MEDSPARKLES MCQs Bank PDF

MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education MEDSPARKLES MCQs Bank 1. Which of the following increase with age? A- Parathyroid hormone B- Total body water C- Bone mass D- Hair growth 2. Suitable co...

MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education MEDSPARKLES MCQs Bank 1. Which of the following increase with age? A- Parathyroid hormone B- Total body water C- Bone mass D- Hair growth 2. Suitable corticosteroids for diaper rash A- 0.025 % hydrocortisone B- 0.5% hydrocortisone C- 0.05 % betamethasone D- Acetamide 0.05% 3. Dorzolamide MOA for glaucoma? A- Decrease production of aqueous humor B- Decrease outflow from ciliary body C- Increase production of aqueous humor D- Increase outflow from ciliary body 4. Last layer of the eye? A- Cornea B- Retina C- Sclera D- Choroid 5. Woman taking combined OCP, which element shall be monitored after 4 weeks? A- CA B- K C- NA D- CL +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 6. A woman wants to stop smoking, she had jaw surgery recently and anorexia nervosa. A- Nicotine gum B- Nicotine patches C- Nicotine lozenges D- Bupropion 7. Which of the following cause acute hepatitis? A- Hepatitis A B- Hepatitis B C- Hepatitis C D- None of these 8. Patient taking Metformin and Amiodarone; hemoglobin is decreased with high MCV. What’s the cause of anemia? A- Hemolytic anemia B- Vitamin B12 deficiency C- Microcytic anemia D- Aplastic anemia 9. Which of the following is least causing hypoglycemia? A- Gliclazide B- Glimepiride C- Glyburide D- Sitagliptin 10. Bacterial vaginosis? A- Itching, white, thick discharge B- Inflammation with mild pain and malodor discharge C- Itching with purulent discharge D- None of these 11. In the body, the N of NO (Nitric Oxide) is taken from? A- L-Arginine B- Alanine +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C- Leucine D- Other AAs 12. Which one of the following is the most basic amino acid? A- Alanine B- Arginine C- Phenylalanine D- Methionine 13. A patient is not willing to take her prescribed Erythromycin anymore because of its GIT side effects. What’s the best assertive and appropriate way to recommend changing the prescription while talking to her physician? A- I am sorry to disturb you, do you have time to discuss Mrs. FH case? B- Are you aware that Erythromycin that you prescribed caused GIT side effects to Mrs. FH? C- I am calling about MRS FH. She claims she can’t take her medication because she can’t tolerate the GIT Side Effects, how about considering Azithromycin? D- Do not bother to take initiative 14. In case of insomnia, a patient was prescribed Sertraline. How long does it take to see the effect? A- 1-2 weeks B- 2-4 weeks C- 5-7 weeks D- 8-10 weeks 15. What are the clinical symptoms of Rhabdomyolysis? A- Dark Urine B- Hematuria C- Edema D- Joint swelling 16. Atrial fibrillation, what to use to decrease heart rate? A- Digoxin B- Amlodipine +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C- Amiodarone D- Acebutolol 17. Which of the following is used for migraine prophylaxis? A- Tramadol B- Naratriptan C- Topiramate D- Carbamazepine 18. Gingival hyperplasia affects? A- Gum B- Lips C- Face D- Skin 19. Montelukast MOA? A- Leukotriene receptor antagonist B- Leukotriene receptor agonist C- COX-1 inhibitor D- COX-2 inhibitor 20. Which of the following does not cause CAP (Community-Acquired Pneumonia)? A- Staphylococcus aureus B- Chlamydophila pneumonia C- Streptococcus pneumoniae D- Mycoplasma pneumonia 21. Most teratogenic? A- Herpes simplex B- Herpes zoster C- Rubella D- Human papillomavirus 22. Carbonic anhydrase is produced by? A- Reticulocytes +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education B- Myocytes C- Astrocytes D- Erythrocyte 23. Contraception after delivery? A- Should take Progesterone injection B- IUD after 4 weeks C- Combined OCPs D- Avoid medroxyprogesterone 24. Type of vaccine we give at 1 year old and a booster at preschool age (4–5 years)? A- MMR vaccine B- Polio vaccine C- Hepatitis B vaccine D- Pneumonia (Pneumococcal) 25. How to store breast milk? A- Could be refrigerated for 48 hours B- Freezer for 1 year C- Room temperature for 12 hours D- The rest after baby feed could be kept in the fridge for 24 hours 26. Where to put vaccines in the fridge shelf and temperature? A- A thermometer shall be placed in the middle shelf of the refrigerator B- Shall be refrigerated from 2-12°C C- Can be refrigerated in the same refrigerator as food but in a separate part D- You have to check and document the degree of the refrigerator daily 27. A kid was successfully treated with Amoxicillin for otitis media and got infected again after 3 weeks. What do you recommend? A- Amoxicillin 5 days B- Amoxicillin-clavulanate 10 days C- Clotrimazole D- Clindamycin +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 28. Who is responsible for hospitals' monitoring and quality in Canada? A- Provincial governments B- Health Canada C- Hospital management D- Regional health authorities 29. Plant/Herbal medicine in Canada is regulated by? A- Health Canada B- Natural Products Directorate C- Canada Food Inspection Agency D- Canadian Pharmacological Association 30. Which program in Canada allows healthcare professionals to access drugs that are not approved for sale for patients with serious or life-threatening conditions? A- Health Canada Special Access Program (SAP) B- Provincial health programs C- Federal emergency drug release D- Compassionate care drug access 31. Nail tinea treatment duration? A- 2 weeks B- 4 weeks C- 6 weeks D- 2 months 32. Verapamil side effect? A- Constipation B- Postural hypotension C- Diarrhea D- None of these 33. A cat scratched a boy. What is the best choice? A- Clindamycin B- Amoxicillin +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C- Amoxicillin-clavulanate D- Cotrimoxazole 34. Which virus causes fetal defect and deafness? A- Rubella B- Varicella zoster C- HSV D- HPV 35. Laxative for infant 10 mmol/L, no action is required. D. Ketones in urine are not a concern in diabetic patients. 1342. Vitamin B12 deficiency causes: A. Optic atrophy B. Papilloedema C. Centrocecal scotoma D. Loss of position sense 1343. Pupil dilatation occurs with: A. Neostigmine B. Cocaine C. Atenolol D. Codeine 1344. Cytochrome P450 is: A. Involved in phase I metabolic reactions B. Found in lysosomes C. Found in hepatocytes D. Found in mitochondria 1345. The effect of glucagon includes: A. Ketogenesis B. Glycogenolysis C. Gluconeogenesis D. All above 1346. Vasodilators produced by the endothelium include: A. Endothelium-derived relaxing factor (EDRF) B. Nitric oxide (NO) C. Prostacyclin (PGL2) D. All above 1347. Balance salt solution (BSS) used in cataract surgery contains: A. Mannitol B. Calcium chloride +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. Magnesium chloride D. Acetate 1348. Actions of angiotensin II include: A. Increases the release of aldosterone B. Reduces renin release from the kidney C. Vasodilatation D. Promotes microalbuminuria 1349. In a normal nephron: A. The descending loop of Henle is impermeable to water B. ADH increases the permeability of collecting ducts to water C. All the filtered glucose is reabsorbed in the proximal tubule D. Nearly all the filtered protein is reabsorbed in the proximal convoluted tubule 1350. The following cranial nerves contain parasympathetic outflow arising at the brainstem: A. Optic nerve B. Oculomotor nerve C. Trigeminal nerve D. Facial nerve 1351. Sudden assumption of an upright position from supine position causes an initial decrease in: A. Cardiac output B. Heart rate C. Cerebral blood flow D. Total peripheral resistance 1352. Used for allergic rhinitis, except: A. Desloratadine B. Ipratropium bromide C. Oxymetazoline D. Latanoprost 1353. Affects a buffer system: A. Strong acid B. Weak acid and its salt C. Weak base and its salt D. Strong base E. Both B and C 1354. Decreases absorption at the injection site, except: A. Increased temperature B. Massage +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. Use of epinephrine D. Decreased temperature 1355. Cortisol characteristics, except: A. Causes gluconeogenesis B. Stimulates lipolysis C. Causes potassium retention D. Has anti-inflammatory properties 1356. Management of dry cough due to Lisinopril: A. Use of dextromethorphan B. Switch therapy to an ARB C. Use of guaifenesin D. Discontinue Lisinopril for a few days 1357. The following stimulate gastric acid production, except: A. Gastrin B. Acetylcholine C. Histamine D. Prostaglandin 1358. Symptoms of kidney failure, except: A. Oliguria B. Hyperkalemia C. Hypocalcemia D. Metabolic alkalosis 1359. Nerve that begins in the hip and ends near the foot: A. Femoral B. Sciatic C. Cauda equina D. Plexus 1360. A hydro-alcoholic solution which contains a sweetening agent: A. Syrup B. Elixir C. Glycerite D. Liniment 1361. Which one is not the Symptoms of liver failure include: A. Ascites B. Jaundice C. Cirrhosis D. Fat cell unaccumulation +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1362. A patient goes to ER and in ECG the P wave is absent, and the patient feels butterfly heartbeat: A. Atrial fibrillation B. Atrial flutter C. Ventricular fibrillation D. Normal sinus rhythm 1363. Which one is a risk factor for thromboembolism? A. Dyslipidemia B. Malignancy C. Hypothyroidism D. Dehydration 1364. What is correct regarding clopidogrel? A. Causes neutropenia & needs blood monitoring B. Good option for preventing atherosclerosis C. Causes vasodilation D. Increases platelet aggregation 1365. Which one increases the rate of survival in CHF patients? A. Digoxin B. ACE inhibitor C. Nitroglycerine D. Furosemide 1366. Which one decreases heart oxygen demand without vasodilation? A. Atenolol B. Nifedipine C. Minoxidil D. Hydralazine 1367. Which one is safe to use in chronic kidney disease? A. Heparin B. Dalteparin C. Warfarin D. Aspirin 1368. What happens in phase 3 of repolarization? A. Decrease permeability to sodium B. Increase permeability to potassium C. Decrease permeability to potassium D. Increase permeability to calcium +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1369. Which one is not an asthma trigger in children? A. Cold weather B. Fever C. Environmental allergens D. Exercise 1370. A patient taking warfarin 5 mg has an INR of 4. What is an appropriate advice? A. Skip the dose for 2 days and continue 5 mg B. Stop taking warfarin for 1 week and continue with 2.5 mg C. Call a physician to get a prescription for vitamin K D. Go to the emergency room 1371. Which statement is correct for digoxin? A. Increases