Neurology Pharma MCQs (For FCPS Part 1)

Neurology Pharma MCQs (For FCPS Part 1)

 

1. Half life of desmethyl diazepam, an inactive metabolite of diazepam is:

a. 20-50 hrs

b. 50-100 hrs

c. 100-200 hrs

d. 36-200 hrs

.

Ans. D

.

  • Desmethy diazepam is a metabolite of diazepam; diazepam metabolites have variable half lives.
  • Also remember that diazepam is the longest acting benzodiazepine while midazolam is the shortest acting benzodiazepine.

    .

    2. L- Dopa is combined with Carbidopa in the treatment of parkinsonism to:

    a. Decrease the efficacy of levodopa

    b. Inhibit peripheral decarboxylation of levodopa

    c. Increase the dose of levodopa required

    d. Inhibit conversion of levodopa to dopamine in the CNS

.

Ans. B. Unlike dopamine, which can not cross the blood brain barrier (BBB), L-dopa can cross BBB where it is converted into dopamine by the enzyme “decarboxylase”. Carbidopa is a peripheral decarboxylase inhibitor, and is given with L-dopa to increase the bioavailability of L-dopa in brain and to limit it’s peripheral side effects.

.

3. Morphine causes

a. Bradycardia & meiosis

b. Bradyapnea & mydriasis

c. Tachyapnea & mydriasis

d. Tachyapnea & meiosis

.

Ans. A

.

4. Diazepam relaxes skeletal muscle by acting on

a. Cerebral cortex

b. NMJ

c. Muscle directly

d. Interneuron

.

Ans. A. Receptors for benzodiazapines are present in many brain regions including:

.

  • Cerebral cortex
  • Thalamus
  • Limbic structures

    .

    5. Which effect of opiods does not develop tolerance

    a. Miosis

    b. Analgesia

    c. Sedation

    d. Euphoria

    e. Decrease threshold to apnea

.

Ans. A. Tolerance develops to all side effects of opoids (morphine) except:

.

  • Miosis
  • Constipation

    .

    6. Drug that is contraindicated in Intracranial HTN

    a. Ketamine

    b. Thiopental

    c. Fentanyl

    d. Midazolam

.

Ans. A. Ketamine increases cerebral blood flow; that’s why it is contraindicated in:

.

  • ↑Intracranial pressure
  • ↑Intraocular pressure

    .

    7. Pharmacodynamics Drug-Drug interaction

    a. Thiazide and lithium

    b. Morphine and Naloxone

    c. Procaine and Adrenaline

    d. Phenobarbital and warfarin

.

Ans. B

.

  • Drug-drug interaction means “a modification of the effect of a drug when administered with another drug”.
  • Morphine is opoid-receptor agonist, while naloxone is opoid–receptor antagonist. So, naloxone decreases the effect of morphine if both drugs are coadministered.

    .

    8. Most toxic local anaesthetic is

    a. Bupivacaine

    b. Ropivacaine

    c. Lidocaine

    d. Dimethocaine

.

Ans. A

.

9. In Huntington’s chorea, succinylcholine is contraindicated. Why

a. Pseducholine esterase is deficient

b. Increased pseudocholine esterase

c. Increased metabolism

.

Ans. A. Huntington disease is occurs due to deficiency of acetylcholine. Succinycholine is a strong acetylcholine receptor agonist; it’s neuromuscular blocking effect is potentiated by cholinesterase inhibitors.

.

10. Regarding General anesthesia influence, which is true

a. Motor is affected 1st

b. Pain neurons blocked 1st

c. Sensory neurons blocked 1st

d. Autonomic neurons blocked 15t

.

Ans. B. General anesthesia block sensations in the following order: Pain > Temperature > Touch > Pressure

.

11. An unconsious man with pin-point pupils not responding to Naloxone, the probable cause is

a. Heroin

b. Hasheesh

c. Morphine

d. Phenobarbitone

.

