Conceptual institute of medical sciences

ANS
Attempt all questions. All questions carry equal marks
Total marks: 44
Passing marks: 22
Total time: 44 minutes

1. Dr. Moneeb used edrophonium for differentiating myasthenic crisis from

cholinergic crisis. He preferred it over other anticholinesterase agents because of its:
(a) Shorter duration of action
(b) Longer duration of action
(c) Direct action on muscle end plate
(d) Selective inhibition of true cholinesterase
2. Mechanism of action of pralidoxime is:
(a) Stimulation of ACh receptors
(b) Inhibition of breakdown of ACh
(c) Blockade of ACh receptors
(d) Reactivation of AChE enzyme
3. You are in the eye OPD and wish to use a topical beta blocker in a patient. The
chosen drug by you should have all the following properties except:
(a) Strong local anaesthetic activity
(b) High lipophilicity
(c) High ocular capture
(d) Low systemic activity
4. A direct acting cholinomimetic that is lipid soluble and has been used in the
treatment of glaucoma is:
(a) Acetylcholine
(b) Physostigmine
(c) Pilocarpine
(d) Neostigmine
5. Drug of choice for treatment of acute organophosphate poisoning is:
(a) Atropine
(b) Pralidoxime
(c) Neostigmine
(d) d- Tubocurarine
6. Which of the following provides the best explanation for neostigmine being
preferred over physostigmine for treating myasthenia gravis?
(a) It is better absorbed orally
(b) It has longer duration of action
(c) It has additional direct agonistic action on nicotinic receptors at the muscle end
plate
(d) It penetrates blood brain barrier
7. A 28 years old woman has been treated with several autonomic drugs for about a
month. Which of the following signs would distinguish between an overdose of a
muscarinic blocker and a ganglionic blocker?
(a) Blurred vision
(b) Dry mouth, constipation
(c) Mydriasis
(d) Postural hypotension
8. Mr. Imran has just been diagnosed with myasthenia gravis. You are his physician
and are considering different therapies for his disease. Neostigmine and
pyridostigmine may cause which one of the following?
(a) Bronchodilation
(b) Diarrhea
(c) Cycloplegia
(d) Irreversible inhibition of acetylcholinesterase
9. Acetylcholine is not used commercially because:
(a) Costly
(b) Long duration of action
(c) Rapidly destroyed in the body
(d) Crosses blood brain barrier
10. A patient requires mild cholinomimetic stimulation following surgery.
Physostigmine and bethanechol in small doses have significantly different effects on
which of the following?
(a) Gastric secretion
(b) Neuromuscular junction
(c) Sweat glands
(d) Ureteral tone
11. The Alpha 2 agonist used in glaucoma is:
(a) Guanacare
(b) Guanabenz
(c) Brimonidine
(d) Tizanidine
12. Use of tiotropium is contra-indicated in:
(a) Bronchial asthma
(b) Hypertension
(c) Urinary retention
(d) Peptic ulcer disease
13. A patient presented in emergency with tachycardia, hyperthermia, bronchial
dilatation and constipation. The person is likely to be suffering from overdose of:
(a) Organophosphorus compound
(b) Pilocarpine
(c) Paracetamol
(d) Atropine
14. What is the most dangerous effect of belladonna in very young children?
(a) Dehydration
(b) Hallucination
(c) Hypertension
(d) Hyperthermia
15. You are being asked to give your expert opinion as a toxicologist regarding an
effective antidote for belladonna poisoning. Which of the following agents would
you suggest?
(a) Neostigmine
(b) Physostigmine
(c) Pilocarpine
(d) Methacholine
16. Which of the following drugs is useful in prophylaxis of motion sickness?
(a) Hyoscine
(b) Metoclopramide
(c) Prochlorperazine
(d) Ondansetron
17. Atropine is substituted by phenylephrine to facilitate fundus examination when:
(a) Mydriasis is required without cycloplegia
(b) Cycloplegia is required
(c) Mydriasis and cycloplegia both are required
(d) Cycloplegia and Mydriasis both are not required
18. Short acting mydriatic used in fundoscopy is:
(a) Homatropine
(b) Cyclopentolate
(c) Atropine
(d) Tropicamide
19. In which of the following organs, the effect of atropine on parasympathetic system is
of the longest duration?
(a) Eye
(b) Heart
(c) Salivary glands
(d) Urinary bladder
20. The following drug is a selective blocker (antagonist) of M-1 muscarinic receptors:
(a) Methacholine
(b) Bethanechol
(c) Methoctramine
(d) Pirenzepine
21. The main mechanism of hyperpyrexia induced by atropine includes:
(a) Vasodilation
(b) Inhibition of sweating