contractility B. Reduces total sodium in the body C. Acts as a vasodilator D. Increases heart rate 1372. The effect of calcium ions on neurotransmitter release at synapses include: A. Vesicular fusion B. Inhibition of presynaptic depolarization C. Reduction in synaptic potentiation D. Decrease in neurotransmitter release 1373. The release of neurotransmitter from synaptic vesicles: A. Takes place by diffusion B. Takes place by exocytosis C. Is independent of calcium influx D. Is random and non-quantal 1374. Which statement are not true about the lens: A. It has a higher concentration of sodium than potassium B. It has the highest concentration of protein among body tissues C. 90% of proteins in the lens are water-soluble D. Glutathione is reduced in cataract 1375. The following are true about acetylcholine: A. It binds primarily to muscarinic receptors B. Is derived from acetyl CoA and choline C. Is synthesized by acetylcholinesterase D. Is broken down into serotonin E. Both A and B +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1376. In rapid eye movement (REM) sleep, the following are seen: A. Increased heart rate B. Increased systolic blood pressure C. Decreased respiratory rate D. All above 1377. The neuronal resting membrane potential of the human brain is: A. Maintained by the sodium-potassium pump B. Around -70 mV C. Maintained by ATP usage D. All above 1378. A lesion in the right medial longitudinal fasciculus: A. Causes left abduction nystagmus B. Impairs right adduction C. Impairs left adduction D. Causes problems with upgaze 1379. The felderstrukter fibers of the extraocular muscles: A. Form the bulk of the orbital part of the muscle B. Have poorly developed sarcoplasmic reticulum C. Are singly innervated D. Are less richly supplied with blood than fibrillenstrukter fibers 1380. When a photon strikes the rhodopsin: A. Bleaching occurs B. Retinal molecules are bound to rhodopsin C. The intracellular cGMP is increased D. The sodium ion channels are closed 1381. The following are true about rods in darkness: A. There is tonic release of neurotransmitters B. The sodium ion channels are open C. The potassium ion channels are shut D. There is a net influx of sodium ions E. A , B and D 1382. Etidronate: A. Used for osteoporosis B. An antipyretic drug C. A bisphosphonate D. Not used for Paget’s disease E. Both A and C +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1383. Ninhydrin reagent detects the presence of: A. Guanine ring B. Indole ring C. Amino group D. Glycosidic linkages 1384. Treatment for carbon monoxide poisoning: A. Oxygen therapy B. Amyl nitrite C. Sodium thiosulfate D. Hemodialysis 1385. Antidote for benzodiazepine overdose: A. Caffeine B. Flumazenil C. FAB fragments D. Naloxone 1386. Which vitamin, when converted in the body, functions as a hormone: A. Ascorbic acid B. Retinoic acid C. Phytonadione D. Cholecalciferol 1387. Short-acting benzodiazepine: A. Bromazepam B. Chlordiazepoxide C. Diazepam D. Midazolam 1388. Test/s used for large volume parenterals: A. Sterility test B. Pyrogen test C. Preservative effectiveness D. Hardness test 1389. The separation principle involved in gel chromatography: A. Adsorption B. Differences in molecular weight C. Partitioning D. Ion formation 1390. Indapamide: A. Loop diuretic +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education B. Potassium-sparing diuretic C. Thiazide-like diuretic D. Osmotic diuretic 1391. COX-2 inhibitors: A. Rofecoxib B. Ibuprofen C. Meloxicam D. Aspirin 1392. Drug passing into breast milk due to lipid solubility: A. High lipid solubility B. Low lipid solubility C. Neutral solubility D. None of the above 1393. Pregnant woman with hypothyroidism taking levothyroxine starts feeling fatigue: A. Double dose B. Discontinue C. Refer to doctor to adjust dose according to TSH D. Continue using the same dose 1394. Which contraceptive has a high dose of estrogen and is contraindicated in DVT? A. Transdermal patch B. IUD C. Oral contraceptive pill D. Rings 1395. Positive hCG—Which drug can be used safely in pregnancy? A. Warfarin B. Isotretinoin C. Levothyroxine D. Tetracycline 1396. When to stop Fingolimod for pregnancy: A. Before 2 months B. 6 months before pregnancy C. Before 6 months D. During pregnancy 1397. Pregnant woman with nausea and vomiting—first-line treatment: A. Cyclizine + pyridoxine B. Pyridoxine alone +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. Diphenhydramine D. Oxytocin 1398. Statins in women positive for hCG (pregnancy): A. Warfarin B. Isotretinoin C. Tetracycline D. None are safe 1399. Warfarin contraindicated in pregnancy because: A. Growth restriction B. Genital abnormality C. Congenital heart diseases D. Craniofacial morphology 1400. Which contraceptive pill reduces lactation: A. Progesterone-only pill B. Estrogen-containing pill C. Combined pill D. None 1401. Which is contraindicated in pregnancy or lactation: A. Doxycycline B. Acyclovir C. Meloxicam D. Piroxicam 1402. Cyclizine is used in: A. Nausea & vomiting B. Antibiotic C. Bronchodilator D. Antihistaminic 1403. What is the specific gravity of a substance with weight = Y and volume = X? A. Y/X B. X/Y C. Y × X D. 1/(Y × X) 1404. 5 mL solution ampule has a concentration of 0.2%. Amount of drug is: A. 0.1 mg B. 1 mg C. 10 mg D. 100 mg +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1405. What is Esmolol? A. Short-acting beta-blocker used in emergencies for acute arrhythmias, administered via IV B. Long-acting beta-blocker used for chronic hypertension management C. Calcium channel blocker used in acute arrhythmias D. Alpha-blocker used in hypertensive crises 1406. Which of the following is not a side effect of Propantheline? A. Blurred vision B. Dry mouth C. Constipation D. Bronchospasm 1407. Which of the following is not a toxic effect of Methyldopa? A. Sedation B. Drug fever C. Gangrene D. Anemia 1408. Which of the following has no effect on drug response? A. Nutrition B. Genetic C. Mental status D. Age 1409. Purified water cannot be used in: A. Ophthalmic preparation B. IV solution C. Oral preparation D. Oral suspension 1410. Probenecid increases the concentration of penicillin through: A. Increased renal tubular reabsorption B. Decreased renal excretion C. Decreased hepatic metabolism D. Increased hepatic metabolism 1411. A patient taking Cisplatin should also be administered with: A. Granisetron (antiemetic) B. Ibuprofen (analgesic) C. Amoxicillin (antibiotic) D. Metformin (antidiabetic) 1412. The following are true about saccade: A. it has a higher velocity than pursuit movements +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education B. the visual acuity is increased during saccades C. horizontal saccade is controlled by the pons D. vertical saccade is controlled by the mid-brain E. A, C, and D 1413. Inhibition of the Edinger-Westphal nucleus: A. causes relaxation of the iris sphincter B. causes contraction of the iris dilator C. occurs in deep sleep D. occurs with narcotics E. Both A and B 1414. True statements about visual adaptation include: A. light adaptation takes longer than dark adaptation B. dark adaptation reaches its maximum in about 20 minutes C. in dark-adapted eye, a higher intensity of light is required to stimulate cones than rods D. people who wear red goggles in the light adapt quicker in the dark than those who do not wear them E. B and C 1415. With regard to the transport of carbon dioxide in blood: A. 25% of carbon dioxide is dissolved in blood B. carbonic anhydrase is found in plasma C. 50% of carbon dioxide is carried as bicarbonate D. deoxygenated haemoglobin facilitates the transport of carbon dioxide 1416. The following are involved in colour vision: A. P pathway B. M pathway C. area V8 of visual cortex D. area V3 of visual cortex E. Both A and C 1417. The following are true about cerebrospinal fluid: A. it has a greater buffering capacity than plasma B. it has a similar chloride concentration to plasma C. it is a plasma ultrafiltrate D. the rate of formation is dependent on the intraventricular pressure over the normal pressure range 1418. With regard to light perception: A. the fovea contains only cones B. the cones have a lower threshold to light than rods C. rods respond most to the red-yellow end of light +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education D. rods respond most to wavelengths of about 500nm E. A and D 1419. The following occur in the proximal tubules of the nephron: A. reabsorption of all glucose B. reabsorption of most water C. secretion of bicarbonate D. active reabsorption of sodium E. A, B, and D 1420. Urine volume is increased with: A. carbonic anhydrase inhibitors B. hyperglycaemia C. increased aldosterone secretion D. damage to the posterior pituitary E. A, B, and D 1421. True statements about the pH of the extracellular fluid: A. in healthy people it is maintained between 7.4 and 7.5 B. is increased in hypovolaemic shock C. decreases following a cardiac arrest D. influences the binding of drugs to plasma proteins E. C and D 1422. Which of the following drugs is a pregnancy category X? A. Rituximab B. Leflunomide C. Ciprofloxacin D. Levothyroxine 1423. Which of the following is a statement that describes a drug with pregnancy category B? A. no available fetal risk studies in women or animals B. controlled studies in women failed to show fetal risk C. animal studies indicate no fetal risk but no data in humans D. positive evidence of fetal risk 1424. Which of the following statements best describes oxytocin? A. high doses may lead to hypertension B. steady state is reached within 5 to 10 minutes C. uterine hyperstimulation is an associated adverse effect D. higher doses can lead to vasopressin receptor-related urinary retention 1425. A 23-year-old woman is currently taking finasteride and wishes to conceive. The doctor immediately recommends her to discontinue its use. Which of the following is the most likely +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education reason for finasteride to be discontinued? A. it is teratogenic B. it is abortifacient C. it causes hypotension D. it causes uterine vascular resistance 1426. Which of the following vitamins is contraindicated in high doses during pregnancy? A. Vitamin A B. Vitamin B6 C. Vitamin C D. Vitamin B12 1427. Which of the following medications is an aromatase inhibitor used for the treatment of breast cancer? A. flutamide B. octreotide C. tamoxifen D. anastrozole 1428. Which of the following is a statement that describes a drug with pregnancy category X? A. Animal studies indicate no fetal risk B. No available