Acute Care Division

TEST PAPER Final Test Paper

Marks Time 1hr. ---------------------------------------------------------------------------------------------------100

Q.1. Fill in the Blanks (Each blank carr !ne mark" 1. Cough is a _______________ reflex. #. Dry Cough has cough without expectoration, has no physiologic purpose and hence should be suppressed with _________________. $. Stimulation of %%%%%%%% receptors in the lungs by Terbutaline leads to relaxation of bronchial smooth muscles. &. _____________ is an abnormal reaction to an ordinarily harmless substance. Is a state of abnormal sensitivity to foreign material called an allergen in susceptible individuals. '. %%%%%%%%%%%%%%% exerts its action by stimulating the stomach reflexes from stomach, and thereby increases intrathoracic pressure to aid expectoration (. Chlorpheniramine effective in relieving symptoms of allergic rhinitis such as %%%%%%%%%%%%%) %%%%%%%%%%%% and itching of nose, eyes and throat. *. !henylephrine is a direct selective %%%%%%%% adrenergic receptor agonist) it does not cause release of endogenous noradrenaline) as pseudoephedrine does. Therefore, is less li"ely to cause __________ such as C#S stimulation, insomnia, anxiety, irritability, $ restlessness. +. _____________ acid lubricating properties. an important component of synovial fluid, provides

,. % sprain is an in&ury involving the stretching or tearing of a ______________.

10. Strains are in&uries that involve the stretching or tearing of a _________ and ___________ structure. 11. %sthma is a ___________ inflammatory disease characteri'ed by airway ______________________ to a variety of stimuli resulting in _____________ which reverses spontaneously or with pharmacotherapy. 1#. In __________ airflow limitations is usually both progressive ( abnormal inflammatory response to noxious particles or gases. 1$. %%%%%%%%%%%%%% infections are called as cross infections in hospitals. 1&. _________ therapy is a medical term referring to the initiation of treatment prior to determination of a firm diagnosis. 1'. is an acute infection of lung tissue including alveolar spaces $ interstitial tissues. 1(. % )ram positive results in a ____________ color while a )ram negative results in a ______________ color. 1*. *raction of drug in unchanged form that reaches the systemic circulation after undergoing first pass metabolism is called __________________. 1+. +olecule of a cell where a drug binds to produce its action is called as a _________________. 1,. %%%%%%%%%%%% means better clinical out come of a drug after its administration. #0. %%%%%%%%%%%%%%% is the detailed study of effects of the drugs on the body. #1. %%%%%%%%%%%%%% are tiny granules composed of ,#% and protein. They synthesi'e proteins from amino acids. Q.#. )ive examples of the following -

_________

a" Inhaled Corticosteroids .any two/ 0 %%%%%%%%%%%% %%%%%%%%%%%%

b/ Antich!liner-ics Short acting - __________________ 1ong acting - %%%%%%%%%%%%%%%

c/ 1eu"otriene +odifiers - _________________. d/ 2eta 3 %gonist 0 . any two/ Sh!rt actin _____________ , ______________ ,

.!n- actin ______________, _______________

e/ +ethylxanthines _______________ , _______________, ______________

Q.# /h!!se the ri-ht ans0ers 1 4. Suppress cough by increasing the threshold of the cough centre to incoming stimuli a/ b/ c/ d/ Codeine Terbutaline %mbroxol )uaifenesin

3. %nti tussive produces action by depressing the cough centre a/ b/ c/ d/ Cortex of 2rain ,espiratory Centre +edulla 5blongata !ituitary )land

6. *acilitates movement of loosened material towards the pharynx by ciliary motion and 7xpectoration a/ b/ c/ d/ %mbroxol )uaifenesin Terbutaline +enthol

8. %lters the structure of mucus to decrease its viscosity a/ b/ c/ d/ Demulcent 7xpectorant 2ronchodilator +ucolytics

9. Direct scavenger of reactive oxygen metabolites a/ b/ c/ d/ %mbroxol Terbutaline )uaifenesin +enthol

:. +ay cause bronchospasm, hence not recommended in asthmatics a/ 7rdosteine b/ %mbroxol c/ 2romhexine d/ # acetylcysteine ;. %lpha 4 agonist causes mucosal vasoconstriction, has indirect action as a sympathomimetic amine 0 a/ Triprolidine <cl b/ Chlorpheneramine maleate c/ !henylpropanolamine <cl d/ Diphenhydramine <cl =. Second generation antihistamines 0 a/ ,upatadine b/ Dexchlorpheniramine c/ %'atidine

d/ <ydroxy'ine >. !rovides a protective coating and soothing effect on the irritated mucosa of the pharynx a/ !henylepherine b/ +enthol c/ %mbroxol d/ 2romhexine <cl 4?. Sinuses are of three types, *rontal, +axillary and 0 a/ 1acrimal sinus b/ #asal sinus c/ 5rbital sinus d/ Sphenoid sinus 44. *irst pass metabolism ta"es place in the 0 a. Intestine b. S"in c. 1iver d. #one of the above. 43. Teratogenicity refers to capacity of the drug to cause a/ 1iver abnormalities b/ @idney dysfunction c/ *oetal abnormalities d/ Cardiac abnormalities 46. Drugs that do not dissolve in water .hydrophobic/ need to be first converted into water soluble metabolites before 0 a. distribution can begin b. metabolism can begin c. excretion can begin d. absorption can begin 48. It is an estimated measure of the degree to which it is AtrueB in a group of population. The higher p level represents a decreasing index of the reliability of a result in clinical trials means -

a/ b/ c/ d/

Statistical Significance 2order line Significance ,elative ris" Significance %bsolute ris" Significance

