UPSC-CMS 2025 - Pharmacology PYQs Practice Questions

Q: Which of the following drugs can cause secondary weight gain? I. Insulin II. Propranolol III. Orlistat IV. Thyroxine Select the correct answer using the code given below :

I and II only. ***I and II only*** - **Insulin** promotes glucose uptake and storage as glycogen or fat, and its therapeutic use can lead to **weight gain** due to increased fat deposition. - **Propranolol**, a non-selective beta-blocker, can decrease metabolic rate and physical activity tolerance due to slowed heart rate, contributing to **weight gain**. *I and III* - While **Insulin** causes weight gain, **Orlistat** specifically acts as a **lipase inhibitor** to *reduce* fat absorption, thereby *promoting weight loss*, not gain. *II, III and IV* - **Propranolol** can cause weight gain, but **Orlistat** facilitates weight loss. **Thyroxine**, used to treat hypothyroidism, generally *promotes weight loss* by increasing metabolism, not weight gain. *I, II and IV* - **Insulin** and **Propranolol** can cause weight gain. However, **Thyroxine** (levothyroxine) is used to correct hypothyroidism and typically leads to **weight loss** by normalizing metabolic rate, rather than causing weight gain. [Practice more Pharmacology PYQs on OnCourse]

Q: Which of the following can be used for the management of severe hyperkalaemia? I. Intravenous calcitonin II. Intravenous sodium bicarbonate III. Oral sodium polystyrene sulphate IV. Intravenous calcium gluconate

II, III and IV. ***II, III and IV*** - **Intravenous sodium bicarbonate** helps shift potassium into cells, primarily used in cases of metabolic acidosis. - **Oral sodium polystyrene sulfonate** (Kayexalate) is a cation-exchange resin that binds potassium in the gut, facilitating its excretion. - **Intravenous calcium gluconate** does not lower serum potassium but stabilizes the cardiac membrane, protecting against life-threatening arrhythmias. *I and II only* - **Intravenous calcitonin** is used in hypercalcemia to lower calcium levels and is not indicated for the management of hyperkalemia. - While intravenous sodium bicarbonate is used, relying on it alone with calcitonin would be insufficient and inappropriate. *I and IV only* - **Intravenous calcitonin** is not a treatment for hyperkalemia. - Although intravenous calcium gluconate is crucial for cardiac stabilization, it does not address the underlying hyperkalemia directly, making this option incomplete and incorrect. *'I, II and IV* - **Intravenous calcitonin** has no role in the management of hyperkalemia. - While intravenous sodium bicarbonate and calcium gluconate are important, the inclusion of calcitonin makes this option incorrect. [Practice more Pharmacology PYQs on OnCourse]

Q: Which one of the following is correct regarding arginine vasopressin antagonist Tolvaptan?

It is an oral drug. ***It is an oral drug*** - **Tolvaptan** is an **orally active selective vasopressin V2-receptor antagonist** used in the treatment of hyponatremia. - Its oral bioavailability makes it convenient for long-term management of conditions like **syndrome of inappropriate antidiuretic hormone (SIADH)**. *It is useful in hypovolemic hyponatremia* - **Tolvaptan** is primarily used to treat **euvolemic** and **hypervolemic hyponatremia** by promoting **free water excretion**, which is not ideal in hypovolemic states where fluid status needs to be increased. - In **hypovolemic hyponatremia**, the primary treatment is **fluid resuscitation** with isotonic saline, not free water excretion. *It antagonises the V1 receptor* - **Tolvaptan** is a **selective V2-receptor antagonist**, meaning it specifically blocks the action of vasopressin at the V2 receptors in the renal collecting ducts. - Blocking **V1 receptors** would primarily affect smooth muscle contraction and platelet aggregation, which is not the therapeutic target for tolvaptan in hyponatremia. *It should be used for at least 1 year* - The duration of **Tolvaptan** treatment is variable and depends on the underlying cause of hyponatremia and the patient's response. - There is no standard recommendation for a minimum usage period of at least one year; treatment is typically continued as long as necessary and tolerated. [Practice more Pharmacology PYQs on OnCourse]

Q: A 42-year old man with history of alcohol dependency presents with progressive abdominal distension. Abdominal examination reveals a shifting dullness. Which one of the following is the most appropriate drug to relieve this abdominal distension?