fetal risk studies in women or animals C. Positive evidence of fetal risk; benefits outweigh the fetal risks D. Definite fetal risk in animals and humans of teratogenicity; fetal risks outweigh the benefits 1429. Which of the following medications is an anti-progestin? A. danazol B. tamoxifen C. finasteride D. mifepristone 1430. A lactating mother comes to the emergency department complaining of nausea and vomiting. Which of the following agents is most appropriate to give? A. cyclizine B. domperidone C. dimenhydrinate D. levomeprimazine 1431. Which property of nicotine is attributed to abortions? A. it is a vasodilator B. it is a potent vasoconstrictor C. it reduces uterine blood flow D. it reduces vascular uterine resistance +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1432. Which of the following is most likely to be excreted in breast milk? A. D-1 B. D-2 C. D-3 D. D-4 1433. Isopretrenol is: A) Alpha & beta agonist B) Alpha blocker C) Alpha agonist D) Beta agonist E) Beta blocker 1434. Ascorbic acid is: A) Vitamin C B) Vitamin A C) Vitamin D D) Vitamin B12 1435. Active immunity can be conferred by: A) Anti-toxin B) Anti-sera C) Vaccine D) Immuno-bodies 1436. The mechanism of action of tricyclic antidepressants (TCAs) is: A) Inhibit reuptake of catecholamines B) Block serotonin synthesis C) Increase breakdown of dopamine D) Enhance release of GABA 1437. The Latin abbreviation for "immediately" is: A) Stat B) QID C) PRN D) BID 1438. The mechanism of action of echothiophate is: A) Forms a stable complex with cholinesterase enzyme (irreversible anticholinesterase) B) Directly stimulates nicotinic receptors +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C) Blocks muscarinic receptors D) Inhibits acetylcholine release from nerve terminals 1439. Tetracaine is used for: A) Spinal anesthesia B) Opioid analgesic C) Neuromuscular blocking agent D) Vitamin D metabolite E) In treatment of Parkinsonism 1440. Not used clinically: A) Heroin B) Morphine C) Codeine D) Oxycodone E) Hydromorphone 1441. A patient allergic to penicillins can use: A) Claforan B) Erythromycin C) Cefotetan D) Augmentin E) Cephalexin 1442. Which increases the action of morphine: A) Vitamin K B) Carbamazepine C) Amiodarone D) Contraceptives E) None of the above 1443. Sterility through a 0.22 µm filter does not remove: A) Bacteria B) Viruses C) Fungi D) A + C E) B + C 1444. The side effect of Class II antiarrhythmic drugs is: +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education A) Bronchospasm B) Hypokalemia C) Tinnitus 1445. How much benzocaine is used to prepare a 1:1000 solution with 80 mL of solvent? A) 0.08 grams B) 8 grams C) 0.8 grams D) 8 milliliters 1446. Parasympathetic ganglia include: A. Gasserian ganglion B. otic ganglion C. stellate ganglion D. celiac ganglion 1447. The effect of stellate ganglion block includes: A. anhydrosis B. dilated conjunctival vessels C. ptosis D. all above 1448. In myasthenia gravis: A. the vertical muscles of the eye are more commonly involved than the horizontal muscles B. the pupil reaction to light is sluggish C. absent antibody to acetylcholine receptors excludes the diagnosis D. Cogan's twitch refers to involuntary twitching of the orbicularis 1449. With regard to knee jerk: A. it is a monosynaptic reflex B. the impulse travels via type Ia afferent fibres C. the Golgi body is an important component D. the stimulus begins in the tendon E. (A and B) 1450. In a patient with dense cataract and poor retina view, the following tests can be used to test macular function: A. relative afferent pupillary defect B. laser interferometry C. Haidinger brushes D. Visual evoked potential E. (B, C, and D) +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1451. Relative afferent pupillary defect is seen in: A. age-related macular degeneration B. optic nerve glioma C. unilateral occipital lobe infarction D. third nerve palsy 1452. Purkinje's shift: A. refers to the transition of retinal sensitivity between photopic and scotopic vision B. refers to the shift in the spectral sensitivity of the human retina toward shorter wavelengths of light C. accounts for blue color appearing brighter at dusk D. all above 1453. The following are true about the sensitivity of the visual system: A. in the dark the peak sensitivity of the eye is around 500nm B. in the light the peak sensitivity of the eye is around 555nm C. the cone cannot respond to white flickering light of 20 Hz and above D. a dark-adapted eye is more sensitive to blue-green light than a light-adapted eye E. (A, B, and D) 1454. The following are true: A. Kirschman's law: the greatest contrast in color is seen when the luminosity difference is small B. Emmert's law: the perceived size of an object varies in proportion to the distance of the surface on which it is projected C. Hering's law: the contraction of a muscle is accompanied by simultaneous and proportional relaxation of the antagonist D. Troxler's phenomenon: an image in the periphery of the retina tends to fade or disappear during steady fixation of another object E. (A, B, and D) 1455. The release of acetylcholine is blocked by: A. hemicholinum B. venom of black widow spider C. cocaine D. botulinum toxins 1456. Which one is not an asthma trigger in children? A. Infection B. Cold weather C. Fever D. Environmental allergen 1457. What is the side effect of Montelukast? +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education A. Headache B. Palpitation C. Mouth thrush D. Mouth dryness 1458. What do we call whistling during asthma? A. Wheezing B. Should be checked C. Bradycardia D. Hypotension 1459. What can differentiate between complicated and uncomplicated UTI? A. Urgency B. Frequency C. Fever D. Obesity 1460. Fecal occult blood test is used for: A. Crohn's disease B. Colorectal cancer screening C. Hemorrhoids D. Peptic ulcer 1461. A 36-year-old woman who smokes and can’t remember to take daily contraception. What do you recommend? A. Depo medroxyprogesterone B. NuvaRing (vaginal ring) C. Oral combination pill D. Norethindrone 1462. We use finasteride for a patient; when should we assess for improvement? A. 6 months B. 3 months C. 16 weeks D. 8 weeks 1463. Which enzyme inhibits conversion of testosterone to its most potent form? A. Aromatase B. 5-alpha reductase +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. 17-alpha keto DHEA D. 21-hydroxylase 1464. A patient had breast cancer 8 years ago but now experiences ongoing hot flushes. What do you recommend? A. Venlafaxine B. Oral combination C. Dermal combination D. Benzodiazepine E. Vaginal estrogen cream 1465. Which of the following hormones is responsible for milk production in mammary glands? A. Oxytocin B. Prolactin C. Luteinizing hormone D. Follicle-stimulating hormone 1466. Which of the following drugs passes into mother's milk due to high lipid solubility? A. Diazepam B. Methyldopa C. Promethazine D. Dihydroergotamine 1467. A 20-year-old pregnant woman presents to the emergency department with severe vomiting. What is the most likely safe drug? A. Pyridoxine (Vitamin B6) B. Ondansetron C. Domperidone D. Promethazine 1468. Which of the following is most likely to inhibit lactation? A. Prolactin B. Progesterone C. Growth hormone D. Chorionic somatomammotropin 1469. For impetigo, what do we use? A. Mupirocin B. Docosanol +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. Clindamycin D. Erythromycin 1470. Which of the following reduces the risk of transmission of sexual diseases? A. Spermicide B. Oral contraceptive C. Intrauterine device D. Male latex condom 1471. Which one is a trigger for cold sores? A. UV light B. Acidic food C. Spicy food D. Stress 1472. In a cost-effectiveness study comparing lice treatments, a sensitivity test means: A. Measure of true positive B. Measure of true negative C. Measure of false positive D. Measure of false negative 1473. Which element is a cofactor of angiotensin-converting enzyme (ACE)? A. Iron B. Zinc C. Selenium D. Copper 1474. In end-stage CKD, we use calcium for what purpose? A. Increase BP B. For alkalosis C. Decrease blood phosphate D. Improve GFR 1475. Which one of these is an antigen-presenting cell? A. Plasma cell B. Dendritic cell C. T cell D. Neutrophil 1476. What is the duration of therapy for osteomyelitis? +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education A. At least 4 weeks B. 6 months C. 3 months D. 7 to 14 days 1477. A patient has no allergy to penicillin but has GI problems with macrolides, suffers from otitis media, and has waited 3 days. What will you advise? A. Acetaminophen PRN B. A course of azithromycin C. A course of high-dose amoxicillin D. A course of cefuroxime 1478. Emphysema means: A. The cell wall of alveoli is destroyed B. Inflammation of bronchi C. Increase in mucus production of bronchi D. Restriction of airway 1479. The duration of therapy with nitrofurantoin in uncomplicated UTI: A. 1 day B. Minimum 3 days C. 5 days D. 3-5 days 1480. The least sedating: A. Diazepam B. Chlordiazepoxide C. Probamate D. Oxazepam E. Buspirone 1481. In (C.H.F.) congestive heart failure we use digoxin to: A. Increase myocardial contraction B. Increase myocardium excitability C. Decrease myocardial contraction 1482. Raloxifene, a selective estrogen receptor modulator, is contraindicated in patients with: A. Deep vein thrombosis (DVT) B. Hypertension +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. Asthma D. Hyperthyroidism 1483. Drug not decreasing LDL: A. Simvastatin B. Clofibrate C. Nicotinamide D. Propecol 1484. Cushing's syndrome can be caused by: A. Glucocorticoid drugs, tumor secreting high cortisol levels B. Hypothyroidism C. Hyperthyroidism D. Insulin resistance 1485. Promethazine is used for: A. Antihistamine B. Antibiotic C. Antidepressant D. Analgesic 1486. Q.d.s. means: A. To be taken 4 times daily B. To be taken twice daily C. To be taken once daily D. To be taken every other day 1487. Which of the following is not used in the diagnosis of acute myocardial infarction (MI): A. Albumin B. Signs and symptoms C. Troponin D. Scurvy E. A & D 1488. Which is not an effect of theophylline: A. Peripheral vasoconstriction B. Cardiac stimulation C. Diuresis D. Relaxation of stomach muscles E. Stimulation of CNS +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1489. Vitamin A is avoided in: A. Rickets B. Blindness C. Pregnancy D. Scurvy E. A & D 1490. The percentage of water according to body weight is: A. 60% B. 40% C. 75% D. 50% 1491. Not expected with inhaled cannabis smoke: A. Increased pulse rate B. Anorexia C. Perceptual changes D. Vascular changes of the eye 1492. Sodium