Correct Answer: D

Propylthiouracil (PTU) is recommended for treatment of hyperthyroidism in women who are in their first trimester of pregnancy by the American Thyroid Association (ATA). Methimazole has been associated with congenital malformations including aplasia cutis in rare cases and thus it is not recommended in the first trimester. The ATA recommends switching to methimazole once in the second trimester as there is a risk of liver injury associated with the use of PTU.

Correct Answer: C

Cisplatin. All chemotherapeutics have similar generalized side effects related to their effects on rapidly growing cells. These include hair loss, nausea, and fatigue. However, many chemotherapeutics have unique toxicities as well which are often tested. Cisplatin (C) is notable for its nephrotoxicity and ototoxicity. Cyclophosphamide (A) is known to cause hemorrhagic cystitis. This is a distinct process from nephrotoxicity. The most noteworthy side effect of bleomycin (B) is pulmonary toxicity that can lead to pulmonary fibrosis. Vinblastine (D) is known for bone marrow suppression. Vincristine (E) causes neuropathy.

Correct Answer: B

The following NSAIDs belong to the propionic acid derivatives group - Ibuprofen - Ketoprofen - Naproxen -Fenoprofen - Flurbiprofen - Oxaprozin whereas piroxicam belongs to the class of Enolic acid derivative which also includes other agents like meloxicam and Nabumetone. They are non-selective COX inhibitors and act by preventing the production of certain prostaglandins.

Correct Answer: D

Correct Answer: B

50gm/100ml × 1equiv/120.4gm × 1000meq/1equiv = 4.16meq/ml

Correct Answer: B

In a normal distribution sample, within 1 standard deviation 68% of the sample falls within 1 standard deviation, 95% within 2 standard deviations, and 99.7% within 3 standard deviations of the mean.

Reference: http://www.bmj.com/about-bmj/resources-readers/publications/statistics-square-one

Correct Answer: E

Patients with heart failure should avoid taking NSAIDs (which includes naproxen), COX-2 inhibitors, nondihydropyridine calcium channel blockers (for reduced EF), thiazolidinediones (which includes pioglitazone), cilostazol, and dronedarone (for severe or recently decompensated heart failure).

Correct Answer: E

Sulfonylureas work in beta cells in the pancreas that are still functioning to enhance insulin secretion. Alpha-Glucosidase Inhibitors stop -glucosidase enzymes in the small intestine and delay digestion and absorption of starch and disaccharides which lowers the levels of glucose after meals. DPP4 blocks the degradation ofGLP-1, GIP, and a variety of other peptides, including brain natriuretic peptide. Glucagonlike peptide-1 receptor agonists work in various organs of the body. Glucagon-like peptide-1 receptor agonists enhance glucose homeostasis through: (i) stimulation of insulin secretion; (ii) inhibition of glucagon secretion; (iii) direct and indirect suppression of endogenous glucose production; (iv) suppression of appetite; (v) enhanced insulin sensitivity secondary to weight loss; (vi) delayed gastric emptying, resulting in decreased postprandial hyperglycaemia. Thiazolidinediones are the only true insulinsensitising agents, exerting their effects in skeletal and cardiac muscle, liver, and adipose tissue. It ameliorates insulin resistance, decreases visceral fat. Biguanides work in liver, muscle, adipose tissue via activation of AMP-activated protein kinase (AMPK) reduce hepatic glucose production. SGLT2 inhibitors work in the kidneys to inhibit sodium-glucose transport proteins to reabsorb glucose into the blood from muscle cells; overall this helps to improve insulin release from the beta cells of the pancreas.

Reference: https://doi.org/10.1093/eurheartj/ehv239

Correct Answer: B

Corrected phenytoin (mg/L) = Observed phenytoin (mg/L) / (0.2 x albumin [g/dL]) + 0.1 = 17.8 / (0.2 x 2.1)

+ 0.1 = 17.8 / 0.42 + 0.1 = 42.48mg/L phenytoin level is high. Normal therapeutic range is: 10-20mg/dL

Correct Answer: B

Pregabalin works as a ligand of the auxiliary 2 subunit site of certain voltage-dependent calcium channels

(VDCCs), and thereby acts as an inhibitor of 2 subunit-containing VDCCs.