PROSTAGLANDINS (PGS) AND THEIR ANALOGUES

1. Natural PGs

a. PGE2 :

Dinoprostone

b. PGF:

Dinoprost

Gemeprost

c. PGE1 :

Alprostadil

d. PGI2 :

Prostacyclin

Epoprostenol

 

2. Prostaglandin Analogues

a. 15-methyl PGF:

Carboprost

b. Methyl–PGE1ester :         

Misoprostol

c. PGF analogue:

Latanoprost

Gastrointestinal Drugs MCQs

1. Histamine H2 blockers attenuate the gastric secretory response to acetylcholine and pentagastrin as well because:

A. H2 blockers block gastric mucosal cholinergic and gastrin receptors as well

B. H2 blockers inhibit the proton pump in gastric mucosa

C. Acetylcholine and gastrin act partly by releasing histamine in gastric mucosa

D. Histamine, acetylcholine and gastrin all act through the phospholipase C-IP3:DAG pathway in gastric mucosa

ANSWER: [  C   ]

2. For healing duodenal ulcer the usual duration of H2 blocker therapy is:

A. 4 weeks

B. 6 weeks

C. 8 weeks

D. 12 weeks

ANSWER: [  C   ]

3. What is true of acid control therapy with H2 blockers:

A. It generally heals duodenal ulcers faster than gastric ulcers

B. It checks bleeding in case of bleeding peptic ulcer

C. It prevents gastroesophageal reflux

D. Both ‘A’ and ‘B’ are correct

ANSWER: [  A   ]

4. In the intact animal H2  receptor antagonists potentiate the following action of histamine:

A. Cardiac stimulation

B. Fall in blood pressure

C. Uterine relaxation

D. Bronchospasm

ANSWER: [  D   ]

5. Gynaecomastia can occur as a side effect of:

A. Bromocriptine

B. Cimetidine

C. Famotidine

D. Levodopa

ANSWER: [  B   ]

6. Which histamine H2 blocker has most marked inhibitory effect on microsomal cytochrome P-450 enzyme:

A. Cimetidine

B. Ranitidine

C. Roxatidine

D. Famotidine

ANSWER: [  A   ]

7. Choose the correct statement about H2 receptor blockers:

A. They are the most efficacious drugs in inhibiting gastric acid secretion

B. They cause fastest healing of duodenal ulcers

C. They prevent stress ulcers in the stomach

D. They afford most prompt relief of ulcer pain

ANSWER: [  C   ]

8. Ranitidine differs from cimetidine in the following respect:

A. It is less potent

B. It is shorter acting

C. It does not have antiandrogenic action

D. It produces more CNS side effects

ANSWER: [  C   ]

9. Compared to H2 blockers, omeprazole affords the following:

A. Faster relief of ulcer pain

B. Faster healing of duodenal ulcer

C. Higher efficacy in healing reflux esophagitis

D. All of the above

ANSWER: [  D   ]

10. Choose the drug which blocks basal as well as stimulated gastric acid secretion without affecting cholinergic, histaminergic or gastrin receptors:

A. Famotidine

B. Loxatidine

C. Omeprazole

D. Pirenzepine

ANSWER: [  C   ]

11. Omeprazole exerts practically no other action except inhibition of gastric acid secretion because:

A. It transforms into the active cationic forms only in the acidic pH of the gastric juice

B. Its active forms have selective affinity for the H+K+ATPase located in the apical canaliculi of gastric parietal cells

C. Its cationic forms are unable to diffuse out from the gastric parietal cell  canaliculi

D. All of the above

ANSWER: [  C   ]

Drugs Affecting Blood MCQs

 

1. The percentage of elemental iron in hydrated ferrous sulfate is:

A. 5%

B. 10%

C. 20%

D. 33%

ANSWER: [  C  ]

 

2. Select the oral iron preparation which does not impart metallic taste and has good oral tolerability despite high iron content but whose efficacy in treating iron deficiency anaemia has been questioned:

A. Iron hydroxy polymaltose

B. Ferrous succinate

C. Ferrous fumarate

D. Ferrous gluconate

ANSWER: [  A  ]

 

