MBBS 2nd PROF

PHARMACOLOGY
Sample Paper: PAPER-A, BFUHS
TIME:3 Hours Max Marks: 100

Q1. Multiple Choice Questions, Use OMR sheet to answer, 1x20=20, Time for MCQs-30 min

1. Various pharmacokinetic concepts help to select a drug and formulate dosage schedule of
drugs. Which of the following concept best describes the selection of thiopental as
induction agent in general anaesthesia?
A. Bioavailability
B. Redistribution
C. Plasma half-life
D. Clearance
2. A clinical pharmacologist wants to determine the loading dose of a drug given intravenously
and with a long plasma half-life to obtain a certain target steady state plasma concentration
(Css). What is the other important parameter needed for the estimation?
A. Clearance (CL)
B. Area under curve (AUC)
C. Volume of distribution (Vd)
D. Elimination rate constant (Kel)
3. A young man had high grade fever with rigors & chills and his peripheral blood film
confirmed plasmodium vivax malaria. He was prescribed chloroquine & primaquine. Later
on, he presented with jaundice and was found to have hemolytic anaemia. Which of the
following is the most likely cause?
A. N-acetyl transferase 2 polymorphism
B. Dehydro-pyrimidine dehydrogenase deficiency
C. CYP2D6 abnormality
D. G6PD deficiency
4. Long-term use of beta-adrenergic agonists in bronchial asthma can decrease their
usefulness. Which of the following term best describes the decreased effects of long-term
use of beta-adrenergic agonists in bronchial asthma?
A. Pharmacokinetic tolerance
B. Pharmacodynamic tolerance
C. Tachyphylaxis
D. Cumulation
5. A female was using oral contraceptives successfully for last 2 years. She got tuberculosis
and was prescribed antituberculosis regimen including rifampicin. She became pregnant
after 2 months of starting rifampicin. Which of the following can be the reason for this?
A. Induction of oral contraceptive metabolism by Rifampicin
B. Stimulation of ovulation by rifampicin
C. Interruption of enterohepatic circulation by rifampicin
D. Increased excretion of oral contraceptives by rifampicin
6. A patient of schizophrenia, treated for psychotic symptoms with an antipsychotic drug
develops muscle rigidity and bradykinesia (EPS). Which one of the following drugs would
you prescribe to control his EPS?
A. Bromocriptine
B. Diazepam
 C. Propranolol
D. Trihexyphenidyl
7. A 36-year female, a known case of epilepsy on valproate therapy since last 3 years, gives
birth to a baby with spina bifida. Name the type of adverse effect in this case?
A. Iatrogenic
B. Teratogenic
C. Mutagenic
D. Pharmacogenetic
8. A 27-year man Raj Kumar who “hears voices” at times complains of fever and chills. His
body temperature is 102oF (38.9o C) with no findings of infection. His white blood cell
count is 800 cells/mm3. Which of the following medications is most likely responsible for
this condition?
A. Risperidone
B. Clozapine
C. Haloperidol
D. Thioridazine
9. A 65-year male presented to a hospital with focal seizures. His renal function was normal.
Which of the following is the drug of choice for this patient?
A. Valproate
B. Pregabalin
C. Levetiracetam
D. Oxcarbazepine
10. A 35 years male with fracture of leg prescribed muscle relaxants so that the fracture could
be set. He was administered a competitive nicotinic receptor antagonist. Which of the
following would be a preferred drug to reverse neuromuscular blockade after orthopaedic
procedure?

