Question: The penicillin G preparation with the longest duration

Penicillin G due to it's rapid tubular secretion, it is very sho acting. It's duration of action is increased with probenecid which compete with penicillin at tubular pump. Procaine penicillin G and benzathine penicillin G are administered IM and serve as depot forms. They are slowly absorbed into the circulation and persist at low levels over a long time period. Specially Benzathine penicillin G has longest duration of action. Penicillin G are not effective orally as it is acid labile. Penicillin which are acid stable are : - V : Penicillin V- O: Ofloxacillin- D: Dicloxacillin- K: Cloxacillin- A: Amoxicilin/Ampicillin


Question: Imatinib used in CML acts by

Competitive inhibition _of ATP binding site of ABL kinase [Ref. Harrison 16thie p 4781 CML is characterized by the presence of a distinctive molecular abnormality namely philadelphia chromosome. Philadelphia chromosome in formed as a result of reciprocal translocation between long arm of chromosome 22 and chromosome 9 i.e. t (9 ; 22). ABL protooncogene from chromosome 9 is translocated to chromosome 22 where BCR is present and results in formation of BCR-ABL fusion chimeric gene. The drug imatinib mesylate is a BCR-ABL tyrosine kinase signal transduction inhibitor. This drug acts as a inhibitor of the ATP binding site on the protein and prevents its phosphorylation and thus its activity. An impoant point CML is caused by reciprocal translocation between BCR and ABL gene located on chromosome 9 and 22. Imatinib mesylate does not block this translocation i.e., BCR ABL translocation. - Instead, it blocks the constitutive abnormal tyrosine kinase, BCR-ABL that is created by the Philadelphia chromose (BCR-ABL). - The drug inhibits the proliferation and induces apoptosis in BCR-ABL positive cells. Also know Protein tyrosine kinase inhibitors Protein kinases are ubiquitous and critical components of signal transduction pathways that transmit information concerning extra cellular or cytoplasmic conditions to the nucleus, thereby influencing gene transcription and/or DNA synthesis. The protein kinases can be classified into three categories: (i) Tyrosine kinase (ii) Serine threonine kinase (iii) Kinases with activity for all three residues Abnormal activation of specific tyrosine kinase has been demonstrated in many human neoplasms. Thus they can be targeted in ceain cancer therapies. There currently are three small-molecular weight protein tyrosine kinase inhibitors that are FDA approved and many others are in clinical trials. i) Imatinib Imatinib has efficacy in diseases in which the ABL, KIT or PDGFR have dominant roles in driving the proliferation of the tumour. Thus, imatinib shows remarkable therapeutic benefits in patients with - CML (BCR-ABL) - GIST (KIT mutation positive) - CMML (EVT6-PDGFR) ii) Gefitinib The epidennal growth factor receptor (EGFR) belongs to the family of tyrosine kinase. Gefitinid is a specific inhibitor of the EGFR tyrosine kinase that competitively inhibits ATP binding. EGFR is overexpressed in non-small cell carcinoma of lung, thus Gefitinib has been approved for use in non-small cell carcinoma. iii) Erlotinib It is a human HERI/EGFR tyrosine kinase inhibitor. It is indicated for patients with locally advanced or metastatic non-small cell lung cancer.

inhibiting Bcr/abl translocation tyrosine kinase

Competitive inhibition of ATP binding site of Abl kinase


Question: Fastest acting antithyroid drug is

KI: It is the fastest acting thyroid inhibitor which inhibits hormone release. it has a direct action on thyroid cells and also attenuates TSH and cyclic AMP induced thyroid stimulation. The gland if enlarged; shrinks, becomes firm and less vascular. The thyroid status returns to normal at a faster rate. So it is used just before thyroid surgeries REF KD tripathi 8th ed


Question: A child has phocomelia. This is due to drug taken by mother aEUR'

Thalidomide [Ref Katzung Ile p. 1029, : K.D.T. 6/e p. 85 www.mayoclinic.com/health/thalidomide, Harrison 17/e p 11821 Thalidomide is the worst teratogen known in the history of medicine. It was widely used as sedative and hypnotic. It was also believed to reduce vomiting in pregnancy. - It was a routine hypnotics in hospitals, was even recommended whelp children adapt themselves to a convalescent home atmosphere. - The indiscrete use of these drugs in pregnant women resulted in an outbreak of phocomelia. Phocomelia means "seal extremities", it is a congenital deformity in which the long bones of the limbs are defective and substantially normal or rudimentary hands and feet arise on or nearly on the trunk like the flippers of seal. Thalidomide was subsequently banned. Now, decades later thalidomide has received approval from the food and drug administration in ceain conditions. According to Indian Journal of pharmacology Clinical uses of thalidomide -AIDS related aphthous ulcersQ - AIDS related wasting syndromeQ - Multiple myeloma and other solid tumoursQ - Prevention of graft versus host disease after transplantationQ - Rheumatoid ahritisQ - Ankylosing spondylitisQ - Crohn's disease and Becher's syndromeQ - Erythema nodosum leprosum0


Question: Carbamazepine in elderly patient can cause

- Carbamazepine DOC for focal seizures DOC for trigeminal neuralgia Used for Diabetes insipidus Bipolar disorder Adverse effect - Release of ADH (leading to dilutional hyponatremia), Agranulocytosis, Aplastic anaemia


Question: Drug metabolized by Glutathionation is

Fosfomycin and Ifosfamide are metabolized by glutathionation.


Question: Cytoprotectant among the following is

Amifostine:It is used as a cytoprotectant(Radioprotectant) in anticancer chemotherapy.Ref: Sharma and Sharma 3rd ed/pg 877


Question: Myaesthenia gravis is diagnosed by (REPEAT)

Tensilon is also known as edrophonium .as it is sho acting it is used to diagnose or differentiate the cause of muscle paralysis-cholinergic vs myasthenia crisis Ref: KDT 6th ed pg 104


Question: Most specific antiemetic for Chemotherapy induced vomiting is

5HT3 Antagonists *5HT3 antagonists like Ondansetron, Granisetron, Dolasetron, Tropisetron and Palanosetron are the most specific and effective agents in the management of chemotherapy-induced nausea vomiting and in nausea associated with upper abdominal irradiation. Ref:- Goodman & Gilman's Pharmacological basis of Therapeutics 13th Ed; Pg.No:- 935-6


Question: Dysguesia is side effect of

Ans. a (Captopril). (Ref. Harrison's medicine, 16th ed., Table 230-8, Pg 1474)ADVERSE EFFECTS OF CAPTOPRIL =# Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems (fetal renal damage), Rash, Increased renin, Lower angiotensin II. Also hyperkalemia, Leukopenia>Pancytopenia, Urticarial rash and ARF in bilateral RASEducational point:# Fosinopril excreted more in bile than others.# Losartan is an angiotensin II receptor antagonist. It is not an ACE inhibitor and does not cause cough.


