Conceptual Institute of Medical Sciences

Attempt all questions. All questions carry equal marks.

Chemotherapy
Total Marks: 34
Total Time: 34mins

Q1. A mother received an antimicrobial therapy for urinary tract infection one week
before delivery, which of the following is more likely to cause kernicterus in the baby.
a) Cephalosporin
b) Penicillin
c) Erythromycin
d) Sulfonamides
e) Aminoglycosides

Q2. Which drug is most likely to cause loss of equilibrium and auditory damage?
a) Ethambutol
b) Amikacin
c) Isoniazid
d) Paraaminosalicylic acid
e) Rifabutin

Q3. Which statement about ciprofloxacin is accurate?

a) It is active against most MRSA strains of staphylococci
b) Clinical antagonism occurs if it is used with inhibitors of dihydrofolate reductase
c) It should not be used for urinary tract infection
d) Organisms associated with middle ear infection are highly resistant
e) Tendinitis and tendon rupture may occur during treatment

Q4. Floroquinolones interfere with the action of the following enzyme

a) Peptidyl transferase
b) Topoisomerase
c) RNA gyrase
d) Dihydroptereoate synthetase
e) Dihydrofolate reductase

Q5. Clindamycin causes fatal pseudomembraneous colitis due to overgrowth of

following organism
a) Bacteroides fragilis
b) Clostridium difficile
c) Enterococci
d) Gonococci
e) Pseudomonas aeroginosa
Q6. The tertracycline which reaches in sufficient quantity in cerebrospinal fluid
a) Minocycline
b) Doxycycline
c) Tertracycline
d) Demeclocycline
e) Tigecycline

Q7. Which of the following drugs should be avoided during therapy with
metronidazole?
a) Alcohol
b) Diloxanide furoate
c) Iodoquinol
d) Paromomycin
e) Emetin

Q8. Black water fever is a specific side effect of

a) Primaquine
b) Antifolates
c) Mefloquine
d) Quinine
e) Artemether

Q9. Which of the following steps in viral replication is (are) targeted by acyclovir?
a) DNA synthesis
b) Packaging and assembly of the virion
c) Protein synthesis by host polysome
d) Uncoating of the viral DNA
e) Release of virion

Q10. Drug that prolongs QT interval and should be avoided in patients predisposed to
arrhythmias
a) Nalidixic acid
b) Ciprofloxacin
c) Ofloxacin
d) Norfloxacin
e) Sparfloxacin

Q11. Which of the following mechanisms accounts for the antifungal activity of
flucytosine?
a) Formation of pores in the cell membrane
b) Inhibition of cytochrome P450 enzymes
c) Inhibition of DNA and RNA synthesis
d) Inhibition of ribosomal protein biosynthesis
e) Inhibition of squalene epoxidase
Q12. Which of the following drugs is poorly absorbed from the intestine and has the
least systemic antifungal activity when administered by the oral route?
a) Amphotericin B
b) Flucytosine
c) Itraconazole,
d) Ketoconazole
e) Terbinafine

Q13. Which of the following represents the greatest limitation in the usefulness of
chloroquine for the treatment of Plasmodium falciparum infection?
a) Hepatotoxicity
b) Nephrotoxicity
c) Poor absorption of the phosphate salt from the GI tract
d) Poor distribution of the drug to the tissues
e) Resistant strains

Q14. Which of the following is the drug of choice for eradication of dormant hepatic
stages of Plasmodium vivax and Plasmodium ovale?
a) Amodiaquine
b) Chloroquine
c) Mefloquine
d) Primaquine
e) Quinine

Q15. Ethambutol is relatively contraindicated in young children. The reason is

a) Their enzyme system is immature to metabolize ethambutol
b) It is not easy to adjust the dose in children
c) It causes retrobulbar neuritis and it is difficult to assess visual acuity and red-green
color discrimination in young children
d) Young children are usually hypersensitive to the ethambutol
e) Pyrazinamide and ethambutol when given in combination in young children may
cause urate retention and gouty arthritis

Q16. Second line antituberculosis drugs do not include

a. Ethionamide
b. Capreomycin
c. Cycloserin
d. Cyclosporine
e. Aminosalicylic acid
Q17. A patient was found to have tapeworms on stool examination. The drug of choice
is
a. Albendazole
b. Parental pamoate
c. Niclosamide
d. Thiabendazole
e. Mebendazole

Q18. A child of 7 years is suffering from Enteric Fever. Which of the followings is a
suitable drug for his treatment?
a) Co-trimoxazole
b) Ciprofloxacin
c) Chloramphenicol
d) Tobramycin
e) Ceftriaxone
Q19. Which of the following drugs is most likely to be effective against Multidrug-
Resistant Strains of M. Tuberculosis including those resistant to streptomycin?
a) Gentamycin
b) Meropenem.
c) Amikacin
d) Spectinomycin.
e) Clarithromycin.
Q20. The drug most effective against malarial parasites in the liver but not effective
against parasites within erythrocytes is:
a) Mefloquine
b) Chloroquine
c) Primaquine
d) Chloroguanide
e) Pyrimethamine
Q21. For an established HIV infection in a 28 year old man the selected drugs are
Ritonavir, Saquinavir, Zidovudine, and Didanosine; the main purpose of using the
Ritonavir is to:
a) Maintain adequate saquinavir levels by inhibiting its metabolism
b) Reduce or hopefully eliminate saquinavir mediated host toxicity
c) Induce the metabolic activation of the NRTIs which are prodrugs.
d) Prevent the likely development of hypoglycemia.
e) Serve as the main most active inhibitor of viral protease in this combination.

