MBBS/II-2/PHAR/2022 (M) 2nd Professional MBBS (Regular) Examination, 2022 (December) PHARMACOLOGY SECOND PAPER " Full Marks : 100 (10+90) Time : 3 hours { First 15 minutes for Q. No. 1 (MCQ) + 2 hours 45 minutes for the rest ] The figures in the margin indicate full marks for the questions FIRST HALF Candidate’s Roll No.: Registration No-,., 1. Choose the correct answer and tick M1 the respective box |: 1x10=10 (a) Amanic patient has been brought to the hospital with non-stop talking, singing, uncontrolable behaviour and apparent loss of contact with reality. Which of the M23/2 ( Turn Over ) Scanned with CamScanner(b) M23/2,. (20) following 1s the most appropriate drug for rapid control of his symptoms? () Lithtum carbonate o (i) Phenobarbitone (il) Haloperidol =O) (iv) Valproic acid | Oo. ‘The following measure can’ minimize pituitary adrenal suppression during long-term corticosteroid therapy. () Use of betamethasone in place of prednisolone O1 ., | (i) Use of prednisolone on ‘alternate days (iti) Division of the daily dose in three equal 8 hourly doses o (iv) Administration of the total, daily dose at, bed, time ( Continued ) Scanned with CamScanner(3) (c) Which of the following statements is correct about lactulose? (i It stimulates, myenteric neurones to enhance gut peristalsis. (ii) Administered orally it acts as a purgative within 2-4 hours. oO (ii) It is an osmotic laxative that produces: soft but formed stools. (iv) All of the‘ above are. correct. (d) Fluconazole differs from ketoconazole in that fj it is not’ active’ by the oral route (ii) it is a more potent inhibitor of drug metabolism (iii) it is not effective in cryptococcal meningitis i ( (iv) it is unlikely to produce anti- androgenic side’ effects’ J M23/2 (Turn Over) Scanned with CamScanner(4) (e) The drug which’ abolishes — the therapeutic effect of levodopa in parkinsonism, but not that of levodopa. carbidopa combination is ) (i, metoclopramide, OI, .,, (i) pyridoxine (iii) chlorpromazine [1] i (iv) isoniazid’ © Di!) te () Which of the following antibiotics is used in the treatment of Clostridium difficile associated diarrhea? () Ciprofloxacin (i) Metronidazole O (iii) Piperacillin (iv) Clindamyein )O1.. ( Continued ) Scanned with CamScanner(g) The following strategy will promote (h) M23/2 rather than curb emergence of antibiotic resistant microorganisms. () Whenever possible use broad spectrum antibiotics (i) Prefer a, Narrow-spectrum antibiotic to a broad spectrum one if both are equally effective (iii) Prefer short and intensive courses of antibiotics (iv) Use antibiotic combinations for prolonged therapy Which of the following statements is correct about allopurinol? (ij It is a purine antimetabolite with antineoplastic activity: (i) It is a competitive inhibitor of xanthine oxidase. (ii) It is inactive itself, but its metabolite alloxanthine is a competitive inhibitor of xanthine oxidase. (iv) Both allopurinol as well as its metabolite alloxanthine are non- competitive inhibitors of xanthine oxidase. i { (Turn Over ) Scanned with CamScanner(6) (i). Ethanol is: used in methanol poisoning because, it (i) antagonises' the actions of methanol ‘| (ii) stimulates the metabolism of “methanol, and reduces its’ blood devel (O° ) (ii) inhibits ,,- the,,.|.metabolism of methanol’ and .generation of toxic metabolite (iv) replenishes" the © folate stores depleted by methanol () Chloroquine is used in all, except ) radical. cure‘in: vivax malaria (ii) extraintestinal amoebiasis (iii) lepra reaction’ ‘((iv) rheumatoid ‘arthritis tO M23—300/2 MBBS /II-2/PHAR/2022 (M) Scanned with CamScannerMBBS/II-2/PHAR/2022 (Q) 2nd Professional MBBS (Regular) Examination, 2022 (December) PHARMACOLOGY SECOND PAPER Full Marks : 100 (10+90) Time : 3 hours [ First 15 minutes for Q. No. 1 (MCQ) + 2 hours 45 minutes for the rest ] The figures in the margin indicate full marks for the questions FIRST HALF (Continued) 2. Classify the preparations of insulin. Describe the adverse effects and uses of insulin. Enumerate four insulin delivery devices. What is insulin resistance? 4+2+2+1+1=10 3. Write in brief : 3x5=15 (a) Advantages of artemisinin-based combination therapy over other antimalarials (b) Six therapeutic uses of metronidazole (c) Six advantages of benzodiazepines over barbiturates as sedative-hypnotics M23/2a ( Turn Over ) Scanned with CamScanner((2)) (d) ‘Schedule X’ drugs (e) Treatment regimens for new patients of pulmonary TB presumed to be drug sensitive 4. Explain why : 5x3=15 (a) Oxytocin, but not ergometrine is used in induction of labour. (b) Ranitidine is preferred over cimetidine for treatment of peptic ulcer. (c) Glucocorticoids should not be withdrawn abruptly after prolonged use. SECOND HALF 5. Aneurologist prescribed an antiepileptic drug to a person suffering from grand mal epilepsy. The patient was regularly taking the drug, but after sometime he developed gum hyperplasia, ataxia, vertigo and nystagmus. Because of these unwanted effects of the drug, one of his friends advised him to discontinue the drug. Questions : (a) Identify the prescribed drug. Describe its antiepileptic mechanism of action. 14+3=4 M23/2a ( Continued ) Scanned with CamScanner(b) Comment about the advice given by patient’s friend. (c). After discontinuation, if he develops status epilepticus, how will you manage the patient? 4 6. Write brief notes on the following : 3x5=15 (a) Adverse effects of non-steroidal anti- inflammatory drugs 3 (b) Mechanism of action and uses of methotrexate 2+1=3 (c) Pharmacotherapy of scabies 3 (d) General toxicity of cytotoxic drugs 3 (e) Mechanism of action of ‘combined oral contraceptive pills’ 3 7. Write in brief : 5x3=15 (a) Five differences between propylthiouracil and carbimazole (b) Advantages of 2nd generation anti- histaminics over 1st generation ones (c) Metoclopramide M23/2a ( Turn Over ) Scanned with CamScanner8. Explain why : 5x2=10 (a) Local anaesthetic often fail to afford adequate pain control in inflamed tissues. (b) Morphine, but not pentazocine is used in acute myocardial infarction. ke M23—300/2a MBBS /II-2/PHAR/2022 (Q) Scanned with CamScanner