DHYEY GPAT 07/09/2023

 

DHYEY GPAT 2024 MCQ SERIES WITH EXPALAINATION




* BOLD CHARACTER IS RIGHT ANSWER FOR THE QUESTION

1. Following statements about pharmacokinetics of a drug are true/false? 
(A) Most drugs are absorbed in ionized form 
(B) Basic drugs are generally bound to plasma albumin 
(C) Microsomal enzymes are located in mitochondria of hepatic cells 
(D) Blood brain barrier is deficient at CTZ 
(E) Highly plasma protein bound drugs have high volume of distribution

EXPLAINATION :
  • Most drugs are absorbed in un-ionized form as this is the lipid soluble form.
  • Acidic drugs bind to albumin and basic drugs usually bind to alpha1 acid glycoprotein.
  • Microsomal enzymes are present in smooth endoplasmic reticulum of hepatocytes. 
  • Chemoreceptor trigger zone is a circumventricular organ, means it is devoid of blood brain barrier
  • If a drug has high plasma protein binding, it decreases the volume of distribution
2. Following statements are true/false about clinical uses of atropine? 
(A) It is used for treatment of belladonna poisoning 
(B) It is drug of choice for producing cycloplegia in children 
(C) It is preferred drug in organophosphate poisoning 
(D) It is used for treatment of bradyarrhythmias 
(E) It is first line drug in angle closure glaucoma

EXPLAINATION :

  • Atropine is contraindicated in belladonna poisoning. Plant atropa belladonna is a source of atropine, so belladonna poisoning itself means atropine poisoning.
  • Atropine is strong cycloplegic drug and is therefore preferred in children as they have high tone of ciliary muscle. 
  • Atropine is drug of choice for organophosphate and carbamate poisoning. 
  • Atropine is drug of choice of Bradycardia and AV block.
  • Atropine is contraindicated in a patient with angle closure glaucoma. It may lead to precipitation of acute attack of glaucoma in such patients. 
3. The following statements are true/false about the use of drugs in Rheumatoid Arthritis? 
(a) NSAIDs are the mainstay of therapy for slowing the disease progression 
(B) Methotrexate is most commonly used disease modifying agent 
(C) Sarilumab is a monoclonal antibody against IL-6 
(D) Abatacept is a co-stimulation inhibitor used in rheumatoid arthritis. 
(E) Etanercept should be avoided in a patient with tuberculosis.

EXPLAINATION :
  • NSAIDs are used for symptomatic treatment in Rheumatoid arthritis. These cannot slow the disease progression.
  • Methotrexate is most commonly used DMARD in rheumatoid arthritis. 
  • Sarilumab is recently approved monoclonal antibody against IL-6. It is a biological DMARD. 
  • Abatacept acts by inhibiting co-stimulatory signal for activation of Tcells 
  • Etanercept is a fusion protein targeted to inhibit TNF-alpha. These drugs can worsen TB and hepatitis B and thus are contraindicated in such patients.
4. Following statements are true/false about drugs affecting renin angiotensin aldosterone system?
(A) Aliskiren acts by inhibiting the secretion of renin
(B) Enalapril can cause cough and angioedema 
(C) Losartan inhibits the formation of angiotensin II 
(D) Epleronone causes gynaecomastia as an adverse effect 
(E) Sampatrilat has additional inhibitory activity on neprilysin apart from inhibitory effect on ACE

EXPLAINATION :

  • Aliskiren is a renin inhibitor. It does not inhibit secretion of renin. Rather it inhibits the action of renin after it is secreted. Beta blockers act by inhibiting the secretion of renin. 
  • ACE inhibitors like enalapril prevent the degradation of bradykinin. Excessive bradykinin can result in cough and angioedema as adverse effects. 
  • Losartan is an angiotensin receptor antagonist. It does not inhibit the formation of angiotensin II. 
  • Epleronone is a new aldosterone antagonist like spironolactone, however unlike spironolactone, it does not cause gynaecomastia. 
  • Sampatrilat and omapatrilat are vasopeptidase inhibitors. These can inhibit two enzymes; ACE and neprilysin.



5. Following statements are true/false about diuretics? 
(a) Mannitol is contraindicated in pulmonary edema 
(b) Thiazides are first line drugs in hypertension
(c) Thiazides are also used in nephrogenic diabetes insipidus 
(d) Furosemide has high ceiling diuretic effect 
(e) Acetazolamide is used for prophylaxis of mountain sickness

EXPLAINATION :

  • Mannitol is contraindicated in pulmonary edema and acute renal failure. 
  • Thiazides are first line drugs in treatment of hypertension. 
  • Thiazides are also drug of choice for the treatment of nephrogenic diabetes insipidus. 
  • Loop diuretics like furosemide are high ceiling diuretics. 
  • Acetazolamide is drug of choice for prophylaxis and treatment of mountain sickness. 

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