Question: Route of administration of amyl nitrite in cyanide poisoning is

Amyl nitrite is usually given in cyanide poisoning by inhalational route.


Question: The following ADR is seen with withdrawal of

The picture shows piloerection which occurs due to sympathetic stimulation which is typically seen with opioid withdrawalRef: Goodman Gillman 12th ed pg 660


Question: Ivacaftor was approved by FDA in 2018 for

Ivacaftor is used for treating cystic fibrosis


Question: Beta 2 agonist causes


Question: Red discolouration of urine is seen with

Doxorubicin & Daunorubicin can cause red discolouration of urine.


Question: Drug of choice for poisoning with Amanita muscaria

Amanita muscaria signs and symptoms are mainly related to anxiety and insomnia which can be treated best with benzodiazepines like diazepam Atropine is contraindicated but for amanita inocybe poisoning atropine is drug of choice Ref: KDT 6th ed pg 98


Question: Salbutamol is used in


Question: Drug of choice for non gonococcal urethritis is

i.e. (Doxycycline) : (715-KDT 6th) (1399-1249-CMDT-11) Drug of choice for Nongonococcal Urethritis trachomatis. Mvcoplasma genitaliumUreaplasmaUrealyticum)* Azithromycin (preferred and safe in pregnancy) lg single doseorDoxycycline (C/I in pregnancy) 100 mg BD for 7 daysorLevoflaxacin (C/I in pregnancy) 500 mg OD for 7 days* Diagnosis made by nucleic acid amplification of urine or swab specimen Drug of choice for Gonococcal Urethritis* Ceftriaxone (III generation cephalosporins) single dose 1/MorCefixime 400mg orally onceorCefpodoxime 200-400mg orally once


Question: Muscarinic receptors on blood vessel endothelium cause

Ans. is'b' i.e., Vasodilatation through NONo direct cholinergic supply is present in blood vessels.But cholinergic receptor (M, types) are present on blood vessels endothelium.Stimulation of these receptors causes release of EDRF (NO) from endothelium resulting in vasodilatation.


Question: Preferred drug for the treatment of ventricular tachycardia is

Doc for ventricular tachycardia - Lignocaine


Question: Indication for intramuscular iron therapy is

Refer KDT 6/e p 868 Drug of choice for acute iron poisoning is desferroxamine, however it has to be admistered parentarally It is not effective by oral route In beta thalassemia major iron excess can result due to repeated blood transfusions and massive Hemolysis Cheating agent has to be admistered for long time OK this case


Question: Hypeension and pulmonary edema associated with scorpion sting is managed by

* Prazosin, a alpha1 selective adrenergic antagonist is a orable choice for management of scorpion sting associated hypeension and pulmonary edema. Ref:- Harrisons Principles of Internal Medicine 20th Ed; Pg Num:- 3329


Question: The loading dose of Aminophylline is

Refer KDT 6/e p 221 Aminophylline IA admistered I'm a dose of 5-7mg/kg slow intravenous infusion. In children, dose required is 7.5mg/kg


Question: High dose Methotrexate is used for treatment of

Refer Harrison 17th/612 Drugs needs for Osteosarcoma Doxorubicin Ifosfamide Cisplatin High dose Methotrexate with Leucovorin


Question: Antihistamines used in motion sickness is

Diphenhydramine and promethazine have maximum anti cholinergic activity and maximum ability to cross the blood brain barrier and are thus most effective in motion sickness . Refer katzung 11/e p278


Question: The drug treatment in a female with complaints of occasional amenorrhea and milk ejection 5yrs after her last baby is born

Cabergoline,pergolide,bromocriptine(Dopamine agonists) are used for hyperprolactinomaRef: KDT 6th ed P 236


Question: Cisplatin induced vomiting on 3rd day of treatment DOC

vomiting induced by chemotherapy has two stages early onset and delayed onset early onset is within 24 hrs of the therapy which can be controlled by drugs like ondansetron but Delayed onset of vomiting is not controlled by ondansetron in cisplatin treatment. hence more poerful drug acting on NK 1 receptors is used like aprepitant and fos apripetant. Ref:katzung 10/6 p 1027.


Question: Pramipexole is

(A) Dopamine agonist # Dopamine agonist: Mirapex is a dopamine agonist used for Parkinson's disease.> Pramipexole Side Effects: Drowsiness and the possibility of suddenly falling asleep during daily activities, which could result in an accident while driving.> Most common MIRAPEX side effects are nausea, sleeplessness, constipation, involuntary movement, dizziness upon standing, and hallucinations.


Question: Type 1 lepra reaction is treated with

Treatment of choice for type 1 as well as type 2 lepra reaction is coicosteroids. For severe reaction, prednisolone 40-60mg/day is staed immediately and continued till the reaction subsides. The dose is then tapered over 2-3 months. For resistant cases of ENL drug of choice is thalidomide

Mycobacterial Diseases (TB, Leprosy and MAC)


Question: Paradoxical action among diuretics is seen with

DIURETICS ARE CONTRAINDICATED IN DIABETES IN WHICH THERE IS AN INCREASED EXCRETION OF URINE But, Thiazides are used in diabetes insipidus- paradoxical action -they create mild hypovolemia which encourages salt and water uptake in the proximal tubule and thus improve nephrogenic diabetes insipidus- action may be mediated through CAMP- poorly understood REF KD Tripathi 8th ed


Question: Cinnarizine used for motion sickness is a

Cinnarizine is an antihistamine with anticholinergic property given for motion sickness & also used in the treatment of vertigo.


Question: Sargramostim is a

Sargramostim: GM - CSF analogue.
Filagastrim: G - CSF analogue.


Question: Infantile spasms with tuberous sclerosis DOC (REPEAT)


Question: The risk of thromboembolism increases in pregnancy because

Increased hepatic production of clotting factor


Question: Derivative of morphine used for diarrhoea

Drugs used in the treatment of diarrhea include opiates (morphine, codeine), synthetic anti-diarrheals (diphenoxylate, loperamide), anticholinergics (atropine, propantheline), adsorbents (kaolin, pectin, cholestyramine resin) and Lactobacillus acidophilus. Chronic diarrhea and acute diarrhea caused by microorgansims, drugs and viruses are described. The management of diarrhea can be divided into three categories: (1) suppoive therapy (fluid and electrolyte replacement); (2) symptomatic therapy which improves the consistency of the stool and reduces the frequency of bowel movements; and (3) specific therapy aimed at treating the cause (e.g., antibiotics for bacteria-induced diarrhea) or blocking the cellular mechanisms of fluid and electrolyte loss. Most acute diarrheal conditions can be managed successfully by avoiding oral solids and ingesting carbohydrate-electrolyte solutions. Synthetic antidiarrheals may increase the toxicity associated with bacterial diahhrea. Ref: katzung 13th ed..


Question: In competetive antagonism

Vmax corresponds to efficacy which remains same in competitive antagonism.
Km corresponds to potency and in competitive antagonism Km increases, potency decreases.


