PHARMACOLOGY

IIIrd Internal Assessment of II MBBS Students (2022 batch)

Paper-I (Section-A & B)
(General Pharmacology, ANS, PNS, CNS, Respiratory System, Autacoids, GIT, AETCOM and
Pandemic Module)

Time: 3 hrs Maximum Marks: 100 Date: 11/11/2024

Section A (MCQs)
Time: 20 min Maximum Marks: 20

Name: Roll No:

Instructions for Answering MCQs

1. Mark Your Answers: Please tick (✓) the correct option for each question directly on this
paper.
2. Single Answer Only: Only one tick mark (✓) per question is allowed. Any question with
multiple ticks or left unanswered will not be counted.
3. No Negative Marking: There is no negative marking, so make your best attempt on each
question.
4. Time Limit: You have 20 minutes to complete this section. Ensure you submit your
paper to the invigilator immediately once the time is up.
5. Submit Carefully: Double-check your answers before submission, as no additional time
or adjustments will be allowed.

I. MCQs (1x20= 20 marks)

1. The therapeutic index of a drug is defined as:

A) The ratio of the drug’s potency to its efficacy.
B) The ratio of the dose that produces toxicity (TD50) to the dose required for a
therapeutic effect (ED50).
C) The dose required to produce 50% of the maximum effect.
D) The time required to reach peak plasma concentration after drug administration.

2. Which of the following terms refers to the phenomenon where an increased dose of a drug
is needed to achieve the same effect?
A) Tolerance
B) Synergism
C) Antagonism
D) Potentiation

3. Which phase of clinical trials is primarily focused on assessing the safety and dosage of a
new drug in healthy volunteers?
A) Phase I
B) Phase II
C) Phase III
D) Phase IV

4. Which term describes the maximum effect that a drug can produce, regardless of dose?
 A) Potency
B) Efficacy
C) Affinity
D) Selectivity

5. Which of the following cytochrome P450 isoenzymes is responsible for metabolizing the
largest number of drugs?
A) CYP1A2
B) CYP2C9
C) CYP2D6
D) CYP3A4

6. Which of the following is a selective beta-1 adrenergic receptor antagonist with intrinsic
sympathomimetic activity?
A) Atenolol
B) Propranolol
C) Pindolol
D) Metoprolol

7. Which of the following drugs is a muscarinic antagonist that can be used as a pre-
anesthetic medication to reduce secretions?
A) Pilocarpine
B) Atropine
C) Neostigmine
D) Bethanechol

8. Which drug is used to treat malignant hyperthermia, a potentially life-threatening

condition associated with certain anesthetics and muscle relaxants?
A) Baclofen
B) Dantrolene
C) Diazepam
D) Cyclobenzaprine

9. Which of the following local anesthetics is known for its long duration of action and is
often used in epidural anesthesia?
A) Lidocaine
B) Procaine
C) Bupivacaine
D) Prilocaine

10. Aspirin irreversibly inhibits COX enzymes. This property is especially useful in
preventing:
A) Respiratory infections
B) Gastric ulcers
C) Platelet aggregation and thrombosis
D) Fever in children

11. Which of the following prostaglandins is known to protect the gastric mucosa and is often
 mimicked by drugs used to prevent NSAID-induced ulcers?
A) Prostaglandin E2 (PGE2)
B) Thromboxane A2 (TXA2)
C) Leukotriene B4 (LTB4)
D) Prostacyclin (PGI2)

12. A 45-year-old man with Parkinson's disease presents with symptoms of tremor, rigidity,
and bradykinesia. His physician prescribes a combination of levodopa and carbidopa.
What is the primary reason for adding carbidopa to levodopa therapy?
A) To increase dopamine receptor sensitivity
B) To prevent peripheral metabolism of levodopa
C) To increase the half-life of levodopa
D) To directly stimulate dopamine receptors in the brain

13. A 32-year-old woman with a history of generalized anxiety disorder (GAD) reports
feeling overly sedated and drowsy on her current benzodiazepine medication. Her doctor
decides to switch her to buspirone. Which of the following is a unique characteristic of
buspirone compared to benzodiazepines?
A) It has a faster onset of action.
B) It causes significant sedation.
C) It has a lower risk of dependence and abuse.
D) It enhances GABA activity directly.