49. Chief cells are responsible for secretion of a. +ucus b. !epsinogen c. )astrin d. <ydrochloric acid 4:. !rimary symptoms may be bloating, fullness $ gas distention of abdomen in 0 a. b. c. d. Clcer li"e dyspepsia +otility li"e dyspepsia ,eflux li"e dyspepsia *unctional or non ulcer dyspepsia li"e cells or mast cells secretes 0

4;. 7nterochromaffin

a. +ucus b. %cetylcholine c. )astrin d. <istamine 4=. Common organism involved in #osocomial !neumonia is a. b. c. d. Staphylococcus aureus +ycoplasma pneumonia <aemophilus influen'a Streptococcus pneumoniae

4>. Crinary tract infections are caused by bacteria and are 4? times more common among women than men and present common symptoms li"e 0 a. !ain or burning during urination b. #eed to urinate more often than usual c. *eeling of urgency during urination d. %ll of the above 3?. Typhoid fever is a life threatening illness caused by the bacterium 0 a. !seudomonas, b. @lebsiella

c. Salmonella typhi d. Serratia 21. S"in and soft tissue infections are usually caused by 0 a. Staphylococcus aureus $ Streptococcus pyogenes. b. @lebsiella $ Serratia c. Streptococcus pneumoniae d. %ll of the %bove 22. Infection of the upper genital tract i.e. above the cervix is "nown as a. )onorrhoea b. 2acterial Cystitis c !elvic Inflammatory disease d. Crinary Tract infections 23. The most common bacterial pathogen in 5titis media is 0 a. Streptococcus pneumoniae b. Staphylococcus aureus c. @lebsiella pneumoniae d. #one of the above 24. Dhich of the following is atypical bacterium 0 a/ Staphylococcus aureus b/ Streptococcus pneumonae c/ 1egionella pneumophilla d/ !seudomonas 25. <ospital acEuired pneumonia or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 0 a/ 8 0 ; hrs. after being admitted b/ = 0 4: hrs. after being admitted c/ 4; 38 hrs. after being admitted d/ 8=0;3 hrs. after being admitted Q.$. State 0hether the Statement is Tr2e !r False. 1. *irst generation antihistamines is reserved for those patients not controlled with Second generation antihistamines. . /

#. <igh doses of !seudoephedrine <cl can produce C#S stimulation $ also slight increase in blood pressure . / $. 7rdosteine reduces cyto"ine synthesis, granule en'yme release $ free radical generation by alveolar macrophages and protects alpha 4 antitrypsin against oxidative inactivation. . / &. 2romhexine <cl does induce hydrolytic depolymeri'ation of mucoprotein fibers and does not stimulate activity of the ciliated epithelium. . / '. Dextromethorphan hydrobromide acts within half an hour of administration by mouth and exerts effect for upto : hrs. . (. Intraarticular in&ection of steroids are only given in severe cases unresponsive to #S%IDs . / *. Cardiovascular morbidity $ mortality has bac" lifted coxibs . / /

+. C5F 4 are "nown as the constitutive or good house"eeping prostaglandins. . / ,. %cute pain which lasts more than 6 months after the in&ury . /

10. +usculos"eletal system is the commonest target, of chronic inflammation causing painful $ restrictive movements. . / 11. In ,% abnormal synovial cells begin to invade $ destroy cartilage $ bone within the &oint. . / 1#. <alf life is the time needed for the plasma concentration of a drug to fall to above the C max value. . / 1$. +ost of the drugs are metaboli'ed in the liver by en'ymes Cytochrome ! 89? . / 1&. Since both <( and Cl ions are outside the cell, they can combine together to form <Cl in the presence of <35 . . /

1'. Infection with <. pylori bacteria .i.e. <. pylori associated ulcers are rare and are reported to be overall &ust only 4?G cases/ . /. 1(. % group of tissues with similar structure and function is "nown as cells . / 1*. The term recurrent is defined as 6 or more episodes in : months, or 8 or more in a year. . /. 1+. H lactams antibiotic inhibits the cell wall synthesis of the bacteria . /

1,. %bout 9? G of chronic cough in referral practices is said to be due to 7osinophilic 2ronchitis. . /. #0. 2acterial Culture ta"es about 8 to = hours for colonies to become visible . /. Q.& Match the 3r-anisms 1 (( marks" A a/ Staphylococcus. spp. b/ Clostridium spp. c/ 7scherichia. coli d/ #eisseria meningitidis e/ +ycobacterium tuberculosis f/ +ycoplasma pneumonae Ans0ers 1 .a /, .b /, .c 4. 3. 6. 8. 9. B )ram !ositive cocci )ram #egative cocci %cid *ast 2acteria )ram !ositive bacilli %typical organism

:. )ram #egative bacilli / , .d /, .e / , .f /.

Q.'. Match the 4!ll!0in- 1 A 1. #. $. /!5eine ph!sphate Ambr!6!l 7cl Er5!steine a. b. c. Br!nch!5ilat!r Act b inhibiti!n !4 m2c2s secreti!n Metab!lite B

&. '. (. *. +. ,. 10 .

Menth!l Phen lephrine :e6tr!meth!rphe n Terb2taline s2lphate <2aiphenesin .e9!-cetri=ine /arb!c steine

5. e. 4. -. h. i. >.

8rritant t! -astric m2c!sa an5 hence ca2ses re4le6 e6pect!rati!n 8ncreases Sali9ati!n ;asal :ec!n-estant Anti-in4lammat!r 3pi!i5 alkal!i5 ;!n-narc!tic c!2-h s2ppressant Metab!lite !4 Br!mhe6ine

Ans0ers 1 .4
.=

/ .3 / .>

/ .6 / .4?

/ .8 /.

/ .9

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