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The CORRECT answer is (a) Lignocaine

For explanation I would say: Benzocaine, procaine, and cocaine are ester type DRUGS. Procaine is used in dentistry when the PATIENTS have proven allergy to the amide group. Lignocaine is an amide-type drug. It is HIGHLY lipophilic and rapidly absorbed.

Correct CHOICE is (a) Cocaine

For explanation: The first and most potent LOCAL anesthetic agent is cocaine though it is rarely used now used because of the problems of misuse. It is unique in it is the ability to produce intense vasoconstriction. The half-life of cocaine is 30 minutes. Dosage of cocaine when used as topical ADMINISTRATION 4 – 10% solution of cocaine.

Right choice is (a) True

The BEST EXPLANATION: EPA is found in fish oil. It acts as a substrate for cyclooxygenases and lipoxygenases. The prostaglandins, thromboxanes, and leukotrienes produced from EPA are LESS active than AA metabolites. These products then compete with products of AA metabolism for shared target receptors. Macrophages with a high content of EPA produce less TNF and IL-l. Dietary EPA supplementation can reduce tissue INJURY due to PGs, TXs, LTS, and cytokines.

Right choice is (c) Mononuclear phagocytes

Best explanation: Synoviocytes phagocytose urate crystals and then SECRETE INFLAMMATORY mediators. These inflammatory mediators attract and activate polymorphonuclear leukocytes and mononuclear phagocytes. Drugs active in gout inhibit crystal phagocytosis and polymorphonuclear leukocytes and MACROPHAGE release of inflammatory mediators such as prostaglandin, interleukin, and LEUKOTRIENE.

The correct answer is (c) NO-NSAIDs

To ELABORATE: Nitric oxide-releasing NSAIDs. It has fewer GI effects than PARENT NSAID from which they are derived. It has a comparable anti-inflammatory EFFECT and superior analgesic effect. The parent NSAID is Naproxen. The possible mechanism can be that nitric oxide IMPROVES gastric blood FLOW.

Right answer is (a) Inhibition of COX 1

To explain: Cyclooxygenase-1 (COX-1) is expressed in a wide variety of cells all over the BODY andknown as “housekeeping enzyme” e.g.Gastric cytoprotection. Cyclooxygenase-2 (COX-2), inducible enzyme an immediate-early gene product in inflammatory and immune cells it is dramatically up-regulated during INFLAMMATION. ADVERSE effects of NSAIDs are theorized to be due to inhibition of COX-1 (EX. GI COMPLICATIONS via decreased PGE2 and potentially altered blood flow).

Correct ANSWER is (a) COX 1

To explain: Cyclooxygenase-1 (COX-1) constitutively EXPRESSED in a wide variety of cells all over the body and THUS known as “housekeeping enzyme” e.g.Gastric cytoprotection. Cyclooxygenase-2 (COX-2), INDUCIBLE enzyme an immediate-early gene product in inflammatory and immune cells it is DRAMATICALLY up-regulated during inflammation.

The correct option is (d) Inhibit cyclooxygenase

Easiest explanation: All NSAIDs inhibit the cyclooxygenase required for the conversion of arachidonic acid to endoperoxide intermediate (PGG2 and PGH2). NSAIDs inhibit prostaglandin and THROMBOXANE synthesis, they are potent inhibitors of cyclooxygenase and eliminate all prostaglandins and thromboxanes in EVERY cell they reach. The key enzyme in the cyclooxygenase pathway is the enzyme cyclooxygenase (COX). There are two FORMS of cyclooxygenase, COX1 (the predominant form) and COX2.

The correct option is (b) False

The explanation: The inflammatory response is a normal (DESIRABLE) DEFENSE mechanism but the SIDE effects are undesirable. Normal inflammatory response has an on/off switch. In chronic inflammation something has gone wrong with the off switch such as that in arthritis. Our immune system tends to attack our own CELLS. THEREFORE we need drugs to control the inflammatory reaction.

Right answer is (B) False

For explanation I would say: The inflammatory response is a normal defense mechanism. But the side effects are undesirable. Normal inflammatory response has an on/off switch. When a BEE STINGS those inflammatory reactions are desirable since these helps US to heal faster. In chronic inflammation SOMETHING has gone wrong with the off switch. Therefore we need drugs to control the inflammatory reaction.

