Solved Past papers.pdf - UHS Past Papers Pharm d 3rd Prof...

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Unformatted text preview: UHS Past Papers Pharm d 3rd Prof • Solved • Multiple choice questions Ammara Batool B.Sc(PU) ,Pharm D (LPC) Pathology 2015 Arifa saeed 1|Page Table of Contents SECTION –I questions Pathology 2015…………………………………………………………………………………….3 pathology 2016…………………………………………………………………………………….9 Pharmaceutics –III 2015……………………………………………………………………….15 Pharmaceutics-III 2016……………………………………………………………………….31 Pharmacognosy-II 2015……………………………………………………………………… 45 Pharmacognosy-II 2016………………………………………………………………………..60 Pharmaceutical chemistry-II 2015…………………………………………………………72 Pharmaceutical chemistry -II2016…………………………………………………………88 Pharmacology-II 2015……………………………………………………………………………108 Pharmacology-II 2016……………………………………………………………………………121 SECTION-II Multiple choice questions Pathology……………………………………………………………………………………………… 137 Pharmacognosy-II…………………………………………………………………………………..229 Pharmaceutics-III…………………………………………………………………………………….268 Pharmaceutical chemistry-II…………………………………………………………………….288 Pharmacology-II……………………………………………………………………………………….312 2|Page SECTION-I QUESTIONS Pathology 2015 1.What is granuloma.Draw and label tuberculus granuloma. Granuloma : A focal area of granulomatous inflammation which consists of aggregates of activated marcophages with scattered lymphocytes and often giant cells . Granulomas are characteristics of certain specific pathologic states. Granulomas can form under three settings : 1.With T cell response to certain microbes Example : T.B caused by Mycobacterium Tuberculosis 2. In some immune mediated disease Example : crohn,s disease 3. In disease of unknown etiology they develop in response to inert foreign bodies (foreign body granulomas ) Example : sarcoidosis Diagram : 3|Page 2.What is necrosis .Name its types with examples. Defination: spectrum of morphologic changes that follow cell death in living tissue that result from progressive degredative action of enzymes on the lethally injured cell. Morphologic appearance of necrosis is the result of enzyme digestion & denaturation of proteins. Histologically: increased eosinophilia, karyolysis (nuclear pallor), pyknosis (nuclear shrinkage), karyorrhexis (nuclear fragmentation). It occurs when too little blood flows to the tissue. This can be from injury, radiation, or chemicals. Necrosis cannot be reversed. Types with examples: 1. Coagulative necrosis: e.g. myocardial infarct 2. Liquefactive necrosis: e.g. bacterial or fungal infections, CNS hypoxia 3. Gangrenous necrosis: e.g. limb ischemia (usually a combination of coagulative and liquefactive necrosis) 4. Caseous necrosis: e.g. tuberculosis (gross: white & cheesy) 5 .Fat necrosis: e.g. pancreatits 6 .Fibrinoid necrosis: e.g. polyarteritis nodosa 3.what are the steps of healing of a clean cut surgical wound. Wound healing: Wound healing is a process that involves both regeneration and the formation of connective tissue scar . Depending on the nature and size of the wound ,the healing of skin wound is said to occur by first intension and second intention. First intention : Healing of clean ,uninfected surgical incision Second intention: healing in large wounds ,ulceration and ischemic necrosis. Steps of healing of clean cut surgical wound : 24 hours: The inflammatory response starts. Neutrophils appear near the margins of the wound. 4|Page The edges of the cut epidermis begin to mitotically divide and thicken, and the basal cells migrate along the cut edges of the dermis and fuse at the base of the wound reforming the basement membrane which had been damaged. Day 3: Macrophages replace neutrophils , granulation tissue invades the wound space at the base. This means angiogenesis, and fibrosis is occurring, tissue remodelling is also occurring. The epithelial cells start to proliferate and the layer thickens. Day 5: Granulation tissue fully invades the space, new blood vessels are formed rapidly (angiogenesis) – the epidermis thickens considerably and collagen is being deposited at a rapid rate into the dermal layer. Second week: The inflammatory response erodes and fibroblasts continue secretion of ECM components into the dermis. The vascularity is decreased considerably. Collagen fibres are in abundance within the dermis. End of first month: The dermis begins to take good shape, tensile strength is slowly established, no inflammatory cells present, epidermis is fully thickened and the dermal appendages (such as hair follicles etc) have been permanently lost 4.what are the microscopic features of malignant tumors? Draw any malignant tumor to show these features. Microscopic Features: There are several features that can be used to differentiate normal cells from malignant cells. 