Ans. D. Both morphine and barbiturates (e.g, phenobarbitone) cause pin-point pupils. But morphine poisoning respond to naloxone while phenobarbital do not (there is no antidote for phenobarbital).

.

12. Flumazenil

a. Onset of action is 30-60 min

b. All unconscious patient must be screened by this drug

c. Paradoxical tachycardia

d. Maximum safe dose is 1 mg/day

.

Ans. A

.

13. True about lsoflurane is

a. MAC 1.9

b. Req special vaporizer

c. Decrease HR

d. None of above

.

Ans. B

.

14. Regarding Enflurane which is true

a. EEG typical of seizures

b. Not concerned to dose / conc administration

c. Increase ICP

d. Cause facial spasm

.

Ans. A. Enflurane is a pro-convulsant (i.e., it causes tonic clonic seizures).

.

15. More pungent is

a. lsoflurane

b. Enflurane

c. Desflurane at MAC <1

d. None of above

.

Ans. C. MAC: MAC value, a mesure of anesthetic potency, is defined as the minimal alveolar concentration (% of inspired air) at which 50% of patients do not respond to surgical stimulus.

.

16. Myocardial toxicity caused by which LJA

a. Bupivacaine

b. Lignocain

c. Prilocain

d. None of above

.

Ans. A

.

17. Cardiovascular collapse occurs with

a. Bupivacaine

b. Cocain

c. Procain.

Ans. A

.

18. MetHaemoglobinemia is caused by

a. Prilocaine

b. Cocain

c. Procain

.

Ans. A

.

19. After induction of anesthesia by 10 mq/kq thiopentone, patient is hypotonic. Cause is

a. Hypersensitivity

b. Decrease HR

c. Decrease contractility

d. None of above

.

Ans. A

.

20. Anesthetics differ from anelqesics in:

a. Only alter A delta and C fibers

b. Anesthetics effect at cerebral level and analgesics at spinal cord level

c. Affects only pain and temperature and no other sensory modalities

.

Ans. B (Consciousness is controlled by cerebrum; so anesthetics act on cerebrum).

.

21. An unconscious patient presented in ED does not respond to Naloxone. Which of the following drug has been taken by this patient

a. Morphine

b. Heroine

c. Pethidine

d. Phenobarbital

.

Ans. D

.

22. Ketarnin is used as anesthetic in repeated dressings of burn patient because:

a. It relieves pain as well.

b. High bioavailability

c. Because cause dissociative anaesthesia

.

Ans. A

.

23. Corneal opacities are caused by

a. Ethambutol

b. Phenothiazides

c. Antiepileptics

.

Ans. B

.

24. Which is P450 inducer

a. Isoniazid

b. Phenobarbitone

c. Cemetidine

d. Ketoconazole

.

Ans. B. Phenobarbitone is P450 inducer while cimetidine is P450 inhibitor.

.

25. Morphine can be given in

a. Biliary cirrhosis

b. Terminal ill patient of cancer

c. Acute pancreatitis

d. None of above

.

Ans. B

.

26. Nor-epinephrine & serotonin degradation is done by

a. MAO

b. COMT

c. Pseudocholinesterase

.

Ans. A. MAO degrades:

.

  • Dopamine
  • Norepinephrine
  • 5HT (serotonin)

    .

    27. A pregnant women is on Phenytoin. What is the least likely complication in fetus

    a. Bone deformity

    b. Mental retardation

    c. Cleft palate

    d. Nail Hypoplasia

.

Ans. A. Phenytoin is teratogenic and causes fetal hydantoin syndrome; features of fetal hydantoin syndrome includes:

.

  • Intrauterine growth restriction with a small head
  • Dysmorphic craniofacial features
  • Limb defects including hypoplastic nails and distal phalanges
  • A smaller population will have growth problems and developmental delay, or intellectual disability
  • Methemoglobinemia (rare)
  • Heart defects
  • Cleft lip

    .

    28. P(Mu) opoid receptor is responsible for the following effects except

    a. Miosis

    b. Bradycardia

    c. Hypothermia

    d. Bronchodilation

.

