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Paper I — 2024 June (Supplementary) (2019 Scheme) — Q4

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Paper I
2024 June (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

Discuss the management of drug induced Parkinsonism. Discuss the management of megaloblastic anaemia. (4+4)

Q48 marksShort Essays

Answer

a) Management of drug-induced parkinsonism Results from dopamine D2 receptor blockade (typically antipsychotics), tipping the striatal dopamine-acetylcholine balance toward relative cholinergic excess.

  • Where feasible, reduce the dose of or switch the causative drug to one with lower D2-blocking potency (e.g. an atypical antipsychotic with a more favorable receptor profile).
  • Anticholinergics (Trihexyphenidyl, Benztropine) — block the excess cholinergic activity, restoring balance; the treatment of choice, since the problem is receptor blockade, not dopamine deficiency.
  • Levodopa is not useful here — since dopamine receptors are pharmacologically blocked rather than dopamine being deficient, adding more dopamine does not overcome the block and can antagonize the causative drug’s own therapeutic effect.
  • Symptoms are generally reversible on stopping the offending drug, over days to weeks.

b) Management of megaloblastic anemia Results from vitamin B12 or folate deficiency, impairing DNA synthesis in rapidly dividing cells.

  • Determine the specific deficiency (B12 versus folate) before treating, since folate replacement alone in a B12-deficient patient corrects the anemia but allows the neurological complications of B12 deficiency (subacute combined degeneration) to progress unchecked.
  • Vitamin B12 (Cyanocobalamin/Hydroxocobalamin) — parenteral (IM) replacement, particularly in pernicious anemia (impaired intrinsic-factor-mediated absorption) or malabsorption; oral high-dose therapy is an alternative in some settings.
  • Folic acid — oral replacement for folate deficiency (dietary insufficiency, increased demand as in pregnancy, or certain drug-induced deficiency).
  • Treat the underlying cause where identifiable (dietary correction, addressing malabsorption, reviewing folate-antagonist drugs).
  1. 1Blood

