FMGE 2017 - Pharmacology PYQs Practice Questions

Q: Empirical drug of choice for treatment of meningococcal meningitis is:-

Ceftriaxone. ***Ceftriaxone*** - As a **third-generation cephalosporin**, **Ceftriaxone** provides excellent coverage against common bacterial causes of meningitis, including *Neisseria meningitidis*. - It achieves high concentrations in the **cerebrospinal fluid (CSF)**, making it highly effective for CNS infections. *Cefotetan* - **Cefotetan** is a **second-generation cephalosporin** that has limited CSF penetration and less reliable coverage against common meningitis pathogens. - While it has activity against some gram-negative bacteria, it is not considered a first-line agent for empirical treatment of meningitis. *Cefoxitin* - **Cefoxitin** is also a **second-generation cephalosporin** with limited ability to cross the blood-brain barrier, making it unsuitable for treating meningitis. - Its spectrum of activity is more focused on anaerobic bacteria and some gram-negative organisms, not typically the main culprits in meningitis. *Gentamicin* - **Gentamicin** is an **aminoglycoside antibiotic** that has poor penetration into the CSF and is less effective as a monotherapy for meningitis. - It is often used in combination with other antibiotics, but not as an empirical monotherapy for suspected meningococcal meningitis. [Practice more Pharmacology PYQs on OnCourse]

Q: Which of the following aminoglycosides is most cochleotoxic:-

Gentamycin. ***Gentamycin*** - **Gentamycin** is known to be the most **cochleotoxic** aminoglycoside, causing irreversible damage to the hair cells in the cochlea [1]. - This toxicity can lead to **permanent hearing loss** and **tinnitus** due to its selective accumulation in inner ear fluids [2]. *Streptomycin* - While streptomycin can cause ototoxicity, its primary adverse effect is vestibulo-toxicity, affecting **balance** more than hearing [2]. - It mainly targets the hair cells of the semicircular canals and otolithic organs, leading to **vertigo** and ataxia [3]. *Amikacin* - Amikacin is also an ototoxic aminoglycoside but is generally considered **less cochleotoxic** than gentamycin. - Its ototoxic effects are comparable to gentamicin, but it is often reserved for infections resistant to other aminoglycosides. *Minocycline* - Minocycline is a **tetracycline antibiotic**, not an aminoglycoside, and is not associated with significant ototoxicity. - Its side effects typically include photosensitivity, gastrointestinal upset, and **vestibular dysfunction** (dizziness, vertigo) in some patients, distinct from cochlear damage. [Practice more Pharmacology PYQs on OnCourse]

Q: Zileuton is:-

5-Lipoxygenase inhibitor. ***5-Lipoxygenase inhibitor*** - **Zileuton** specifically inhibits **5-lipoxygenase**, an enzyme crucial for the synthesis of **leukotrienes**. - By blocking this enzyme, zileuton reduces the production of **pro-inflammatory leukotrienes**, which are involved in the pathophysiology of **asthma**. *Phospholipase inhibitor* - **Phospholipase A2 inhibitors** like **corticosteroids** act upstream by preventing the release of **arachidonic acid**, a precursor to both prostaglandins and leukotrienes. - Zileuton's action is more specific to the **leukotriene pathway**, occurring after arachidonic acid is already formed. *Cyclooxygenase inhibitor* - **Cyclooxygenase (COX) inhibitors** (like NSAIDs) block the synthesis of **prostaglandins** and **thromboxanes** from arachidonic acid. - Zileuton does not affect the COX pathway but rather targets the **lipoxygenase pathway**. *Leukotriene receptor antagonist* - **Leukotriene receptor antagonists** (e.g., Montelukast, Zafirlukast) block the binding of leukotrienes to their receptors, preventing their downstream effects. - While both target the **leukotriene pathway**, zileuton works by **inhibiting their production**, not their receptor binding. [Practice more Pharmacology PYQs on OnCourse]

Q: Which among the following is an iron chelator?