3. The daily dose of elemental iron for maximal haemopoietic response in an anaemic adult is:

A. 30 mg

B. 100 mg

C. 200 mg

D. 500 mg

ANSWER: [  C  ]

 

4. The side effect which primarily limits acceptability of oral iron therapy is:

A. Epigastric pain and bowel upset

B. Black stools

C. Staining of teeth

D. Metallic taste

ANSWER: [  A  ]

 

5. Choose the correct statement about severity of side effects to oral iron medication:

A. Ferrous salts are better tolerated than ferric salts

B. Complex organic salts of iron are better tolerated than inorganic salts

C. Liquid preparations of iron are better tolerated than tablets

D. Tolerability depends on the quantity of elemental iron in the medication

ANSWER: [  D  ]

 

6. Absorption of oral iron preparations can be facilitated by coadministering:

A. Antacids

B. Tetracyclines

C. Phosphates

D. Ascorbic acid

ANSWER: [  D  ]

 

7. The gut controls the entry of ingested iron in the body by:

A. Regulating the availability of apoferritin which acts as the carrier of iron across the mucosal cell

B. Regulating the turnover of apoferritin-ferritin interconversion in the mucosal cell

C. Complexing excess iron to form ferritin which remains stored in the mucosal cell and is shed off

D. Regulating the number of transferrin receptors on the mucosal cell

ANSWER: [  C  ]

 

8. In the iron deficient state, transferrin receptors increase in number on the:

A. Intestinal mucosal cells

B. Erythropoietic cells

C. Reticuloendothelial cells

D. All of the above

ANSWER: [  B  ]

 

Drugs Acting on Kidney MCQs

 

1. Select the diuretic which is orally active, efficacious in acidosis as well as alkalosis, causes diuresis even in renal failure and has additional carbonic anhydrase inhibitory action:

A. Mannitol

B. Benzthiazide

C. Indapamide

D. Furosemide

ANSWER: [   D  ]

 

2. Furosemide acts by inhibiting the following in the renal tubular cell:

A. Na+-K+-2Cl– cotransporter

B. Na+-Cl– symporter

C. Na+-H+ antiporter

D. Na+ K+ ATPase

ANSWER: [   A  ]

 

3. The following diuretic abolishes the corticomedullary osmotic gradient in the kidney:

A. Acetazolamide

B. Furosemide

C. Hydrochlorothiazide

D. Spironolactone

ANSWER: [   B  ]

 

4. Intravenous furosemide promptly mitigates dyspnoea in acute left ventricular failure by:

A. Producing bronchodilatation

B. Causing rapid diuresis and reducing circulating blood volume

C. Increasing venous capacitance and reducing cardiac preload

D. Stimulating left ventricular contractility

ANSWER: [   C  ]

 

5. Secretion of K+ in the late distal tubule and collecting ducts of kidney depends on:

A. Intracellular K+ content

B. Unabsorbed Na+ load presented to the distal segment

C. Aldosterone level

D. All of the above

ANSWER: [   D  ]

 

6. Diuretics acting on the ascending limb of loop of Henle are the most efficacious in promoting salt and water excretion because:

A. Maximum percentage of salt and water is reabsorbed in this segment

B. Reabsorptive capacity of the segments distal to it is limited

C. This segment is highly permeable to both salt and water

D. This segment is responsible for creating corticomedullary osmotic gradient

ANSWER: [   B  ]

 

7. Parenteral furosemide is an alternative diuretic to mannitol in the following condition:

A. Pulmonary edema

B. Cirrhotic edema

C. Cerebral edema

D. Cardiac edema

ANSWER: [   C  ]

 

8. Thiazide diuretics and furosemide have directionally opposite effect on the net renal excretion of the following substance:

A. Uric acid

B. Calcium

C. Magnesium

D. Bicarbonate

ANSWER: [   B  ]

 

9. Select the diuretic which is similar in efficacy and pattern of electrolyte excretion to furosemide, but is 40 times more potent dose to dose:

A. Piretanide

B. Bumetanide

C. Xipamide

D. Metolazone

ANSWER: [   B  ]

 