Ans. D. Opoid agonists cause bronchoconstriction; that’s why morphine is contraindicated in asthma (COPD).

.

29. Barbiturates are absolutely contraindicated in which of the following conditions

a. Kernicterus

b. Epilepsy

c. Acute intermittent porphyria

d. Alcoholics

.

Ans. C

.

30. Intramuscular morphine is

a . Independent of blood flow

b. Stable in slow release

c. Pain relief in 3 -4 hr

d. Peak little variable

e. Onset of action 1 hr.

.

Ans. C

.

31. Patient presented with taking deep breaths and resp rate of 6/min. Which drug cause this poisoning

a. Morphine

b. Pethidine

c. Nalbuphine

d. Pheobarbitone

.

Ans. A

.

32. Opoid Toxicity causes

a. Nausea & vomiting

b. Psychosis

c. Pin point pupil

d. Respitory depression

.

Ans. D

.

33. Which of the following is classified as non barbiturate hypnotic

a. Bromide

b. Chloral hydrate

c. Triazolam

d. Chlormethimazole

.

Ans. B

.

34. In which of the following disorders, administration of barbiturates is contraindicated

a. Anxiety disorders

b. Acute intermittent porphyria

c. Kernicterus

d. Refractive status epilepticus

.

Ans. B

.

35. Granulocytopenia. gingival hyperplasia and facial hirsutism are all possible side effects of one of the following

anticonvulsant drugs:

a. Phenytoin

b. Valproate

c. Carbamazepine

d. Phenobarbitone

.

Ans. A

.

36. Carbamazepine’s dopamine receptor blocking effects doesn’t include

a. Amenorrhea & galactorrhea in females

b. Antiemetic

c. Antipsychotic

d. Postural hypotension

e. Parkinson’s

.

Ans. D

.

37. Regarding anti epileptic drugs, which one is incorrect

a. Diazepam inhibits GABAchannels

b. Ethusuxsimide act via blocking of K channels

c. Phenytoin prolongs the inactivated stated on Na Channels

d. Vigabatrin irreversibly block the enzyme

.

Ans. B. Ethosuximide blocks thalamic T-type Ca+ channels.

.

38. Endogeneous muscle relaxant is

a. Endorphin

b. Nitroglycerine

c. MGSO4

d. Diazepam

.

Ans. A

.

39. Ketamine used in repeated burn dressings because

a. It does not cause hypotension

b. Causes profound analgesia

c. It can be given intravenously

d. It does not causes addiction

e. Its not narcotic

.

Ans. B

.

40. Local anaesthetic used during epidural analgesia that has least fetal to maternal ratio:

a. Bupivacane

b. Lidocaine

c. Mepivacaine

d. Etidocain

.

Ans. A

.

41. best time for intravenous prophylactic antibiotic Administration is

A. 12 hours before surgery

B. 6 hours before surgery

C. At the end of the operation

D. At the time of change of first dressing

E. At the time of induction of anaesthesia

.

Ans. E

.

42. which one of the following statements explains most Correctly the effects of curare on striated muscles

A. It affects the formation of the enzyme cholinestrase

B. It inhibits the development of an action potential in the nerve fiber

C. It makes the nerve cell end-plate more permeable to Acetylcholine

D. It prevents depolarization of the post synaptic membrane

E. It stimulates the formation of acetylcholine at the nerve cell end-plate

.

Ans. D

.

SURGERY

43. re.gardinc: succinylcholine (suxamethonium) followir g Statements are true except that

A. Ii is a depolarising type of neuromuscular blocker

B. Muscle paralysis is preceded by muscle twitching

C. Overdose effects are reversed by neostigmine

D. Rate of metabolism markedly differs in different persons

E. Use with halothane may sometimes cause malignant hyperthermia

.

Ans. C

.

44. Recognized side-effects of phenytoin include except

A. Ataxia

B. Epilsptic seizures

C. Folate depletion

D. Gum hyperplasia

E. Hlirsutism

.

Ans. B

.