14. A 68-year-old woman with Alzheimer's disease is prescribed donepezil. She returns to the
clinic after a few weeks with complaints of nausea and diarrhea. What is the likely
mechanism of these side effects?
A) Direct dopamine agonism
B) Increased central serotonin levels
C) Peripheral cholinergic stimulation
D) Increased norepinephrine release

15. Which of the following drugs is a non-benzodiazepine hypnotic that is used for short-term
treatment of insomnia?
A) Diazepam
B) Zolpidem
C) Lorazepam
D) Alprazolam

16. Which respiratory medication is often administered via inhalation to reduce systemic side
effects?
A. Theophylline
B. Fluticasone
C. Loratadine
D. Dexamethasone

17. Which of the following drugs is recommended for acute asthma exacerbations?
 A. Salmeterol
B. Ipratropium
C. Albuterol
D. Cromolyn

18. A 60-year-old woman with a history of osteoporosis has recently been prescribed
omeprazole for GERD. Which of the following should be monitored due to potential adverse
effects?
A. Blood pressure levels
B. Bone mineral density
C. Liver enzyme levels
D. Potassium levels

19. A patient with inflammatory bowel disease (IBD) has been prescribed mesalamine. What
is the primary mechanism of action of this drug in IBD?
A. Neutralizing gastric acid
B. Inhibiting prostaglandin synthesis to reduce inflammation
C. Blocking dopamine receptors in the gut
D. Binding to opioid receptors to reduce pain

20. Metoclopramide primarily acts by:

A. Inhibiting serotonin receptors
B. Enhancing acetylcholine action in the GI tract
C. Inhibiting histamine receptors
D. Blocking opioid receptors
 PHARMACOLOGY

IIIrd Internal Assessment of II MBBS Students (2022 batch)

Paper-I (Section-A & B)

(General Pharmacology, ANS, PNS, CNS, Respiratory System, Autacoids, GIT, AETCOM and Pandemic
Module)

Section B
Time: 2hrs 40 min Maximum Marks: 80

II. Structured Short notes (attempt any eight out of ten) (8x5 = 40 marks)

1. Define first pass metabolism. Explain its process and its clinical implications with examples.
2. Write pharmacotherapy of open angle glaucoma
3. Compare and contrast peripherally and centrally acting skeletal muscle relaxants
4. A 60-year-old man with a history of hypertension and hyperlipidemia presents for a follow-up.
a) What factors would you consider before advising him on low-dose aspirin? (2)
b) What are the potential benefits, risks & mechanism of aspirin in primary prevention
for this patient? (3)
5. Write pharmacological actions of Clozapine
6. What are the merits & demerits of halothane as a general anaesthetic?
7. Write pharmacotherapy of methanol poisoning
8. Describe and discuss the role of autonomy and shared responsibility as a guiding principle in
patient care
9. Write briefly on Disease modifying drugs in rheumatoid arthritis
10. Write briefly on prokinetic antiemetic drugs

III. Structured Long Question (attempt any four out of six) (4x10= 40) marks

11. Classify beta adrenergic blockers. Describe the uses and contraindications of beta blockers.
What are the merits of cardioselective beta blockers. (4+4+2)
12. Classify Antiepileptic drugs based on their mechanism of action. Write the uses and adverse
effects of Sodium Valproate. Explain the treatment of status epilepticus. (4+4+2)
13. A 55-year-old male patient presents with a history of chronic gastroesophageal reflux disease
(GERD). His primary complaints are frequent heartburn, regurgitation, and occasional
difficulty swallowing. An upper GI endoscopy reveals erosive esophagitis. Additionally, the
patient has a history of hypertension and is on a low-dose thiazide diuretic.
a) Enumerate the drugs used in pharmacological management of chronic GERD with
erosive esophagitis in this patient. (4)
b) Write the mechanisms of action, indications, and side effects of drugs used for GERD.
(4)
c) What could be the Potential drug-drug interactions and monitoring requirements in
this patient (write any two). (2)
14. Classify drugs used in Bronchial Asthma. Describe the pharmacological management of
Bronchial Asthma explaining its rationale (4+6)
15. Explain why BZDs are preferred over barbiturates as sedative hypnotics and write briefly on
newer sedative hypnotics. (5+5)
16. A 32-year-old woman, Sarah, presents to the clinic with a 6-month history of recurrent,
throbbing headaches that last 4–8 hours and are often associated with nausea, photophobia,
and phonophobia. She experiences approximately 5-6 episodes per month. Sarah has been
using over-the-counter ibuprofen for relief, but her headaches persist and often interfere with
her work and daily activities.
a) What pharmacological options are available for acute migraine treatment? (3)
b) Compare the mechanisms of action, benefits, and potential side effects of each of them. (4)
c) What pharmacologic options are recommended for her migraine prevention? (3)