Q1.

A lipid-soluble cholinomimetic with direct action that has been used to treat glaucoma

is:

(a) Pilocarpine

(b) Neostigmine

(c) Acetylcholine

(d) Physostigmine

Ans: a

Rational: Pilocarpine is a directly acting cholinomimetic, whereas physostigmine is an indirectly

acting cholinomimetic that is useful for treating glaucoma.

Q2. Any of the following is an NSAID that doesn't work to reduce inflammation:

(a) Diclofenac sodium

(b) Ibuprofen

(c) Ibuprofen

(d) Paracetamol

Ans: d

Rational: The accumulation of peroxides released at the inflammation site makes it useless,

hence it cannot be considered to have anti-inflammatory function.

Q3. Digoxin activity is unaffected by

(a) electrolyte abnormalities

(b) myocardial infarction

(c) renal failure

(d) hepatic illness

Ans: d
Rational: Digoxin is removed mostly by renal excretion, while digitoxin is processed by the

liver.

In hepatic failure, the dose of digoxin does not need to be adjusted, however in renal failure it

must be decreased.

In cases of MI, the arrhythmogenic digitalis dosage is decreased. Only when CHF is

accompanied by AF and fast ventricular rate can it be utilised after a myocardial infarction.

Hypokalemia, hypomagnesemia, and hypercalcemia increase the likelihood of digitalis toxicity.

Q4. Ravi, a 30-year-old man, comes to your outpatient clinic complaining of weakness in

his muscles and a headache.

He has a blood pressure of 170/120 mmHg and a heart rate of 100 beats per minute. An

assessment in the laboratory indicates hypokalemia, metabolic alkalosis, and a reduction in

plasma renin activity.

On CT scan, a tumour on the left suprarenal gland was seen.

The patient took the suggested medication for a few weeks, and the symptoms resolved.

Normal laboratory readings and blood pressure were restored. What is the likely medicine

prescribed to this patient?

(a) Propanolol

(b) Hydrochlorothiazide

(c) Spironolactone

(d) Clonidine

Ans: c
Rational: This patient's most likely diagnosis is an aldosterone-secreting tumour (adenoma) that

is causing primary hyperaldosteronism (Conn's Syndrome). An overabundance of aldosterone

will result in hypertension, hypokalemia, metabolic alkalosis, and renin suppression.

As a treatment for Conn's syndrome, aldosterone antagonists such as spironolactone or

eplerenone can be used.

Q5. Ramesh, a 47-year-old gentleman, displayed signs and symptoms of acromegaly.

Radiological examinations revealed the existence of a significant pituitary tumour. The

tumor's surgical removal was only partially effective in treating the condition. Which of the

following medications is most likely to be utilised as pharmacological treatment at this

time?

(a) Leuprolide

(b) Octreotide

(c) Somatropin

(d) Desmopressin

Ans: b

Rational: Bromocriptine and cabergoline are two drugs that can help with acromegaly.

Somatostatin and octreotide (long acting somatostatin analogue) are also helpful.

• Pegvisomant (growth hormone receptor antagonist) can be used to treat this condition.