Question: Mydriatic with no cycloplegic effect is seen with

Mydriasis with no loss of accommodation(cycloplegia) is seen with phenylephrine which is alpha agonist Ref: Katzung 11th ed pg 117


Question: Best for treatment of irritable bowel syndrome with spastic colon is

Ans. d (Dietary fibers). (Ref. KD Tripathi 5th ed. - 614)Spastic constipation/Irritable bowel1st choice laxative:# Dietary fibers# Bulk forming laxative such as Ispaghula, methylcellulose.While Stimulant purgatives like:# Castor oil,# Senna,# Bisacodyl, Phenolphthalein........ are contraindicated.


Question: Select the most suitable antiarrhythmic drug for counteracting ventricular extrasystoles due to digoxin toxicity

Digitalis Toxicity:- Toxicity of digitalis is high, margin of safety is low (therapeutic index 1.5-3). Higher cardiac moality has been repoed among patients with steady-state plasma digoxin levels > 1.1 ng/ml but still within the therapeutic range during maintenance therapy. Manifestations and treatment of toxicity For ventricular arrhythmias:- Lidocaine i.v. repeated as required is the drug of choice. It suppresses the excessive automaticity, but does not accentuate A-V block. Quinidine, procainamide and propafenone are contraindicated. Ref:- kd tripathi; pg num:-516


Question: The parenteral administration of streptokinase

Streptokinase (SK) is thrombolytic (or fibrinolytic) because it activates plasminogen, resulting in the increased formation of plasmin. Its efficacy is equivalent to that of tissue plasminogen activator (t-PA), but SK is not clot-specific. All thrombolytics can cause bleeding, which may be counteracted to some extent by administration of antifibrinolysins, such as aminocaproic acid.

is less effective following a myocardial infarct than t-pA

causes a high incidence of thrombocytopenia

may cause bleeding reversible by aminocaproic acid


Question: A 2 years old child without fever develops bone pain, vomiting and features of increased intracranial pressure following excessive meditation. The drug most likely to be responsible for this is;

Since vit. A is stored in liver, deficiency symptoms appear only after long- term deprivation, but vit A deficiency is quite prevalent, especially among infants and children in developing countries. Manifestations are: * Xerosis (dryness) of eye, 'Bitot' s spots', kerato- malacia (softening of cornea), corneal opacities, night blindness (nyctalopia) progressing to total blindness. * Dry and rough skin with papules (phryno- derma), hyperkeratinization, atrophy of sweat glands. * Keratinization of bronchopulmonary epithe- lium, increased susceptibility to infection. * Unhealthy gastrointestinal mucosa, diarrhoea. * Increased tendency to urinary stone formation due to shedding of ureteric epithelial lining which acts as a nidus. * Sterility due to faulty spermatogenesis,etc ESSENTIALS of medical PHARMACOLOGY SIXTH EDITION-KD TRIPATHI Page:870


Question: Vitamin K is a cofactor in

Refer Katzung 10/e p 549 Vitamin K is involved in activition if various clotting factors as well as anticlotting clotting proteins It carries out the final step in activation of these ors I. E, gamma carboxylation of glutamate residues in these factors


Question: Bisphoshonates act by

Refer Katzung 10/e p713 bisphoshonates are used for the treatment of post menopausal osteoporosis, steroid induced osteoporosis, Pagets disease and hypercalcemia of malignancy

Increasing the mineralization of Osteoid

Decreasing the osteoclast mediated resorption of bone

Decreasing the parathyroid hormone receptors


Question: Loading dose of 25mg was needed to achieve 0.5mg / L of Plasma concentration. Volume of distribution is 40L. Calculate the Bioavailabity


Question: Neostigmine used in treatment of Myasthenia gravis acts by

Refer kDT 6/e p 101 In most people with myasthenia gravis, the immune system blocks or damages these acetylcholine receptors. The acetylcholine cannot then attach to the receptor and so the muscle is less able to tighten.Neostigmine works by slowing the breakdown of acetylcholine when it is released from nerve endings.

Increasing the number of receptor for acetylcholine


Question: Therapeutic index is a measure of

(c) Safety,Ref: Lippincott, 6th ed., pg. 35The therapeutic index (TI) of a drug is the ratio of the dose that produces toxicity to the dose that produces a clinically desired or effective response in a population of individuals:TI=TD50/ED50Where TD50 = the drug dose that produces a toxic effect in 50% the population and ED50 = the drug dose that produces a therapeutic or desired response in 50% the population. TI is a measure of a drug's safety, because a larger value indicates a wide margin between doses that are effective and doses that are toxic.


Question: The Gustatory nucleus is a pa of(NOT REALTED TO PHARMACOLOGY)

The rostral pa of the solitary nucleus is sometimes referred to as the gustatory nucleus. The solitary nucleus conveys information about taste and visceral sensations


Question: Fluoroquinolone contraindicated in liver disease is

Dose ofpefloxacin needs to be reduced in liver disease, but not in renal insufficiency. FQs c/I in renal failure except P - Pefloxacin M -Moxifloxacin T - Trovafloxacin


Question: The ratio of the median lethal dose of the median effective dose is the


Question: A child presents with bladder exstrophy and chronic renal failure. The muscle relaxant of choice to be used during surgery of exstrophy in this child is

Atracurium:- A bisquaternary competitive blocker and shoer acting: reversal is mostly not required. The unique feature of atracurium is inactivation in plasma by spontaneous non- enzymatic degradation (Hofmann elimination) in addition to that by cholinesterases. Consequently its duration of action is not altered in patients with hepatic/renal insufficiency or hypodynamic circulation. It is the preferred muscle relaxant for liver/kidney disease patients as well as for neonates and the elderly. Hypotension may occur due to dose dependent histamine release. Ref:- kd tripathi; pg num:-353,354


Question: GABA transmission is facilitated by

GABAergic transmission refers to activation ofGABA receptors and release of GABA by endogenous or pharmacological modulators. g-Aminobutyric acid (GABA) is the most prevalent inhibitory neurotransmitter in the mammalian central nervous system. Ref: KD Tripathi 8th ed.


Question: The composition of Lugol&;s iodine

Lugol's iodine is 10% KI with 5% Iodine. Used as an adjuvent in Graves patients planned for surgery. Iodides decrease the vascularity of the gland anf inhibit the release of thyroid hormones hence called thyroid constipating agents. Ref: KDT 7th ed Pg 255


Question: Lutetium dotatate was approved by FDA in 2018 for

Lutetium (Lu 177) dotatate a radiolabeled somatostatin analogue, for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumours (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumours in adults.


Question: Sho acting anticholinesterase drug is

Refer kDT 6/e p 101 Edrophonium is the only sho-acting anticholinesterase available; it is a synthetic quaternary ammonium compound. The drug competes with acetylcholine and binds by a non-covalent bond to acetylcholinesterase at the anionic site. The recommended dose for antagonism of neuromuscular block is 0.5-1 mg kg-1.