Other Years Asked

  1. 1A 52-year-old man presented with complaints of tightness and discomfort in middle part of chest, particularly after brisk walking. This is relived within 10 minutes of rest. A diagnosis of Angina pectoris was made by physician after appropriate investigations. (2023 July (Supplementary) (2019 Scheme)Essay · 15 marks
  2. 2(2022 February (2019 Scheme)Short Essay · 8 marks
  3. 3(2022 July (Supplementary) (2019 Scheme)Short Essay · 8 marks
  4. 4Heparin. (2+3+3)2023 January (Supplementary) (2019 Scheme)Short Essay · 8 marks
  5. 5Mention two low molecular weight heparins. Explain their mechanism of action. What are the differences between unfractionated heparin and low molecular weight heparins. (1+2+3)2024 December (Supplementary) (2019 Scheme)Short Essay · 6 marks
  6. 6Read the clinical problem and answer the following question: Mr.Shankar, 54 years suddenly developed severe chest pain. He was a diabetic and admitted in the ICCU with the diagnosis of acute myocardial infarction,2015 February (2010 Scheme)Essay · 6 marks
  7. 7A 24year old lady comes to the OPD with complaints of high fever with chills and rigors for the past 3 days. She also complains of headache, body ache and weakness. The fever lasts for 4 to 6 hours and subsides after sweating. You make a diagnosis of malaria based on blood smear which showed P. vivax parasites.2024 August (Supplementary) (2010 Scheme)Essay · 6 marks
  8. 8Pharmacological basis for the use of Protamine sulphate in heparin overdosage.2024 June (Supplementary) (2019 Scheme)Short Answer · 4 marks
  9. 9(2022 July (Supplementary) (2019 Scheme)Short Essay · 4 marks
  10. 10Mechanism of action and therapeutic indications of Atorvastatin2024 March (Supplementary) (2019 Scheme)Short Answer · 4 marks
  11. 11Explain the rationale of Levodopa and Carbidopa fixed drug combination in Parkinson’s disease2025 March (Supplementary (SAY)) (2019 Scheme)Short Answer · 4 marks
  12. 12Streptokinase.2023 July (Supplementary) (2019 Scheme)Short Answer · 4 marks
  13. 13Pharmacological basis for the use of Fenofibrate in Hyperlipedemia.2023 July (Supplementary) (2019 Scheme)Short Answer · 4 marks
  14. 14Clopidogrel.2017 August (Supplementary) (2010 Scheme)Short Note · 3 marks
  15. 15Low molecular weight heparins2021 May (Supplementary) (2010 Scheme)Short Note · 3 marks
  16. 16Fibrinolytic drugs2019 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  17. 17Heparin2024 March (Supplementary) (2010 Scheme)Short Note · 3 marks
  18. 18Low molecular weight heparin2017 February (2010 Scheme)Short Note · 3 marks
  19. 19Atorvastatin2024 August (Supplementary) (2010 Scheme)Short Note · 3 marks
  20. 20Low dose Aspirin.2025 August (Supplementary) (2010 Scheme)Short Note · 3 marks
  21. 21Clopidogrel2018 February (2010 Scheme)Short Note · 3 marks
  22. 22Second generation antihistaminic agents2021 May (Supplementary) (2010 Scheme)Short Note · 3 marks
  23. 23Ezetimibe2023 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  24. 24Heparin.2015 February (2010 Scheme)Short Note · 3 marks
  25. 25Treatment of Iron deficiency anemia2017 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  26. 26Beta blockers in angina2021 May (Supplementary) (2010 Scheme)Short Answer · 1 mark
  27. 27Heparin overdosage is treated with:2024 December (Supplementary) (2019 Scheme)MCQ · 1 mark
  28. 28Radical cure in plasmodium vivax infection2014 March (2010 Scheme)Short Answer · 1 mark
  29. 29Combination of adrenaline with lignocaine in infiltration local anesthesia2019 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  30. 30Carbidopa in combination with Levodopa.2021 December (Supplementary) (2010 Scheme)Short Answer · 1 mark
  31. 31Two differences between heparin and warfarin2014 March (2010 Scheme)Short Answer · 1 mark
  32. 32Fibrinolytic agents2018 February (2010 Scheme)Short Answer · 1 mark
  33. 33Dextran2022 May (Supplementary) (2010 Scheme)Short Answer · 1 mark
  34. 34Atorvastatin in primary hyperlipidaemia.2025 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  35. 35Levodopa and carbidopa in parkinsonism2023 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  36. 36Aspirin in the secondary prevention of Ischaemic heart disease2024 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  37. 37Low molecular weight heparins2013 April (2010 Scheme)Short Answer · 1 mark
  38. 38Thrombolytic agents2017 February (2010 Scheme)Short Answer · 1 mark
  39. 39Levodopa and Carbidopa in the treatment of Parkinsonism2024 March (Supplementary) (2010 Scheme)Short Answer · 1 mark
  40. 40Low dose Aspirin in prophylaxis of myocardial infarction2023 March (Supplementary) (2010 Scheme)Short Answer · 1 mark
  41. 41Rationale for use of prostaglandin in acid peptic disease2015 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  42. 42Acute myocardial infarction.2016 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  43. 43The direct oral anticoagulants (DOACs) that inhibit factor Xa are2025 March (Supplementary (SAY)) (2019 Scheme)MCQ (Multi) · 1 mark
  44. 44Anti platelet drugs2013 April (2010 Scheme)Short Answer · 1 mark
  45. 45Low molecular weight heparins2015 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  46. 46Iron deficiency anemia.2016 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  47. 47Hyperlipidemia2014 March (2010 Scheme)Short Answer · 1 mark
  48. 48Assertion (A): Aspirin is used for its antiplatelet effects to prevent blood clots. Reason (R): Aspirin inhibits the enzyme cyclooxygenase (COX), which decreases thromboxane A2 production, a molecule that promotes platelet aggregation.2025 March (Supplementary (SAY)) (2019 Scheme)MCQ (A/R) · 1 mark
  49. 49Adrenaline with lignocaine in local anaesthesia2022 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  50. 50Vitamin K in warfarin toxicity2022 May (Supplementary) (2010 Scheme)Short Answer · 1 mark
  51. 51Fibrinolytics.2016 February (2010 Scheme)Short Answer · 1 mark
  52. 52Levodopa and carbidopa combination in Parkinson’s disease2019 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  53. 53Hyperlipidemia.2016 February (2010 Scheme)Short Answer · 1 mark
  54. 54Due to her intolerance, the physician decides to initiate parenteral iron therapy to restore her iron levels effectively. The following iron preparation may be used in her by intravenous route:2024 December (Supplementary) (2019 Scheme)MCQ · 1 mark
  55. 55Adrenaline with lignocaine for tooth extraction2023 July (Supplementary) (2010 Scheme)Short Answer · 1 mark
  56. 56Human erythropoietin (Epoietin)2020 February (Supplementary) (2010 Scheme)Short Answer · 1 mark
  57. 57Tenecteplase2019 February (2010 Scheme)Short Answer · 1 mark
  58. 58Low molecular weight heparin2023 March (Supplementary) (2010 Scheme)Short Answer · 1 mark
  59. 59Plasma expanders2019 July (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  60. 60Plasma expanders2023 July (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  61. 61HMG CoA reductase inhibitors2025 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  62. 62Low molecular weight heparin2020 February (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  63. 63Second generation antihistaminics2022 October (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  64. 64Antiplatelet agent2019 February (2010 Scheme)Short Answer · 0.3 marks
  65. 65Antiplatelet drugs2021 May (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  66. 66Oral direct factor Xa inhibitors2021 February (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  67. 67Fibrates2022 May (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  68. 68Metoclopramide as antiemetic in paediatric population Name the following (Two examples for each) (5x1=5)2023 July (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  69. 69Atropine as a Pre anaesthetic medication Name the following (Two examples for each): (5x1=5)2024 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  70. 70Parenteral preparations of Iron2023 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  71. 71Fibrinolytics2024 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  72. 72Plasma expanders2024 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  73. 73Warfarin as Anticoagulant in pregnancy.2025 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  74. 74Fibrinolytic drugs.2025 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  75. 75Recombinant tissue plasminogen activators2021 February (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  76. 76Hypolipidaemic drugs2024 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  77. 77Second generation antihistaminics.2025 August (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  78. 78Fibrinolytics2023 July (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  79. 79HMG-CoA Reductase inhibitors2022 October (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
  80. 80 Levocetirizine for a machine operator. Name the following (Two examples for each): (8x1=8)2024 June (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  81. 81Chlorpheniramine maleate for Acute Rhinitis in a driver2022 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  82. 82Parenteral iron preparation.2024 June (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  83. 83Centrally acting alpha-2 receptor agonists.2023 January (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  84. 84Fibrinolytic drugs.2022 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  85. 85Antiplatelet agents2022 February (2019 Scheme)Short Answer · 0.2 marks
  86. 86Drugs used to treat Venous thromboembolism2024 March (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  87. 87 Domperidone for vomiting in a Parkinsonism patient on Levo Dopa. Name the following (Two examples for each) : (8x1=8)2023 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks
  88. 88Drugs for treating Malaria.2023 July (Supplementary) (2019 Scheme)Short Answer · 0.2 marks

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