Acute Care Division

TEST PAPER Final Test Paper

Marks Time 1hr. ---------------------------------------------------------------------------------------------------100

Q.1. Fill in the Blanks (Each blank carr !ne mark" 1. Cough is a Pr!tecti#e reflex. $. Dry Cough has cough without expectoration, has no physiologic purpose and hence should be suppressed with Anti-t%ssi#es. &. Stimulation of Beta -$ receptors in the lungs by Terbutaline leads to relaxation of bronchial smooth muscles. '. Aller( is an abnormal reaction to an ordinarily harmless substance. Is a state of abnormal sensitivity to foreign material - called an allergen in susceptible individuals. ). *%ai+enesin exerts its action by stimulating the stomach reflexes from stomach, and thereby increases intrathoracic pressure to aid expectoration ,. Chlorpheniramine effective in relieving symptoms of allergic rhinitis such as snee-in(. rhin!rrh!ea and itching of nose, eyes and throat. /. henylephrine is a direct selective 0lpha 1 -adrenergic receptor agonist. it does not cause release of endogenous noradrenaline. as pseudoephedrine does. Therefore, is less li!ely to cause si1e-e++ects such as C"S stimulation, insomnia, anxiety, irritability, # restlessness. 2. 3 al%r!nic acid - an important component of synovial fluid, provides lubricating properties. 4. $ sprain is an in%ury involving the stretching or tearing of a li(ament.

10. Strains are in%uries that involve the stretching or tearing of a m%scle and ten1!n structure. 11. $sthma is a chr!nic inflammatory disease characteri&ed by airway h peresp!nsi#eness to a variety of stimuli resulting in br!nch!spasm which reverses spontaneously or with pharmacotherapy. 1$. In 56P7 airflow limitations is usually both progressive ' abnormal inflammatory response to noxious particles or gases. 1&. 8!s!c!mial infections are called as cross infections in hospitals. 1'. Empiric therapy is a medical term referring to the initiation of treatment prior to determination of a firm diagnosis. 1). Pne%m!nia is an acute infection of lung tissue including alveolar spaces # interstitial tissues. 1,. $ (ram positive results in a p%rple9bl%e color while a (ram negative results in a pink9re1 color. 1/. )raction of drug in unchanged form that reaches the systemic circulation after undergoing first pass metabolism is called Bi!a#ailabilit . 12. *olecule of a cell where a drug binds to produce its action is called as a Recept!r. 14. E++icac means better clinical out come of a drug after its administration. $0. Pharmac!1 namics is the detailed study of effects of the drugs on the +ody. Q.$. (ive examples of the following , a" Inhaled Corticosteroids -any two. / Becl!methas!ne, B%1es!ni1e

Fl%ticas!ne 5icles!ni1e

b) Antich!liner(ics Short acting - :pratr!pi%m 0ong acting - Ti!tr!pi%m

c. 0eu!otriene *odifiers - M!ntel%kast d. +eta 1 $gonist / - any two. Sh!rt actin( Salb%tam!l . ;e#!-salb%tam!l . Terb%taline

;!n( actin( Salmeter!l. F!rm!ter!l

e. *ethylxanthines The!ph lline . Amin!ph lline. 7!<!+ lline

Q.$ 5h!!se the ri(ht ans=ers > 2. Suppress cough by increasing the threshold of the cough centre to incoming stimulia" 5!1eine b. Terbutaline c. $mbroxol d. (uaifenesin 1. $nti-tussive produces action by depressing the cough centre a. Cortex of +rain b. 3espiratory Centre c" Me1%lla 6bl!n(ata d. ituitary (land

4. )acilitates movement of loosened material towards the pharynx by ciliary motion and 5xpectoration a. b" c. d. $mbroxol *%ai+enesin Terbutaline *enthol

6. $lters the structure of mucus to decrease its viscosity a. b. c. 1" Demulcent 5xpectorant +ronchodilator M%c!l tics