Question: Monday disease is seen with

Nitrates because of tolerance produce Monday headache in workers working in nitrate industry which gradually subsides by Friday. Ref: Katzung 12th ed.


Question: Erenumab was approved by FDA in 2018 for

Erenumab belongs to a new class of drugs known as selective calcitonin gene-related peptide (CGRP) antagonists, which are used for the treatment of acute migraine attacks.


Question: Drug of choice for Hypercalcemia of malignancy is

Drug of choice for hypercalemia of malignancy is Bisphophonates and for immediate treatment IV fluids are used.Salcatonin / calcitonin is fastest calcium lowering drug.


Question: Short acting mydriatic used in fundoscopy is

(Tropicamide) (98 - KDT) (111-KDT6th)Tropicamide - It has the quickest (20 - 40 min) and briefest (2-6 hours) action, but it is a relatively unreliable cyclopegic* However it is satisfactory for refraction testing in adults and as short acting mydriatic for fundoscopy


Question: DENOSUMAB a monoclonal antibody against RANKL receptor is used in the treatment of

Ans. is 'b' i.e. Osteoporosis Osteoclast is a cell responsible for bone resorption.Osteoclasts express RANK receptors on its surface (RANK receptor activator for nuclear factor)When RANK receptor combine with their ligands (RANKL), osteoclastogenesis is a initiated and bone resorption occurs.Denosumab is a fully humanized monoclonal antibody against RANK ligand.It prevents the activation of the osteoclasts by these ligand.Note:Osteoporosis is a disease characterized by decrease in the bone massIn osteoporosis there is increase in the osteoclast activity and there is increased expression of RANK and RANKL.


Question: Drug that can be used for producing alkalinization of urine is

CARBONIC ANHYDRASE INHIBITORS Carbonic anhydrase is an enzyme which catalyses thereversible reaction H2O+CO2 -> H2CO3. Carbonic acid spontaneously ionizes H2CO3 -> H+ + HCO3-. Carbonic anhydrase thus functions in CO2 and HCO3 - transpo and in H+ ion secretion. The enzyme is present in renal tubular cell (especially PT) gastric mucosa, exocrine pancreas, ciliary body of eye, brain and RBC. Acetazolamide:- Mech of action:- It is a sulfonamide derivative which noncompetitively but reversibly inhibits CAse (type II) in PT cells resulting in slowing of hydration of CO2 ->decreased availability of H+ to exchange with luminal Na+ through the Na+-H+ antipoer. Inhibition of brush border CAse (type IV) retards dehydration of H2CO3 in the tubular fluid so that less CO2 diffuses back into the cells. The net effect is inhibition of HCO3 - (and accompanying Na+) reabsorption in PT. However, the resulting alkaline diuresis is only mild (maximal fractional Na+ loss 5%), because pa of the Na+ (but not HCO3 - ) rejected in the PT is reabsorbed at the high capacity AscLH. The urine produced under acetazola mide action is alkaline and rich in HCO3 - which is matched by both Na+ and K+. Continued action of acetazolamide depletes body HCO3 - and causes acidosis. Ref:- kd tripathi; pg num:-586,587


Question: The following is the indication of eptifibatide

Eptifibatide, terofiban are the newer antiplatelet drugs(Glycoprotein IIB/IIIA inhibitors) used in unstable anginaRef: Goodman Gillman 12thed. Pg: 871


Question: 5HT1 paial agonists are used as

Buspirone, gepirone, spiperone - atypical anti-anxiety agents they do not affect GABA levels- so atypical they are serotonin paial agonists Ref: KD Tripathi 8th ed


Question: ADR of acarbose

The most common ADR of alpha glucosidase inhibitors are flatulence due to indigestion of polysaccharides Ref: Katzung 12th ed, diabetis Mellitus..


Question: Hot nodule in liver scan is due to(NOT RELAVENT TO PHARMACOLOGY)

50% of the focal nodular hyperplasia shows presence of Kupfer cells (phagocytes). So uptake of sulphur colloid is noted in these lesions. No uptake is seen in HCC, hepatic adenoma and metastases


Question: Pegvaliase was approved by FDA in 2018 for

Pegvaliase is a drug approved for the treatment of phenylketonuria. Chemically, it is a pegylated derivative of the enzyme phenylalanine ammonia-lyase that metabolizes phenylalanine to reduce its blood levels.


Question: Activation of postsynaptic M2 receptors on the hea is associated with

M2 and M4 receptors act by the opening of K+ channels. M1 and M4 act by the IP3-DAG pathway.


Question: Condyloma accuminata in pregnancy is treated by

Treatment of condyloma -acuminata - (verruca-genital is) Podophyllum is effective only on the genital was Podophyllum is potentially toxic and must be avoided in during pregnancy Chemical cauterization is usually done with liquified phenol or concentrated trichloroacetic acid Ref: KD Tripathi 8th ed/


Question: Action of adranaline is reversed by prazosine but not by propranol

i.e. (Urinary symptoms of BHP): (133-KDT 6th)* Prazocine is a1 blocker and propranol is non selective beta blocker* Urinary symptoms in BHP are solely due to alpha receptorsThe a blockers have no effect on adrenergically induced cardiac stimulation, bronchial dilatation, vasodilation and most of the metabolic changes because these are mediated predominantly through b-receptors (133-KDT 6th)


Question: Drug used in type DM 1 apa from insulin

Pramlintide is recently approved to be used for type 1 diabetes apa from insulin. It is given by SC route. It is an amylin analogue. Ref: KD Tripathi 8th ed.


Question: Melphalan is used in

Ans. is 'a' i.e., Multiple myeloma Melphalan is an anticancer (alkylating) agent which is most effective in multiple myeloma.Most common toxicity of Melphalan is Bone marrow toxicity.


Question: lxabepilone is

Ans. is 'b' i.e., Antineoplastic Ixabepilone o Ixabepilone also known as azaepothilone B. o It has been approved by FDA for the treatment of aggressive metastatic or locally advanced breast cancer which is not responding to standard chemotherapy o It is given in combination with capecitabine. o It has also been investigated for use in treatment of non-Hodgkin's lymphoma. o It acts by binding to tubulin and promoting microtubule stabilization (like taxanes) thereby acting on M phase of cell cycle.


Question: Treatment of chronic phase of CML is

(A) Imatinib # Standard treatment for chronic phase CML is a tyrosine kinase inhibitor (TKI) such as imatinib, Nilotinib, or Dasatinib.> For imatinib, the usual starting dose is 400 mg per day.> If the first drug stops working (or it never really worked well at all) the dose may be increased or the patient may be switched to one of the other TKIs (including Bosutinib/Bosulif).> Ponatanib is an option after all of the other TKIs have been tried or if the leukemia cells later develop the T315I mutation.> Switching to another TKI is also an option if the patient can't take the first drug because of side effects.> Some people in chronic phase may be treated with an allogeneic stem cell transplant (SCT).