picosulfate is used for: A. Laxative B. Antacid C. Antibiotic D. Antihistamine 1493. How many grams of Dextrose are required to prepare 5% of 500 cc solution? A. 2.5 gm B. 25 gm C. 55 gm D. 5 gm 1494. Phocomelia is a known teratogenic effect of A. Anticancer drugs B. Antiviral drugs C. Antiepileptic drugs D. Thalidomide 1495. Which of the following drugs are known to cause toxic cataract? +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education A. Chloroquine B. Ergot C. Phenothiazine D. Naphthalene E. All of the above 1496. The passage of drugs into the fetus from placenta A. Is by active transport B. Is by passive diffusion C. Is by carrier-mediated transport D. By any of the above methods 1497. Idiosyncrasy reaction of a drug is A. A type of hypersensitivity reaction B. A type of drug antagonism C. Unpredictable, inherent, qualitatively abnormal reaction of a drug D. Quantitatively exaggerated response 1498. Two drugs having similar effects are termed as A. Heterergic drugs B. Isomer drugs C. Homergic drugs D. Antagonistic drugs 1499. If the combined effect of two drugs acting by the same mechanism is equal to the algebraic sum of their individual effects, it is called as A. Antagonism B. Additive effect C. Potentiation D. None of the above 1500. Antagonism between barbiturate and amphetamine is termed as A. Non-competitive antagonism B. Physiological antagonism C. Competitive antagonism D. Synergism 1501. Indication for thalidomide A. Nausea B. Multiple myeloma +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. Malaria D. Depression 1502. Amphotericin is metabolized by... Hydrolysis A. Hydrolysis B. Oxidation C. Conjugation D. Reduction 1503. A patient is receiving dopamine at an infusion rate of 500 mcg/min. The dopamine solution is prepared as 200 mg in 100 mL. Calculate the total volume of dopamine solution (in mL) infused during the first hour of treatment. A. 10 mL B. 15 mL C. 20 mL D. 25 mL 1504. Pharmacophore of cinoxacin A. Quinolone B. Sulfonamide C. β-lactam D. Macrolide 1505. A drug x 3/4 teaspoon for child, which is 25% of the adult dose. What will be adult dose? A. 1 B. 2 C. 3 D. 4 1506. Antidote of heparin toxicity... A. Protamin sulfate B. Vitamin K C. FFP (Fresh Frozen Plasma) D. Activated charcoal 1507. Interaction between verapamil and carbamazepine A. No interaction B. Decrease in verapamil levels C. Increase in carbamazepine levels D. Increase in verapamil metabolism 1508. A drug X is available in 100mg per 5ml bottle. A prescription calls for drug X 20mg 3 times daily for 7 days. How many ml are needed for 5 days? A. 7.5 +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education B. 15 C. 75 D. 150 1509. Anti for atropine-like toxicity... A. Neostigmine B. Atropine C. Physostigmine D. Pilocarpine 1510. Orotic aciduria can be treated by a diet rich in A. Adenine B. Guanine C. Uridine D. All of the above 1511. Lesch–Nyhan syndrome occurs due to deficiency of which enzyme? A. PRPP synthetase B. Xanthine oxidase C. HGPRT D. Glucose-6-phosphatase 1512. Krebs–Henseleit cycle occurs in A. Mitochondria B. Cytosol C. Both (a) and (b) D. Kidney 1513. Menke’s disease is due to deficiency of which of the following? A. Iron B. Copper C. Molybdenum D. Sodium 1514. Which amino acid is the precursor of melanin? A. Alanine B. Tyrosine C. Aspartic acid D. Lysine 1515. Krabbe’s disease occurs due to defect in A. β-glucosidase B. β-galactosidase +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. Sphingomyelin metabolism D. Hexosaminidase A 1516. Which is the storage form of iron? A. Ferritin B. Hemosiderin C. Both (a) and (b) D. None of the above 1517. Jamaican vomiting sickness disease is due to A. Hypoglycin C B. Hemoglobin C. Hypoglycin A D. Both (a) and (b) 1518. Hyperlipoproteinemia type III is due to elevated plasma level of which of the lipoproteins? A. LDL B. VLDL C. IDL D. Chylomicron 1519. Citrullinemia is due to defect in which of the following enzyme? A. Carbamoyl phosphate synthase B. Arginase C. Ornithine transcarbamoylase D. Arginosuccinate synthase 1520. Agent that blocks nerve conduction, producing transient localized loss of sensation: A. General anesthesia B. Hypnotic C. Local anesthesia D. None of them E. All of above 1521. Violent involuntary contraction or series of contractions of the voluntary muscles: A. Convulsion B. Migraine C. Depression D. Hypertension E. None of them 1522. Drugs that produce drowsiness and encourage sleep (hypnosis): A. Hypnotic +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education B. Anti-Migraine C. Antiepileptic D. Anti-Parkinsonism E. Anti-hypertensive 1523. Oral drug that reduces anxiety and causes calm (sedation): A. Local anesthesia B. Anti-Depressant C. Sedative D. None of them E. All of above 1524. Movement disorder characterized by muscle rigidity, tremors, and postural instability: A. Hypnotic B. Migraine C. Antiepileptic D. Parkinsonism E. Epilepsy 1525. Agent that depresses the central nervous system, producing loss of consciousness: A. Local anesthesia B. Sedative C. General anesthesia D. All of the above E. None of above 1526. Group of disorders with disturbance of mood, thought, and behavior: A. Depression B. Psychosis C. Both A & B D. None of them E. All of them 1527. Drugs that produce drowsiness with analgesia, and are usually addictive: A. Narcotic analgesics B. Antipsychotic C. Epilepsy D. None of them E. All of above 1528. Chronic lifelong disorder characterized by recurrent seizures or convulsions: A. Epilepsy B. Psychosis C. Narcotics +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education D. CNS stimulant E. None of above 1529. Disturbance of mood manifested by decreased self-esteem, decreased vitality, and increased sadness: A. Depression B. Psychosis C. Epilepsy D. Both A & B E. None of above 1530. The following are true about smooth muscle cells: A. Presence of a striated appearance B. Do not contain actin and myosin C. Spontaneous muscle contraction D. Mitochondria are absent 1531. In humans, hemorrhage causes: A. Venous constriction B. Decreased blood flow to the skin C. A fall in cardiac output D. All above 1532. The effect of the sympathetic nervous system includes: A. Contraction of the bladder detrusor muscle B. Pupillary dilatation C. Reduced gastrointestinal motility D. Constricts bronchiole smooth muscle E. B, C 1533. The prothrombin time: A. Assesses the extrinsic pathway of the blood coagulation cascade B. Is prolonged in patients with fat malabsorption C. Is increased by warfarin D. All above 1534. The following are true about muscarinic receptors: A. They are found at the postganglionic parasympathetic synapses B. They can be selectively blocked by atropine C. M1 muscarinic receptors are found in the brain D. All above 1535. The following are true about acetylcholine: A. It is synthesized from acetyl-coenzyme A and choline B. Its formation is catalyzed by acetylcholinesterase +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education C. At the synaptic cleft, it is inactivated by hydrolysis D. Reuptake by the presynaptic neurons plays an important role in inactivating acetylcholine E. A, C 1536. The following are true about the autonomic nervous system: A. The preganglionic fibers are mainly myelinated, slow-conducting B fibers B. The postganglionic fibers are mainly unmyelinated C fibers C. All preganglionic neurons are cholinergic neurons D. All above 1537. The pain sensation: A. Arises from stimulation of free nerve endings B. Is transmitted to the central nervous system by unmyelinated C fibres C. Is transmitted to the brain via the spinothalamic tracts D. All above 1538. True statements about the following neurotransmitters include: A. Dopamine is formed from tyrosine B. In the synapse, noradrenaline is inactivated by active reuptake into the presynaptic terminals C. Noradrenaline is formed by hydroxylation of dopamine D. All above 1539. The following are true about acetylcholine receptors: A. Receptors at all autonomic ganglia are nicotinic B. Receptors at the skeletal neuromuscular junction are muscarinic C. Acetylcholine receptors in the autonomic ganglia can be selectively blocked by atropine D. Acetylcholine receptors in the neuromuscular junction can be selectively blocked by tubocurarine 1540. A 37-year-old man with tinnitus and transient hearing loss is diagnosed with Meniere's disease. What is the most appropriate management? A. Cyclosporin B. Flucytosine C. Betahistine D. Lisinopril 1541. How many phases of clinical trials are required to approve a new drug? A. III B. I C. IV D. II 1542. A woman with T2D has an A1C of 8.6%. She is receiving insulin glargine and aspart with consistent carbohydrate intake. Her bedtime BG readings are elevated (185–200 mg/dL). Which +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education is the best insulin adjustment to improve her overall glycemic control? A. Increase prebreakfast aspart to 10 units B. Increase predinner aspart to 14 units C. Increase bedtime glargine to 65 units D. Increase prelunch aspart to 9 units 1543. Convert trypsinogen to trypsin by: A. Ligase B. Nuclease C. RNA Polymerase D. Endopeptidase 1544. Which amino acid has an imidazole ring? A. Tryptophan B. Histidine C. Proline D. Valine 1545. Recommended policy for dealing with free medical sample drugs: A. Dispense them directly to the patient B. Keep them with the rest of original items C. Keep in outpatient clinics or nursing units D. Exclude them from in-patient pharmacy, drug store, or doctors' offices 1546. Naranjo score 8 is: A. Probable B. Possible C. Definite D. Doubtful 1547. Which dietary supplement can be suggested to overcome jetlag? A. Melatonin B. Echinacea C. Yohimbine D. S-adenosyl-L-methionine (SAMe) 1548. Which body is responsible for the approval of research in health institutions? A. Data and Safety Monitoring Board B. Institutional Review Board C. Data Review Board D. Research Review Board 1549. A prescription for labetalol 800 mg twice daily for 3 days requires 200 mg tablets. How many tablets are needed for the total duration? +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education A. 24 B. 32 C. 12 D. 16 1550. A 25-year-old man presents with a mass in the groin after heavy lifting. Exam reveals a reducible mass above and medial to the pubic tubercle. Ring occlusion test is positive. What is the most likely diagnosis? A. Direct inguinal hernia B. Indirect inguinal hernia C. Femoral hernia D. Strangulated hernia 1551. A 20-year-old male presents with a history of anorexia, vomiting, central abdominal pain localized to the right iliac fossa. Rovsing's