(c) Through central actions
(d) Increase in basal metabolic rate
22. A child, Salman has swallowed the contents of 2 bottles of a nasal decongestant
whose primary ingredient is adrenoceptor agonist drug. The signs of activation
that may occur in this patient include:
(a) Tachycardia
(b) Dilatation of pupil
(c) Vasodilation
(d) All of the above
23. The neurotransmitter agent that is normally released in the SA node of the heart in
response to increased blood pressure is:
(a) Acetylcholine
(b) Dopamine
(c) Adrenaline
(d) Noradrenaline
24. A patient, Sundas came to the emergency after receiving penicillin injection. She
was diagnosed to have anaphylactic shock. Which of the following is the only life
saving measure to treat him?
(a) Intravenous hydrocortisone hemisuccinate
(b) Intravenous adrenaline hydrochloride
(c) Intramuscular adrenaline hydrochloride
(d) Intravenous glucose saline
25. The only non-catecholamine sympathomimetic drug out of the following is:
(a) Adrenaline
(b) Ephedrine
(c) Dopamine
(d) Isoprenaline
26. A patient Baneen comes to you in the medicine emergency and you diagnose her to
be suffering from severe Congestive heart failure. You choose a drug Z which is a
short term ionotropic agent having selective adrenergic -1 agonistic activity but
lacking dopaminergic agonistic activity. What can be Z?
(a) Dopamine
(b) Dobutamine
(c) Amrinone
(d) Salmeterol
27. Dopamine is preferred in treatment of shock because of:
(a) Renal vasodilatory effect
(b) Increased cardiac output
(c) Peripheral vasoconstriction
(d) Prolonged action
28. Which one of the following is a relatively selective Alpha-2 adrenergic blocker with
short duration of action?
(a) Yohimbine
(b) Prazosin
(c) Terazosin
(d) Doxazosin
29. Depression occurs as a side effect due to the use of:
(a) Propanolol
(b) Morphine
(c) Amphetamine
(d) Reserpine
30. The most important action of beta-blockers in glaucoma is which of the following:
(a) Membrane stabilizing effect
(b) Retinal neuron protecting effect
(c) Decrease in the production of aqueous humor
(d) Pupillary constriction
31. Which of the following is used in beta-blocker overdose?
(a) Nor-epinephrine
(b) Atropine
(c) Glucagon
(d) Thyroxin
(e) Calcium chloride
32. All of the following are cardioselective beta blockers except:
(a) Atenolol
(b) Esmolol
(c) Bisoprolol
(d) Propanolol
33. Propanolol, a non-selective beta blocker can be prescribed to decrease anxiety
associated with:
(a) Chronic neurotic disorder
(b) Schizophrenia
(c) Short term stressful situations
(d) Endogenous depression
34. -blocker with intrinsic sympathomimetic properties:
(a) Propanolol
(b) Oxprenolol
(c) Pindolol
(d) Esmolol
(e) Butoxamine
35. An old man comes to you and is diagnosed to be having benign hypertrophy of
prostate. The drug which provides faster and greater symptomatic relief to this
patient will be:
(a) Terazosin
(b) Desmopressin
(c) Finasteride
(d) Sildenafil
36. An ultrashort acting blocker devoid of partial agonistic or membrane stabilizing
action is:
(a) Esmolol
(b) Timolol
(c) Atenolol
(d) Pindolol
37. Which of the following alpha-blocker drug is used in the treatment of benign
hypertrophy of prostate without producing significant hypotension?
(a) Phentolamine
(b) Tamsulosin
(c) Terazosin
(d) Dexazosin
38. Which one of the following drugs increases gastrointestinal motility?
(a) Glycopyrrolate
(b) Atropine
(c) Neostigmine
(d) Fentanyl
39. Mechanism of action of clonidine is mediated by which of the following receptors?
(a) Alpha 1
(b) Alpha 2
(c) Beta 1
(d) Beta 2
40. Which of the following drugs is most effective for control of orthostatic
hypotension?
(a) Clonidine
(b) Fludrocortisone
(c) Esmolol
(d) Phenylephrine
41. Atropine is added to commercial preparations containing diphenoxylate to:
(a) Potentiate us anti-spasmodic effect
(b) To reduce excretion of salt and water
(c) To prevent over dosage and discourage opioid dependence
(d) To prolong its duration of action
42. Atropine when used as a pre-medication causes all of the following symptoms
except:
(a) Skin flush
(b) Bronchoconstriction
(c) Prevents bradycardia
(d) Dryness of mouth
43. A 33 years old patient 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?
(a) Isoprenaline
(b) Labetalol
(c) Metoprolol
(d) Propanolol
44. Drug of choice for attention deficit hyperactivity disorder is:
(a) Fluoxetine
(b) Haloperidol
(c) Deriphylline
(d) Methylphenidate