The correct OPTION is (a) ASA

The best I can explain: Anti-inflammatory drugs are of five KINDS and these are salicylates, phenylpropionic acids, pyrazalone derivatives, indole derivatives and DISEASE modifying drugs. Salicylates e.g., ASA, phenylpropionic acids e.g., ibuprofen, ketoprofen, pyrazalone derivatives e.g., phenylbutazone, indole derivatives e.g., INDOMETHACIN, disease modifying drugs: e.g. chloroquine.

Right OPTION is (b) Ibuprofen

Easiest explanation: Examples of phenylpropionic acid derivative is ibuprofen, ketoprofen. SALICYLATES are such as ASA, pyrazalone derivatives e.g., phenylbutazone, indole derivatives e.g., indomethacin, disease modifying drugs: e.g. CHLOROQUINE.

The correct option is (b) Influx of plasma PROTEINS, phagocytic CELLS into the tissue spaces

The best explanation: The swelling is DUE to the influx of plasma proteins and phagocytic cells into the tissue spaces. And the pain is due to local release of enzymes and INCREASED tissue pressure. The redness and heat is due to the local blood vessel dilation. Redness, swelling, heating, paining these signs are common during any inflammation reaction.

Correct option is (c) BRADYKININ

Easiest explanation: Bradykinin major CONTRIBUTORS to symptoms of inflammation, it helps to increase the vasodilation during inflammation reaction. Leukotrienes increase vascular PERMEABILITY and increase mobilization of endogenous mediators of inflammation. Prostaglandins promote edema and leukocyte INFILTRATION and increase vascular permeability, enhance pain producing properties of bradykinin.

Correct option is (a) Local blood vessel dilation

The best I can explain: The redness and heat is due to the local blood vessel dilation. The swelling is due to the influx of plasma proteins and phagocytic cells into the tissue SPACES. And the pain is due to the local release of ENZYMES and INCREASED tissue pressure. These are the four signs of INFLAMMATION which can be seen in a human body.

Right option is (c) PROSTAGLANDINS

The best explanation: Prostaglandins released during inflammation reaction PROMOTE edema, causes chemotaxis, leukocyte infiltration and increase vascular permeability, enhance pain producing PROPERTIES of bradykinin. Bradykinin major contributors to symptoms of inflammation. Leukotrienes increase vascular permeability and increase mobilization of ENDOGENOUS mediators of inflammation.

The correct answer is (c) Bradykinin

Easiest explanation: Bradykinin major contributors to symptoms of inflammation it is the main cause behind pain. Leukotrienes increase vascular permeability and iincrease mobilization of ENDOGENOUS MEDIATORS of inflammation. PROSTAGLANDINS increase the vascular permeability, enhance pain producing PROPERTIES of bradykinin.

The correct answer is (d) Prostaglandins

To explain I would say: Prostaglandins promote edema and leukocyte infiltration and INCREASE vascular permeability, ENHANCE pain PRODUCING properties of bradykinin. Bradykinin MAJOR contributors to symptoms of inflammation. Leukotrienes increase vascular permeability and iincrease MOBILIZATION of endogenous mediators of inflammation.

Correct option is (c) Remifentanil

To ELABORATE: Remifentanil, currently the shortest acting opioid, has the BENEFIT of rapid offset, even after prolonged infusions. ALFENTANIL, ultra-short acting i.e. 5-10 minutes analgesic. Sufentanil, a potent analgesic 5 to 10 TIMES more potent than fentanyl for use in heart surgery. Carfentanil is used in veterinary PRACTICE.

The correct option is (a) Alfentanyl

Easy explanation: Alfentanil (Alfenta) is an ultra-short acting (5-10 MINUTES) analgesic. Sufentanil 5 to 10 times more POTENT than fentanyl. Remifentanil currently the shortest acting OPIOID. CARFENTANIL has analgesic potency 10,000 times that of morphine.

The correct answer is (a) NALOXONE

Explanation: A HEROIN overdose is USUALLY treated with an opioid antagonist, such as naloxone (Narcan) which has a high affinity for opioid receptors but does not ACTIVATE them. Many death are caused due to the overdoses caused by interaction with depressant drugs like alcohol.