Spironolactone. **Spironolactone** - **Spironolactone** is an **aldosterone antagonist**, which is the **first-line diuretic** used in the management of **ascites** due to **cirrhosis**, often developing secondary to alcohol dependency. - It works by blocking aldosterone receptors in the **renal collecting duct**, leading to increased sodium and water excretion while conserving potassium, effectively reducing fluid accumulation. *Lactulose* - **Lactulose** is a non-absorbable disaccharide primarily used to treat and prevent **hepatic encephalopathy** by reducing ammonia levels. - It does not directly relieve abdominal distension caused by ascites, and its use is unrelated to fluid overload. *Propranolol* - **Propranolol** is a **non-selective beta-blocker** used to reduce **portal pressure** and prevent **variceal bleeding** in patients with cirrhosis. - While it addresses a complication of chronic liver disease, it does not directly manage or relieve ascites. *Octreotide* - **Octreotide** is a **somatostatin analog** used to treat complications like **acute variceal bleeding** or **hepatic encephalopathy** by reducing splanchnic blood inflow. - It is not indicated for the management of ascites or relief of abdominal distension caused by fluid accumulation. [Practice more Pharmacology PYQs on OnCourse]

Question 1

Which of the following drugs can cause secondary weight gain?
I. Insulin
II. Propranolol
III. Orlistat
IV. Thyroxine

Select the correct answer using the code given below :

Accepted Answer

I and II only

Answer

I and III

Answer

II, III and IV

Answer

I, II and IV

Question 2

Under which one of the following conditions, the HPA axis suppression is likely to result in crisis due to adrenal insufficiency following withdrawal of glucocorticoids?

Accepted Answer

If glucocorticoids have been prescribed repeatedly within the previous year

Answer

If the dose is less than equivalent of 5 mg prednisolone per day

Answer

If glucocorticoids have been given by intravenous route for five days

Answer

If glucocorticoids have been administered orally for one week

Question 3

Which of the following can be used for the management of severe hyperkalaemia?
I. Intravenous calcitonin
II. Intravenous sodium bicarbonate
III. Oral sodium polystyrene sulphate
IV. Intravenous calcium gluconate

Accepted Answer

II, III and IV

Answer

I and II only

Answer

I and IV only

Answer

I, II and IV

Question 4

Which one of the following is correct regarding arginine vasopressin antagonist Tolvaptan?

Accepted Answer

It is an oral drug

Answer

It is useful in hypovolemic hyponatremia

Answer

It antagonises the V1 receptor

Answer

It should be used for at least 1 year

Question 5

A 42-year old man with history of alcohol dependency presents with progressive abdominal distension. Abdominal examination reveals a shifting dullness. Which one of the following is the most appropriate drug to relieve this abdominal distension?

Accepted Answer

Spironolactone

Answer

Lactulose

Answer

Propranolol

Answer

Octreotide

Question 6

Which one of the following agents used in the treatment of inflammatory Bowel Disease acts by inhibiting the enzyme 'Janus Kinase'?

Accepted Answer

Tofacitinib

Answer

Adalimumab

Answer

Vedolizumab

Answer

Infliximab

Question 7

Which one of the following responses to intravenous adenosine is correctly matched?

Accepted Answer

Atrio-ventricular nodal reentrant tachycardia - Termination and complete recovery

Answer

Atrial flutter - Termination and complete recovery

Answer

Ventricular tachycardia - Termination and complete recovery

Answer

Atrial fibrillation - Termination

Question 8

Consider the following steps for using a metered dose inhaler (MDI) :
I. Incline the head backward to minimize oropharyngeal deposition
II. Remove the cap and shake the inhaler
III. Breathe out gently and place the mouthpiece into the mouth
IV. Hold the breath for 10 seconds
V. Simultaneously, begin a slow deep inspiration, depress the canister and continue to inhale

Which one of the following is the correct sequence of using MDI?

Accepted Answer

II, III, I, V, IV

Answer

III, II, I, V, IV

Answer

II, I, IV, III, V

Answer

III, I, II, IV, V

Question 9

Treatment of first choice in acute Gout is

Accepted Answer

Oral Colchicine

Answer

Oral Methotrexate

Answer

Sulfasalazine

Answer

Allopurinol

Question 10

Which one of the following is an antidote for Rivaroxaban and Apixaban, when reversal of anticoagulation is needed due to uncontrolled bleeding?

Accepted Answer

Andexanet Alfa

Answer

Hydroxocobalamin

Answer

Glucarpidase

Answer

Idarucizumab

UPSC-CMS 2025 — Pharmacology