28.1 The barbiturate having higher anticonvulsant: sedative activity ratio is:
A. Pentobarbitone
B. Phenobarbitone
C. Butabarbitone
D. Thiopentone
28.2 The most probable mechanism of anticonvulsant
action of phenytoin is:
A. Facilitation of GABAergic inhibitory transmission
B. Hyperpolarization of neurones
C. Interaction with Ca2+ channels to promote Ca2+ influx
D. Prolongation of voltage sensitive neuronal Na+ channel inactivation
28.3 The following antiepileptic drug is most likely to
impair learning and memory, and produce behavioral
abnormalities in children:
A. Valproic acid
B. Phenobarbitone
C. Phenytoin
D. Ethosuximide
28.4 Phenytoin appears to derive its anticonvulsant action from:
A. Selective inhibition of high frequency neuronal discharges
B. Selective inhibition of epileptic focus
C. Selective inhibition T-type Ca2+ current in brain cells
D. Selective enhancement of inhibitory transmission in the brain
28.5 The characteristic feature of phenytoin pharmacokinetics is:
A. High first pass metabolism
B. Nonsaturation kinetics of metabolism
C. Capacity limited metabolism saturating at higher therapeutic concentration range
D. Extrahepatic metabolism
28.6 The following adverse effect(s) of phenytoin is/are
related to high plasma drug concentration:
A. Ataxia
B. Hirsutism
C. Gum hyperplasia
D. All of the above
28.7 The following drug displaces plasma protein bound
phenytoin as well as decreases its metabolism:
A. Carbamazepine
B. Sodium valproate
C. Cimetidine
D. Chloramphenicol
28.8 Carbamazepine possesses the following property
not shared by phenytoin:
A. Modification of maximal electroshock seizures
B. Raising threshold for pentylenetetrazol convulsions
C. Suppression of complex partial seizures
D. Amelioration of trigeminal neuralgia
28.9 Select the antiepileptic drug that is effective in manicdepressive
illness as well:
A. Ethosuccimide
B. Primidone
C. Phenobarbitone
D. Carbamazepine
28.10 The following antiepileptic drug is likely to cause
hyponatremia as a side effect, especially in elderly
patients:
A. Primidone
B. Carbamazepine
C. Phenytoin
D. Sodium valproate
28.11 The drug of choice for trigeminal neuralgia is:
A. Aspirin
B. Imipramine
C. Carbamazepine
D. Valproic acid
28.12 The following statement is not true of carbamazepine:
A. It generates an active metabolite
B. Its plasma half life decreases to nearly half of the original value after chronic use
C. It is being used in mania
D. It is not effective in complex partial seizures
28.13 The following antiepileptic drug raises pentylene
tetrazol seizure threshold but does not modify maximal
electroshock seizures:
A. Ethosuximide
B. Carbamazepine
C. Primidone
D. Phenobarbitone
28.14 The antiepileptic drug which suppresses maximal
electroshock as well as kindled seizures, raises pentylenetetrazol
threshold and is effective in both generalized
tonic-clonic as well as absence seizures is:
A. Phenytoin
B. Carbamazepine
C. Sodium valproate
D. Ethosuximide
28.15 Select the drug having a narrow spectrum antiepileptic
activity restricted to absence seizures:
A. Lamotrigine
B. Ethosuccimide
C. Sodium valproate
D. Primidone
28.16 Sodium valproate has been shown to:
A. Prolong neuronal Na+ channel inactivation
B. Attenuate ‘T’ type Ca2+ current in neurones
C. Inhibit degradation of GABA by GABA-transaminase
D. All of the above
28.17 Sodium valproate should be used with caution in
young children because they are particularly at risk of
developing the following adverse effect:
A. Hepatitis
B. Loss of hair
C. Anorexia
D. Tremor
28.18 The preferred drug for suppressing febrile convulsions is:
A. Intramuscular phenobarbitone
B. Intravenous phenytoin
C. Rectal diazepam
D. Oral sodium valproate
28.19 Despite having anticonvulsant action, diazepam is
not used in the treatment of epilepsy because:
A. It is not effective orally
B. It causes sedation
C. Its anticonvulsant action wanes off with chronic use
D. Both ‘B’ and ‘C’ are correct
28.20 Clobazam is a benzodiazepine used as:
A. Hypnotic
B. Muscle relaxant
C. Anxiolytic
D. Antiepileptic
28.21 Choose the correct statement about lamotrigine:
A. It is a dopaminergic agonist used in parkinsonism
B. It acts by blocking NMDA-type of glutamate receptors
C. It is a broad spectrum antiepileptic drug
D. It suppresses tonic-clonic seizures, but worsens absence seizures
28.22 Select the antiepileptic drug that in addition is a
preferred treatment for post herpetic neuralgia and
pain due to diabetic neuropathy:
A. Carbamazepine
B. Gabapentin
C. Lamotrigine
D. Primidone
28.23 Gabapentin acts:
A. As GABAA agonist
B. As precursor of GABA
C. By enhancing GABA release
D. By GABA independent mechanism
28.24 Select the anticonvulsant drug that acts as a GABAtransaminase inhibitor:
A. Gabapentin
B. Vigabatrin
C. Lamotrigine
D. Clobazam
28.25 The following is true of topiramate except:
A. It is a broad spectrum antiepileptic drug
B. It inhibits the enzyme carbonic anhydrase
C. It is used as add-on therapy in refractory partial seizures
D. It is not effective in generalized tonic-clonic seizures
28.26 The following is true in the treatment of epilepsy except:
A. The choice of drug depends on the cause of epilepsy and not on the seizure type
B. Treatment should be instituted as early as possible
C. Treatment is generally started with a single
drug and the other drug is added or
substituted according to response
D. Withdrawal of drug can be attempted if no
seizures have occurred for 3-5 years
28.27 A combination of two or more antiepileptic drugs is used:
A. Routinely in all types of epilepsy
B. In all cases of complex partial seizures
C. In all cases of secondarily generalized seizures
D. Only when monotherapy with first/second choice drugs fails
28.28 Select the factor which indicates that withdrawal of
the successfully used antiepileptic medication is
likely to result in recurrence of seizures:
A. Childhood epilepsy
B. Partial seizures
C. Treatment started soon after seizure onset
D. Absence of EEG abnormality
28.29 An epileptic woman controlled by phenytoin therapy
conceives. Which of the following measures is most
appropriate:
A. Medical termination of pregnancy
B. Withdraw phenytoin therapy
C. Gradually reduce phenytoin dose to the lowest effective level
D. Substitute phenytoin with a combination of
carbamazepine and sodium valproate
28.30 Risk of neural tube defect in the offspring can be
minimised in pregnant women receiving antiepileptic
drugs by supplemental therapy with:
A. Folic acid
B. Vitamin A
C. Vitamin E
D. Pyridoxine
28.31 Which of the following is the most suitable drug for a
6-year-old girl suffering from absence seizures with
occasional generalized tonic-clonic seizures:
A. Ethosuccimide
B. Sodium valproate
C. Carbamazepine
D. Phenytoin
28.32 A 3-year-old boy gets seizures whenever he develops
fever. Which is the most appropriate strategy so that
he does not develop febrile convulsions:
A. Treat fever with paracetamol and do not give any anticonvulsant drug
B. Continuous phenobarbitone prophylaxis till the age of 10 years
C. Continuous diazepam prophylaxis for 3 years
D. Intermittent diazepam prophylaxis started at the onset of fever
28.33 The preferred drug for status epilepticus is:
A. Intravenous diazepam
B. Intravenous phenytoin sodium
C. Intramuscular phenobarbitone
D. Rectal diazepam
Ans:
28.1 B 28.2D 28.3 B 28.4 A 28.5 C 28.6 A 28.7 B 28.8 B 28.9D 28.10 B28.11 C 28.12D 28.13 A 28.14 C 28.15 B 28.16D 28.17 A 28.18 C 28.19D 28.20D 28.21 C 28.22 B 28.23 C 28.24 B 28.25D 28.26 A 28.27D 28.28 B 28.29 C 28.30 A 28.31 B 28.32D 28.33 A
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