45. regardii4g barbiturates, all of the following are true except;

A. Are rapidly excreted in acid urine

B. Are usually metabolized in the liver

C. Depress the respiratory centre

D. Have anticonvulsant properties

E. Inhibit the activity of certain liver enzyme systems

.

Ans. A

.

46. Gallamine triethiodide causes paralysis of muscles by

A. Blocking interneurons in spinal cord

B. Blocking release of activator ca2+ in the sarcoplasm

C. Blocking the synthesis of acetylcholine in motor nerve endings

D. Competing with acetylcholine at motor end plate

E. Depolarizing motor end-plate

.

Ans. D

.

47. a 16 year old female is induced with thiopental and succinyl Chloride. Anesthesia is maintained with halothane. The patient is spontaneously ventilating. The most reliable Feature of malignant hyperthermia is

A. Hypertension

B. Increased pco2

C. Metabolic alkalosis

D. Tachycardia

E. Tachypnea

.

Ans. B

.

48. an 18 year old boy had motor vehicle accident. On x-ray chest he Fracture of right 5th and 6th ribs.Which will be the most appropriate local anaesthetic to relieve his pain for a longer duration

A. Bupivacaine

B. Cinchocaine

C. Lignocaine

D phenol

E. Procainamide

.

Ans. A

.

49. drug blocks neuromuscular transmission is

A. Di isopropyl fluorophosphate

B. Methacholine

C. Neostigmine

D. Physostigmine

E. Tubocurarine

.

Ans. E

.

50. rapid eye movement (rem) sleep can be induced by

A. Barbiturates

B. Benzodizepines

C. Halothane

D. Morphine

E. No known drug can do it

.

Ans. E

.

51. a young man was operated for inguinal hernia under general Anaesthesia. In the recovery room nurse rushed and reported That the patient ws not breathing. He was cyanosed. The most Likely drug which caused this problem is

A. Diazepam

B. Fialothane

C. Neosticimine

D. Pancuronium

E. Pentazocin

.

Ans. D

.

52. recognized s:de-effects of phenytuin does not include;

A. Ataxia

B. Epileptic, seizures

C. Rotate depletion

D. Gum hyperplasia

E. Hirsutism

.

Ans. B

.

53. a 30 year old labourer is brought to the hospital in a comatose State with constricted pupil and depressed respiration. He is Diagnosed to be under the influence of a large dose of Morphine. The best drug to antagonise morphine effects in this Patient is

A. Dexamphetamine

B. Flumezanidl

C Nalorphine

D. Naloxone

E. Peutazocine

.

Ans. D

.

54. a 12-year old boy suffers from generalised tonic – clonic Epileptic seizures. He is on antiepileptic drugs for the last one Year. Recently he has developed painful swelling of his_gums in Addition to the earlier problems of nystagmus and ataxia. These Adverse effects are most likely due to

A. Carbamazepine

B. Clonazepam

C. Phenobarbitone

D. Phenytoin

E. Valproic acid

.

Ans. D. Phenytoin causes gingival hyperplasia (swelling of gums).

.

55. when halothane is used alone as general anaesthetic, 11′ do s Not produce quick induction and good analgesia. Which of t Following drugs is used with it for making 1.3p both of these Deficiencies

A desflurane

B. Ether

C Etomidate

D Nitrous oxide

E. Thioperitone

.

Ans. D

.

  • Being a weak anesthetic, NO is used with other anesthetics to reduce their dose.
  • Though NO is a weak anesthetic, it has a rapid onset (and rapid recovery).

    .

    56. naloxone

    A. Can be given by ntranaiscukr route

    B. Can precipitate acute opioid withdrawl in an addict

    C. °cannot be given by continous infusion

    D. Has a narrow therapeutic index

    E. Is effective within 30 seconds

    .

    Ans. B

    .

    57. Which one of allowing is Antagonist of Morphine Poisoning?

    A. Naloxone

    B. Neostigmine

    C. Diazepam

    D. Atropine

    E. Frusemide

    .

    Ans. A

    .