sign is positive. What is the most likely diagnosis? A. Acute appendicitis B. Colitis C. Gastroenteritis D. Ureteric colic 1552. What is the immediate and necessary step for treating a 35-year-old woman with burns covering 15% of her body? A. IV Fluid therapy B. Analgesics C. Antibiotics D. Antiemetics 1553. A 10-year-old child develops fever, headache, altered sensorium, and a ring-enhancing lesion on CT after recurrent otitis media. What is the diagnosis? A. Meningitis B. Encephalitis C. Brain abscess D. Subarachnoid hemorrhage 1554. A patient presents with nasal congestion, runny nose, fever, and worsened symptoms every April. Biopsy shows degranulation of which cells? A. Mast cells B. Basophils C. Eosinophils D. Monocytes 1555. An elderly woman on NSAIDs presents with sudden epigastric pain, nausea, vomiting, and gas under the diaphragm on X-ray. What is the most likely diagnosis? A. Acute pancreatitis +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education B. Adhesive small bowel obstruction C. Ruptured left dome of diaphragm D. Perforated peptic ulcer 1556. In a 35-year-old G3P2 woman with type 2 diabetes and a neonate born at 38 weeks GA, what parameter should be prioritized in the neonate? A. Blood glucose B. Creatinine C. Hemoglobin D. Calcium 1557. Which is a contraindication to performing a lumbar puncture? A. Focal neurological sign B. Papilledema C. Raised intracranial pressure D. Coagulopathy E. All 1558. Fracture midshaft of humerus (diaphysis fracture), which nerve is at risk of damage? A. Radial nerve damage B. Axillary nerve damage C. Ulnar nerve damage D. Musculocutaneous nerve damage 1559. Typhoid fever is associated with which manifestation at the end of the first week? A. Constipation B. Rose spots on trunk C. Coma D. Headache 1560. Dipivefrine is: A. Epinephrine analog used in glaucoma B. A corticosteroid used for inflammation C. A calcium channel blocker for hypertension D. An antihistamine for allergies 1561. Natural water can be used in: A. External preparations B. Oral medications C. Intravenous fluids D. Injectable formulations 1562. When a pharmacy owner gives direction to employees in his pharmacy to monitor policies and regulations, it is: +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education A. Autocratic B. Democratic C. Participative D. Consultative 1563. Propranolol is: A. Non-selective beta-blocker B. Selective beta-1 blocker C. Calcium channel blocker D. Alpha-blocker 1564. Ideal volume of eye solution: A. 500 microL B. 50–250 microL C. 10–50 microL D. 15% of the body surface 1553. C ✓ Explanation: A ring-enhancing lesion on CT in the context of recurrent ear infections indicates a brain abscess 1554. A ✓ Explanation: Mast cell degranulation releases histamine, a key mediator of allergic rhinitis and seasonal allergies 1555. D +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Gas under the diaphragm on X-ray and the clinical presentation suggest a perforated ulcer 1556. A ✓ Explanation: Neonates born to mothers with diabetes are at risk of hypoglycemia due to hyperinsulinism. Early glucose monitoring is essential 1557. E ✓ Explanation: All listed conditions are contraindications to lumbar puncture due to the risk of herniation or bleeding 1558. A ✓ Explanation: The radial nerve runs along the radial groove of the humerus and is commonly injured in midshaft humerus fractures 1559. B ✓ Explanation: Rose spots are a characteristic feature of typhoid fever, appearing during the second week of illness 1560. A ✓ Explanation: Dipivefrine is a prodrug of epinephrine used to reduce intraocular pressure in glaucoma patients. 1561. A ✓ Explanation: Natural water is not purified or sterilized to meet the requirements for oral, intravenous, or injectable formulations but can be used for external preparations. 1562. D ✓ Explanation: The consultative style involves the owner directing employees while seeking their feedback to ensure compliance with policies and regulations. 1563. A ✓ Explanation: Propranolol blocks both beta-1 and beta-2 receptors, making it non- selective. 1564. B ✓ Explanation: The ideal volume for eye drops ensures optimal retention and minimizes wastage or overflow. 1565. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Nitroglycerin causes vasodilation, leading to reflex tachycardia as a compensatory mechanism. 1566. B ✓ Explanation: Enkephalins bind to opioid receptors and exhibit analgesic effects similar to morphine. 1567. A ✓ Explanation: Idoxuridine is an antiviral agent used topically to treat herpes simplex infections of the eye. 1568. C ✓ Explanation: Hydralazine causes vasodilation, which can lead to reflex tachycardia as a compensatory response. 1569. B ✓ Explanation: Caffeine is a CNS and cardiac stimulant, and a diuretic, but it does not relax skeletal muscles—it can enhance muscle contraction. 1570. D ✓ Explanation: Parasympathomimetic, parasympathetic agonist, and cholinomimetic are terms for agents that mimic the effects of the parasympathetic system by stimulating muscarinic and/or nicotinic receptors. 1571. D ✓ Explanation: Sympathomimetic, sympathetic agonist, and adrenomimetic are synonymous terms describing agents that mimic the effects of the adrenergic system by stimulating adrenergic receptors. 1572. B ✓ Explanation: Ganglion blockers inhibit transmission at autonomic ganglia, affecting both sympathetic and parasympathetic systems. 1573. D ✓ Explanation: Sympatholytic agents or sympathetic antagonists inhibit the effects of the sympathetic nervous system by blocking adrenergic receptors or inhibiting sympathetic activity. 1574. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Ganglion stimulators activate both sympathetic and parasympathetic ganglia by stimulating nicotinic receptors. 1575. D ✓ Explanation: Parasympatholytic agents or parasympathetic antagonists inhibit the effects of the parasympathetic system by blocking muscarinic or nicotinic receptors. 1576. D ✓ Explanation: Thiopental and ketamine are intravenous agents used to induce and maintain general anesthesia. 1577. C ✓ Explanation: Skeletal muscle relaxants reduce muscle tone by acting on neuromuscular junctions or central pathways. 1578. B ✓ Explanation: Lidocaine is a local anesthetic used to block nerve conduction, providing localized loss of sensation. 1579. D ✓ Explanation: Nitrous oxide and halothane are inhalational agents used to induce general anesthesia. 1580. C ✓ Explanation: Cellulose acetate phthalate is commonly used as an enteric coating agent to protect the tablet from stomach acid. 1581. D ✓ Explanation: Cytochrome P450 enzyme 2D6 (CYP2D6) is responsible for the O- demethylation of codeine to morphine, its active form. 1582. A ✓ Explanation: Vancomycin is primarily eliminated by the kidneys, so its dose must be adjusted in patients with renal impairment to prevent toxicity. 1583. C ✓ Explanation: Salbutamol is safe for IV bolus injection, while others like KCl, vancomycin, and doxorubicin require slow infusion to avoid adverse effects. 1584. D +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: The first dose of MMR vaccine is routinely administered at 12–15 months of age, as earlier administration is less effective due to maternal antibody interference. 1585. A ✓ Explanation: Bioavailability F=Fraction absorbed×(1−Hepatic extraction ratio)= 0.4×(1−0.6) = 0.16 or 16%. 1586. C ✓ Explanation: Magnesium citrate is an osmotic laxative that draws water into the intestines, softening stool and promoting bowel movements. 1587. C ✓ Explanation: Total Dexamethasone needed = 20 mg/10 ml×300 ml=600 mg. Tablets needed = 600 mg/50 mg = 12. 1588. C ✓ Explanation: Calcium edetate is used in lead poisoning, not in aspirin toxicity. NaHCO3 alkalinizes the urine to promote salicylate excretion. 1589. C ✓ Explanation: Carbon monoxide binds to hemoglobin with much greater affinity than oxygen, reducing the blood's oxygen-carrying capacity and causing tissue hypoxia. 1590. A ✓ Explanation: Ethanol induces the CYP2E1 enzyme, increasing the production of NAPQI (a toxic metabolite of acetaminophen), leading to liver damage. 1591. A ✓ Explanation: Atropine is the first-line antidote for cholinesterase inhibitor toxicity. It blocks the effects of excessive acetylcholine, which accumulates due to enzyme inhibition. 1592. A ✓ Explanation: Ricin, a potent toxin in castor seeds, inhibits protein synthesis, leading to cell death and systemic toxicity. 1593. A ✓ Explanation: Lead is the toxic component often found in traditional kohl, and it poses risks of lead poisoning, especially in children. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1594. B ✓ Explanation: Hypokalemia increases the risk of digoxin toxicity by enhancing the drug’s binding to sodium-potassium ATPase. 1595. C ✓ Explanation: The symptoms suggest neurotoxic envenomation. Administering ASV addresses the toxin, while neostigmine reverses neuromuscular blockade. 1596. A ✓ Explanation : 150 mg/kg over 1 hour, followed by 50 mg/kg over 4 hours, then 100 mg/kg over 16 hours 1597. E ✓ Explanation: A. Oral digoxin: Digoxin affects cardiac conduction, particularly the AV node. ECG monitoring is required to detect arrhythmias or signs of digoxin toxicity. B. IV potassium: Rapid infusion of potassium can cause life-threatening arrhythmias. Continuous ECG monitoring is essential during IV potassium administration. 1598. A ✓ Explanation: Oxybutynin is an anticholinergic medication commonly used to treat overactive bladder. In elderly patients, it can cause urinary retention, particularly in the presence of benign prostatic hyperplasia (BPH), leading to hesitancy and worsening symptoms. Discontinuing oxybutynin may alleviate these issues. 1599. C ✓ Explanation: Cholera vaccine provides protection against Vibrio cholerae and related enterotoxins, which are significant causes of traveler’s diarrhea. 1600. D ✓ Explanation: Ciprofloxacin is not recommended for children with meningitis as it has limited penetration into the cerebrospinal fluid and potential adverse effects on cartilage development. 1601. B ✓ Explanation: Rifamycin is not known to cause significant ocular toxicity. Hydroxychloroquine and ethambutol can lead to retinopathy and optic neuritis, respectively. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1602. A ✓ Explanation: Cephalexin, a first-generation cephalosporin, has poor activity against H. influenzae, making it ineffective for treating such pneumonia. 1603. C ✓ Explanation: Preventing delayed nausea and vomiting requires effective acute-phase treatment with agents such as 5-HT3 antagonists and corticosteroids. 