Revise MBBS

Paper I — 2023 July (Supplementary) (2019 Scheme) — Q1

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Paper I
2023 July (Supplementary) (2019 Scheme) · 100 marks · 180 min

Question

A 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. (

  • (a) Mention four different drug groups used in treatment of Angina with two examples each. ( 4 mark(s)
  • (b) Write the mechanism of action and adverse effects of Nitrates. ( 3 mark(s)
  • (c) Outline the management of Acute pulmonary edema, with rationale for use of each drug. ( 4 mark(s)
  • (d) Briefly describe Antiplatelet drugs. 4 mark(s)
Q115 marksEssays

Answer

a) Four drug groups for angina, two examples each

GroupExamples
NitratesGlyceryl trinitrate, Isosorbide dinitrate
Beta-blockersAtenolol, Metoprolol
Calcium channel blockersAmlodipine, Diltiazem
Newer agentsRanolazine, Nicorandil

b) Nitrates — mechanism and adverse effects Mechanism: enzymatically denitrated within vascular smooth muscle to release nitric oxide, activating soluble guanylyl cyclase, raising cGMP and dephosphorylating myosin light chain kinase → smooth muscle relaxation. Dilate veins more than arteries, pooling blood peripherally and reducing preload — the dominant benefit in this patient’s classical exertional angina. Adverse effects: throbbing headache, flushing, postural hypotension with reflex tachycardia; tolerance with continuous exposure; dangerous potentiation of hypotension with PDE-5 inhibitors.

c) Management of acute pulmonary edema, with rationale

  • Oxygen — corrects hypoxia.
  • IV Furosemide — rapid venodilation and diuresis, relieving pulmonary congestion.
  • IV Glyceryl trinitrate — venous pooling reduces preload, directly relieving pulmonary congestion.
  • Morphine (cautiously) — reduces anxiety and sympathetic drive, venodilation further reduces preload.
  • Inotropic support (Dobutamine) if hypotensive/cardiogenic shock.

d) Antiplatelet drugs

  • Aspirin — irreversibly inhibits platelet COX-1, blocking thromboxane A2 synthesis for the platelet’s lifespan.
  • Clopidogrel — irreversibly blocks the P2Y12 ADP receptor, preventing ADP-mediated platelet activation.
  • Glycoprotein IIb/IIIa inhibitors (Abciximab) — block the final common pathway of platelet aggregation, used in high-risk PCI settings.

Used for secondary prevention of myocardial infarction/stroke and in acute coronary syndrome; dual antiplatelet therapy (aspirin + a P2Y12 inhibitor) is standard after coronary stenting.

  1. 1Blood

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  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
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  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
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  26. 26Beta blockers in angina2021 May (Supplementary) (2010 Scheme)Short Answer · 1 mark
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  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
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  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
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  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
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