Important Pharmacology MCQ for NORCET 2021

Q 1. Suresh presents to emergency with pinpoint pupil, salivation, lacrimation, tremors and red tears. Plasma cholinesterase level was 30% of normal. Most probable Diagnosis is:

  1.  Dhatura poisoning
  2.  Organophospahte poisoning
  3. Opioid poisoning
  4. Pontine hemorrhage
  • Ans. (2) Organophospahte poisoning these are characteristic features of anti-cholinestearse (organophosphate and carbamate) poisoning

Q 2.  A patient came to the casualty with acute bronchial asthma after treatment for glaucoma. The probable drug may be:

  1.   Anticholinesterase
  2.   Betaxolol
  3.   Latanoprost
  4.  Timolol
  •   Ans. (4) Timolol

Q. 3. A patient presented in emergency with tachycardia, hyperthermia, bronchial dilatation and constipation. The person is likely to be suffering from overdose of:

  1.   Atropine
  2.  Organophosphorus compound
  3.  Paracetamol
  4.   Mushroom
  •  Ans (1) Atropine These are the characteristic features of anti-cholinergic overdose.

Q 4. A drug ‘Z’ belongs to the anticholinergic drug group. It is primarily used in pre anesthetic medication and also during surgery. Which of the following can be ‘Z’?

  1.  Glycopyrrolate
  2. Pipenzolate methyl bromide
  3.  Dicyclomine
  4.  Isopropamide
  •     Ans. (1) Glycopyrrolate

 
Q 5. A patient, pawan came to the emergency after receiving penicillin injection. He was diagnosed to have anaphylactic shock. Which of the following is the only life saving measure to treat him?

  1.  Intravenous adrenaline hydrochloride
  2.  Intravenous hydrocortisone hemisuccinate
  3.   Intramuscular adrenaline hydrochloride
  4.    Intravenous glucose saline
  •  Ans. (3) Intra-muscular adrenaline hydrochloride.

Q 6. In cardiogenic shock, Dopamine is used at the following dose rate:

  1.  <1 – 2 mg/kg/min
  2.   1 – 2 mg/kg/min
  3.   Greater than 10 mg/kg/min
  4.    2 – 10 mg/kg/min
  •  Ans. (3) Greater than 10 mg/kg/min

Q. 7. A 32 years old patient Gaurav with history of asthma is being treated for symptoms of hypertension. Which of the following beta blocker would be an appropriate therapy for this patient?

  1. Labetalol
  2.  Isoprenaline
  3.  Metoprolol
  4.  Propanolol
  •  Ans. (3) Metoprolol

Q 8. Digoxin toxicity is increased by all except:

  1. Renal impairment
  2.  Hyperkalemia
  3.   Hypomagnesemia
  4.  Hypercalcemia
  • Ans. (2) Hyperkalemia

Q. 9. Digoxin toxicity is aggravated by:

  1.  Hypokalemia
  2. Hypermagnesemia
  3.  Hypercalcemia
  4. Hyperkalemia
  5. Hypocalcemia
  •  Ans. (1) Hypokalemia; (3) Hypercalcemia

Q 10. A 60-year old Bholu hypertensive patient on angiotensin II receptor antagonist (losartan) is posed for hernia repair surgery. The antihypertensive drug should be:

  1. Continued till the day of operation
  2.  Discontinued one week preoperatively
  3. Discontinued 24 hrs preoperatively
  4.  Administered in an increased dosage on the day of operation
  •  Ans. (1) Continued till the day of operation
  • Before surgery, antihypertensive drugs should be continued till the day of surgery.

Q 11. An elderly hypertensive Jitendra has diabetes mellitus and bilateral renal artery stenosis. The best management is:

  1.  Enalapril
  2. Thiazides
  3. Beta blockers
  4. Verapamil
  •  Ans. (4) Verapamil

Q 12. Which of the following drugs is used in severe hypertensive emergencies, is very short acting and must be given by i.v. infusion?