7. Direct scavenger of reactive oxygen metabolites a" b. c. d. Ambr!<!l Terbutaline (uaifenesin *enthol

8. *ay cause bronchospasm, hence not recommended in asthmatics a. 5rdosteine b. $mbroxol c. +romhexine 1" 8 - acet lc steine 9. $lpha 2 agonist causes mucosal vasoconstriction, has indirect action as a sympathomimetic amine / a. Triprolidine :cl b. Chlorpheneramine maleate c" Phen lpr!pan!lamine 3cl d. Diphenhydramine :cl ;. Second-generation antihistamines / a" R%pata1ine b. Dexchlorpheniramine

c. $&atidine d. :ydroxy&ine <. rovides a protective coating and soothing effect on the irritated mucosa of the pharynx a. henylepherine b" Menth!l c. $mbroxol d. +romhexine :cl 2=. Sinuses are of three types, )rontal, *axillary and / a. 0acrimal sinus b. "asal sinus c. >rbital sinus 1" Sphen!i1 sin%s 22. )irst pass metabolism ta!es place in the / a. Intestine b. S!in c. ;i#er d. "one of the above. 21. Teratogenicity refers to capacity of the drug to cause a. 0iver abnormalities b. ?idney dysfunction c" F!etal abn!rmalities d. Cardiac abnormalities 24. Drugs that do not dissolve in water -hydrophobic. need to be first converted into water soluble metabolites before / a. distribution can begin b. metabolism can begin c. e<creti!n can be(in d. absorption can begin 26. It is an estimated measure of the degree to which it is @trueA in a group of population. The higher p-level represents a decreasing index of the reliability of a result in clinical trials means ,

a" b. c. d.

Statistical Si(ni+icance +order line Significance 3elative ris! Significance $bsolute ris! Significance

27. 5hie+ cells are resp!nsible +!r secreti!n !+ a. *ucus b. Pepsin!(en c. (astrin d. :ydrochloric acid 28. rimary symptoms may be bloating, fullness # gas distention of abdomen in / a. b. c. d. Blcer-li!e dyspepsia M!tilit -like 1 spepsia 3eflux-li!e dyspepsia )unctional or non-ulcer dyspepsia

29. 5nterochromaffin - li!e cells or mast cells secretes / a. *ucus b. $cetylcholine c. (astrin 1. 3istamine 2;. Common organism involved in "osocomial neumonia is a. Staphylococcus aureus b. *ycoplasma pneumonia c. :aemophilus influen&a 1. Strept!c!cc%s pne%m!niae 2<. Brinary tract infections are caused by bacteria and are 2= times more common among women than men and present common symptoms li!e / a. ain or burning during urination b. "eed to urinate more often than usual c. )eeling of urgency during urination 1. All !+ the ab!#e 1=. Typhoid fever is a life-threatening illness caused by the bacterium / a. seudomonas, b. ?lebsiella

c. Salm!nella t phi d. Serratia 21. S!in and soft tissue infections are usually caused by / a. Staph l!c!cc%s a%re%s ? Strept!c!cc%s p !(enes. b. ?lebsiella # Serratia c. Streptococcus pneumoniae d. $ll of the $bove 22. Infection of the upper genital tract i.e. above the cervix is !nown as a. (onorrhoea b. +acterial Cystitis c Pel#ic :n+lammat!r 1isease d. Brinary Tract infections 23. The most common bacterial pathogen in >titis media is / a. Strept!c!cc%s pne%m!niae b. Staphylococcus aureus c. ?lebsiella pneumoniae d. "one of the above 24. Chich of the following is atypical bacterium / a. Staphylococcus aureus b. Streptococcus pneumonae c" ;e(i!nella pne%m!philla d. seudomonas 25. :ospital-acDuired pneumonia or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least / a. 6 / 9 hrs. after being admitted b. ; / 28 hrs. after being admitted c. 29- 16 hrs. after being admitted 1" '2/$ hrs. a+ter bein( a1mitte1