Question: Diuretic that is useful in mild to moderate hypeension is

Thiazides are not only drug of choice for mild to moderate hypeension but I first line choice for this type of patients as antihypeensive drugs Refer Harrison 19e/p1623


Question: Telmisaan lowers blood pressure by

Refer kDT 7/e p 561 Telmisaan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues, such as vascular smooth muscle and the adrenal gland. Its action is therefore independent of the pathways for angiotensin II synthesis.

Inhibiting formation of angiotensin 1 to angiotensin

Inhibiting conversion ofrenin to angiotensin 1

Interfering with degradation of bradykinin


Question: Effect of Vmax and Km in competitive inhibition is as follows

In competitive inhibition, Drug binds to enzyme only .So, Velocity remains unchanged and Conc- km increases. In non- competitive inhibition, drug binds to enzyme substrate complex deceasing velocity unaffecting km. Ref: K.D.Tripati.7th ed. Pg 39


Question: The following antiasthma drug is not a bronchodilator

Bronchodilators :- a) b2 Sympathomimetics: Salbutamol, Terbutaline, Bambuterol, Salmeterol, Formoterol, Ephedrine. B) Methylxanthines: Theophylline (anhydrous), Aminophylline, Choline theophyllinate, Hydroxyethyl theophylline, Theophylline ethanolate of piperazine, Doxophylline. C) Anticholinergics: Ipratropium bromide, Tiotropium bromide. Sodium cromoglycate:- mech of action :- It inhibits degranulation of mast cells by trigger stimuli(MAST CELL STABILISER). Bronchospasm induced by allergens,irritants,coldair and exercise may be attenuated. It is also not a bronchodilator and does not antagonize constrictor action of histamine, ACh, LTs, etc. Therefore, it is ineffective if given during an asthmatic attack. Pharmacokinetics:- Sod. cromoglycate is not absorbed orally. It is administered as an aerosol through metered dose inhaler it is rapidly excreted unchanged in urine and bile. uses:- 1. Bronchial asthma: Sod. cromoglycate is a long-term prophylactic in mild-to-moderate asthma. Decrease in the frequency and severity of attacks is more likely in extrinsic (atopic) and exercise-induced asthma, especially in younger patients. 2. Allergic rhinitis 3. Allergic conjunctivitis Ref:- kd tripathi; pg num:- 222,229


Question: The following teratogenic effect is produced by

The picture shows scalp defect-aplasia cutis which is a teratogenic effect of carbimazoleRef: KD Tripathi 7th ed pg 253


Question: Alkalinization of urine is done in

Alkalinization of urine is done to treat acidic drug poisoning
Ex:- Aspirin, Barbiturates, Methotrexate, Penicillin.
Acidification of urine is done to treat basic drug poisoning
Ex: - Amphetamine, Morphine, Atropine, Quinine.


Question: Not used in treatment protocol of hodgkin's lymphoma

Ref: Katzungy 14th ed. pg. 970; Harrison, 17th ed. pg. 699Preferred regimen for Hodgkins and Non-hodgkins lymphomaHodgkins lymphoma (ABVD)Non-hodgkin's lymphomaA: Adriamycin (Doxorubicin)B: BleomycinV: VinblastinD: DacarbazineR: RituximabC: CyclophosphamideH: Hydroxdaunorubicin (doxorubicin)O: Oncovin (vincristine)P: Prednisolone


Question: Lactic acidosis is common in

(Phenformin) (247-KDT) (689-BB) (267-KDT 6th)* Lactic acidosis more common in Phenformin and rare in Metformin* * Hypoglycemia is the most common adverse effect with sulphonyl ureas.Repaglinide indicated only in type 2 DM as an alternative to sulfonyl ureas.* It should be avoided in liver diseaseRosiglitazone - Thiozolidinediones* It is indicated once daily in patients not controlled by metformin alone.* It is contraindicated by cardiac or hepatic failure.* Weight gain and oedema are the main adverse effects others - headache, myalgia and mild anaemia


Question: The characteristic toxicity of ethambutol is

Ethambutol It is selectively tuberculostatic. mechanism of action:- It has been found to inhibit arabinosyl transferases (encoded by embABgenes) involved in arabinogalactan synthesis thereby interfering with mycolic acid incorporation in mycobacterial cell wall. Ethambutol Resistance:- Develops slowly and is most commonly associated with mutation in embB gene, reducing the affinity of the target enzyme for Ethambutol. No cross resistance with any other antitubercular drug has been noted. pharmacokinetics:- About 3/4 of an oral dose of Ethambutol is absorbed.It is distributed widely, but penetrates meninges incompletely and is temporarily stored in RBCs. Less than 1/2 of E is metabolized. It is excreted in urine by glomerular filtration and tubular secretion; plasma t 1/2 is ~4 hrs. Caution isrequired in its use in patients with renal disease. side effects:- Loss of visual acuity/colour vision, field defects due to optic neuritis is the most impoant dose and duration of therapy dependent toxicity. Contraindication:- Young children & patients with optic neuritis. Ref:- kd tripathi; pg num:-769


Question: A patient is having bronchodilation, increased temperature, constipation and tachycardia. The tentative diagnosis is


Question: Drug of choice in pregnancy induced hypertension is


Question: Tetracyclines act by

Inhibiting the binding of aminoacyl tRNA to the ribosomal complex


Question: Ivermectin is a

Ivermectin is the drug of choice for Strongyloides and Onchocerca volvulus. It is a filaricide (effective against W. bancrofti and malayi).Ivermectin, a semisynthetic macrocyclic lactone, a mixture of avermectin B1a and B1b. It is derived from the soil actinomycete Streptomyces avermitilisIvermectin is used only orally in humans. The drug is rapidly absorbed, reaching maximum plasma concentrations 4 hours after a 12mg dose. Ivermectin appears to paralyze nematodes and ahropods by intensifying g-aminobutyric acid (GABA)-mediated transmission of signals in peripheral nervesReference: Katzung Pharmacology; 13th edition; Chapter 53; Clinical Pharmacology of the Antihelminthic Drugs


Question: Mechanism of action of Paclitaxel

(It enhance polymerization of tubulin) (774-KDT) (825-KDT 6th)Mechanism of actionA. Vinca-Alkaloids (Vincristine, Vinblastine) - These are mitotic inhibitors bind to microtubular protein- tubulin" prevent its polymerization and assembly of microtubules, causes disruption of mitotic spindle and interfere with cytoskeletal functions.B. Texanes (Paclitaxel, Docetaxel) - complex diterpintaxane. It enhances polymerization of tubulin cytotoxic action of Paclitaxel emphasizes the importance of tubulin-microtubule dynamic equilibrium.C. Epipodophvllotoxins (Etoposid) - plant glycoside, it is not mitotic inhibitor but arrest cells in the G2 phase and causes DNA breaks by affecting DNA topoisomerase II functionsD. Camptothecin analogues (Topotecan and Irinotecan). They act in a manner similar to etoposide, but interact with a different enzyme DNA topoisomerase I

Causes DNA breaks by affecting DNA topoisomerase II function

Cause DNA breaks by affecting DNA topoisomerase I


Question: Triamterene causes

Inhibitors of renal epithelial Na+ channel Include Triamterene and amiloride. Triamterene:- It is incompletely absorbed orally, paly bound to plasma proteins, largely metabolized in liver to an active metabolite and excreted in urine. Plasma t 1/2 is 4 hours, effect of a single dose lasts 6-8 hours. Side effects:- consist of nausea, dizziness, muscle cramps and rise in blood urea. Impaired glucose tolerance and photosensitivity are repoed, but urate level is not increased. Ref:- kd tripathi; pg num:-590


Question: Antihypeensive drug that causes coombs test positive is

Refer kDT 6/e p547 Methyldopa is known to cause the production of autoantibodies against red blood cells (RBCs), leading to apositive direct antiglobulin test (DAT) and hemolytic anemia. ... Her mother had the history of taking methyldopain her pregnancy.