5|Page Invasion: Malignant cells do not respect tissue boundaries, and can be seen infiltrating or invading into surrounding structures. Increased mitotic rate: Mitoses are rarely seen in normal tissues. Malignant cells will often have increased numbers of mitoses'. More aggressive tumours typically have a higher mitotic rate; however these tumours are typically more sensitive to radiation. Differentiation and Anaplasia: Normal cells are usually structured in a particular way that corresponds with their function. This is known as differentiation. Malignant cells may become less differentiated as part of their path to malignancy. This is known as anaplasia. o Well differentiated maligant cells show features similar to the parent tissue. For example, well differentiated adenocarcinoma cells will tend to form gland-like structures; well differentiated squamous cell carcinomas may show intercellular bridging or keratin formation. o Poorly differentiated cells have lost most of their resemblance to the parent tissue, which may be difficult to identify without special staining techniques. o Anaplastic cells have no resemblence to their parent tissue, and usually indicate a very aggresive malignancy. 5.What is type-1 hypersensitivity reaction.Describe its mechanism and give example of it. Type I hypersensitivity (or immediate hypersensitivity) is an allergic reaction provoked by re exposure to a specific type of antigen referred to as an allergen. It can vary from simply a runny nose and watery eyes to a life threatening disorder. Mechanism 6|Page • A type I hypersensitivity has all the characteristics of a humoral immune response. • It begins with the entry of a substance, called an allergen, which triggers an allergic reaction in the body. • The allergen may be any of a wide variety of materials such as plant pollen, certain foods, bee venom, serum proteins, or a drug, such as penicillin. • In case of penicillin, the drug molecule itself is the allergen, but the molecule does not stimulate the immune system until it has combined with tissue proteins to form an allergenic. • Doses of antigen as low as 0.001 mg have been known to sensitize a person. • The first dose of antigen is called as the sensitizing dose. • The immune system responds to the allergen as if it was a dangerous antigen, such as a pathogen. • The allergen is taken up by antigen-presenting cells (APCs) and fragments presented to helper T2 (TH2) cells. • As in humoral immunity, TH2 cells stimulate B cells to mature into plasma cells, which produce IgE antibodies. • This antibody, enters the circulation and attaches by its Fc tail to the surface of mast cells and basophils • Mast cells and basophils each have over 100,000 receptor sites where IgE antibodies can attach by the Fc tail portion. • As IgE antibodies attach to mast cells and basophils, the individual becomes sensitized. • Multiple stimuli by allergen molecules may be required to sensitize a person fully. • Sensitization usually requires a minimum of one week, during which time millions of molecules of IgE attach to thousands of mast cells and basophils. • On subsequent exposure to the same allergen, the allergen molecules bind to the Fab ends and cross-link IgE antibodies. • This crosslinking triggers degranulation, a release of granule contents at the cell surface. • As granules fuse with the plasma membrane of the basophils and mast cells, they release a number of mediator substances having substantial pharmacologic activity. 7|Page • The most important preformed mediator of allergic reactions is histamine, a derivative of the amino acid histidine. Once in the bloodstream, histamine circulates to the body cells and attaches to the histamine receptors present on most body cells. • Still other mediators must be synthesized after the antigen-IgE reaction e.g leukotriens and prostaglandins and cytokines. • Examples: • Anaphylactic reactions • Food allergies • Common allergies • • 8|Page Pathology 2016 1.a) What are the different types of pigments in the body? Pigments are colored substances. There are two types of pigments : exogenous and endogenous . 1.Exogenous :coming from outside the body . Example: Carbon: is coal dust .it is phagocytosed by alveolar macrophages and transported through lymphatic channels to the regional tracheobronchial lymph nodes. Pigment blacken the draining lymph nodes and pulmonary parenchyma. 2.Endogenous: within the body itself . Examples: a. Lipofuscin Lipofuscin or Wear and tear pigment is an insoluble brownish yellow granular intracellular material b. Melanin Endogenous brown-black pigment that is synthesized by melanocytes located in the epidermis c. Hemoglobin derivatives: hemosidrin derivatives. b) What is pathological calcification? Pathological calcification is a common process in a wide variety of disease states ;it implies the abnormal deposition of calcium salts together with smaller amounts of iron magnesium and other minerals . Types a.dystrophic calcification: deposition in dead or dying tissues b.metastatic calcification: 9|Page deposition of calcium salts in normal tissue 2. Write down in a tabulated form difference between trasudate and exudate. 