Answers – Orris AI

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Answers

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Here are the correct answers for all 10 MCQs, along with an evaluation of the marked answers:

Pharmacology MCQ - Correct Answers & Explanations

Q1. KR2250 (high molecular weight, extensively albumin-bound) - apparent volume of distribution

Correct Answer: b) Low ✅ (marked correctly)

A drug that is extensively bound to plasma proteins (albumin) and has high molecular weight stays largely in the vascular compartment. It cannot easily distribute into tissues, so its apparent volume of distribution (Vd) is low (close to plasma volume, ~3-5 L).

Q2. Same maximum effect, smaller dose needed - this property is:

Correct Answer: a) Potency ❌ (marked b - Efficacy, which is WRONG)

Potency = how much drug is needed to produce an effect. A drug that achieves the same maximum effect with a smaller dose is more potent.
Efficacy = the maximum effect a drug can produce. Since both drugs produce the same maximum pain relief, their efficacy is equal.
The marked answer (b - Efficacy) is incorrect. The correct answer is a) Potency.

Q3. Reverse nondepolarizing NMB - which drug?

Correct Answer: c) Neostigmine ❌ (marked d - Atropine, which is WRONG)

Nondepolarizing NMBs (e.g., vecuronium, pancuronium) are reversed by anticholinesterases like Neostigmine, which increases ACh at the NMJ to compete with the blocker.
Atropine is given alongside neostigmine to counter the muscarinic side effects, but it does NOT reverse NMBs.
The marked answer (d - Atropine) is incorrect. The correct answer is c) Neostigmine.

Q4. Diagnose myasthenia gravis (drooping eyelids, difficulty chewing, muscle fatigue):

Correct Answer: b) Edrophonium ❌ (marked a - Atropine, which is WRONG)

The Tensilon (Edrophonium) test is the classic diagnostic test for myasthenia gravis. Edrophonium is a short-acting anticholinesterase; it transiently improves muscle weakness in MG patients.
Atropine is an anticholinergic drug with no diagnostic role in MG.
The marked answer (a - Atropine) is incorrect. The correct answer is b) Edrophonium.

Q5. Bilateral renal artery stenosis + hypertension - contraindicated drug class:

Correct Answer: b) ACE inhibitors ✅ (marked correctly)

In bilateral renal artery stenosis, efferent arteriolar tone (maintained by angiotensin II) is critical to sustain GFR. ACE inhibitors block angiotensin II, causing efferent dilation and a sharp drop in GFR, leading to acute renal failure.

Q6. Bronchial asthma + hypertension - contraindicated antihypertensive:

Correct Answer: c) Propranolol ❌ (marked b - Enalapril, which is WRONG)

Beta-blockers (Propranolol) are contraindicated in asthma because they cause bronchoconstriction by blocking β2 receptors in the airways, potentially triggering fatal bronchospasm.
Enalapril (ACE inhibitor) can cause a dry cough but is not an absolute contraindication in asthma.
The marked answer (b - Enalapril) is incorrect. The correct answer is c) Propranolol.

Q7. Acute non-bloody diarrhoea - reduces intestinal motility:

Correct Answer: b) Loperamide ❌ (marked a - Lactulose, which is WRONG)

Loperamide is an opioid receptor agonist in the gut that reduces intestinal motility and is the classic antidiarrhoeal.
Lactulose is an osmotic laxative used for constipation, not diarrhoea.
The marked answer (a - Lactulose) is incorrect. The correct answer is b) Loperamide.

Q8. Long-term pantoprazole (PPI) - likely vitamin deficiency:

Correct Answer: d) Vitamin B12 ✅ (marked correctly)

Long-term PPI use suppresses gastric acid, which is needed to cleave Vitamin B12 from food proteins. This impairs B12 absorption, leading to deficiency over time.

Q9. Iron deficiency - haemoglobin normalized after 3 months - next step:

Correct Answer: b) Continue oral iron therapy for another 3 months ❌ (marked d - Continue for 15 more days, which is WRONG)

Once haemoglobin normalizes in iron deficiency anaemia, treatment should be continued for at least 3 more months (or until serum ferritin normalizes) to replenish iron stores. 15 more days is insufficient. The marked answer (d) is incorrect. The correct answer is b).

Q10. STEMI within 1 hour - thrombolysis when primary PCI unavailable:

Correct Answer: b) Streptokinase ✅ (marked correctly)

Streptokinase is a fibrinolytic/thrombolytic agent used when primary PCI is unavailable. Aspirin is also given but is an antiplatelet, not a thrombolytic. Heparin is an anticoagulant. Atorvastatin is a statin.

Summary Scorecard

Q	Marked Answer	Correct Answer	Result
1	b) Low	b) Low	✅ Correct
2	b) Efficacy	a) Potency	❌ Wrong
3	d) Atropine	c) Neostigmine	❌ Wrong
4	a) Atropine	b) Edrophonium	❌ Wrong
5	b) ACE inhibitors	b) ACE inhibitors	✅ Correct
6	b) Enalapril	c) Propranolol	❌ Wrong
7	a) Lactulose	b) Loperamide	❌ Wrong
8	d) Vitamin B12	d) Vitamin B12	✅ Correct
9	d) 15 more days	b) 3 more months	❌ Wrong
10	b) Streptokinase	b) Streptokinase	✅ Correct

Score based on marked answers: 4/10

The questions on potency vs. efficacy (Q2), reversal of NMBs (Q3), MG diagnosis (Q4), beta-blocker contraindication in asthma (Q6), loperamide for diarrhoea (Q7), and iron therapy duration (Q9) need review.

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