcium concentration while a biphosphonate provides a more sustained effo. Biphosphonates - The biphosphonates are nonhydrolyzable analogues of inorganic pyrophosphate that adsorb to the surface of bone hydroxyapatite and inhibits calcium release by interfering with osteoclast mediated bone resorption. They are effective in treating the hypercalcemia resulting ,from excess of any cause. All of the biphosphonates are relatively nontoxic compounds and they are more potent than calcitonin and saline .for patients with moderate or severe hypercalcemia. As a result, they have became the preferred agents for management of hypercalcemia due to excessive bone resorption from a variety of causes. -Their maximum effifct occurs in two to four days so that they are usually given in conjunction with saline / calcitonin which reduce serum calcium concentration more rapidly. Biphosphonates in renal impairment "Biphosphonates have potential nephrotoxicity. But this does not mean that they are completely avoided in patients with renal failure" In clinical trials of zolindronate for the treatment of hypercalcemia, patients with serum creatinine concentration as high as 4.5 mg/d1 were eligibile for paicipation. In addition there are case repos of successful use of ibandronate and pamidronate in patients with renal failure and multiple myeloma, renal insufficiency (creatinine 2 1.5 mg/dl) and in hemodialysis patients with severe hypercalcemia. - However caution is suggested when using intravenous to treat hypercalcemia in patients with impaired renal function (creatinine > 4.5 mg/dl). - Adequate hydration with saline and t/t with a reduced dosage and/or slower infusion rate (4 mg Z4 over 30-60 minutes, 30-45 mg pamidronate over 4 hours, 2 mg ibandronate over one hour / ?nay minimize risk). Dialysis -Hemodialysis with little or no calcium in the dialysis fluid and peritoneal dialysis (though it is slower) are both effective therapies for hypercalcemia and are considered tit of last reso. - Dialysis may be indicated in patients with severe malignancy associated hypercalcemia and renal insufficiency or hea, failure, in whom hydration cannot be safely administered. - The use of hypercalcemia in patients with without renal failure may require alterations in the composition of conventional dialysis solutions in order to avoid an exacerbation or induction of other metabolic abnormalities, paicularly hypophosphatemia. | Surgery | null | [
"furosemide"
] | 59,554 |
8b5b65aa-ffb3-45db-85b6-72399f043296 | The most cardiotoxic local anaesthetic is: | Lignocaine | exparel | Prilocaine | novocaine | 1b
| single | Bupivacaine is the most cardiotoxic and long acting amides. Inadveent injection of intravenous bupivacaine has been associated with frequent cardiotoxic reactions; ventricular tachycardia, fibrillation, and cardiac arrest. This is the main drawback of bupivacaine and for this reason bupivacaine is no longer used for intravenous regional anaesthesia. It is contraindicated in IV anesthesia due to cardiotoxicity. | Anaesthesia | null | [
"procaine",
"bupivacaine"
] | 59,577 |
f5819104-8ddc-4102-b303-0fab5f583cb9 | An old man has enlarged prostate. Which of the following may be use to suppress his prostatic growth: | carospir | extina | Finasteride | eulexin | 2c
| single | null | Pharmacology | null | [
"flutamide",
"spironolactone",
"ketoconazole"
] | 59,598 |
131f9564-e6d1-4555-ad00-9f109e13d223 | ['thalomid'] was once used for treating emesis of pregnancy. Later it was withdrawn from market due to side effects. But it was reintroduced for certain indications like multiple myeloma. All of the following are side effects of ['thalomid'] except : | Hypothyroidism | Diarrhea | Teratogenicity | Deep Vein Thrombosis | 1b
| multi | null | Pharmacology | null | [
"thalidomide"
] | 59,612 |
ad931c0b-5a31-40aa-a69e-fc3824b0d690 | Prophaylaxis for malaria not used - | vibramycin | Aesunate | resochin | lariam | 1b
| single | Drugs for chemoprophylaxis of malaria include Chloroquine Proguanil Mefloquine Doxycycline Reference : Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 285 | Social & Preventive Medicine | Communicable diseases | [
"chloroquine",
"mefloquine",
"doxycycline"
] | 59,614 |