Right option is (d) Endomorphins

To elaborate: ENDOGENOUS opioid peptides are produced naturally in the body, such as endorphins, Endomorphins, etc. Heroin and morphine exert their effects by mimicking naturally occurring substances, CALLED endogenous opioid peptides or endorphins. Natural opiates are alkaloid contained in the resin of the opium poppy INCLUDING morphine and codeine. Semi-SYNTHETIC opiates are created from natural opiates such as hydromorphone, oxycodone, and diacetylmorphine. Fully synthetic OPIOIDS are such as fentanyl, methadone, etc.

Correct answer is (B) Oxycodone

Best EXPLANATION: Semi-synthetic opiates are created from natural opiates such as hydromorphone, oxycodone, and diacetylmorphine. These are MAD by simple modification of the existing natural chemical structure of the compound making it more potent, less toxic etc. Natural opiates are alkaloid contained in the resin of the opium poppy including morphine and CODEINE. FULLY synthetic opioids are such as fentanyl, methadone, etc.

The correct choice is (a) Codeine

The best I can explain: Natural opiates are alkaloid CONTAINED in the resin of the opium poppy including morphine and codeine. Semi-SYNTHETIC opiates are created from natural opiates such as hydromorphone, oxycodone, and diacetylmorphine. FULLY synthetic OPIOIDS are such as fentanyl, methadone, etc.

The correct answer is (a) Alveoli

Easiest explanation: General anesthetics when allowed to inhaled 1st ENTER the lungs. Then they can readily pass through the alveolar WALLS and mix with the arterial blood. Furthermore, the depth of anesthesia induced by an inhaled anesthetic depends on the partial PRESSURE of the anesthetics in the brain, and the rate of induction and recovery from anesthesia depends on the rate of CHANGE of partial pressure in the brain. These drugs are small lipid-soluble molecules that can cross the alveolar membrane easily. Move into and out of the blood based on the partial pressure gradient.

The CORRECT OPTION is (c) Render insensitive to pain by binding to opioid receptors

The BEST explanation: Analgesics, or pain killers, that bind to opioid receptors which are found principally in the CNS and Gastrointestinal tract. Most of the time increase the pain THRESHOLD level thus decreasing the patient’s perception of the occurring pain.

Correct option is (a) True

Explanation: Amount of anesthetics that REACHES the brain can be indicated by oil: gas ratio (lipid solubility) and Partial Pressure of anesthetics. The LOWER the blood: gas ratio, the more anesthetics will arrive at the brain SINCE more gas can dissolve in the blood.

Correct choice is (b) False

The BEST I can explain: Local ANESTHETICS help block conduction. It decreases the axonal Na+ entry thus prevents action potential PROPAGATION. Administration of general anesthetics decreases the presynaptic Ca^2+ entry, thus decreases the neurotransmitter release. It INCREASES postsynaptic Cl^– entry and ALSO increases postsynaptic K+ leakage from the cell.

Right CHOICE is (d) Muscle contraction

Best EXPLANATION: The most essential components of ANESTHESIA are analgesia that is the perception of PAIN, hypnosis that is unconsciousness, Depression of spinal motor reflexes and muscle relaxation. These components altogether emphasize the role of immobility.

Right option is (b) F < CL < BR < I

For explanation: Although halogenations of hydrocarbons and ethers increase anesthetic potency, it also increases the potential for INDUCING cardiac arrhythmias in the following order F < Cl < Br < I. Halogenated methyl ethyl ethers (ENFLURANE and Isoflurane) are more stable, are more potent, and have better clinical profile than halogenated diethyl ethers.

The correct answer is (b) Render a full body of the PATIENT insensitive to pain

To explain I would say: GENERAL anesthesia is a drug that brings about a reversible loss of CONSCIOUSNESS. These drugs are generally administered by an anaesthesiologist in order to induce or maintain general anesthesia to FACILITATE surgery. It helps to prevent the psychological and somatic adverse effect of surgical trauma and create a BETTER condition for surgery.

