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

Tofacitinib. ***Tofacitinib*** - **Tofacitinib** is an oral medication that functions as a small molecule **Janus Kinase (JAK) inhibitor**, primarily targeting JAK1 and JAK3. - By inhibiting JAK enzymes, tofacitinib disrupts the signaling pathways of several **cytokines** involved in inflammation, including those implicated in **inflammatory bowel disease (IBD)**. *Adalimumab* - **Adalimumab** is a monoclonal antibody that targets and neutralizes **tumor necrosis factor-alpha (TNF-α)**, a key inflammatory cytokine. - It is not a JAK inhibitor but rather works by blocking the interaction of TNF-α with its receptors on cell surfaces. *Vedolizumab* - **Vedolizumab** is an anti-integrin monoclonal antibody that selectively blocks the α4β7 integrin on lymphocytes. - This action prevents lymphocytes from migrating into the gastrointestinal tract, thereby reducing inflammation in IBD. *Infliximab* - **Infliximab** is a chimeric monoclonal antibody that, like adalimumab, targets and neutralizes **tumor necrosis factor-alpha (TNF-α)**. - It works by binding to soluble and transmembrane forms of TNF-α, preventing its pro-inflammatory effects. [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 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 4

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 5

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 6

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 7

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

Question 8

Which one of the following is used to reverse the anticoagulant effects of Dabigatran?

Accepted Answer

Idarucizumab

Answer

Desferrioxamine

Answer

Protamine

Answer

Glucarpidase

Question 9

Fomepizole is an antidote used to treat poisoning from which of the following substances?
I. Methanol
II. Digoxin
III. Cocaine
IV. Ethylene glycol

Select the correct answer using the code given below :

Accepted Answer

I and IV

Answer

III and IV

Answer

I and II

Answer

II and III

Question 10

What is the antidote for belladonna poisoning?

Accepted Answer

Physostigmine

Answer

Atropine

Answer

Amitriptyline

Answer

Flumazenil

UPSC-CMS 2025 — Pharmacology