3f37b840-2abd-4048-bd25-dfcddb5fbf7d | A patient on treatment for leukemia, develops chest pain, pulmonary infiltrates and pleural effusion. The likely cause is - | Daunorubicin | Hydroxyurea | cytosar | Tretinoin | 3d
| single | Ans. is 'd' i.e., Tretinoin o Tretinoin causes chest pain, pleuritis, pulmonary infiltrates and pleural effusion. It is a known human teratogen. Daunorubicin and doxorubicin cause cardiotoxicity manifested as arrhythmias and CHF. | Pharmacology | null | [
"cytarabine"
] | 59,619 |
14355d9f-4b6b-428e-ae5f-1c3714f1152e | Antiandrogen is - | mifeprex | serophene citrate | eulexin | nolvadex | 2c
| single | Ans. is 'c' i.e., Flutamide | Pharmacology | null | [
"clomiphene",
"flutamide",
"mifepristone",
"tamoxifen"
] | 59,620 |
e523a1a0-d0d4-46cc-b00e-dce65d87671e | Bull's eye maculopathy is an adverse effect caused by | resochin | Lumefantrine | qualaquin | Primaquine | 0a
| single | Bull's eye maculopathy It is a rare dystrophy, also known asbenign concentric annular macular dystrophy (BCAMD). It causes a daboard, or ring-shaped, pattern of damage around the macula. It can be caused bychloroquineorhydroxychloroquine Side effects of antimalarial drugs Chloroquine (4-aminoquinoline) - Bull's eye maculopathy,confusion,psychosis,agranulocytosis. Primaquine (8-aminoquinoline ) - hemolytic anaemia in G6PD deficiency,leukopenia,agranulocytosis,leukocytosis,cardiac arrhythmias. Quinine - Cinchonism (constellation of symptoms:tinnitus,headache,nausea,dizziness,flushing,visual disturbances. Tafenoquine (8-aminoquinoline) - Hemolysis in G-6PD Def Pt | Pharmacology | Anti-Malaria Drugs | [
"quinine",
"chloroquine"
] | 59,631 |
d7d5c188-26ee-4e55-81a1-59e9a4e1a925 | Which one of the following is the fastest acting inhalational agent? | fluothane | isoflo | Ether | Sevofluron | 3d
| single | Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. It is inversely propoional to the induction rate. It determines the onset of induction and recovery. anesthetic blood gas solubility Nitrous oxide 0.47 Halothane 2.4 Isoflurane 1.4 Sevoflurane 0.65 Desflurane 0.45 Methoxyflurane 12 Enflurane 1.9 Newer anesthetics (such as desflurane) typically have smaller blood-gas paition coefficients than older ones (such as ether); these are preferred because they lead to faster onset of anesthesia and faster emergence from anesthesia once application of the anesthetic is stopped. | Anaesthesia | General anaesthesia | [
"isoflurane",
"halothane"
] | 59,633 |
d5d89c48-53e6-43cb-90cf-92eb95c561b1 | Which is the most active single chemotherapeutic agent in the treatment of leiomyosarcoma ? | Adriamycin | Daunorubicin | trexall | platinol | 0a
| single | null | Pharmacology | null | [
"methotrexate",
"adriamycin",
"cisplatin"
] | 59,645 |
3d1f8803-aa00-416d-9010-2e95d4e31c7b | Active form of Vitamin D3 is: | calcijex | Calciferol | Calcidiol | drisdol | 0a
| single | Ans. A CalcitriolRef: Ganong, 25th ed. pg. 378The active metabolite of vitamin D3 is produced in kidney and is called calcitriol or 1,25 dihyroxycholecalciferol. The cells of proximal convoluted tubule produce an enzyme by name of 1 alpha hydroxylase that converts 25 hydroxycholecalciferol into 1,25 dihyroxycholecalciferol. | Physiology | Endocrinology metabolism | [
"calcitriol",
"ergocalciferol"
] | 59,673 |
b21cc93a-fdab-45a2-ae58-a03e1c93ea04 | cuprimine is commonly used in the management of following heavy metal poisoning except | Arsenic | Copper | Lead | Mercury | 0a
| multi | null | Medicine | null | [
"penicillamine"
] | 59,676 |
266db90b-9a85-49b5-86b4-d659c4759d0f | Toxic dose of xylocaine causes | Increase salivation | Mydriasis and diarrhea | Respiratory paralysis | Seizures | 3d
| single | Lignocaine reaching bloodstream causes severe CNS stimulation followed by coma.Ref:KDT 6/e p356. | Pharmacology | All India exam | [
"lidocaine"
] | 59,682 |
f73241fa-afba-4c8a-9323-22a9f75b867a | Cephalosporin that does not require dose reduction in patient with any degree of renal impairment is? | Cefuroxime | cefobid | fortaz | claforan | 1b
| single | Ceftriaxone and cefoperazone are excreted mainly in the bile, therefore do not require dose reduction in any grade of renal failure. | Pharmacology | null | [
"cefotaxime",
"ceftazidime",
"cefoperazone"
] | 59,683 |