NEET-PG 2012 - Pharmacology PYQs Practice Questions

Q: What is considered a toxic serum level of lithium?

2.6. **2.6 mEq/L** - **Lithium toxicity** is generally considered to occur when serum lithium levels are above **1.5 mEq/L** with severe toxicity typically seen at levels above **2.5 mEq/L**. - At a level of **2.6 mEq/L**, patients are at high risk for significant neurological symptoms such as seizures, coma, and even death. *0.6 mEq/L* - A serum lithium level of **0.6 mEq/L** is within the normal therapeutic range, which is typically between **0.6 and 1.2 mEq/L**. - At this concentration, lithium is generally effective for bipolar disorder and other conditions with minimal risk of toxicity. *12 mEq/L* - A serum lithium level of **12 mEq/L** would represent an **extremely severe and likely fatal level of toxicity**, far beyond typical therapeutic or even severely toxic ranges. - Survival at such a high concentration would be highly improbable, as it would cause irreversible organ damage and profound central nervous system depression. *<0.6 mEq/L* - A serum lithium level of **less than 0.6 mEq/L** is considered subtherapeutic, meaning it is unlikely to be effective in treating bipolar disorder or other conditions. - While not toxic, such a low level would indicate a lack of therapeutic benefit and potential for symptom recurrence. [Practice more Pharmacology PYQs on OnCourse]

Q: Which of the following drugs is known to cross the blood-brain barrier?

Physostigmine. ***Physostigmine*** - **Physostigmine** is a **tertiary amine** that is uncharged at physiological pH, allowing it to readily cross the **lipophilic blood-brain barrier**. - Its ability to enter the central nervous system makes it useful for treating **central anticholinergic toxicity**, as it can inhibit acetylcholinesterase in the brain. *Glycopyrrolate* - **Glycopyrrolate** is a **quaternary ammonium compound**, meaning it carries a permanent positive charge. - This charge prevents it from crossing the **blood-brain barrier** effectively, limiting its effects to the peripheral nervous system. *Neostigmine* - **Neostigmine** is also a **quaternary ammonium compound**, similar to glycopyrrolate, making it highly ionized. - Due to its poor lipid solubility and charge, **neostigmine** has very limited penetration into the **central nervous system**. *All of the options* - This option is incorrect because both **glycopyrrolate** and **neostigmine** are charged molecules that do not readily cross the **blood-brain barrier**. - Only **physostigmine** among the listed drugs possesses the necessary lipophilicity to enter the central nervous system. [Practice more Pharmacology PYQs on OnCourse]

Q: What is the mechanism of action of Clopidogrel?

Inhibition of ADP-mediated platelet activation. ***Inhibition of ADP-mediated platelet activation*** - Clopidogrel is an **antiplatelet agent** that works by a direct antagonistic action at the **P2Y12 receptor** on the surface of platelets. - This binding prevents adenosine diphosphate (ADP) from binding to its receptor, thereby inhibiting the activation of the **GP IIb/IIIa receptor complex** and subsequent platelet aggregation. *Inhibition of Thromboxane A2* - This mechanism of action is characteristic of **aspirin**, which inhibits the enzyme **cyclooxygenase-1 (COX-1)**. - COX-1 inhibition leads to reduced production of **Thromboxane A2**, a potent platelet aggregator and vasoconstrictor. *Inhibition of GP IIb/IIIa receptors* - While Clopidogrel ultimately affects the activation of **GP IIb/IIIa receptors**, it does not directly inhibit them. - Drugs like **abciximab**, **eptifibatide**, and **tirofiban** are direct inhibitors of the GP IIb/IIIa receptors, preventing fibrinogen binding and platelet aggregation. *No effect on platelet activation* - This statement is incorrect as Clopidogrel is a well-established **antiplatelet drug**. - Its therapeutic effect is specifically to **reduce platelet activation** and aggregation, thus preventing thrombotic events. [Practice more Pharmacology PYQs on OnCourse]

Q: What is the primary mechanism by which epinephrine reduces insulin secretion?