  1.  Diazoxide
  2. Labetalol
  3.  Hydralazine
  4. Nitroprusside
  •    Ans. (4) Nitroprusside

Q 13. Nitin is working as a CEO in a company. He has a traveling job. He is a known diabetic controlled on oral hypoglycemic drugs. On his recent visit to the doctor, his blood pressure was found to be 164/102 mm Hg. Most suitable drug for this patient should be?

  1.  Clonidine
  2. Enalapril
  3.  Propanolol
  4. Hydrochlorthiazide
  •  Ans. (2) Enalapril

Q 14. Bhawani was presented to causality in an unconscious state. His blood pressure was found to be 220/110 mm Hg. Most suitable drug for this patient to rapidly decrease the blood pressure is:

  1.  Intravenous injection of clonidine
  2. Intramuscular injection of hydralazine
  3. Intravenous infusion of sodium nitroprusside
  4. Sublingual nifedipine
  •  Ans. (3) Intravenous infusion of sodium nitroprusside

Q 15. Organic nitrates can lead to the development of tolerance when used chronically. Which of the following preparations is least likely to develop tolerance?

  1. Sustained release oral nitroglycerine
  2. Sublingual nitroglycerine
  3. Transdermal nitroglycerine
  4. Oral pentaerythritol tetranitrate
  •  Ans. (b) Sublingual nitroglycerine

Q 16. A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use nitroglycerine. Which route of administration would be most suitable?

  1. Oral
  2. Sublingual
  3. Intravenous bolus injection
  4. Slow intravenous infusion
  • Ans. (4) slow i.v. infusion Nitrates can be used in acute LVF by slow i.v. infusion.

Q. 17. Ravinder singh developed acute CHF and was put on digitalis therapy. ECG of this patient revealed the presence of ventricular extrasystoles. Which of the following drugs can be administered safely to this patient in order to counteract this arrhythmia?

  1.  Lignocaine
  2. Quinidine
  3.  Atropine
  4. Amiodarone
  • Ans. (a) Lignocaine

Q 18.   In patient of head injuries with rapidly increasing intracranial tension without haematoma, the drug of choice for initial management would be:

  1.  Furosemide
  2.  Steroids
  3. 20% Mannitol
  4. Glycine
  • Ans. (3) 20% mannitolMannitol is an osmotic diuretic indicated for cerebral edema and glaucoma. It is contra-indicated in active bleeding in the brain

Q. 19. A 51-year-old man has a history of frequent episodes of renal colic with high calcium renal stones. The most useful diuretic in the treatment of recurrent calcium stones is:

  1. Spironolactone
  2. Furosemide
  3. Hydrochlorthiazide
  4.  Acetazolamide
  • Ans. (3) Hydrochlorthiazide Thiazides cause hypercalcemia by decreasing the renal excretion of Ca2+. These are useful in a patient having hypercalciurea. In such a patient, thiazides decrease the excretion of Ca2+ in the kidney and thus reduces the chances of stone formation.

Q  20. A 45-year-old male, Sangram Singh presented to the emergency with muscle weakness and cramping. He has been taking hydrochlorothiazide for recently diagnosed hypertension. Which of the following is the most likely cause of his symptoms?

  1.  Hypocalcemia
  2.  Hyponatremia
  3. Hypoglycemia
  4.  Hypokalemia
  • Ans. (4) Hypokalemia
  1. A decrease in the intravascular fluid volume stimulates aldosterone secretion and leads to increased excretion of potassium and hydrogen ions in the urine. This results in hypokalemic metabolic alkalosis, which is a common side effect of most diuretics other than the potassium- sparing class. Hypokalemia manifests with muscle weakness and cramping.