    58. Which of the following is effect of CURARE drugs of skeletal muscle fiber?

    A. Affects the cholinesterase activity

    B. Increase the release of acetylcholine

    C. Inhibit the depolarization of postsynaptic membrane

    D. Cause stimulation of postsynaptic membrane

    E. Bled the receptors on postsynaptic membrane

    .

    Ans. C

    .

    59. During giving the General Anesthesia to a patient, Halothane has less analgesia Et is difficult to induce. Which of the following drugs is given before Hatothane to minimize this problem.

    A. Nitroflurane

    B. Nitrous Oxide

    C. Thiopentone

    D. Enflurane

    E. Diazepam

    .

    Ans. B

    .

    60. Succinylcholine is used during anesthesia as skeletal muscle relaxant. Which is the Enzyme responsible for its metabolism?

    A. Acetyl cholinesterase

    B. Pseudocholine esterase •

    C. Phosphorylase

    D. Succinyl cholinesterase

    E. Plasma cholinesterase

    .

    Ans. B

    .

    61- A patient after the chest injury is brought to emergency room. Third & fourth ribs are Fractured. For the prevention of pain which of the following local anesthetics with long Duration of action should be used in this patient?

    A. Lignocaine

    B. Bupivicaine

    C. Cinchocane

    D. Procainamide

    E. Cocaine

    .

    Ans. B

    .

    62- An unconscious pt. Does not respond even after he is given naloxone, wat drug he has taken?

    A. Morphine

    B. Heroine

    C. Pethidine

    D. Phenobarbitone

    .

    Ans. D

    .

    63. Drug that causes constipation

    A. Amoxicillin

    B. Coichicines

    C. Diamorphin

    D. Digoxin

    .

    Ans. C

    .

    64. Morphine causes’

    A) bradypneaarlliosis

    B) bradypneaamyddasis

    CI tachypnea amiosis

    D) tachypnea amydrasis

    .

    Ans. A

    .

    65. Which is correct statement regarding the anesthetic agents

    A) Thiopental decreases heart rate

    B) Ketamine is bronchoditator

    C) Thiopental increases heart rate

    D) 11alothane is safe in ao

    E) None of the istorrect

    .

    Ans. B

    .

    66. Dependence does not develop to which one of the followings effects of (molds

    A) Pupittary constriction

    B) Pupittary dilatation

    C) Effect on CVS

    D) Respiratory depression

    E) Both C and D

    .

    Ans. A

    .

    MEDICINE

    67. Regarding REM sleep

    A. Low threshold for wakening

    B. Beta waves

    C. Enuresis

    D. Simbutism

.

Ans. B

.

68. Which drug has action similar to atropine

A. Succinylcholine

B. Scopolamine

C. Hexamethonium

D. Carbachol

.

Ans. B

.

69. Endogenous muscle relaxant is

A. Endorphin

B. Nitroglycerine

C. Mgso4

D. Salbutamol

.

Ans. A

.

70. Which of the following is Pharmacokinetic action of the durg

A. Bone marrow suppression by Methotrexate reversed with aspirin

B. Morphine induced respiratory depression with nalaxone

C. Beta beta-blockers induced asthma-a can be relieved with Hydrazaline

D. Adverse effect of levodopa can be increased by carbidopa

.

Ans. B

.

71. A Pt known case of epilepsy is suffering from episode of tonic clonic seizures. Physcian is trying to stop it since half an hour but has failed to do so. What should be the drug Of choice now

A. Diazepam

B. Lorazepam

C. Alprazolam

D. Midazolam

.

Ans. B

.

72. A person with the history of drug intake excessive amount, Naloxon was given but the Person has not responded what drug It may be

A. Morphine

B. Opium

C. Organnophosphorus

D. Phenobarbitone

E. Pethidine

.

Ans. C

.

73. A semiconscious patient is brought to the emergency room. He has history of taking Some unknown drug. Nahco3 reverses the action of the drug. Which drug the pt has Likely taken:

A. Phenobarbital

B. Phenothiazine

C. Morphine

D. Diazepam

E. Alcohol

.