Question: Absolute contraindication to thrombolytic therapy is

Ans. b (History of hemorrhagic stroke in past one year). (Ref. Harrison's Medicine - 18th/Table 370-1).Thrombolytic therapyIndicationContraindicationClinical diagnosis of strokeOnset of symptoms to time of drug administration 3 hCT scan showing no hemorrhage or edema of >1/3 of the MCA territoryAge 18 yearsConsent by patient or surrogateSustained BP >185/110 mm Hg despite treatmentPlatelets <100,000; HCT <25%; glucose <50 or >400 mg/dLUse of heparin within 48 h and prolonged PTT, or elevated INRRapidly improving symptomsPrior stroke or head injury within 3 months; prior intracranial hemorrhageMajor surgery in preceding 14 daysMinor stroke symptomsGastrointestinal bleeding in preceding 21 daysRecent myocardial infarctionComa or stupor


Question: Treatment for scabies is


Question: A patient with normal renal function has received a daily maintenance dose of digoxin for 2 weeks, if the dosage is changed, the new steady state plasma digoxin concentration would be achieved in approximately

The time required to establish a new steady-state plasma drug concentration when maintenance doses are changed is approximately four half-lives, the same amount of time required to establish the initial steadystate level. Because the half-life of digoxin is approximately 1.6 days, the time required to reach a new steady state is approximately 7 days. Digitoxin has a much longer half-life of approximately 7 days and the time required to reach steady state with digitoxin is approximately 4 weeks. The time required to reach steady state is independent of dose or dosage interval


Question: Drug of choice for treatment of chronic myeloid leukemia is

Imatinib - first line drug for chronic phase CML,in blast crisis and second line therapy for chronic phase CML that has progressed on prior IFN-a therapy Imatinib is also first line drug for metastatic c-kit positive GIST. Nilotinib, Bosutinib, Dasatinib - used in treatment of resistant CML Dasatinib is also used for treatment of Philadelphia chromosome positive ALL. Sunitinib-approved for the treatment of Advanced RCC and for the treatment of GIST after disease progression on or with intolerance to Imatinib. Methotrexate- DOC of choriocarcinoma Cisplatin - DOC- esophageal or gastric cancer Tamoxifen - DOC for ER positive breast cancer

Targeted Anticancer Drugs and Immunosuppressants


Question: Immediate treatment of hypercalcemia of malignancy is

Drug of choice for hypercalcemia of malignancy is Bisphosphanates but immediate treatment involves administration of IV fluids.


Question: Anti CD25 antibody among the following is

IL-2 receptor antagonist The CD-25 molecule is expressed on the surface of immunologically activated, but not resting T-cells. It acts as a high affinity receptor for IL-2 through which cell proliferation and differentiation are promoted. Some anti CD-25 antibodies have been developed as IL-2 receptor antagonist to specifically arrest the activated T-cells. 1)Daclizumab It is a highly humanized chimeric monoclonal anti CD-25 antibody which binds to and acts as IL-2 receptor antagonist. Combined with glucocoicoids, calcineurin antagonists and/or azathioprine/MMF, it is used to prevent renal and other transplant rejection reaction. The plasma t 1/2 of daclizumab is long (3 weeks), and it has also been used in combination regimens for maintenance of graft. 2)Basiliximab This is another anti CD-25 antibody with higher affinity for the IL-2 receptor, but shoer plasma t 1/2 (1 week). Ref:- kd tripathi; pg num:-884


Question: Pharmacodynamics include

Pharmacodynamics- the study of drug actions in the body and mechanism of action drug actions- therapeutic effects and adverse effects pharmacokinetics- ADME- absorption, distribution, metabolism and excretion ref KD Tripathi 8th ed


Question: Shoest acting non depolarising muscle relaxant

Refer Miller's anesthesia 5/e p 892 Among the given options Rapacuronium IA the shoest acting drug Rapacuronium has been withdrawn from the market because it produces intense bronchospasm in a significant number of patients Mivacurium is shoest acting NDMR


Question: Simple paial seizures DOC


Question: The biochemical mechanism of action of digitalis is associated with

Digitalis medicines strengthen the force of the heabeat by increasing the amount of calcium in the hea's cells. (Calcium stimulates the heabeat.) ... Digitalismedicines control irregular hea rhythms (called arrhythmias) by slowing the signals that sta in the sinoatrial (SA) node. Refer katzung 11e p 214

An increase in conduction from Atrium to ventricle

An increase in systolic intracellular calcium levels


Question: If a thiazide diuretic is administered for hypeension, the response seen within 24 hrs on excretion of different electrolytes is

Excretory and Renal Hemodynamic Effects of Diuretics: Na+ K+ H+ Ca2+ Mg2+ Cl- HCO3- Carbonic anhydrase inhibitors | || I NC V | || Osmotic diuretics || | I | || | | Loop Diuretics || || | || || || | Thiazides | || | | | | | Epithelial sodium channels blockers | | | | | | | Aldosterone antagonists | | | I | | | |: INCREASE, |: DECREASE, NC: No change, V: Variable change. I: Insufficient data Do not get confused by the term 'within 24 hours' in the question. These are the acute effects of diuretics and these may be modified later by the compensatory responses of the body.


Question: Local anaesthetic causing malignant hypehermia is

Lignocaine by releasing calcium from sarcoplasmic retinaculum can cause malignant hypehermia in susceptible individuals.


Question: Ticagrelor is used

Ticagrelor is a platelet agreggaion inhibitor, used for the prevention of thrombotic events in people with an acute coronary syndrome or myocardial infarction with ST elevation. other drus in this group include cangrelor pasugrel . The drug is combined with acetylsalicylic acid Ref: KD T ripathi 8th ed.


Question: Mexiletine is an oral active congner of

Ans. is'b'i.e., LidocaineRef: Clinical pharmacology 3'd/e p. 501; KDT Vhle p. 531Mexiletine is an orally active congener of lidocaine.It is a local anaesthetic and an orally active antiarrhythmic; chemically and pharmacologically similar to lidocaine.