The correct choice is (B) Stage II ending

To elaborate: The PATIENT starts vomiting by the end of stage II, THUS the patient has to be GIVEN with anti-vomiting MEDICINES.

The correct answer is (c) Cocaine

To elaborate: PANTOPRAZOLE is a proton pump inhibitor used to reduce peptic ULCER. Amlodipine is a 2nd line drug for HYPERTENSION. Cocaine be the potent anesthetics. But not in general purpose use because of it high demand for drug addiction. Mannitol is an osmotic DIURETIC. It is used in severe HEAD injury to reduce blood loss.

The correct choice is (a) True

For explanation: The FIRST and most potent LOCAL anesthetic agent, rarely used because of the PROBLEMS of misuse. It is unique in it is the ABILITY to produce intense vasoconstriction. Cocaine, when used TOPICALLY for local anesthetic, has a half-life of 30 minutes.

The correct choice is (b) Phenylbutazone

Easiest explanation: Phenylbutazone a pyrazolone derivative is a powerful anti-inflammatory drug but its usefulness is limited by its toxicity chiefly short-term therapy. Piroxicam has a half-life of 45 hours and THUS can be administered once a day but it can show some GI DISTURBANCE. Ibuprofen is a propionic acid derivative has the same potency as acetyl Salicylate but better tolerated (FEWER side effects). Indomethacin is an indole derivative more potent than ASA but inferior at doses tolerated by rheumatoid arthritis PATIENTS it becomes TOXIC for these patients.

The correct choice is (a) HISTAMINE

Easiest EXPLANATION: The hormone that acts as a MAJOR contributor for increasing vascular permeability during INFLAMMATION is histamine. In most cases, it is observed that histamine tends to increase vascular permeability by (NO)-dependent vascular dilation and also with increased blood flow.

Correct answer is (d) Carfentanil

Best EXPLANATION: Alfentanil, ultra-short acting analgesic. Sufentanil, a potent analgesic (5 to 10 times more potent than fentanyl) for USE in heart surgery. Remifentanil has the benefit of rapid offset, even after prolonged INFUSIONS. Carfentanil has analgesic potency 10,000 times that of morphine and is USED in veterinary practice to immobilize certain large animals such as elephants.

Right option is (d) Indomethacin

The explanation is: PHENYLBUTAZONE is a powerful anti-inflammatory drug. Piroxicam has a half-life of 45 hours and thus can be administered once a day. Ibuprofen is a propionic acid derivative has the same potency as acetyl SALICYLATE but better tolerated. Indomethacin is an indole derivative more potent than ASA but inferior at doses tolerated by rheumatoid arthritis patients, QUITE toxic.

The correct choice is (C) Render INSENSITIVE to pain by DECREASING the pain threshold

Easy explanation: In general, opioids act upon mu-, delta-, and kappa-receptors on the brain and spinal cord neurons producing analgesia VIA decreased neuronal transmitter release.Opioid most of the times appear to work by elevating the pain threshold, thus decreases the brain’s awareness of pain in the PATIENT’s body. Mu-binds morphine strongest. K-safest analgesic due to less dangerous side effects.

Right CHOICE is (a) PIROXICAM

For explanation I would say: Phenylbutazone a pyrazolone derivative is a powerful anti-inflammatory drug but its usefulness is limited by its toxicity chiefly short-term therapy. Piroxicam has a half-life of 45 hours and thus can be ADMINISTERED once a day but it can show some GI DISTURBANCE. Ibuprofen is a propionic acid derivative has the same potency as acetyl Salicylate but better tolerated (fewer side effects). Indomethacin is an indole derivative more potent than ASA but inferior at doses tolerated by rheumatoid arthritis patients, QUITE toxic.

Correct choice is (d) Brain

Explanation: Partial Pressure in brain quickly EQUILIBRATES with partial pressure in arterial blood which has EQUILIBRATED with partial pressure perfused alveoli. FURTHERMORE, the depth of anesthesia induced by an inhaled anesthetic depends on the partial pressure of the anesthetics in the brain, and the RATE of induction and RECOVERY from anesthesia depends on the rate of change of partial pressure in the brain. These drugs are small lipid-soluble molecules that can cross the alveolar membrane easily. Move into and out of the blood based on the partial pressure gradient.