Ans. A

.

74. Example of Drug-Drug interaction is

A. Morphine with Naloxone

.

Ans. A

.

75. Diazepam relaxes skeletal muscle by acting on:

A. Cerebral cortex

B. NMJ

C. Muscle directly

D. Intemeuron

.

Ans. D

.

76. Analgesic effect of morphine is useful for:

A. Terminal cancer pain

B. Head injury

C. Binary colic pain

D. Ulcer pain/upper 21 hemorrhage

E. COPD

.

Ans. A

.

GYNAE

77. A semiconscious patient is brought to emergency department. He has history of taking some unknown drug. NaHCO2 reverses the action of drug. Which drug he has most likely taken?

A. Phenobarbital

B. Phenothiazine

C. Morphine

D. Diazepam

E. Alcohol

.

Ans. A

.

78. During general anesthesia Halothane is given in combination with which of the following drugs?

A. Thiopentone

B. Nitric oxide

C. Enfluran

D. Phenobarbital

E. Ketamine

.

Ans. B

.

79. In which of the following conditions there is increased half life of succinylcholine?

A. Acetyl cholinesterase deficiency

B. Plasma cholinesterase deficiency

C. Succinylcholineesterase deficiency

D. High doses of h..ethane

.

Ans. B

.

80. Half life dopamine is:

A. 02 minutes

B. 15 minutes

C. 24 minutes

D. 60 minutes

E. 05 minutes

.

Ans. A

.

81. Which of the following is the least likely side effect of Phenytoin?

A. Mental retardation

B. Cataract

C. Limb defects

D. Cardiac defects

.

Ans. C

.

82. In drug receptor relations which one is incorrect?

a) Bradycardia Propranolol

b) Thesis Pilocarpine

c) Skeletal Muscle Paralysis — Tubocurarine

d) Bronchodilation Salbutamol

.

Ans. C

.

83. 1f you give L Dopa to the pt of Parkinsonism which hormone will decrease?

a) Prolactin

b) FSH,LH

c) Testosterone

.

Ans. A

.

84. A pregnant women is on Phenytoin, what is the least likely complication in fetus?

a) Bone deformity

b) Mental retardation

c) Cleft palate

.

Ans. A

.

EYE

85. Carbidopa inhibits which of the following enzymes

A. Dopa decarboxylase

B. Tyrosine kinase

C. Dopamine hydroxytase

D. Dope oxygenase

.

Ans. A

.

ANESTHESIA

86. T 1/2 of desmethyl diazepam, an inactive metabolite of diazepam is:

a. 20-50 hrs

b. 50-100 hrs

c. 100-200 hrs

d. 36-200 hrs

.

Ans. D

.

MIXED

87. Which of the following nerve fibers is first blocked by the local anesthetic

A. Motor fibers

B. Large pain fibers

C. Sensory touch fibers

D. Small deep pain fibers

E. Vibration sense fibers

.

Ans. D

.

88. A patient after the chest injury is brought to emergency room, third 13 tooth ribs are fractured. For the prevention of pain which of the following local anesthetics with long duration of action should be used in this patient?

A. LIgnocain

B. Bupivicane

C. Cinchocaine

D. Procainamlde

E. Cocaine

.

Ans. B

.

89. The administration of focal anesthetics will result in all of the following EXCEPT:

A. Tachycardia

B. Vasodilation

C. Myocardial depression

D. Seizures

E. Failure of anesthesia in acidotic tissues

.

Ans. A

.

90. L -Dopa treatment of parkinson’s disease is most likely in dramatic improvements in:

A. Mood

B. Tremor

C. Long term disease progression

D. Strength

E. Hypokinesia

.

Ans. E

.

91. The best treatment of pain in a patient with myocardial infarction is;

A. Morphine

B. Nitrates

C. Streptokinase

D. Aspirin

E. NSAIDS

.

Ans. B

.

.

.

.

Be nice whenever possible. It is always possible.