10 | P a g e 4.Define thrombosis.write down the components of a thrombus. Thrombosis Formation of a clot in an unijured vessel or after a minor injury Pathologic form of hemostasis is thrombosis. Types of thrombosis : 1.Arterial thrombi (white thrombus): Site of endothelial injury or turbulance 11 | P a g e Tend to grow in retrograde direction from point of attachment Conatin platelets,fibrin,rbc and leukocytes 2 .Venous thrombi (red thrombus) Cause is stasis mainly Tend to grow in the direction of flow of blood Always occlusive Contain more rbc's Components: There are two components to a thrombus: 1.aggregated platelets that form a platelet plug, 2.mesh of cross-linked fibrin proteins LINES OF ZAHN represent pale platelet and fibrin layers alternating with rbc's 12 | P a g e 5.a) Define leukemia. Leukemia is cancer of the white blood cells.In leukemia, the bone marrow produces abnormal white blood cells. These cells crowd out the healthy blood cells, making it hard for blood to do its work. There are different types of leukemia, including Acute lymphocytic leukemia Acute myeloid leukemia Chronic lymphocytic leukemia Chronic myeloid leukemia b) write the difference between acute lymphoid leukemia (ALL) and acute myeloid leukemia (AML). AML ALL Hematological Findings: • • • Anemia (normochromic, normocytic) Leukocytosis (median = 15,000) Thrombocytopenia (< 100,000) • • • • Anemia (normochromic, normocytic) WBC < 5,000 (or > 25,000) Leukocytosis (median = 15,000) Thrombocytopenia (< 50,000) Common Symptoms Fatigue Pallor Anorexia Fatigue Weight loss Shortness of breath Fever without evident cause Easy bruising Easy Bruising Petechiae Bleeding Weight loss / failure to thrive 13 | P a g e Bone and/or joint pain Morphology and Cytology: • • • No auer rods > 20% myeloblasts in blood or in bone marrow Auer Rods (cytoplasmic granules) Positive myeloperoxidase reaction in > 3% blasts 14 | P a g e Pharmaceutics –III 2015 1.Define the followings: a. community pharmacy b. disease c. occasional patient Community pharmacy: • A community pharmacy is a healthcare facility that emphasizes providing pharmaceutical services to a specific community. It dispenses medicine and typically involves a registered pharmacist. • Community Pharmacy is a community based pharmacy. Community pharmacy, all of those establishments that are privately owned and whose function is to serve the society needs for both drug products and the pharmaceutical services. or Disease: An abnormal condition of a part, organ, or system of an organism resulting from various causes, such as infection, inflammation, environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both. Occasional patient Patients attending a health care provider who receive most of their care from another provider. They are considered core patients of the other provider. 2. Define and enlist fundamental operations in compounding and write a note on any one fundamental operation. The accurate and elegant compounding of medicines requires several basic operations: Weighing Measurement of liquids Solution preparation Filtration 15 | P a g e Mixing Size reduction Size separation Solution preparation The common process in dispensing is the preparation of solution of one or more solids in a liquid. “A solution is a clear liquid in which the drug is completely dissolved”. A dilute solution contains a very small amount of particles or solute in solution. A concentrated solution contains large quantities of solute in solution. A saturated solution contains the maximum amount of solute that can be dissolved in a solvent or at a given temperature or pressure. Factors affecting rate of solution formation: The rate of solution formation of a solid in liquid is increased by: Finely powdering the solid Agitation Raising the temperature: Procedure For Dispensing a Solution: 1. Solubility of ingredients: Check the solubility of ingredients from official books. Some substances are less soluble at raised temp. e.g. Paraldehyde 2. Selection of proper measure for making solution: 1st decide the volume of solvent in which solute is quickly dissolved, then select the proper measure for making solution. If heating is involved for solution preparation then select a more suitable vessel. Otherwise transferring of the liquid and undissolved medicament to other vessel results in under strength of final solution. 16 | P a g e Generally, a conical flask is preferable to a beaker because it facilitate shaking and avoiding spillage. Select a flask that will hold the final volume of the preparation. 3. Powdering the solid: Powder a suitable quantity of solid before weighing. Powdering after weighing may lead to under strength preparation An exception is preparation of solution of very soluble substances. In this case, solid may be weighed first then powdered then dissolved in glass mortar. Generally porcelain mortar is preferred for powdering because base is flat and size reduction is efficient. Glass mortars are preferred for sub. That taint (methanol) or stain (iodine) the porcelain type. 4. Solvents contain volatile substance: Solvents contain volatile substance(chloroform water, peppermint water) should not be heated. Dissolve solute in hot water then add the concentrate of these volatile substances after cooling. 