UPSC-CMS 2017 - Pharmacology PYQs Practice Questions

Q: Absolute contraindication to combined oral contraceptive is:

History of thrombo-embolism. ***History of thrombo-embolism*** - A history of **thromboembolism** (e.g., DVT, pulmonary embolism) is an **absolute contraindication** to combined oral contraceptives (COCs) due to the increased risk of further thrombotic events associated with estrogen. - COCs, particularly their estrogen component, can increase levels of clotting factors and decrease natural anticoagulants, significantly raising the risk of **venous thromboembolism (VTE)**. *History of gallbladder disease* - A history of **gallbladder disease** is generally considered a **relative contraindication** rather than an absolute one for COCs. - While COCs may exacerbate pre-existing gallbladder conditions or increase the risk of gallstone formation in some individuals, it doesn't preclude their use in all cases. *History of GDM* - A history of **gestational diabetes mellitus (GDM)** is a **relative contraindication** or caution for COC use, particularly in women with additional risk factors for diabetes. - While COCs can affect glucose tolerance, they are not absolutely contraindicated unless the woman has developed overt diabetes or has poorly controlled metabolic issues. *History of previous two caesarean section* - A history of previous **two cesarean sections** is **not a contraindication** to combined oral contraceptive use. - This obstetric history does not impact the metabolic or thrombotic risks associated with COCs, and thus, does not directly interact with their safety profile. [Practice more Pharmacology PYQs on OnCourse]

Q: A woman with which of the following health problems should avoid centchroman?

Woman with dysfunctional uterine bleeding. ***Woman with dysfunctional uterine bleeding*** *(Marked as official answer, but medically questionable)* - **Important Note:** Centchroman (Ormeloxifene) is actually **approved for treating DUB** in India and is commonly used for this indication. - Its **anti-estrogenic effect on the endometrium** helps reduce abnormal bleeding by preventing excessive proliferation. - This PYQ answer may reflect specific exam context or outdated understanding, but current medical practice uses centchroman **as a treatment for DUB**, not as a contraindication. - Students should be aware this contradicts standard therapeutic use. *Polycystic ovarian syndrome* - Centchroman is **not contraindicated** in PCOS and is sometimes used for contraception in PCOS patients. - It doesn't worsen insulin resistance and may help manage endometrial effects of unopposed estrogen. - Its anti-estrogenic effects can be beneficial in preventing endometrial hyperplasia. *Endometriosis* - Centchroman is **not contraindicated** in endometriosis. - Its **anti-estrogenic action** could theoretically reduce estrogen-dependent growth of endometrial implants. - However, progestins and GnRH agonists are preferred first-line treatments. *Endometrial hyperplasia* - Centchroman has **anti-estrogenic effects on the endometrium**, making it potentially **beneficial** rather than contraindicated. - It inhibits estrogenic stimulation and promotes endometrial shedding. - May actually be used to prevent or treat endometrial hyperplasia. **Clinical Note:** None of the listed options represent absolute contraindications to centchroman. True contraindications include pregnancy, breastfeeding, hormone-dependent cancers, and severe hepatic/renal disease. [Practice more Pharmacology PYQs on OnCourse]

Q: Intramuscular injection of iron dextran is given by ‘Z’ technique to:

Reduce the staining. ***Reduce the staining*** - The **Z-track technique** creates a staggered path that prevents the dark iron solution from leaking back into the subcutaneous tissue, which can cause **permanent skin discoloration or staining**. - This method seals the medication deep in the muscle, preventing its reflux along the needle track. *Increase the iron absorption* - The Z-track technique is primarily about preventing **leakage and staining**, not enhancing the absorption rate of the iron. - Iron absorption is largely determined by factors like the patient's iron deficiency status and the form of iron administered, not the injection technique. *Alleviate the pain* - While proper injection technique can minimize discomfort, the Z-track method's primary purpose is not pain reduction but rather **preventing reflux** and associated staining. - Pain during injection is often related to the volume, viscosity, and acidity of the medication, as well as the injection site. *Decrease the incidence of infection* - Standard aseptic techniques, not the Z-track method itself, are crucial for **preventing infection** during intramuscular injections. - The Z-track technique does not inherently reduce the risk of infection beyond what is achieved with good sterile practice. [Practice more Pharmacology PYQs on OnCourse]

Question 1

Absolute contraindication to combined oral contraceptive is:

Accepted Answer

History of thrombo-embolism

Answer

History of gallbladder disease

Answer

History of GDM

Answer

History of previous two caesarean section

Question 2

A woman with which of the following health problems should avoid centchroman?

Accepted Answer

Woman with dysfunctional uterine bleeding

Answer

Polycystic ovarian syndrome

Answer

Endometriosis

Answer

Endometrial hyperplasia

Question 3

Intramuscular injection of iron dextran is given by ‘Z’ technique to:

Accepted Answer

Reduce the staining

Answer

Increase the iron absorption

Answer

Alleviate the pain

Answer

Decrease the incidence of infection

UPSC-CMS 2017 — Pharmacology