13.1 The following analgesic lacks antiinflammatory action:
A. Paracetamol
B. Ibuprofen
C. Diclofenac sodium
D. Piroxicam
13.2 Choose the correct statement about nonopioid analgesics:
A. All have antiinflammatory property
B. All lack dependence producing liability
C. All act exclusively at peripheral pain mechanisms
D. All inhibit prostaglandin synthesis
13.3 The distinctive feature of the isoenzyme cyclooxygenase-2 is:
A. It is not inhibited by indomethacin
B. It is inducible
C. It generates cytoprotective prostagladins in gastric mucosa
D. It is found only in foetal tissues
13.4 Aspirin produces analgesia by:
A. Preventing sensitization of peripheral pain receptors
B. Affecting gating of pain impulses at spinal level
C. Raising pain threshold at subcortical level
D. Both ‘A’ and ‘C’ are correct
13.5 Select the drug which inhibits cyclooxygenase irreversibly:
A. Aspirin
B. Mephenamic acid
C. Naproxen
D. Diclofenac
13.6 Inhibitors of prostaglandin synthesis share the following features except:
A. Prolongation of bleeding time
B. Prolongation of prothrombin time
C. Prolongation of labour
D. Gastric mucosal damage
13.7 Selective COX-2 inhibitors differ from nonselective COX-1/COX-2 inhibitors in that they:
A. Are antiinflammatory but not analgesic
B. Donot bring down fever
C. Have no renal effects
D. Do not inhibit platelet aggregation
13.8 Inhibition of prostaglandin synthesis does not underlie the following action of aspirin:
A. Analgesia
B. Closure of patent ductus arteriosus
C. Hyperventilation
D. Bleeding tendency
13.9 Metabolic effects that generally attend antiinflammatory doses of aspirin include the following except:
A. Increased CO2 production
B. Hepatic glycogen depletion
C. Metabolic acidosis
D. Compensated respiratory alkalosis
13.10 Which of the following is seen at low (analgesic) doses of aspirin:
A. Respiratory stimulation
B. Increased occult blood loss in stools
C. Increased cardiac output
D. Hyperglycaemia
13.11 Aspirin reduces fever by:
A. Decreasing heat production in the body
B. Enhancing cutaneous blood flow
C. Inducing sweating
D. Both ‘B’ and ‘C’ are correct
13.12 The isoenzyme cyclooxygenase-2 (COX-2) is expressed constitutively at the following site:
A. Gastric mucosa
B. Neutrophils
C. Blood platelets
D. Juxtaglomerular apparatus
13.13 Antiinflammatory dose of aspirin given to diabetics is prone to cause:
A. Hyperglycaemia
B. Hypoglycaemia
C. Ketoacidosis
D. Alkalosis
13.14 The plasma half life of aspirin (along with salicylic acid released from it):
A. Remains constant irrespective of dose
B. Is longer for antiinflammatory doses compared to that for analgesic dose
C. Is shorter for antiinflammatory doses compared to that for analgesic dose
D. Can be shortened by acidifying urine
13.15 In the treatment of chronic inflammatory diseases, the most important limitation of aspirin is:
A. Acid-base and electrolyte disturbances
B. Hypersensitivity and idiosyncratic reactions
C. Gastric mucosal damage
D. Salicylism
13.16 Generally the earliest manifestation of salicylism is:
A. Visual disturbance
B. Excitement
C. Hyperventillation
D. Tinnitus
13.17 Aspirin is contraindicated in children suffering from influenza or similar viral infection because of increased risk of:
A. Gastric bleeding
B. Thrombocytopenia
C. Fancony syndrome
D. Reye’s syndrome
13.18 Aspirin is contraindicated in pregnant women near term because:
A. Labour may be delayed and prolonged
B. Blood loss during delivery may be more
C. Foetus may suffer premature closure of ductus arteriosus
D. All of the above risks
13.19 Concurrent administration of aspirin interacts unfavourably with the following drugs except:
A. Furosemide
B. Spironolactone
C. Codeine
D. Methotrexate
13.20 Choose the correct statement about aspirin:
A. In an afebrile patient acute overdose of aspirin produces hypothermia
B. Aspirin suppresses flushing attending large dose of nicotinic acid
C. Aspirin therapy prevents granulomatous lesions and cardiac complications of acute rheumatic fever
D. Long term aspirin therapy increases the risk of developing colon cancer
13.21 Choose the action for which the dose of aspirin required is the lowest:
A. Analgesic
B. Antipyretic
C. Antiinflammatory
D. Antiplatelet aggregatory
13.22 Selective inhibition of thromboxane A2 synthesis by low
dose aspirin therapy might retard the progression of:
A. Pregnancy induced hypertension
B. Steroid induced hypertension
C. Renal hypertension
D. Malignant hypertension
13.23 Phenylbutazone should be used only in patients not responding to other nonsteroidal antiinflammatory drugs (NSAIDs) because:
A. It has lower antiinflammatory efficacy than other NSAIDs
B. It has potential to cause agranulocytosis
C. It has weak analgesic action
D. It alters the protein binding and metabolism of many drugs
13.24 The NSAIDs aggravate the following diseases except:
A. Hypertension
B. Congestive heart failure
C. Peptic ulcer
D. Chronic gout
13.25 Which of the following analgesics itself frequently causes headache as a side effect:
A. Indomethacin
B. Mephenamic acid
C. Piroxicam
D. Metamizol
13.26 The patient taking the following non-steroidal antiinflammatory drug should be cautioned not to drive motor vehicle:
A. Celecoxib
B. Indomethacin
C. Naproxen
D. Diclofenac sodium
13.27 Choose the correct statement about nonsteroidal antiinflammatory drugs (NSAIDs):
A. NSAIDs attenuate hypoglycaemic action of sulfonylureas
B. NSAIDs potentiate antihypertensive action
of ACE inhibitors
C. Serum lithium levels are lowered by concurrent administration of NSAIDs
D. Combined therapy with prednisolone and NSAIDs carries higher risk of gastric bleeding
13.28 The constellation of adverse effects associated with nonsteroidal antiinflammatory drugs include the
following except:
A. Sedation
B. Gastric irritation
C. Fluid retention
D. Rashes
13.29 Which analgesic antiinflammatory drug is more
appropriate in musculo-skeletal disorder where pain is more prominent than inflammation:
A. Ibuprofen
B. Piroxicam
C. Indomethacin
D. Nimesulide
13.30 The following nonsteroidal antiinflammatory drug is a preferential cyclooxygenase-2 (COX-2) inhibitor:
A. Tenoxicam
B. Meloxicam
C. Diclofenac sod.
D. Ketoprofen
13.31 Which of the following is an efficacious antiinflammatory drug but a relatively weak inhibitor of cyclooxygenase:
A. Nimesulide
B. Paracetamol
C. Ketoprofen
D. Indomethacin
13.32 What is true of nimesulide:
A. It exerts antiinflammatory action by several mechanisms in addition to cyclooxygenase inhibition
B. It is preferred for long-term use in rheumatoid arthritis
C. It is contraindicated in aspirin intolerant asthma patients
D. All of the above
13.33 The distinctive feature of nimesulide is:
A. It does not inhibit prostaglandin synthesis
B. It does not cause gastric irritation
C. It is usually well tolerated by aspirin intolerant asthma patients
D. It is not bound to plasma proteins
13.34 Among the following, choose the NSAID with the highest COX-2 selectivity:
A. Nimesulide
B. Nabumetone
C. Rofecoxib
D. Celecoxib
13.35 The selective COX-2 inhibitors have the following advantage(s) over the nonselective NSAIDs:
A. They are less likely to cause gastric ulcers and their complications
B. They are likely to be more effective in rheumatoid arthritis
C. They are not likely to produce renal complications
D. All of the above
13.36 Choose the correct statement about paracetamol:
A. It increases uric acid excretion
B. It is the most common drug implicated in causing analgesic nephropathy
C. In equianalgesic doses it is safer than aspirin
D. It stimulates cellular metabolism
13.37 Select the drug which inhibits cyclooxygenase in the brain but not at peripheral sites of inflammation:
A. Nimesulide
B. Paracetamol
C. Ketorolac
D. Mephenamic acid
13.38 N-acetyl cysteine is beneficial in acute paracetamol poisoning because:
A. It reacts with paracetamol to form a nontoxic complex
B. It inhibits generation of the toxic metabolite of paracetamol
C. It is a free radical scavenger
D. It replenishes hepatic glutathione which in turn binds the toxic
metabolite of paracetamol
13.39 Paracetamol has the following advantage(s) over NSAIDs:
A. It is the first choice analgesic for majority of osteoarthritis patients
B. It can be given safely to all age groups from infants to elderly
C. It is not contraindicated in pregnant or breast feeding women
D. All of the above
13.40 For a patient of peptic ulcer, the safest nonopioid analgesic is:
A. Celecoxib
B. Diclofenac sodium
C. Paracetamol
D. Ibuprofen
13.41 Choose the correct statement about nefopam:
A. It is a nonopioid analgesic which does not inhibit prostaglandin synthesis
B. It is an orally active opioid analgesic
C. It is an analgesic with potent antiinflammatory activity
D. It is a preferential COX-2 inhibitor
13.42 Choose the correct statement about topical NSAID preparations:
A. They produce high drug levels in the blood by avoiding hepatic first pass metabolism
B. They produce high drug levels in the subjacent muscle and joint tissues upto a depth/distance of 10 cm from the site of application
C. They elicit symptomatic relief in soft tissue rheumatism mainly by a strong placebo effect
D. Interindividual variability in clinical response to these preparations is minimal
13.43 The following anti inflammatory analgesic has been
cleared for pediatric use:
A. Indomethacin
B. Ibuprofen
C. Ketorolac
D. Piroxicam
13.1 A 13.2 B 13.3 B 13.4 D 13.5 A 13.6 B 13.7 D 13.8 C 13.9 C 13.10 B 13.11 D 13.12 D 13.13 B 13.14 B 13.15 C 13.16 D 13.17 D 13.18 D 13.19 C 13.20 B 13.21 D 13.22 A 13.23 B 13.24 D 13.25 A 13.26 B 13.27 D 13.28 A 13.29 A 13.30 B 13.31 A 13.32 A 13.33 C 13.34 C
13.35 A 13.36 C 13.37 B 13.38 D 13.39 D 13.40 C 13.41 A 13.42 C 13.43 B