1604. A ✓ Explanation: Malaria prophylaxis typically starts 1 week before travel, continues throughout the trip, and extends for 4 weeks after leaving the malaria-endemic area. 1605. B ✓ Explanation: Phenol undergoes detoxification primarily via conjugation with glutathione, protecting against oxidative stress. 1606. B ✓ Explanation: Poly-unsaturated fatty acids contain more than one double bond in their carbon chain, distinguishing them from mono-unsaturated and saturated fatty acids. 1607. A ✓ Explanation: Toxoplasma gondii, a parasite found in cat feces, poses a significant risk of congenital infections during pregnancy. 1608. B ✓ Explanation: Esterases hydrolyze ester bonds into alcohol and acid derivatives, especially for drugs with ester or ketone groups. 1609. A ✓ Explanation: A hypertonic solution draws water out of red blood cells, causing them to shrink (crenation). 1610. A ✓ Explanation: Hydrolysis is the primary metabolic process in the gastrointestinal tract, breaking down large molecules like proteins and fats into smaller absorbable units. 1611. B ✓ Explanation: A hypotonic solution causes water to flow into red blood cells due to osmotic imbalance, leading to swelling and eventual hemolysis. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1612. D ✓ Explanation: Nitroglycerin infusion allows for precise control of blood pressure in hypertensive emergencies. 1613. E ✓ Explanation: Hypothyroidism reduces metabolic rate, leading to weight gain and low body temperature. 1614. B ✓ Explanation: Denaturation affects proteins by disrupting their secondary and tertiary structures, impairing their function. 1615. D ✓ Explanation: The first-pass effect is enhanced with higher absorption rates and increased metabolism in the liver before the drug reaches systemic circulation. 1616. B ✓ Explanation: Hydralazine can induce lupus-like symptoms due to its effect on immune system activation. 1617. A ✓ Explanation: LDL is the primary transporter of cholesterol in the plasma, delivering it to peripheral tissues. It is often referred to as "bad cholesterol" due to its association with atherosclerosis. 1618. B ✓ Explanation: ACE inhibitors block the enzyme converting angiotensin I to angiotensin II, reducing vasoconstriction and lowering blood pressure. 1619. C ✓ Explanation: Atropine is an anticholinergic drug that inhibits salivary secretions, causing dry mouth as a common side effect. 1620. B ✓ Explanation: Vasopressin is an antidiuretic hormone used to manage diabetes insipidus by reducing excessive urine output. 1621. A ✓ Explanation: Rifampicin is a potent inducer of liver enzymes, especially cytochrome P450, enhancing the metabolism of several drugs. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1622. C ✓ Explanation: Buscopan (hyoscine butylbromide) is an antispasmodic with anticholinergic effects, leading to dry mouth as a side effect. 1623. B ✓ Explanation: Amphotericin B is an antifungal agent used to treat severe fungal infections. 1624. C ✓ Explanation: Metformin is an oral hypoglycemic agent widely used to manage type 2 diabetes mellitus. 1625. C ✓ Explanation: Cimetidine is a known inhibitor of cytochrome P450 enzymes, leading to reduced metabolism of certain drugs. 1626. C ✓ Explanation: Pindolol is a beta-blocker with intrinsic sympathomimetic activity, not a beta agonist. 1627. A ✓ Explanation: Streptokinase is a thrombolytic agent used to dissolve clots in conditions like pulmonary embolism. 1628. B ✓ Explanation: The recommended maximum dose of diclofenac for adults is 200 mg/day to minimize the risk of side effects. 1629. B ✓ Explanation: Augmentin combines amoxicillin and clavulanic acid to provide enhanced activity against beta-lactamase-producing bacteria. 1630. E ✓ Explanation: Morphine is more efficacious than ibuprofen, making it a better choice for pain relief in appropriate clinical situations. 1631. A ✓ Explanation: A full agonist produces the same maximal effect (Emax) as the endogenous ligand. Isoproterenol fully activates cardiac β-adrenergic receptors, mimicking epinephrine. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1632. B ✓ Explanation: Pentazocine is a partial agonist because it has lower efficacy (Emax) than morphine but still produces some effect. 1633. B ✓ Explanation: Potency refers to the amount of drug needed to produce an effect. Naproxen is more potent because a lower dose achieves the same effect as ibuprofen. 1634. E ✓ Explanation: Picrotoxin decreases the maximal effect of diazepam, indicating it is a noncompetitive antagonist that binds at a site distinct from the agonist-binding site. 1635. A ✓ Explanation: Naloxone binds to the same receptor as morphine but does not activate it. Its inhibitory effect can be overcome by increasing the concentration of morphine, consistent with competitive antagonism. 1636. E ✓ Explanation: Continuous exposure to a β1 receptor antagonist (e.g., propranolol) reduces receptor activation, causing up-regulation to compensate for reduced signaling. 1637. D ✓ Explanation: Somatic motor neurons directly innervate skeletal muscles without ganglia, leading to faster responses compared to autonomic neurons. 1638. C ✓ Explanation: Spare receptors amplify the signal by requiring only a fraction of receptors to be occupied for a maximal cellular response. 1639. C ✓ Explanation: Both sympathetic and parasympathetic ganglia use acetylcholine (ACh) as the neurotransmitter. 1640. A ✓ Explanation: Insulin inhibits gluconeogenesis by promoting glucose uptake in cells and decreasing hepatic glucose production, opposing the actions of glucagon and epinephrine. 1641. B +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Carbamazepine induces liver enzymes, increasing warfarin metabolism and reducing its anticoagulant effect, thereby decreasing INR. 1642. A ✓ Explanation: Glucose is the primary energy source in cellular respiration, producing the most immediate energy. While sucrose and maltose are disaccharides, they must first be broken into monosaccharides like glucose for energy production. 1643. A ✓ Explanation: Ibuprofen competes with aspirin for the same binding site on COX-1, preventing aspirin's irreversible acetylation and thus reducing its antiplatelet effect. 1644. B ✓ Explanation: Haloperidol, a dopamine receptor antagonist, is commonly used to manage tic disorders, including Tourette syndrome, which may present with motor spasms and eye blinking. 1645. B ✓ Explanation: Ginseng can enhance insulin sensitivity and glucose uptake, thereby potentiating the effects of oral antidiabetic medications. 1646. A ✓ Explanation: The air bubble in prefilled enoxaparin syringes is intended to ensure the full dose is delivered and prevents leakage of the drug. 1647. C ✓ Explanation: Carbidopa inhibits peripheral dopa decarboxylase, reducing the peripheral conversion of levodopa to dopamine, thus increasing levodopa availability in the brain. 1648. A ✓ Explanation: The tautomer with positive charges on both amino groups is the least stable and least dominant due to electrostatic repulsion. 1649. D ✓ Explanation: Infliximab, a tumor necrosis factor (TNF) inhibitor, can reactivate latent tuberculosis. Screening for tuberculosis is recommended before starting therapy. 1650. B +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Isocitrate dehydrogenase catalyzes the oxidative decarboxylation of isocitrate to α-ketoglutarate via the intermediate oxalosuccinate in the Krebs cycle. 1651. B ✓ Explanation: The hexose monophosphate (HMP) shunt, also known as the pentose phosphate pathway, occurs exclusively in the cytosol where it generates NADPH and ribose-5-phosphate. 1652. D ✓ Explanation: Fluoroacetate is metabolized to fluorocitrate, which inhibits aconitase, thereby blocking the conversion of citrate to isocitrate in the Krebs cycle. 1653. B ✓ Explanation: Retinol (Vitamin A) synthesis begins with beta-ionone and methylvinyllactone as precursors. 1654. A ✓ Explanation: Phosphatidylcholine (lecithin) is a major component of pulmonary surfactant, which reduces alveolar surface tension. Its deficiency in premature infants leads to respiratory distress syndrome. 1655. B ✓ Explanation: Cori’s disease (Type III glycogen storage disease) is caused by a deficiency of the debranching enzyme amylo-α-1,6-glucosidase, leading to abnormal glycogen accumulation. 1656. D ✓ Explanation: Palmitic acid is a saturated fatty acid and is classified as non-essential because the body can synthesize it. 1657. E ✓ Explanation: Lysozyme is the most abundant protein in the tear film, and IgA is present in greater amounts than IgG to provide immune defense at the ocular surface. 1658. E ✓ Explanation: Saccadic eye movements have a maximum velocity of about 700 degrees/second, and their latency is approximately 250 milliseconds. 1659. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Rods outnumber cones by about 20:1. However, the fovea contains a high concentration of cones and minimal rods. 1660. D ✓ Explanation: The viscosity of the vitreous is largely due to the presence of sodium hyaluronate, which forms a gel-like matrix. 1661. D ✓ Explanation: Dural venous sinuses lack valves, and the cavernous sinus is anatomically close to the pituitary gland and the first two divisions of the trigeminal nerve. 1662. E ✓ Explanation: Brain stem death is assessed using cranial nerve reflexes such as the gag reflex (IX, X) and pupil reflex (II, III). 1663. E ✓ Explanation: The a-wave originates from photoreceptors, the c-wave is from the retinal pigment epithelium, and different light stimuli can differentiate rod and cone responses. 1664. E ✓ Explanation: Cerebral blood flow is autoregulated between 50-150 mmHg, hypocapnia leads to vasoconstriction, and arterioles adjust to maintain pressure. 1665. D ✓ Explanation: At birth, the blood-brain barrier is immature, allowing bilirubin to pass. It is maintained by tight junctions and astrocyte processes and is selectively permeable to glucose. 1666. E ✓ Explanation: Pure sensory/motor nerves regenerate better than mixed nerves. Wallerian degeneration occurs distal to the site of injury, typically within 3 days. 1667. D ✓ Explanation: This patient likely has a type 4 hypersensitivity reaction (delayed-type hypersensitivity), which is commonly caused by contact with plants such as poison ivy or other allergens and manifests with a rash and blisters. 1668. C +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Given the signs of potential addiction (multiple injection spots), it is essential to refer the patient to an addiction clinic for proper management and assessment of potential opioid use disorder. 