5. Mechanical Shaking: Mechanical Shaking is done either by hand or by electric stirrer for complete solution formation. 6. Examine the solution for traces of undissolved medicament in suspension or deposited at the bottom of flask. 7. Solution must be cooled before adjustment to final volume. 8. Pouring the solution in final container. 9. Label the container an then supply to patient. 3.write a note on extemporaneous dispensing of solutions taken orally? oral solutions 17 | P a g e Mixtures Elixirs Linctuses Draughts Syrups Paediatric Drops Mixtures mixtures are seldom formulated for long life because they are mainly prescribed for acute conditions such as cough, indigestion, diarrhea and constipation for which a short period of treatment is often adequate. Dispensing Freshly prepared Stating Expiry: Mostly a month Preferable only 15 days supply should be issued Expiry is based on the date of issue Last date of use may be two days after the last dose time particularly in case of few mixtures such as gentian mixture, alkaline with phenobarbitone B.P.C. Statement use for expiry Discard any unused part on the 15th January 2011. Do not use after 15th January 2011 Do not write as: Expiry Date: 15-1-2011 Do not use after 15 days of issue of this medicine Dilution Dilute If dose is not the exact multiple of a 5ml spoon? 18 | P a g e There is nothing like Half teaspoonful On describing half the lower and upper half are difficult to identify if marking is not provided Upper half is broader and lower is deeper Dilution of the mixture with diluent advised by BPC are used. Dilution directories are also used. Dilutions may reduce the stability of preparation, it should be carried out immediately before issue. Amount of diluent is adjusted according to dose advised. Wrong diluent might reduce stability or adversely affect flavor. on at the time of dispensing Dispense for fifteen days only Recall the patient for remaining doses if required Adjust dose to administer dose as multiples of 5ml spoon Use the officially advised diluents only Consult product monograph, BPC, dictionary of diluents Linctuses Used for treatment of cough, contain sedative or expectorants. Dispensing vehicle is ALWAYS SYRUP Should be taken undiluted to obtain prolonged local action. To be sipped and swallowed slowly. The usual dose is 5ml and part doses must be diluted to the volume. Diluent is syrup except codeine linctus for diabetic pt. chloroform water is used. 19 | P a g e Do not dispense more than 14 days supply. Dilutions must be prepared freshly. VEHICLES: Syrup B.P for most linctuses. Tolu syrup is preferred in cough preparations. Because of low water contents, dissolution of medicament is low. So most linctuses have some water or other liquid ingredients in which medicament is dissolved and then add syrup. In codeine linctus, diabetic the syrup is replaced by sorbital soln. Storage: At constant temp. in well closed container Label: To be sipped and swallowed slowly without adding water EXAMPLE: Codeine linctus, pediatric B.P.C For a four year old child. Label: 10ml t.d.s Draughts: Single dose liquid preparation (usual volume is 50ml). Supplied in single dose container. Ipecacuanha Emetic Draught B.P.C has smaller dose and supplied in multiple dose containers. Paraldehyde Draught B.P.C: Prepared by dissolving medicament in water. Sweetened with syrup. and flavoured with liquorice liquid extract. 20 | P a g e Stored in well closed container (50ml volume). Discard if it becomes discolored or odour of acetic acid is produced. Label emphasise storage conditions. If only one dose is prescribed , very early expiry should given e.g. 48 hrs from date of dispensing. Mixing of paraldehyde. PAEDIATRIC DROPS: The direction that , a preparation is diluted so that dose is 5ml does not apply to certain preparations.e.g Digoxin elixir Paracetamol elixir Because stability of preparation nos effected by dilution. Use of these preparations in infants require two method Use of dropper graduated in fractions of ml. Use of precaliberated dropper. ELIXIRS: Clear, ORAL, LIQUID of potent(antibiotics, sedatives and antihistamines) and nauseous drugs, Pleasantly flavored and attractively colored. Rule for dispensing Mixtures also apply here but the diluent is always syrup. 4.What is HLB method how emulsions can be formulated by HLB method? Griffin (1949) devised a useful method for calculating balanced mixtures of emulsifying agents to provide a particular type of emulsion. It is called hydrophile –Lipophile Balance or H.L.B. Method. Mainly important for non ionic emulgents. Emulsion formulation 21 | P a g e Each emulsifying agent is given a number on HLB scale. High no. indicate hydrophilic( lipophobic) properties. Low no. indicate hydrophobic ( lipophilic) ...
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