Q 21. Maximum dose of lignocaine given with adrenaline for infiltration anaesthesia is:

  1. 3 mg/kg
  2. 7 mg/kg
  3. 5 mg/kg
  4. 10 mg/kg
  • Ans. (2) 7mg/kg

Q 22.  A patient receives a toxic dose of lignocaine i.v., the patient is likely to exhibit:

  1. Excessive salivation 
  2.  Respiratory paralysis
  3.  Mydriasis and diarrhea
  4. Seizures and coma
  • Ans. (4) Seizures and coma

Q 23. Epinephrine added to a solution of lignocaine for a peripheral nerve block will:

  1.  Increase the duration of action of the local anesthetic
  2. Increase risk of convulsions
  3. Both (a) and (b)
  4. None of these
  • Ans. (1) Increase the duration of action of the local anaesthetic
  • Adrenaline is the vasoconstrictors that are added to LA solution.
  •  By causing vasoconstriction, these drugs
  • decrease the systemic absorption resulting in less CNS adverse effects (decreased chances of seizures).
  • Prolong the stay of drug at the site of action resulting in the increase in duration of action of LA.

Q. 24. Which of the following drugs has a high surface activity and vasoconstrictor actions that reduce bleeding in mucus membranes?

  1. Bupivacaine
  2. Cocaine
  3.  Procaine
  4.  Lidocaine
  • Ans. (2) Cocaine

Q. 25. Percentage of lignocaine used in spinal anesthesia is:

  1. 0.5%
  2. 2%
  3. 8%
  4. 5%
  • Ans. (4) 5%

Q 26. Adrenaline is added to lignocaine to prolong its effect and decrease its absorption into blood stream in a ratio of:

  1. 1:50,000
  2. 1:100,000
  3. 1:200,000
  4. 1:500,000
  • Ans. (3) 1:200,000

Q 27. A patient with ruptured spleen is taken for laparotomy. His blood pressure is 80/50 and heart rate is 125/min. Induction agent of choice for this patient is:

  1. Sodium Thiopentone
  2. Halothane
  3. Ketamine
  4. Fentanyl
  • Ans. (3) Ketamine
  • Ketamine increases all pressures (blood pressure, intracranial tension, intraocular pressure) in the body. It is therefore intravenous anaesthetic of choice for shock (increases blood pressure).

28. All the following statements regarding levodopa are correct EXCEPT:

  1. In Parkinsonism, phenothiazines reduce its efficacy
  2. It is a prodrug
  3.  Pyridoxine reduces effect of levodopa in Parkinsonism
  4. Domperidone blocks levodopa induced emesis and its therapeutic potential.
  • Ans. (4) Domperidone blocks levodopa induced emesis and its therapeutic potential

 
Q 29. A 30-year old epileptic female, Kamla on phenytoin therapy, developed weakness and fatigue. Blood examination revealed Hb = 4.6 gm. MCV = 102 fl and MCH = 40 pg/dl. What is the most probable diagnosis?

  1. Phenytoin induced agranulocytosis
  2.  Iron deficiency anemia
  3. Heart failure
  4. Megaloblastic anemia
  • Ans. (4) Megaloblastic anemia    Phenytoin can cause folic acid deficiency resulting in megaloblastic anemia. This is confirmed by raised MCV and MCH in the blood examination.

Q 30. Therapeutic level of phenytoin is:

  1. 1-9 mg/ml
  2. 10-19 mg/ml
  3. 20-29 mg/ml
  4. 30-39 mg/ml
  • Ans. (2) 10-19 μg/ml The theraputic level of phenytoin is 10-20 micro g/ml.

Q. 31. What is the drug of choice for Obsessive Compulsive Disorder?

  1.  Imipramine
  2. Fluoxetine
  3. Benzodiazepines
  4. Alprazolam
  • Ans. (2) Fluoxetine SSRIs are drug of choice for most of the neurotic disorders including OCD

Q 32.  An old woman, Nanda suffered stroke for which she was given alteplase. She improved considerably. To prevent the recurrence of stroke, this patient is most likely to be treated indefinitely with:

  1. Aspirin
  2. Warfarin
  3. Urokinase
  4. Enoxaparin
  • Ans-1 Aspirin Antiplatelet drugs like aspirin or clopidogrel are used to prevent arterial thrombosis (in diseases like MI and stroke).