1669. A ✓ Explanation: Liquorice can lead to increased blood pressure due to its effects on sodium and potassium balance, often causing sodium retention and potassium loss. 1670. B ✓ Explanation: The healthcare team should increase the dose to 2500 mg/day to bring the serum Vancomycin level within the target therapeutic range of 17 mg/L. 1671. A ✓ Explanation: "Amlodipine 5.0 mg PO OD" is written with a decimal point that could be misread, potentially leading to a medication error. It is safer to write the dose without the decimal for clarity. 1672. A ✓ Explanation: This incident is a Category H medication error, which is a "significant error" that results in a life-threatening or near-fatal event, such as anaphylaxis from a known allergy. 1673. B ✓ Explanation: Vitamin A deficiency is a leading cause of childhood blindness, particularly in developing countries, as it is crucial for proper vision. 1674. D ✓ Explanation: Ibuprofen displaces warfarin from plasma proteins, increasing the free (active) concentration of warfarin, which could lead to an increased risk of bleeding. 1675. B ✓ Explanation: Ascorbic acid (vitamin C) acts as a preservative in pharmaceutical formulations due to its antioxidant properties, which prevent degradation. 1676. A ✓ Explanation: The required vaccinations for Hajj include the influenza vaccine and meningococcal vaccine, which are necessary to prevent the spread of these diseases in crowded environments. 1677. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Adrenaline (epinephrine) causes vasodilation in muscles, vasoconstriction in the skin, and increased heart rate, which matches the described effects. 1678. D ✓ Explanation: The friability test evaluates the tablet's resistance to breaking or crumbling when subjected to mechanical stress, such as being thrown in a rotating drum. 1679. C ✓ Explanation: Accepting Drug A, which is cheaper than Drug B while maintaining the same efficacy, offers the best cost-effective decision. 1680. A ✓ Explanation: The symptoms and rash pattern are hallmark signs of scabies. 1681. C ✓ Explanation: BCG (Bacillus Calmette-Guérin) is given for tuberculosis protection, and OPV (Oral Polio Vaccine) is given for polio, typically at birth. Hep B and Measles are not included at birth under the EPI schedule. 1682. B ✓ Explanation: Septic arthritis requires gram staining and culture for a definitive diagnosis. 1683. A ✓ Explanation: The facial nerve exits the skull via the stylomastoid foramen. 1684. A ✓ Explanation: Antibiotics disrupt normal vaginal flora, leading to an overgrowth of yeast like Candida, causing candidiasis. 1685. A ✓ Explanation: Secondary hemorrhage typically occurs 7–14 days after a procedure, often due to infection. 1686. B ✓ Explanation: Serum ferritin is used to diagnose anemia caused by iron deficiency. 1687. E ✓ Explanation: Meckel's diverticulum is the most common cause of painless rectal bleeding in children. 1688. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Vitamin K deficiency leads to hemorrhagic disease of the newborn. 1689. A ✓ Explanation: Staph aureus is the most common cause of food poisoning due to heat- stable enterotoxins. 1690. D ✓ Explanation: Pentoxifylline is a xanthine derivative used to improve blood flow in peripheral vascular diseases, promoting vasodilation. 1691. C ✓ Explanation: One teaspoon equals 5 ml, so the total concentration in micrograms is calculated as: 5 ml×0.05 g/ml×1,000,000 µg/g=50,000 µg 1692. A ✓ Explanation: Most drugs and their metabolites are excreted through the kidneys via urine, making it the primary excretion route. 1693. A ✓ Explanation: Sterile water for injection is specifically prepared to meet sterility requirements necessary for parenteral preparations. 1694. B ✓ Explanation: The total dose is calculated by dividing the total amount (100 ml) by the daily dose (0.5 ml): 100 ml÷0.5 ml/day=50 doses 1695. C ✓ Explanation: Reserpine depletes neurotransmitters like dopamine, which can lead to parkinsonism and depression. 1696. C ✓ Explanation: Hexokinase catalyzes the phosphorylation of glucose to glucose-6- phosphate, a reaction that requires ATP as the phosphate donor and Mg²⁺ as a cofactor to stabilize ATP. 1697. A ✓ Explanation: Lecithin and sphingomyelin are classic examples of phospholipids, containing a phosphate group as part of their structure. 1698. D +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Pantothenic acid (Vitamin B5) synthesis starts with formaldehyde and isobutyraldehyde as precursors. 1699. D ✓ Explanation: Clofibrate reduces plasma triglycerides and lipoprotein levels, primarily by increasing lipoprotein lipase activity. 1700. A ✓ Explanation: The enzyme CYP450 was identified by Mieczysław Koonen for its role in drug metabolism and detoxification. 1701. C ✓ Explanation: Hydrocortisone does not cause arthritis; instead, it may be used to treat inflammatory conditions like arthritis. 1702. D ✓ Explanation: pH measures the acidity or basicity of a solution, indirectly related to POH. 1703. B ✓ Explanation: To calculate the percentage of elementary iron: (Amount of Elementary Iron) Percentage of Elementary Iron = Total amount of Ferrous Sulphate X 100 390 =( ) X 100 = 20% 1950 1704. A ✓ Explanation: For emergency asthma attacks, the recommended IV hydrocortisone dose is typically 100 mg every 6 hours. Higher doses are unnecessary and may increase side effects. 1705. C ✓ Explanation: Boric acid, with a pKa around 9, is suitable for creating a buffer at this pH. The others have pKa values too low for a pH of 9. 1706. C ✓ Explanation: Chlorpropamide is a sulfonylurea used for diabetes, not as an antiemetic. The other options are commonly used for nausea control. 1707. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education Explanation: ✓ The relationship between pKa, pH, and the ratio of ionized to unionized species of a drug is given by the Henderson-Hasselbalch equation: [Ionized] pH=pKa+log ( [UnIonized] ) Here: pKa = 2.2 Ratio of ionized to unionized = 103 Substitute the values: pH= 2.2 + log103 pH = 2.2 +3 = 5.2 1708. D ✓ Explanation: Weighted average calculation: (25 X 2 ) + (60×1.5) 50+90 Final percentage = = = 1.65 % ( 25+60 ) 85 1709. B ✓ Explanation: Alginic acid is used as a gelling agent, not for chemical extraction, unlike the other strong acids. 1710. D ✓ Explanation: Formoterol is a long-acting β2 agonist used in asthma and COPD for prolonged bronchodilation. 1711. A ✓ Explanation: After two half-lives (6 hours), the drug concentration will reduce to 25% of its original level. 1712. B ✓ Explanation: The symptoms and history suggest a possible zoonotic infection like brucellosis or tuberculosis. Further investigation and specific treatment are necessary. 1713. D ✓ Explanation: Bisphosphonates are associated with osteonecrosis of the jaw, especially in patients undergoing dental procedures or receiving high doses. 1714. D ✓ Explanation: Botulinum toxin is used therapeutically for conditions like muscle spasticity, chronic migraines, and hyperhidrosis. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1715. D ✓ Explanation: Paracetamol is the safest analgesic for HF and HTN patients. Oxymetazoline, a nasal decongestant, avoids the systemic effects of pseudoephedrine. 1716. C ✓ Explanation: Carbon monoxide binds to hemoglobin with high affinity, reducing its ability to carry oxygen and leading to hypoxia. 1717. C ✓ Explanation: Whole bowel irrigation is indicated for significant iron ingestion as activated charcoal does not bind iron effectively. 1718. C ✓ Explanation: Calcium gluconate counters the effects of calcium channel blocker overdose, stabilizing myocardial contractility. 1719. D ✓ Explanation: In paracetamol toxicity, excess metabolites are formed by CYP-450, which depletes glutathione, leading to liver damage. 1720. C ✓ Explanation: Prednisone, a corticosteroid, is commonly used for flare-ups in Crohn’s disease to reduce inflammation quickly. Cyclosporine and azathioprine are reserved for refractory or severe cases. 1721. A ✓ Explanation: Asthma exacerbation is the most acute and potentially life-threatening condition. After stabilizing asthma, high blood glucose (DM) should be addressed, followed by HTN management. 1722. A ✓ Explanation: Oligonucleotide probes are short DNA or RNA sequences used in hybridization techniques to detect specific nucleic acid sequences. 1723. A ✓ Explanation: Glycosylation of proteins occurs after translation as a post-translational modification, where carbohydrates are added to specific amino acids of a protein to modify its function. 1724. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: The medulla oblongata regulates the respiratory rhythm and controls the rate and depth of breathing. 1725. C ✓ Explanation: Taq polymerase, used in Taq-PCR, is thermostable and operates at higher temperatures, allowing the denaturation and synthesis of DNA during PCR. 1726. C ✓ Explanation: Galantamine is an acetylcholinesterase inhibitor used to treat cognitive symptoms in Alzheimer’s disease. 1727. A ✓ Explanation: Acetylcholine acts on muscarinic receptors in the airway smooth muscle, leading to bronchoconstriction. 1728. B ✓ Explanation: Levothyroxine is best taken on an empty stomach in the morning to enhance absorption and avoid interfering with sleep. 1729. A ✓ Explanation: Thiazide diuretics can increase uric acid levels and exacerbate gout symptoms. 1730. A ✓ Explanation: The sciatic nerve supplies motor and sensory innervation to the lower limb except for the medial aspect of the thigh. 1731. C ✓ Explanation: Filgrastim is a granulocyte colony-stimulating factor used to stimulate the production of neutrophils in neutropenic patients. 1732. A ✓ Explanation: Dopamine is used in hypodynamic shock to improve cardiac output and perfusion via its vasopressor effects. 1733. D ✓ Explanation: Warfarin is contraindicated in pregnancy due to teratogenic effects. Alternative anticoagulants like heparin are used instead. 1734. B +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Age, disease state, and overall health significantly affect renal clearance, while sex has minimal impact unless due to secondary factors like hormonal changes. 1735. A ✓ Explanation: Acyclovir is an antiviral medication primarily used to treat herpes simplex and varicella-zoster infections. 1736. C ✓ Explanation: Ointments act as a carrier for drugs and have emollient properties, providing hydration and protection to the skin. 1737. C ✓ Explanation: Drotaverine is a spasmolytic agent that relaxes smooth muscles and is used in conditions like biliary or renal colic. 