A. Physostigmine
B. Neostigmine
C. Carbachol
D. Succinylcholine
11. A 30-year man from nearby village is bought to the emergency department in an
unconscious state. There is history of domestic problems. Patient’s clothes are wet and are
soiled with urine and faeces. On examination, frothy secretion present in the mouth, pupil
are constricted both side, BP= 80/60 mmHg, ECG showed bradycardia (HR 52 beats/min).
Which of the following is the most likely drug poisoning?
A. Organophosphorus compound (OPC)
B. Atropine
C. Opioids
D. Benzodiazepine
12. Five friends, each treated with a different drug for an underlying condition, go to a red wine
and cheese party. Which one is most likely to come away with a severe pounding headache
and tachycardia?
A. Taking prazosin for benign prostrate hypertrophy
B. Taking clorgiline for depression
C. Taking benztropine Parkinson’s disease
D. Taking propranolol for angina
13. A 6-year child has to undergo fundus examination and needs a drug that causes mydriasis
and cycloplegia. Which one of the following drug is most suited for this purpose?
A. Phenylephrine
B. Carbachol
C. Prazosin
D. Atropine
14. A 45-year female is diagnosed with trigeminal neuralgia and prescribed carbamazepine.
Which of the following is the mechanism of action of carbamazepine in this disorder?
A. It inhibits cyclooxygenase
B. Acts on opioids receptors
C. Has membrane stabilising action
D. It is GABA agonist
15. A 50-year male presents in emergency with renal and hepatic insufficiency. Which of the
following muscle relaxant is the best choice in the given scenario?
A. Rocuronium
B. Pipecuronium
C. Mivacurium
D. Atracurium
16. An 11-year boy with Bronchial Asthma, wakes up during night with difficulty in breathing.
Which of the following is most appropriate pharmacological agent to use, which has a rapid
onset of action and will provide quick relief of his problem?
A. Salbutamol
B. Omalizumab
C. Fluticasone
D. Ipratropium
17. A 60-year former smoker with cardiac disease and severe chronic obstructive pulmonary
disease (COPD) associated with frequent episode of bronchospasm. Which of the following
is a bronchodilator useful in COPD and least likely to cause cardiac arrhythmias?
A. Aminophylline
B. Ipratropium
C. Salmeterol
D. Adrenaline
18. A 45-year male patient presented with an episode of acute gout. He was treated with a 10-
day course of naproxen. His blood uric acid level is 8g%. Which of the following future
line of treatment is most appropriate?
A. Regular long-term treatment with naproxen
B. Regular long-term treatment with allopurinol
C. Start with prednisolone and continue naproxen for the next two weeks.
D. Start allopurinol and continue naproxen for the next two weeks.
19. A 28-year female presented to the hospital with abdominal pain. She was prescribed
drotaverine. Which one of the following explains the mechanism of action of drotaverine?
A. Antagonist action at M2 receptors.
B. Antagonist action on 5 HT3 receptors and agonist action on 5 HT4 receptors.
C. Antagonist action on D2 receptors
D. Inhibition of Phosphodiesterase-4
20. A 24-year-old female patient presents in labour room in first stage of labour. Labour is
progressing well and there is no indication for caesarean section, but patient insists on
painless delivery. Which of the following is most suitable approach for this case?
A. Spinal anaesthesia
B. General anaesthesia
C. Epidural anaesthesia
D. Infiltration anaesthesia

Q 2. Long essay question 2+5+5=12

Define biotransformation of drugs. Describe phase 1 and phase 2 reactions of
biotransformation with suitable examples.

Q 3. Short answers: 5x4=20

a) Pre-anaesthetic medication: Enumerate objectives and describe drugs used in it
b) Comment on current status of COX-2 (cyclooxygenase) inhibitors as analgesics
c) Enumerate atropine substitutes and describe their therapeutic uses
d) Describe therapeutic uses and adverse effects of SSRIs (selective serotonin reuptake
inhibitors).

Q 4. Explain why: 3x5=15

a. Benzodiazepines are preferred over barbiturates as sedatives/hypnotics
b. Tamsulosin is used in benign prostatic hypertrophy
c. Adrenaline is drug of choice in anaphylactic shock
d. Therapeutic drug monitoring needed for some drugs
e. Dantrolene sodium is used in neuroleptic malignant hyperthermia

Q 5 Short answers (applied aspects): 6x3=18

a) Describe management of status asthmaticus
b) Enumerate complications of spinal anaesthesia & describe their management
c) Describe drug tolerance and its clinical significance

Q 6 Short answers: 5x3=15

a) Enumerate prostaglandin analogues and describe their therapeutic uses.
b) Describe therapeutic uses of beta-adrenergic blockers
c) Define autonomy. Explain Conflict between autonomy and beneficence