Q. 33.True statements about heparin are all EXCEPT:

  1. It prolongs aPTT
  2. Hyperkalemia is not seen
  3.  It can result in alopecia
  4.  It can cause thrombocytopenia
  • Ans. (2) Hyperkalemia is not seen

Q 34. Thrombolytics can provide relative mortality reduction in the treatment of acute myocardial infarction, if patient comes within:

  1. 6 hours
  2. 12 hours
  3. 18 hours
  4. 24 hours
  • Ans. (2) 12 hours

Q 35. If a fibrinolytic drug is used for the treatment of acute myocardial infarction, the adverse effect most likely to occur is:

  1. Acute renal failure
  2. Development of antiplatelet antibodies
  3. Encephalitis secondary to liver dysfunction
  4. Hemorrhagic stroke
  • Ans. (4) Hemorrhagic stroke Bleeding is the most common adverse effect of anticoagulants, antiplatelets and fibrinolytic agents. This bleeding can manifest as hemorrhagic stroke..

Q. 36. A 54-year-old female who is taking propanolol for the management of a cardiovascular disease experiences an acute asthmatic attack. Which of the following drugs would you prescribe to attenuate this asthmatic attack?

  1. Cromolyn sodium
  2. Salbutamol
  3. Beclomethasone
  4.  Ipratropium bromide
  • Ans. (4) Ipratropium bromide

Q 37. All of the following drugs useful in bronchial asthma are bronchodilators EXCEPT:

  1. Theophylline
  2. Salmeterol
  3.  ketotifen
  4. Ipratropium
  • Ans. (3) ketotifen

Q. 38. A patient is taking famotidine, sucralfate and antacid tablets. This treatment is irrational because:

  1. Sucralfate increases the toxicity of famotidine
  2. Sucralfate decreases the absorption of famotidine
  3. Sucralfate decreases the absorption of antacids
  4. Sucralfate polymerizes only when gastric pH is less than 4
  • Ans. (4) Sucralfate polymerizes only when gastric pH is less than 4

Q 39. Which    of    the    following    laxatives    lowers    blood    ammonia    level    in    hepatic encephalopathy?

  1. Liquid paraffin
  2. Bisacodyl
  3. Lactulose
  4. Magnesium sulfate
  • Ans. (3) Lactulose Lactulose is degraded to lactic acid that converts NH3 to NH4 +. As ionic molecules cannot cross biological membranes, it is not absorbed and is thus excreted

Q 40. A 47-year-old male presents to OPD with diarrhea and abdominal pain. On investigations, it was found to be non-infective and you proceed with diphenoxylate therapy in this patient. Which of the following is the primary target for the drug you prescribed to this patient?

  1. Secretion
  2. Digestion
  3. Inflammation
  4. Motility
  • Ans. (4) Motility Diphenoxylate is an opioid; it binds to mu receptors in the GIT and slows motility.

Q 41.  A 14 year old girl with type 1 diabetes is brought to emergency complaining of dizziness. Laboratory findings include severe hyperglycemia, ketoacidosis and blood pH of 7.15. To achieve rapid control of severe ketoacidosis, appropriate drug is:
 

  1. Crystalline zinc insulin
  2. NPH insulin
  3. Tolbutamide
  4. Ultra lente insulin
  • Ans. (1) Crystalline zinc insulin
  • Diabetic ketoacidosis must be managed by fast acting insulin preparations like
  • Regular insulin [crystalline zinc insulin]
  • Insulin lispro
  • Insulin aspart

Q 42. A 53- year old obese patient with type 2 diabetes mellitus and a history of alcoholism probably should not receive metformin because it can increase the risk of:

  1. Disulfiram like reaction
  2. Hypoglycemia
  3. Lactic acidosis
  4. Severe hepatic toxicity
  • Ans. (3) Lactic acidosis

Q 43. Long term steroid therapy can lead to suppression of hypothalamic-pituitary-adrenal axis. It can be overcome by using alternate day therapy with corticosteroids. Which of the following steroids are unsuitable for alternate day therapy for such purpose?