10. Though ethacrynic acid is also a high ceiling diuretic, it is practically not used because:

A. It is more ototoxic

B. It causes diarrhoea and gut bleeding

C. Its response increases steeply over a narrow dose range

D. All of the above

ANSWER: [   D  ]

 

11. The Na+-Cl– symport in the early distal convoluted tubule of the kidney is inhibited by:

A. Thiazides

B. Metolazone

C. Xipamide

D. All of the above

ANSWER: [   D  ]

Cardiovascular Drugs MCQs

 

1. The following factors enhance renin release from the kidney except:

A. Fall in blood pressure

B. Reduction in blood volume

C. Enhanced sympathetic activity

D. Volume overload

ANSWER: [   D  ]

 

2. Angiotensin II plays a key role in the following risk factor for ischaemic heart disease:

A. Hypercholesterolemia

B. Ventricular hypertrophy

C. Carbohydrate intolerance

D. Cardiac arrhythmia

ANSWER: [   B  ]

 

3. Ventricular remodeling after myocardial infarction involves the mediation of: A. Angiotensin II

B. Prostaglandin

C. Bradykinin

D. Thromboxane A2

ANSWER: [   A  ]

 

4. Captopril pretreatment:

A. Inhibits the pressor action of angiotensin I

B. Inhibits the pressor action of angiotensin II

C. Potentiates the depressor action of bradykinin

D. Both ‘A’ and ‘C’ are correct

ANSWER: [   D  ]

 

5. Captopril produces greater fall in blood pressure in:

A. Diuretic treated patients

B. Patients having low plasma renin activity

C. Sodium replete normotensive individuals

D. Untreated CHF patients

ANSWER: [   A  ]

 

6. Under physiological conditions the rate limiting enzyme in the generation of angiotensin II is:

A. Renin

B. Angiotensin converting enzyme

C. Aminopeptidase

D. Angiotensinase

ANSWER: [   A  ]

 

7. Angiotensin II causes rise in blood pressure by:

A. Direct vasoconstriction

B. Releasing adrenaline from adrenal medulla

C. Increasing central sympathetic tone

D. All of the above

ANSWER: [   D  ]

 

8. Angiotensin III is equipotent to angiotensin II in:

A. Releasing aldosterone from adrenal cortex

B. Promoting Na+ and water reabsorption by direct intrarenal action

C. Causing vasoconstriction

D. Contracting intestinal smooth muscle

ANSWER: [   A   ]

 

9. The following is a pressor peptide that can be generated both in circulation as well as locally in certain tissues:

A. Bradykinin

B. Angiotensin

C. Kallidin

D. Plasmin

ANSWER: [   B  ]

 

Hormones and Related Drugs MCQs

1. Gonadotropins are indicated in the following conditions except

A. Hypogonadotrophic hypogonadism in males

B. Cryptorchism in a boy less than 7 years old

C. Amenorrhoea and infertility in women

D. Polycystic ovaries

ANSWER:  [  d  ]

2. The hypothalamic gonadotropin releasing hormone (GnRH) is

A. A single peptide

B. A mixture of two distinct peptides FSH-RH and LH-RH

C. A mixture of several peptides

D. Dopamine

ANSWER:  [  a  ]

3. Menotropins is a preparation of

A. FSH + LH obtained from urine of menstruating women

B. LH obtained from urine of pregnant women

C. FSH + LH obtained from urine of menopausal women

D. LH obtained from serum of pregnant mare

ANSWER:  [  c  ]

4. Gynaecomastia can be treated with

A. Chlorpromazine

B. Cimetidine

C. Bromocriptine

D. Metoclopramide

ANSWER:  [  c  ]

5. The most prominent action of bromocriptine is

A. Dopamine D2 agonism

B. Dopamine D2 antagonism

C. Dopamine D1 antagonism

D. α adrenergic antagonism

ANSWER:  [  a  ]

6. Bromocriptine causes the following

A. Prolactin release

B. Vomiting

C. Uterine contraction

D. Impotence

ANSWER:  [  b  ]

7. Hyperprolactinemia can cause the following except

A. Amenorrhoea

B. Gynaecomastia

C. Multiple ovulation

D. Depressed fertility

ANSWER:  [  c  ]