Question: Drug used in hepatitis B infection is

Ans. is 'a' i.e., Entecavir Treatment of acute hepatitis Hepatitis B - No treatment is required. Hepatitis C - Pegylated Interferon (PEG - IFN). Treatment of chronic hepatitis Hepatitis B - Lamivudin, entecavir (preferred) or interferon. Hepatitis C - Pegylated Interferon (PEG - IFN), entecavir plus ribavirin.


Question: Nitrous oxide contraindicated on patients with pnumothorax, pneumopericrdium or intestinal obstruction, because it

Refer Goodman Gilman 12/e p 547 N2O use is contraindicated in pneumothorax and volvulus because it may lead to development of High pressure in the closed cavities in the body

Depressess an already compromised myocarium

Causes the expansion of air filled body cavities


Question: BAL is contraindicated in

BAL or Dimercaprol is a chelating agent used to treat poisoning by Arsenic, Lead, Mercury and Gold.
It is contraindicated in Iron & Cadmium poisoning.


Question: Lovastatin causes

Ans. is 'a' and 'c' i.e., Increased LDL receptor and Decreased LDL cholesterol Statins -Mechanism of action -Decrease the synthesis of cholesterol by inhibition of rate limiting enzyme HMG CoA. reductase.Effect on lipids Decrease in lipids Decrease Triglycerides Increase HDLStatins decrease synthesis of cholesterol by liver (inhibition of HMG CoA reductase). This leads to compensatory increase in LDL receptor expression on liver cells.Increased LDL receptor causes increase uptake and catabolism of IDL and LDL. This reduces LDL and IDL concentration.Other important points about statinsStatins are administered at bed time to obtain maximum effectiveness.Simvastatin is more potent than lovastatinSimvastatin has extensive first pass metabolismPravastatin causes decrease in fibrinogen level.Statins cause myopathy and lens opacity


Question: A methotrexate intolerant psoriasis patient has been prescribed an alternate disease modifying drug (DMARD) that resulted in liver dysfunction combined with skin rashes and bone marrow suppression of RBC's & platelets. The most probable drug is

Answer: b) Leflunomide* Abatacept is associated with infections due to inhibition of normal T-cell activity.* Sulfasalazine causes agranulocytosis and hepatitis along with rashes.* Leflunomide causes skin rashes and bone marrow suppression of RBC's & platelets.* Anakinra therapy may lead to neutropenia but not bone marrow suppression.


Question: Lubipristone is a

Lubipristone is a chloride channel activator used in treatment of IBS (Irritable bowel syndrome) with constipation.


Question: Anticoagulant of choice in pregnancy

Ref: KD Tripathi, 6th ed. pg. 597* Heparin is a powerful and instantaneously acting anticoagulant, effective both in vivo and in vitro.* It acts indirectly by activating plasma antithrombin III* The heparin -AT III complex then binds to clotting factors of the intrinsic and common pathways (Xa, IIa, IXa, XIa, XIIa and XIIIa) and inactivates them.* Heparin is the anticoagulant of choice in pregnancy* Warfarin on the other hand is effective only in vivo (body). It acts by inhibiting vitamin K.Heparin is monitored by aPTTLow molecular heparin inhibits factor Xa only. It does not require monitoring because of consistent bioavailability.Antidote for heparin overdose: Protamine Sulfate.Warfarin monitoring is done by: INRAntidote of warfarin overdose: Vitamin K.TOC for warfarin induced bleeding: FFP


Question: High plasma protein binding of a drug results in

* Most drugs bind to plasma proteins in a reversible fashion without translating into a pharmacological response. (Plasma proteins are hence called Silent Receptors) * Acidic drugs bind to Albumin, Basic drugs to alpha1 acid- glycoprotein. * Binding of the drug to plasma protein affects the pharmacokinetic handling of drug by the body. Ref:- HL & KK Sharma's Principles of Pharmacology 3rd Ed; Pg Num:- 48


Question: Increasing the concentration of norepinephrine in adrenergic synapses leads to

Classification:- Adrenergic receptors are classified into two types a and b. The a receptors were demonstrated to be present prejunctionally as well. To differentiate these release inhibitory prejunctional a receptors, a subdivision into a1 and a2 was suggested. b receptors were fuher subdivided into b1, b2, beta 3subtypes. Alpha2 receptor is located prejunctionally and inhibits the release of neurotransmitter. Ref:- kd tripathi; pg num:-126,127

Activation of presynaptic Gi (C) coupled receptors


Question: A patient present to emergency with pinpoint Pupil,salivation, lacrimation, tremors and red tears. Plasma chlolinesterase level was 30% of normal. Most probable diagnosis is

These are characteristic features of anti-cholinestearse(organophosphate and carbamate) poisoning. Features of Organophosphate poisoning: Muscarinic symptoms: Pin point pupil, salivation,lacrimation, urination, defecation, gastrointestinal distress, vomiting, bronchospasm, bradycardia Nicotinic symptoms: Fasciculations and fibrillations of muscle, tachycardia, tachypnea CNS symptoms: Temors, giddiness, ataxia, coma Red tears: Due to accumulation of porphyrin in the lacrimal glands Ref-Katzung 12/e p110


Question: The antiretroviral drug most commonly associated with nephrolithiasis is

Side effects of Indinavir- Nephrolithiasis, indirect hyperbilirubinemia, hyperglycemia, fat redistribution, lipid abnormalities. Ref: Sharma and Sharma , Chapter 62 pg : 809


Question: Efavirenz is used for treatment of HIV infections. It acts

By inhibiting the HIV entry into the cell


Question: Drug resistance transmitting factor present in bacteria

Ref KDT 6/e p671 Plasmids contain extra chromosomal DNA that help in transforming the gene responsible for multiple drug resistance among bacteria These are therefore involved in horizontal transfer not resistance


Question: Belimumab is used in

Belimumab is a monoclonal antibody against B - cell activating factor ( BAFF ) and is thus useful in decreasing autoimmune response in Systemic lupus erythematous .


