INI-CET 2019 - Pharmacology PYQs Practice Questions

Q: The patient who developed a rash on the skin, hypotension, and difficulty in breathing after being given 2 g of ampicillin intravenously should be managed by.

0.5 ml of 1:1000 adrenaline by intramuscular injection. ***0.5 ml of 1:1000 adrenaline by intramuscular injection*** - This presentation describes **anaphylaxis**, characterized by a rapid onset of rash, **hypotension**, and **difficulty breathing** following drug administration. - The immediate and definitive treatment for anaphylaxis is **intramuscular adrenaline (epinephrine)**, typically at a concentration of **1:1000** for rapid absorption and systemic effect. *0.5 ml of 1:1000 adrenaline by intravenous injection* - **Intravenous adrenaline** is generally reserved for patients who are unresponsive to intramuscular administration or are in **cardiac arrest**, as it carries a higher risk of adverse effects like arrhythmias. - The initial, first-line treatment in an evolving anaphylactic reaction should be **intramuscular injection** due to its safer profile and rapid onset of action. *0.5 ml of 1:10000 adrenaline by intramuscular injection* - A concentration of **1:10,000 adrenaline** is typically used for **intravenous administration** during advanced cardiac life support (ACLS) protocols, not for initial intramuscular injection in anaphylaxis. - Administering 1:10,000 adrenaline intramuscularly would provide a **suboptimal dose** for treating severe anaphylaxis effectively. *0.5 ml of 1:10000 adrenaline by intravenous injection* - While intravenous adrenaline uses a **1:10,000 concentration**, it's not the initial route for managing anaphylaxis unless the patient is in **cardiac arrest** or unresponsive to IM adrenaline. - Starting with IV adrenaline carries a higher risk of **cardiac complications** and can be difficult to administer promptly in an emergency outside of a controlled setting. [Practice more Pharmacology PYQs on OnCourse]

Q: In a clinical scenario where a patient presents with flaccid paralysis, which of the following toxins is most likely responsible?

Botulism. ***Correct Option: Botulism*** - **Botulinum toxin** blocks the release of **acetylcholine** at the neuromuscular junction, leading to **flaccid paralysis**. - This paralysis typically progresses symmetrically and can affect ocular, bulbar, and peripheral muscles. *Incorrect Option: Tetanus* - **Tetanus toxin** inhibits the release of **inhibitory neurotransmitters** (**GABA** and **glycine**) in the central nervous system. - This leads to uncontrolled muscle contractions, presenting as **spastic paralysis** and **lockjaw**. *Incorrect Option: Diphtheria* - **Diphtheria toxin** causes local inflammation and can lead to systemic effects, including **myocarditis** and **neuropathy**. - The neuropathy can cause weakness, but it is typically a **delayed polyneuropathy** rather than acute flaccid paralysis. *Incorrect Option: Cholera* - **Cholera toxin** activates adenylyl cyclase in intestinal cells, leading to excessive fluid and electrolyte secretion. - The primary symptom is **severe watery diarrhea** and dehydration, not paralysis. [Practice more Pharmacology PYQs on OnCourse]

Question 1

The patient who developed a rash on the skin, hypotension, and difficulty in breathing after being given 2 g of ampicillin intravenously should be managed by.

Accepted Answer

0.5 ml of 1:1000 adrenaline by intramuscular injection

Answer

0.5 ml of 1:1000 adrenaline by intravenous injection

Answer

0.5 ml of 1:10000 adrenaline by intramuscular injection

Answer

0.5 ml of 1:10000 adrenaline by intravenous injection

Question 2

In a clinical scenario where a patient presents with flaccid paralysis, which of the following toxins is most likely responsible?

Accepted Answer

Botulism

Answer

Tetanus

Answer

Diphtheria

Answer

Cholera

INI-CET 2019 — Pharmacology