Q22. The dose limiting toxicity of Amphotericin B is:

a) Myelosuppression.
b) Renal tubular acidosis.
c) Infusion related adverse effects.
d) Hypotension.
e) Hepatitis.
Q23. A 35 years old lady is suffering from Advanced Breast Cancer; a plan has been
made to give a cell cycle specific anticancer drug which acts mainly in the M phase of
the Cell Cycle; the drug is:
a) Cisplatin
b) Bleomycin
c) Paclitaxel
d) Etoposide
e) Methotrexate

Q24. After failure of the initial therapy of a case of Hodgkin's Lymphoma with MOPP
regimen, the patient was put on ABVD regimen but it lead to pulmonary toxicity; this is
most commonly observed with:
a) Vincristine.
b) Prednisone.;
c) Methotrexate.
d) Doxorubicin.
e) Bleomycin.
Q25. A patient with an opportunistic infection with Pneumocystis carinii is receiving a
combination drug, Co-trimoxazole. The mechanism by which this combination exerts its
desired and better effects is:
a) The combination exerts significant antiviral activity
b) TMP inhibits normal transmission of, resistance factors directed against SMZ
c) They inhibit sequential steps in bacterial synthesis of tetrahydrofolic acid.
d) TMP kills gut flora that otherwise reduce oral bioavailability of the SMZ.
e) The combination permeabilizes bacterial cell walls, allowing better penetration.
Q26. Which of the followings is the most effective agent in the treatment of Rickettsia,
Mycoplasma and Chlamydia infections?
a) Bacitracin
b) Tetracycline
c) Gentamicin
d) Vancomycin
e) Penicillin G
Q27. The following drug causes inhibition of bacterial beta lactamases:
a) Azlocillin
b) Nafcillin
c) Sulbactum
d) Monobactum
e) Moxalactum
Q28. Regarding Sulfasalazine which of the following statements is incorrect?
a. It is a combination of sulfapyridine and 5-aminosalicylic acid.
b. It is used in the treatment of ulcerative colitis and rheumatoid arthritis.
c. Sulfapyridine is the active agent in the treatment of ulcerative colitis
d. 5-aminosalicylic acid is not absorbed and reduces inflammation by local action
e. Sulfapyridine is therapeutically inert in the treatment of ulcerative colitis but is the
active moiety as disease modifying antirheumatic drug.

Q29. The reason to start second line antituberculous drugs includes the followings
except
a. In case of resistance to first line drugs
b. In case of failure of clinical response to conventional therapy
c. In case of serious treatment limiting adverse drug reactions
d. In case of easy availability of drugs
e. When expert guidance is available to deal with the toxic effects

Q30. Cyclophosphamide is an alkylating agent developed as an anticancer drug.

However it may be useful in following conditions except
a. Systemic lupus erythematosis
b. Autoimmune hemolytic anemia
c. Wegeners granulomatosis
d. Severe rheumatic diseases
e. Myasthenia gravis

Q31. Trimethoprim is selectively toxic to bacterial versus mammalian cells

because:
a. Mammalian cells don't synthesize folic acid
b. Mammalian cells don't take up trimethoprim
c. Mammalian cells don't reduce dihydrofolic acid to tetrahydrofolic acid
d. Trimethoprim reacts only with the bacterial dihydrofolate reductase to inactivate
it in a noncompetitive manner
e. The mammalian dihydrofolate reductase is much less sensitive to competitive
inhibition by trimethoprim than the bacterial enzymes

Q32. A 37-year-old female presents with fever & malaise. Blood tests reveal that she has
an increase in her liver enzymes. Her hepatitis serology indicates that she has hepatitis
B virus (HBV). Which of the following agents can be used in the management of this
virus?
a. Lamivudine
b. Zidovudine
c. Ribavirin
d. Interferon
e. Acyclovir
Q33. What is the treatment for Trichomonas vaginalis:
a. Lindane
b. Mebendazole
c. Metronidazole
d. Praziquantel
e. Thiabendazole

Q34. Extensively drug resistant (XDR) organisms are those which are resistant to
a) Rifamicin
b) INH + rifampin
c) 1st line drugs
d) 2nd line drugs
e) 1st line + 2nd line drugs