Q.&. State =hether the Statement is Tr%e !r False. 1. )irst-generation antihistamines is reserved for those patients not controlled with Second-generation antihistamines. - TR@E . $. :igh doses of seudoephedrine :cl can produce C"S stimulation # also slight increase in blood pressure - TR@E . &. 5rdosteine reduces cyto!ine synthesis, granule en&yme release # free radical generation by alveolar macrophages and protects alpha-2antitrypsin against oxidative inactivation. - TR@E . '. +romhexine :cl does induce hydrolytic depolymeri&ation of mucoprotein fibers and does not stimulate activity of the ciliated epithelium. - FA;SE . ). Dextromethorphan hydrobromide acts within half an hour of administration by mouth and exerts effect for upto 8 hrs. ( TR@E " ,. Intraarticular in%ection of steroids are only given in severe cases unresponsive to "S$IDs - Tr%e . /. Cardiovascular morbidity # mortality has bac! lifted coxibs - Tr%e . 2. C>E-2 are !nown as the constitutive or good house!eeping prostaglandins. - Tr%e . 4. $cute pain which lasts more than 4 months after the in%ury - False . 10. *usculos!eletal system is the commonest target, of chronic inflammation causing painful # restrictive movements. - Tr%e . 11. In 3$ abnormal synovial cells begin to invade # destroy cartilage # bone within the

%oint. - Tr%e . 1$. :alf life is the time needed for the plasma concentration of a drug to fall to above the C max value. - False . 1&. *ost of the drugs are metaboli&ed in the liver by en&ymes Cytochrome 67= - Tr%e . 1'. Since both :' and Cl- ions are outside the cell, they can combine together to form :Cl in the presence of :1> . - Tr%e . 1). Infection with :. pylori bacteria -i.e. :. pylori-associated ulcers-are rare and are reported to be overall %ust only 2=F cases. - False .. 1,. $ group of tissues with similar structure and function is !nown as cells False . 1/. The term recurrent is defined as 4 or more episodes in 8 months, or 6 or more in a year. - Tr%e .. 12. G lactams antibiotic inhibits the cell wall synthesis of the bacteria - Tr%e . 14. $bout 7= F of chronic cough in referral practices is said to be due to 5osinophilic +ronchitis. - FA;SE .. $0. +acterial Culture ta!es about 6 to ; hours for colonies to become visible False.. Q.' Match the 6r(anisms > (, marks" A a. Staphylococcus. spp. b. Clostridium spp. c. 5scherichia. coli d. "eisseria meningitidis e. *ycobacterium tuberculosis 2. 1. 4. 6. 7. B (ram ositive cocci (ram "egative cocci $cid )ast +acteria (ram ositive bacilli $typical organism

f. *ycoplasma pneumonae

8. (ram "egative bacilli

Ans=ers > -a - 1 ., -b - '., -c - ,. , -d - $ ., -e - & . , -f - )..

Q.). Match the +!ll!=in( > A 1. $. &. '. ). ,. /. 2. 4. 10 . 5!1eine ph!sphate Ambr!<!l 3cl Er1!steine Menth!l Phen lephrine 7e<tr!meth!rphe n Terb%taline s%lphate *%aiphenesin ;e#!-cetri-ine 5arb!c steine a. b. c. 1. e. +. (. h. i. A. Br!nch!1ilat!r Act b inhibiti!n !+ m%c%s secreti!n Metab!lite :rritant t! (astric m%c!sa an1 hence ca%ses re+le< e<pect!rati!n :ncreases Sali#ati!n 8asal 7ec!n(estant Anti-in+lammat!r 6pi!i1 alkal!i1 8!n-narc!tic c!%(h s%ppressant Metab!lite !+ Br!mhe<ine B

Ans=ers > (1 - h" ($ - A " (& - ( " (' - e " () - + " (, - i " (/ - a "
(2 - 1 " (4 - c " (10 - b ".
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