8. For therapeutic use, growth hormone is obtained from

A. Recombinant DNA technique

B. Human cadaver pituitaries

C. Porcine pituitaries

D. Chemical synthesis

ANSWER:  [  a  ]

9. Drugs that suppress growth hormone release in acromegaly include the following except

A. Bromocriptine

B. Somatostatin

C. Octreotide

D. Nafarelin

ANSWER:  [  d  ]

10. Indications of somatostatin include

A. Macroprolactinoma

B. Zollinger Ellison syndrome

C. Bleeding esophageal varices

D. Steatorrhoea

ANSWER:  [  c  ]

11. Somatostatin inhibits the release of

A. Growth hormone

B. Insulin

C. Thyrotropin

D. All of the above

ANSWER:  [  d  ]

12. Octreotide is a long acting synthetic analogue of

A. Prolactin

B. Growth hormone

C. Somatostatin

D. Gonadotropin releasing hormone

ANSWER:  [  c  ]

13. Several actions of growth hormone are exerted through the elaboration of

A. Cyclic AMP

B. Cyclic GMP

C. Somatostatin

D. Insulin like growth factor-1

ANSWER:  [  d  ]

14. The following hypothalamic regulatory hormone is not a peptide

A. Growth hormone release inhibitory hormone

B. Prolactin release inhibitory hormone

C. Gonadotropin releasing hormone

D. Corticotropin releasing hormone

ANSWER:  [  b  ]

15. Which hormone acts through a cytoplasmic receptor

A. Calcitriol

B. Prolactin

C. Vasopressin

D. None of the above

ANSWER:  [  a  ]

16. Actions of growth hormone include the following except

A. Increased protein synthesis

B. Increased fat utilization

C. Increased carbohydrate utilization

D. Glucose intolerance

ANSWER:  [  c  ]

PNS Drugs MCQs

1. Pancuronium differs from tubocurarine in that

A. It is a depolarizing blocker

B. Its action is not reversed by neostigmine

C. It can cause rise in BP on rapid I.V. injection

D. It causes marked histamine release

ANSWER:  [  c  ]

2. Which of the following drugs undergoes ‘Hofmann’ elimination

A. Succinylcholine

B. Pancuronium

C. Vecuronium

D. Atracurium

ANSWER:  [  d  ]

3. The neuromuscular blocker that does not need reversal of action by neostigmine at the end of the operation is

A. d-Tubocurarine

B. Doxacurium

C. Pipecuronium

D. Mivacurium

ANSWER:  [  d  ]

4. The most rapidly acting nondepolarizing neuromuscular blocking agent which can be used as an alternative to succinylcholine for tracheal intubation is

A. Rocuronium

B. Pancuronium

C. Doxacurium

D. Pipecuronium

ANSWER:  [  a  ]

5. Which of the following drugs is a nondepolarizing neuromuscular blocker

A. Succinylcholine

B. Vecuronium

C. Decamethonium

D. Dantrolene sodium

ANSWER:  [  b  ]

6. The site of action of d-tubocurarine is

A. Spinal internuncial neurone

B. Motor nerve ending

C. Muscle end-plate

D. Sodium channels in the muscle fibre

ANSWER:  [  c  ]

7. At the muscle end-plate, d-tubocurarine reduces the

A. Number of Na+ channels

B. Duration for which the Na+ channels remain open

C. Ion conductance of the open Na+ channel

D. Frequency of Na+ channel opening

ANSWER:  [  d  ]

8. Depolarizing neuromuscular blockers differ from competitive blockers in the following attributes except

A. They induce contraction of isolated frog rectus abdominis muscle

B. Ether anaesthesia intensifies block produced by them

C. Tetanic nerve stimulation during partial depolarizing block produces well sustained contraction

D. Neostigmine does not reverse block produced by them

ANSWER:  [  b  ]

9. Succinylcholine produces spastic paralysis in

A. Rabbits

B. Frogs

C. Birds

D. Patients with atypical pseudocholinesterase

ANSWER:  [  c  ]

10.The fall in blood pressure caused by d-tubocurarine is due to

A. Reduced venous return

B. Ganglionic blockade

C. Histamine release

D. All of the above

ANSWER:  [  d  ]