Question: Drug of Choice for Digoxin induced Ventricular Tachycardia

* Lignocaine is the drug of choice for Digoxin induced Ventricular Tachycardia. * Digoxin, a cardiac glycoside - used in treatment of hea failure and in control of ventricular rate in atrial fibrillation/flutter. * It has low margin of safety and high toxicity index. (Therapeutic Index: 1.5-3). * About 25% of patients on Digoxin therapy develop toxicity features. * Digoxin toxicity can induce almost any cardiac dysrrhythmia except rapidly conducted atrial arrhythmias like atrial flutter and atrial fibrillation. Mobitz type II AV block is also a rare phenomenon in digoxin toxicity. Second-degree AV block (Type 2) is usually caused by structural damage to the distal conduction system located in the ventricular poion of the myocardium- linked to an infarction/idiopathic Fibrosis/cardiac surgery/ infections/ inflammations/ auto-immune disease. * Digoxin- specific Fab antibody is a specific antidote for Digoxin Overdosage. (~40mg of Fab = 1mg Digoxin ). Ref:- KD Tripathi Essentials of Medical Pharmacology 8th Ed; Pg num:- 560


Question: SERM drug used in treatment of osteoporosis aEUR'

Raloxifene Traditionally hormone replacement therapy with estrogen was being used to prevent/treat osteoporosis in postmenopausal worsen. H has been shown to reduce the risk of osteoporosis in women. But long term use of estrogen leads to range of adverse effect including cardiovascular disease, stroke, pulmonary emboli and invasive breast cancer. These serious adverse effect made to look for other options. Selective estrogen receptor modulators These are class of compounds that act on estrogen receptors. Their characteristic feature is that they do not have pure agonist or antagonistic action on estrogen receptors. - Their selective action distinguishes these substances .from pure receptor agonist or antagonist. - SERMS are "selective" that means SERMS block estrogen in some tissues and activate estrogen action in others. - All the SERMS bind to the estrogen receptor but each agent produces a unique receptor drug conformation. - As a result specific coactivator or co-oppressor proteins are bound to the receptor resulting in differential effects. Two SERMS are currently being used Raloxifens For the t/t and prevention of osteoporosis Tamoxifen --> For the t/t and prevention of Breast Ca The .first SERM to reach the market was Tamoxifen which blocks the stimulative effect of estrogen on breast tissue and is used in breast cancer. Raloxifene is the second SERM to be approved by the FDA. Raloxifens has been approved for the tit and prevention of osteoporosis in postmenopausal women. Raloxifens acts like estrogen on bone and helps to build and maintain bone density. - Raloxifen has been shown in clinical trials to increase bone density in the spine and hip and to reduce the risk of spinal fractures in women with osteoporosis. While it acts like estrogen on bone, it blocks the action of estrogen on breast and uterus. - This profile makes it very useful for the t/t of osteoporosis because Raloxifene provides the bone benefits of estrogen without increasing the risk for estrogen related breast and uterine cancers. Raloxifene in Breast cancer Due to its antiestrogenic effect on breast, Raloxifene has been shown to reduce the risk of invasive breast cancer in women who are taking it for osteoporosis. Raloxifene reduces the risk of breast cancer by 50-70% in both low risk and high risk postmenopausal women. The national cancer institute U.S.A. funded the STUDY OF TAMOXIFEN AND RALOXIFEN (STAR) a clinical trial comparing raloxtfens with tamoxifen in preventing breast cancer, in postmenopausal women who are at increased risk of developing the disease. The study found that tamoxifen and Raloxifen are equally effective in reducing invasive breast cancer risk in postmenopausal women who are at increased risk of the disease. The study also .found out that women who took raloxifen had fewer uterine cancer and.fewer blood clots than women who took tamoxifen. However, Raloxifen did not decrease the risk of noninvasive breast Ca. On September 14 2007, the US. food and drug administration announced approval of raloxifens for reducing the risk of invasive breast cancer in postmenopausal women with osteoporosis and in postmenopausal women at high risk for invasive cancer.


Question: The anticoagulant of choice in pregnancy is

(Heparin) (562-KDT) (598-KDT6th)HEPARIN - is the anticoagulant of choice during pregnancy because it does not cross BBB or placentaAdverse effects1. Bleeding due to overdoses is the most serious complications2. Thrombocytopenia is another common problem3. Transient and reversible alopecia is infrequent4. Osteoporosis5. Hypersensitivity reactionsCONTRAINDICATIONS1. Bleeding disorders, thrombocytopenia2. Severe hypertension (risk of cerebral haemorrhage) threatened abortion, piles, GI ulcers (aggrevated bleeding)3. SABE, large malignancies, Tuberculosis (hemoptesis)4. Ocular and neuro-surgery, lumber puncture5. Chronic alcoholics, cirrhosis, renal failure6. Aspirin and other antiplatelet drugs, should be used very cautiously during heparin therapy


Question: Etanercept is a biological disease modifying agent used in the management of rheumatoid ahritis. its mechanism of action is

TNF alpha blocking drugs are used in Rheumatoid ahritis and crohn's disease. these include adalimumab ceolizumab etanercept infliximab golimumab Refer kDT 6/e 883


Question: Colour of oxygen cylinder is

Refer anesthetic equipments and procedures, Practical Approach /p 37,38. The color of a medical oxygen xylinder6 is a black body with a white shoulder


Question: Drug of choice in nocturnal enuresis is

(Imipramine) (449-KDT 6th)Enuresis - In children above 5years, imipramine at bed time is effective, but bed wetting may again start when the drug is stopped* Elderely subjects with bed wetting have also benefittcd* Imipramine is most likely and nortriptyline is least likely to cause orthostatic hypotension (145-LP3rd)


Question: Lorazepam is preferred over Diazepam in treatment of status epilepticus as

It has more sustained action because of lower lipid solubility & slower distribution


Question: Nitroglycerine exes beneficial effect in classical angina pectoris primarily by

nitrates are vasodilators mainly acting on the veins only. hence they are venous dilators therefore decrease the preload on the hea where as aerial dilators like hydralazine decrease the after load. Ref: KD Tripathi 8th ed.


Question: Drug causing hirsuitism and gynaecomastia


Question: Selegiline is

(B) MAO-B inhibitor # Selegiline is a MAO-B inhibitor.> MAO exist in forms MAO-A & MAO-B.> MAO-A predominates in peripheral adrenergic structures & intestinal mucosa.> MAO-B predominates in brain & Blood platelets. Selegline, along c- levodopa, prolongs its action, & wearing-off effect.> Based on the theory that oxidation of DA or toxin MPTP in the striatum by MAO to free radicals is cause for parkinsonism early therapy c- selegiline night delay progression of disorders.> Non selective MAO inhibitors include: Phenelzinec/lsocarboxazide/Tranylcypromine.> Selective MAO-A are: Clorgiline/ Moclobemidee> Selective MAO-B are: Selegiline (Deprenyl), Rasagline, Periphery, BLood brain barrier


Question: Drug of choice for cerebral malaria due to Pl.falciparum is

Resistance has been developed for chloroquine for P. falciparum due to mutations in chloroquine transpoer gene, Quinine is the mainstay of treatment for cerebral and other forms of complicated malaria, through some resistance is repoed, in such cases aemisnin compounds are used. Quinine 20mg/kd loading dosein 5%dextrose infusion over 4 hrsRef: HL Sharma 3rd ed Pg:830


Question: Drug frequently associated with the development of noninfectious chronic meningitis is

Answer: a) IbuprofenDrugs associated with noninfectious chronic meningitis: NSAIDs (mc-ibuprofen), sulfonamides, isoniazid, tolmetin, ciprofloxacin, penicillin, carbamazaepine, lamotrigine, IV immunoglobulin, OKT3 antibodies, phenazopyridine