1738. D ✓ Explanation: Temazepam, while a benzodiazepine, has milder sedative effects compared to the others, often used for short-term sleep disturbances. 1739. A ✓ Explanation: Pentoxifylline improves blood flow in peripheral vascular diseases, reducing viscosity and increasing red blood cell flexibility. 1740. C ✓ Explanation: Desmopressin mimics vasopressin to treat nocturnal enuresis and diabetes insipidus by reducing urine output. 1741. C ✓ Explanation: Ceftazidime is a third-generation cephalosporin with excellent activity against gram-negative bacteria, including Pseudomonas aeruginosa. 1742. C ✓ Explanation: Normal water is not sterile and is unsuitable for eye or parenteral preparations but can be used for external applications. 1743. B ✓ Explanation: Aminoglycosides are associated with significant nephrotoxicity and ototoxicity, requiring monitoring of therapeutic levels. 1744. D +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Montelukast is a leukotriene receptor antagonist that blocks the action of cysteinyl leukotrienes (C4, D4, E4), which mediate bronchoconstriction. 1745. C ✓ Explanation: Platelet activating factor (PAF) is a key mediator in airway inflammation, causing prolonged airway hyperreactivity. 1746. D ✓ Explanation: Leukotriene B4 is a potent chemotactic factor, attracting neutrophils and monocytes to sites of inflammation. 1747. B ✓ Explanation: Platelet activating factor causes bronchoconstriction, not bronchodilatation. 1748. C ✓ Explanation: Prostaglandins soften and dilate the cervix by remodeling the extracellular matrix, aiding labor induction. 1749. A ✓ Explanation: Paracetamol provides analgesic and antipyretic effects but lacks significant anti-inflammatory properties. 1750. B ✓ Explanation: COX-2 is inducible in response to inflammatory stimuli and is responsible for producing inflammatory prostaglandins. 1751. D ✓ Explanation: Prostaglandin E2 is commonly used for cervical ripening and labor induction. 1752. D ✓ Explanation: Aspirin inhibits prostaglandin synthesis, preventing peripheral pain receptor sensitization and raising pain thresholds centrally. 1753. B ✓ Explanation: Non-opioid analgesics, like paracetamol and NSAIDs, do not cause dependence, though not all inhibit prostaglandin synthesis or have anti-inflammatory effects. 1754. B +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Prostaglandin synthesis inhibitors prolong bleeding time but do not significantly affect prothrombin time. 1755. A ✓ Explanation: Aspirin irreversibly inhibits cyclooxygenase enzymes, unlike other NSAIDs that inhibit COX reversibly. 1756. D ✓ Explanation: Inhibition of the parasympathetic system reduces salivation, leading to dry mouth, and also increases heart rate, dilates pupils, and decreases gastric motility. 1757. A ✓ Explanation: The "fight-or-flight" response activates the sympathetic system, causing an increase in heart rate, dilation of pupils, and decreased gastric motility, while inhibiting lacrimation. 1758. A ✓ Explanation: Neurotransmitters are released from presynaptic terminals when action potentials trigger calcium influx. The primary neurotransmitters in the ANS are acetylcholine and norepinephrine. 1759. A ✓ Explanation: Acetylcholine activates muscarinic receptors in the parasympathetic system. Adrenergic receptors are activated by norepinephrine, and the sympathetic system increases blood pressure. 1760. B ✓ Explanation: Carvedilol blocks β1 receptors, reducing heart rate, and α1 receptors, causing vasodilation and lowering blood pressure. 1761. C ✓ Explanation: The parasympathetic system regulates essential functions like digestion, vision, and urination, using acetylcholine as a neurotransmitter. It operates discretely, with short postganglionic fibers, unlike the sympathetic system. 1762. A ✓ Explanation: ANS neurotransmitters like acetylcholine and norepinephrine bind to receptors (metabotropic or ionotropic), triggering specific cellular responses. 1763. B +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: A sudden drop in blood pressure activates the sympathetic system, not the parasympathetic system, to restore blood pressure. 1764. C ✓ Explanation: Inhibiting acetylcholinesterase increases acetylcholine levels by reducing its breakdown, which can partially compensate for the cholinergic deficiency seen in Alzheimer’s disease, alleviating symptoms. 1765. B ✓ Explanation: Ciprofloxacin dosing in CKD must be adjusted to prevent drug accumulation. A 24-hour interval is appropriate in reduced renal function. 1766. A ✓ Explanation: Antibiotics like amoxicillin require a prescription due to the potential for resistance and inappropriate use. 1767. B ✓ Explanation: Methotrexate is administered weekly in rheumatoid arthritis to reduce side effects while maintaining efficacy. 1768. C ✓ Explanation: Artesunate is the preferred treatment for severe Plasmodium falciparum malaria, providing rapid action and high efficacy. 1769. A ✓ Explanation: NSAIDs like ibuprofen are effective for acute gout flares. Colchicine and indomethacin can worsen cardiac conditions, while acetaminophen lacks anti- inflammatory action. 1770. B ✓ Explanation: Repackaged drugs typically have a maximum beyond-use date of 6 months, provided proper storage conditions are maintained. 1771. B ✓ Explanation: Doxycycline is contraindicated in pregnancy due to its teratogenic effects and potential to cause fetal bone and teeth discoloration. 1772. A ✓ Explanation: Reporting to regulatory authorities like SFDA ensures accountability and helps prevent future medication errors. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1773. D ✓ Explanation: Sertraline is an SSRI preferred for elderly patients as it is safer in the context of seizures and arrhythmia compared to other options. 1774. D ✓ Explanation: Tetanus is caused by Clostridium tetani, found in soil and environmental sources, and is not transmitted between individuals. 1775. A ✓ Explanation: Adrenaline activates α- and β-adrenergic receptors, causing vasodilation in some vessels and positive inotropic and chronotropic effects. 1776. A ✓ Explanation: High-dose statins are used to aggressively lower LDL cholesterol in patients with significantly elevated levels. 1777. A ✓ Explanation: The Cockcroft-Gault equation is a standard method to estimate creatinine clearance based on age, weight, gender, and serum creatinine. 1778. A ✓ Explanation: Atenolol concentrates in breast milk and poses a risk to infants due to its long half-life and potential for bradycardia. 1779. D ✓ Explanation: Hyaluronic acid is a glycosaminoglycan that plays a crucial role in joint lubrication and maintaining skin hydration. 1780. B ✓ Explanation: Glycogen is the storage form of glucose in animals, including humans, found primarily in the liver and muscle tissues. 1781. D ✓ Explanation: Zymogens are inactive enzyme precursors that require hydrolysis of specific peptide bonds for activation (e.g., pepsinogen to pepsin). 1782. A ✓ Explanation: Transamination reactions require aminotransferases, which use pyridoxal phosphate (PLP) as a coenzyme to transfer amino groups. +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education 1783. A ✓ Explanation: Isocitrate dehydrogenase catalyzes the oxidative decarboxylation of isocitrate to α-ketoglutarate in the Krebs cycle. 1784. B ✓ Explanation: Starch is the primary dietary polysaccharide, serving as a major energy source in human nutrition. 1785. C ✓ Explanation: The enzyme oxidizes various L-amino acids but not D-amino acids, demonstrating relative substrate specificity. 1786. B ✓ Explanation: Kinases are enzymes that add phosphate groups to specific amino acid residues, often activating or deactivating target proteins. 1787. B ✓ Explanation: Isozymes are different molecular forms of an enzyme that catalyze the same reaction but differ in structure. 1788. A ✓ Explanation: α-Tocopherol is the most biologically active form of vitamin E, known for its antioxidant properties. 1789. D ✓ Explanation: Cholinergic stimulation activates muscarinic receptors, leading to ciliary muscle contraction, reduced atrial contractility, and gallbladder contraction. 1790. E ✓ Explanation: Hypophysectomy can relieve pain in advanced cancer by reducing hormone-driven effects, and stimulation of β-receptors in the brain is linked to analgesic effects. 1791. E ✓ Explanation: Carbachol and isofluorophosphate cause miosis by stimulating muscarinic receptors or inhibiting acetylcholinesterase. Cocaine and scopolamine are mydriatics. 1792. E +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Two-point discrimination is carried in the dorsal column. Hemisection causes contralateral loss of pain and temperature sensation due to decussation of these fibers in the spinal cord. CSF is located in the subarachnoid, not the subdural space. 1793. D ✓ Explanation: Hypercapnia and hypoxia increase cerebral blood flow, which constitutes about 15% of total cardiac output. 1794. E ✓ Explanation: Synaptic potentials are graded, involve simultaneous Na+ and K+ currents, and use ligand-gated ion channels. Inhibitory potentials are typically hyperpolarizing. 1795. E ✓ Explanation: The blood-brain barrier involves astrocytic foot processes and endothelial tight junctions but allows bidirectional transport and diffusion of water. 1796. E ✓ Explanation: Cerebral blood flow increases in response to hypoxia (as in anemia), hypercapnia (CO2 inhalation), and seizures. Hyperbaric oxygen reduces cerebral blood flow. 1797. B ✓ Explanation: ADH increases water reabsorption, which can lead to reduced cardiac output under certain conditions. It does not increase sodium reabsorption or affect ACTH release. 1798. E ✓ Explanation: Sodium channels are polypeptides concentrated at the nodes of Ranvier and open in response to depolarization but inactivate shortly after. 1799. C ✓ Explanation: Elevated INR with minor bleeding requires stopping warfarin and administering oral vitamin K to stabilize clotting factors. 1800. A ✓ Explanation: Verapamil inhibits CYP3A4, increasing simvastatin levels and the risk of myopathy. The dose is limited to 10 mg daily to reduce this risk. 1801. A +92 348 9085185 [email protected] www.medsparkles.com  MEDSPARKLES (SMC-PRIVATE) LIMITED Empower the Medical Profession through Research and Education ✓ Explanation: Adding ambulatory services with clinical pharmacists highlights an internal strength of the healthcare system, improving patient care. 1802. B ✓ Explanation: Ceftriaxone targets typical pathogens, w