11. Select the skeletal muscle relaxant that is commonly used for endotracheal intubation despite causing histamine release, K+ efflux from muscles and cardiovascular changes

A. Pipecuronium

B. Succinylcholine

C. Pancuronium

D. Cisatracurium

ANSWER:  [  b  ]

12. Neuromuscular blocking drugs do not produce central actions because

A. They do not cross the blood-brain barrier

B. Nicotinic receptors are not present in the brain

C. They are sequestrated in the periphery by tight binding to the skeletal muscles

D. They do not ionise at the brain pH

ANSWER:  [  a  ]

CNS Drugs MCQs

1. The minimal alveolar concentration of an inhalational anaesthetic is a measure of its:

A. Potency

B. Therapeutic index

C. Diffusibility

D. Oil: water partition coefficient

ANSWER:  [  A  ]

 

2. The primary mechanism by which general anaesthetics produce their action is:

A. Affecting receptor operated ion channels in cerebral neurones

B. Blocking voltage sensitive Na+ channels in neuronal membrane

C. Depressing metabolic activity of cerebral neurones

D. Blocking production of high energy phosphates in the brain

ANSWER:  [  A  ]

 

3. General anaesthetics produce immobility in response to painful surgical stimuli by acting primarily at the:

A. Motor cortex

B. Basal ganglia

C. Thalamus

D. Spinal cord

ANSWER:  [  D  ]

 

4. Which general anaesthetic selectively inhibits excitatory NMDA receptors:

A. Thiopentone

B. Halothane

C. Desflurane

D. Ketamine

ANSWER:  [  D  ]

 

5. If a patient being anaesthetised with ether is unconscious, has regular respiration, blood pressure and heart rate are normal, corneal reflex is present and eyeballs are roving, the patient is in:

A. Stage II

B. Stage III plane 1

C. Stage III plane 2

D. Stage III plane 3

ANSWER:  [  B  ]

 

6. No surgical operation should be performed during the following stage of anaesthesia:

A. Stage I

B. Stage II

C. Stage III, plane 1

D. Stage III, plane 3

ANSWER:  [  B  ]

 

7. Which of the following is a sign of deep anaesthesia:

A. Appearance of tears in eyes

B. Resistance to passive inflation of lungs

C. Fall in blood pressure

D. Patient makes swallowing movements

ANSWER:  [  C  ]

 

8. The following factor delays induction with an inhaled general anaesthetic:

A. Alveolar perfusion-ventilation mismatch

B. Hyperventilation

C. Low blood:gas partition coefficient of the anaesthetic

D. Inclusion of 5% carbon dioxide in the inhaled gas mixture

ANSWER:  [  A  ]

 

9. ‘Second gas effect’ is exerted by the following gas when coadministered with halothane:

A. Nitrous oxide

B. Cyclopropane

C. Nitrogen

D. Helium

ANSWER:  [  A  ]

 

10. ‘Diffusion hypoxia’ is likely to occur only after use of nitrous oxide because it:

A. Is a respiratory depressant

B. Has low blood solubility and is used in high concentration

C. Is a very potent anaesthetic

D. Interferes with diffusion of oxygen into the tissues

ANSWER:  [  B  ]

 

11. Select the inhalational general anaesthetic which is metabolized in the body to a significant extent:

A. Sevoflurane

B. Isoflurane

C. Ether

D. Halothane

ANSWER:  [  D  ]

 

12. The following anaesthetic can be used by the open drop method:

A. Ether

B. Desflurane

C. Halothane

D. Isoflurane

ANSWER:  [  A  ]

 

13. The minimal alveolar concentration (MAC) of halothane is:

A. 75%

B. 25%

C. 7.5%

D. 0.75%

ANSWER:  [  D  ]

 

14. The following general anaesthetic has poor muscle relaxant action:

A. Ether

B. Nitrous oxide

C. Halothane

D. Isoflurane

ANSWER:  [  B  ]

 