Desferrioxamine. ***Desferrioxamine*** - **Desferrioxamine** is a specific iron chelator used to treat **acute iron poisoning** and chronic iron overload, such as in patients with **thalassemia** requiring frequent transfusions. - It works by binding to free iron in the bloodstream and promoting its **excretion via urine**. *BAL* - **BAL (dimercaprol)** is primarily used as a chelating agent for **heavy metal poisoning**, particularly **arsenic, mercury, and lead** [1], [2]. - While it can chelate some metals, its affinity and primary use are not for iron. *EDTA* - **EDTA (ethylenediaminetetraacetic acid)** is a chelator often used for **lead poisoning** [1], [2] and hypercalcemia. - It has a high affinity for various divalent and trivalent metal ions [2], but it is not the primary or most specific iron chelator. *Penicillamine* - **Penicillamine** is a chelating agent primarily used for the treatment of **copper overload** in **Wilson's disease**. - It is also used in the treatment of severe **rheumatoid arthritis** and **cystinuria**, but not typically for iron chelation. [Practice more Pharmacology PYQs on OnCourse]

Q: Which of these is the best for management of methanol poisoning?

Fomepizole. ***Fomepizole*** - **Fomepizole** is a competitive inhibitor of **alcohol dehydrogenase**, the enzyme responsible for metabolizing methanol into toxic metabolites like formic acid. - By inhibiting this enzyme, it prevents the formation of these toxic metabolites, thereby reducing organ damage and metabolic acidosis in methanol poisoning. *Naltrexone* - **Naltrexone** is an **opioid receptor antagonist** used in the treatment of alcohol and opioid dependence. - It does not have any direct action on the metabolism of methanol or its toxic byproducts. *Disulfiram* - **Disulfiram** inhibits **aldehyde dehydrogenase**, leading to an unpleasant reaction when alcohol is consumed (flushing, nausea, vomiting). - It is used for alcohol cessation and has no role in the management of methanol poisoning. *Acamprosate* - **Acamprosate** is a medication used to reduce alcohol cravings in individuals recovering from alcohol dependence, possibly by modulating **glutamate neurotransmission**. - It does not directly affect the metabolism of methanol or mitigate its toxic effects. [Practice more Pharmacology PYQs on OnCourse]

Question 1

Empirical drug of choice for treatment of meningococcal meningitis is:-

Accepted Answer

Ceftriaxone

Answer

Cefotetan

Answer

Cefoxitin

Answer

Gentamicin

Question 2

Which of the following aminoglycosides is most cochleotoxic:-

Accepted Answer

Gentamycin

Answer

Streptomycin

Answer

Amikacin

Answer

Minocycline

Question 3

Zileuton is:-

Accepted Answer

5-Lipoxygenase inhibitor

Answer

Phospholipase inhibitor

Answer

Leukotriene receptor antagonist

Answer

Cyclooxygenase inhibitor

Question 4

Which among the following is an iron chelator?

Accepted Answer

Desferrioxamine

Answer

BAL

Answer

EDTA

Answer

Penicillamine

Question 5

Which of these is the best for management of methanol poisoning?

Accepted Answer

Fomepizole

Answer

Naltrexone

Answer

Disulfiram

Answer

Acamprosate

Question 6

Many drugs are used as rescue therapy for preventing the adverse effects of anticancer drugs. Folinic acid is used in:-

Accepted Answer

Methotrexate toxicity

Answer

Cyclophosphamide toxicity

Answer

Doxorubicin toxicity

Answer

Cisplatin toxicity

Question 7

Ritodrine is a:-

Accepted Answer

β2 agonist

Answer

β antagonist

Answer

α agonist

Answer

α1 antagonist

Question 8

Mechanism of action of Pemetrexed is:-

Accepted Answer

Thymidylate synthase inhibitor

Answer

Topoisomerase inhibitor

Answer

Dihydrofolate reductase inhibitor

Answer

Dopamine agonist

Question 9

All of the following statements about pralidoxime in organophosphate poisoning are true except:-

Accepted Answer

It should be started after 24 hours of poisoning

Answer

It does not cross blood brain barrier

Answer

Reactivates the AChE enzyme

Answer

It is given intravenously

Question 10

Atorvastatin is used as an anti-dyslipidemic drug. These drugs inhibit their target enzyme by:-

Accepted Answer

Competitive inhibition

Answer

Noncompetitive inhibition

Answer

Irreversible inhibition

Answer

Uncompetitive inhibition

FMGE 2017 — Pharmacology