  1. Prednisolone
  2. Cortisol
  3. Betamethasone
  4. Hydrocortisone.
  • Ans. (3) Betamethasone
  • Steroids with long half life like betamethasone and dexamethasone cannot be used for alternate day therapy because evenin alternate day therapy there will be sufficient blood levels of these steroids to cause suppression of HPA axis

Q 44. A 63-year-old female, Rajwanti presents to the emergency with acute severe low back pain after too quickly sitting down onto a chair. She has a history of rheumatoid arthritis and bronchial asthma. She reports that she was on many medications for several years. X-ray shows a fracture of the fifth lumbar vertebra. Which of the following drugs are likely responsible for the patient’s complaints?

  1. Methotrexate
  2. Prednisolone  
  3. Salbutamol
  4. Indomethacin
  • Ans. (2) Prednisolone Osteoporosis is a common cause of pathological vertebral fractures. Chronic systemic use of corticosteroids like prednisolone promotes osteoporosis and therefore may cause such fractures.

Q 45. ‘Hand and Foot’ syndrome can be caused by:

  1. Cisplatin
  2.  Vincristine
  3. Capecitabine
  4. Mitomycin-C
  • Ans. (3) Capecitabine 5-FU, capecitabine and liposomal doxorubicin can cause hand and foot syndrome. Generally, this disease affects infants and children. Adults with immunodeficiency can also be affected

Q 46. Phoolwati , A 55-year-old female with lymph-nodepositive breast cancer was treated with systemic chemotherapy. Four weeks later, she developed frequent urination, suprapubic pain, dysuria, and hematuria. Which of the following could have prevented this patient’s condition?

  1. Folinic acid
  2. Mesna
  3. Dexrazoxane
  4. Amifostine
  • Ans. (2) Mesna
  • The patient described in the question has hemorrhagic cystitis caused by drugs like cyclophosphamide and ifosfamide. Hemorrhagic cystitis during therapy with cyclophosphamide or ifosfamide is caused by the urinary excretion of the toxic metabolite acrolein. This can be prevented by aggressive hydration, bladder irrigation, and administration of mesna, a sulfhydryl compound that binds acrolein in the urine.

 
Q 47. Suresh, a young male was diagnosed as suffering from acute myeloid leukemia. He was started on induction chemotherapy with doxorubicin based regiments. Induction regimen was successful. Two months later, he presents to OPD with swelling of both the feet and breathlessness on climbing the stairs. He also complains the he had to wake up many times because of breathlessness. Which of the following is most likely responsible for this patient’s symptoms?

  1. Restrictive cardiomyopathy
  2. Hypertrophic cardiomyopathy
  3. Dilated cardiomyopathy
  4. Pericardial fibrosis
  • Ans. (3) Dilated cardiomyopathy

Q 48. Once weekly administration of which of the following antibiotics has prophylactic activity against bacteremia caused by M. avium complex in AIDS patients?

  1. Azithromycin
  2. Clarithromycin
  3. Isoniazid
  4.  Rifabutin
  • Ans. (1) Azithromycin

Q 49. A patient with AIDS and a CD4 cell count of 100/μl, has a persistent fever and a weight loss associated with invasive pulmonary disease due to M avium complex. Optimal management of this case requires:

  1. Select an antibiotic regimen based on drug susceptibility of the cultured organism
  2. Start treatment with isoniazid and rifampicin
  3. Treat the patient with clarithromycin, ethambutol and rifabutin
  4. Treat with trimethoprim sulfamethoxazole
  • Ans. (3) Treat the patient with clarithromycin, ethambutol and rifabutin
  • Mycobacterium avium complex infection is treated with combination of rifabutin, ethambutol and clarithromycin

 
Q 50.  A 26-year-old male, Vikas presents to OPD complaining of hair loss and itching on scalp. Physical examination reveals moderate patchy hair loss from the central portion of scalp and the lesions have ring like configuration with central clearing. Which of the following drugs can be used to treat this patient’s condition?

  1. Local glucocorticoids
  2. Progesterone
  3. Finasteride
  4. Terbinafine
  • Ans (4) Terbinafine
  • The diagnosis is Tinea capitis and terbinafine is used for the treatment. Male pattern baldness starts from anterior portion and scalp and are non-pruritic will family history. The treatment of latter is finasteride.
     

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