15. Select the correct statement about nitrous oxide:

A. It irritates the respiratory mucosa

B. It has poor analgesic action

C. It is primarily used as a carrier and adjuvant to other anaesthetics

D. It frequently induces post anaesthetic nausea and retching

ANSWER:  [  C  ]

Drugs for Respiratory Disorders MCQs

1. Antitussives act by:

A. Liquifying bronchial secretions

B. Raising the threshold of cough centre

C. Reducing cough inducing impulses from the lungs

D. Both ‘B’ and ‘C’ are correct

Answer: [  D  ]

 

2. Dextromethorphan is an:

A. Analgesic

B. Antitussive

C. Expectorant

D. Antihistaminic

Answer: [  B  ]

 

3. Which of the following is not an antitussive:

A. Oxeladin

B. Clophedianol

C. Dextropropoxyphene

D. Dextromethorphan

Answer: [  C  ]

 

 

4. The following antitussive is present in opium but has no analgesic or addicting properties:

A. Noscapine

B. Codeine

C. Pholcodeine

D. Ethylmorphine

Answer: [  A  ]

 

5. Which of the following ingredients has neither specific antitussive nor expectorant nor bronchodilator action, but is commonly present in proprietary cough formulations:

A. Ambroxol

B. Chlorpheniramine

C. Guaiphenesin

D. Noscapine

Answer: [  B  ]

 

6. The following expectorant acts both directly on the airway mucosa as well as reflexly:

A. Potassium iodide

B. Guaiphenesin

C. Terpin hydrate

D. Bromhexine

Answer: [  A  ]

 

7. Bromhexine acts by:

A. Inhibiting cough centre

B. Irritating gastric mucosa and reflexly increasing bronchial secretion

C. Depolymerizing mucopolysaccharides present in sputum.

D. Desensitizing stretch receptors in the lungs

Answer: [  C  ]

 

8. Codeine is used clinically as:

A. Analgesic

B. Antitussive

C. Antidiarrhoeal

D. All of the above

Answer: [  D  ]

 

9. Mucokinetic is a drug which:

A. Reduces airway mucus secretion

B. Increases airway mucus secretion

C. Makes respiratory secretions more watery

D. Stimulates mucociliary activity of bronchial epithelium

Answer: [  C  ]

Autocoids & Related Drugs MCQs

 

1. Histamine exerts the following actions except:

A. Dilatation of large blood vessels

B. Dilatation of small blood vessels

C. Stimulation of isolated guineapig heart

D. Itching

Answer: [   D  ]

 

2. Fall in blood pressure caused by larger doses of histamine is blocked by:

A. H1 antihistaminics alone

B. H2 antagonists alone

C. Combination of H1 and H2 antagonists

D. None of the above

Answer: [   D  ]

 

3. The following statement about histamine is not correct:

A. It is the sole mediator of immediate hypersensitivity reaction

B. It plays no role in delayed hypersensitivity reaction

C. It serves as a neurotransmitter in the brain

D. All types of histamine receptors are G protein coupled receptors

Answer: [   D  ]

 

4. Histamine is involved as a mediator in the following pathological condition:

A. Delayed hypersensitivity reaction

B. Inflammation

C. Carcinoid syndrome

D. Variant angina

Answer: [   D  ]

 

8. The drug that can directly release histamine from mast cells without involving antigen-antibody reaction is:

A. Aspirin

B. Procaine

C. Morphine

D. Sulfadiazine

Answer: [   D  ]

 

9. Autacoids differ from hormones in that:

A. Autacoids are involved only in the causation of pathological states

B. Autacoids do not have a specific cell/tissue of origin

C. Autacoids generally act locally at the site of generation and release

D. Both ‘B’ and ‘C’ are correct

Answer: [   D  ]

 

10.  Which of the following is a selective H1 receptor agonist:

A. 4-methyl histamine

B. Impromidine

C. 2-Thiazolyl ethylamine

D. Chlorpheniramine

Answer: [   C  ]

 

10. The action of histamine that is not mediated through H1  receptors is:

A. Release of EDRF from vascular endothelium resulting in vasodilatation

B. Direct action on vascular smooth muscle causing vasodilatation

C. Bronchoconstriction

D. Release of catecholamines from adrenal medulla

Answer: [   B   ]