Predominantly through alpha action. ***Predominantly through alpha action*** - **Epinephrine** primarily reduces insulin secretion by stimulating **alpha-2 adrenergic receptors** on pancreatic beta cells. - Activation of these receptors leads to a decrease in **cAMP levels** and an inhibition of insulin release. *Predominantly through beta action* - **Beta-2 adrenergic receptor activation** on pancreatic beta cells typically **stimulates** insulin secretion, which is opposite to epinephrine's overall effect. - While epinephrine has both alpha and beta effects, the **alpha-2 inhibition** of insulin release predominates in this context. *Through both alpha and beta actions* - Although epinephrine exerts both alpha and beta effects, the **alpha-2 receptor-mediated inhibition** of insulin secretion is the dominant mechanism. - The **beta-2 receptor-mediated stimulation** of insulin release is overridden by the stronger inhibitory alpha-2 effect. *Through muscarinic receptors* - Muscarinic receptors are part of the **parasympathetic nervous system** and are involved in stimulating insulin secretion. - **Epinephrine** acts on adrenergic receptors, not muscarinic receptors, to influence insulin release. [Practice more Pharmacology PYQs on OnCourse]

Q: Which of the following is a guanosine analogue?

Abacavir. ***Abacavir*** - **Abacavir** is a nucleoside reverse transcriptase inhibitor (NRTI) used in HIV treatment. - It is a **carbocyclic analogue of guanosine** (specifically, a 2'-deoxyguanosine analogue). - Structurally, it contains a modified cyclopentane ring instead of the ribose sugar, but retains the guanine base, making it a guanosine analogue. *Acyclovir* - **Acyclovir** is also a **guanosine analogue** - specifically an acyclic guanosine analogue. - It is an antiviral drug used to treat herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections. - Note: Both Abacavir and Acyclovir are technically guanosine analogues; in this PYQ context, Abacavir is the expected answer. *Bromodeoxyuridine* - **Bromodeoxyuridine** is a **pyrimidine analogue**, specifically a thymidine analogue. - It is incorporated into DNA during replication and is used in research and as a radiosensitizer. *Allopurinol* - **Allopurinol** is a purine analogue (hypoxanthine analogue) that inhibits xanthine oxidase. - It is primarily used to treat **gout** and prevent kidney stones by reducing uric acid production. - While it's a purine derivative, it is not specifically a guanosine analogue. [Practice more Pharmacology PYQs on OnCourse]

Question 1

What is considered a toxic serum level of lithium?

Accepted Answer

2.6

Answer

0.6

Answer

12

Answer

<0.6

Question 2

Which of the following drugs is known to cross the blood-brain barrier?

Accepted Answer

Physostigmine

Answer

Glycopyrrolate

Answer

Neostigmine

Answer

All of the options

Question 3

What is the mechanism of action of Clopidogrel?

Accepted Answer

Inhibition of ADP-mediated platelet activation

Answer

Inhibition of Thromboxane A2

Answer

Inhibition of GP IIb/IIIa receptors

Answer

No effect on platelet activation

Question 4

What is the primary mechanism by which epinephrine reduces insulin secretion?

Accepted Answer

Predominantly through alpha action

Answer

Predominantly through beta action

Answer

Through both alpha and beta actions

Answer

Through muscarinic receptors

Question 5

Which of the following is a guanosine analogue?

Accepted Answer

Abacavir

Answer

Bromodeoxyuridine

Answer

Allopurinol

Answer

Acyclovir

Question 6

Which of the following is not a selective serotonin reuptake inhibitor?

Accepted Answer

Buspirone

Answer

Citalopram

Answer

Fluoxetine

Answer

Fluvoxamine

Question 7

All are true regarding Sunitinib except which of the following?

Accepted Answer

It is excreted primarily in urine

Answer

It inhibits tyrosine kinase receptors

Answer

It is used for the treatment of GIST

Answer

It is used for renal cell carcinoma

Question 8

Which of the following medications does not interact with warfarin?

Accepted Answer

Benzodiazepines

Answer

Barbiturate

Answer

Oral contraceptive

Answer

Cephalosporins

Question 9

As per RNTCP guidelines, Multi drug resistance (MDR) TB is defined as resistance to:

Accepted Answer

Rifampicin and isoniazid

Answer

Rifampicin

Answer

Rifampicin, isoniazid and ethambutol

Answer

None of the above

Question 10

Which of the following antibiotics is known to cause bleeding due to its effect on blood clotting?

Accepted Answer

Moxalactam

Answer

Cefaloridine

Answer

Cefazolin

Answer

Ceftazidime

NEET-PG 2012 — Pharmacology