Model Paper 2 Therapeutics

PHARMACEUTICAL CHEMISTRY
MODEL PAPER – 2
Syllabus to be covered in
this module are-
Chapter-2 (E) Gastro Intestinal Disorders
Chapter-2 (F) Haematological Disorders
Chapter-2 (G) Infectious Diseases
Chapter-2 (H) Musculoskeletal Disorders
Chapter-2 (I) Dermatology
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Questions
Long Questions-
Ques.1 Discuss in detailed about Gastro Oesophageal Reflux Disease.
Ques.2 Define Inflammatory Bowel Disease. Mention its types, symptoms, & medications
also.
Ques.3 Discuss in detailed about Urinary Tract Infections.
Ques.4 Prepare notes on Musculoskeletal disorders.
Ques.5 Differentiate between Rheumatoid Arthritis & Osteoarthritis.
Ques.6 Discuss in detail about alcoholic liver disease.
Ques.7 Give the epidemiology of the following-

a) Psoriasis
b) Hepatitis
c) Alcoholic Liver Disease
d) Pneumonia
e) Scabies
f) Rheumatoid Arthritis
g) Eczema
Short Questions
Ques.1 Write a short note on pneumonia.
Ques.2 What is scabies. Give its pathophysiology also.
Ques.3 Give the diagnosis of gonorrhoea & syphilis.
Ques.4 What is malaria. Give its treatment along with the medications.
Ques.5 Define eczema. Give its signs & symptoms.
Ques.6 Write a short note on HIV and opportunistic infections.
Ques.7 What is hepatitis & give its etiology also.

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Ques.8 What are the risk factors & medical risk factors of tuberculosis.
Ques.9 Define iron deficiency. What is the sign & symptoms of it.
Ques.10 What is peptic ulcer. Mention its diagnosis also.
Ques.11 Write a short note on gastro intestinal disorders.
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Long Answers
Ques.1 Discuss in detailed about Gastro Oesophageal Reflux
Disease.
Ans- GASTROESOPHAGEAL REFLUX DISEASE
Gastroesophageal reflux disease (GERD) is defined as "a condition which develops when the reflux of
stomach contents causes troublesome symptoms and/or complications". This uncomfortable feeling in the
chest is often called heartburn.
Etiology
There are many factors contributing to GERD, including transient lower esophageal sphincter relaxation
(TLESR), reduced LES pressure, impaired esophageal mucosal defense, poor esophageal clearance,
visceral hypersensitivity, hiatal hernia and delayed gastric emptying.
Pathophysiology
There are numbers of mechanisms involved in the pathogenesis of GERD including
1 Motor abnormalities such as impaired lower esophageal sphincter (LES) resting tone, transient LES
relaxations (TLESR), impaired esophageal acid clearance and delayed gastric emptying
2. Anatomical factors, such as hiatal hernia and obesity
3. Other may include decreased salivary production and esophageal hypersensitivity.
Risk factors
 Age
 Body Mass Index
 Tea/Coffee
 Alcohol Consumption
 Tobacco consumption and smocking
 Non-Vegetarian Diet
Diagnosis
 Upper gastrointestinal endoscopy is one of the principal tests used and its main use is patients
with GERD is the evaluation of treatment failures and risk management.
 Endoscopy may detect esophageal mucosal injury due to GERD (erosive esophagitis, ulceration,
structure, Barrett' Esophagus).
GERD Treatment:
 Treatment Approaches for GERD
 1. Lifestyle and dietary changes
 2. Medication
 3. Endoscopic therapy
 4.Surgery
Medication
 Antacids
 Proton pump inhibitors
 Histamine blockers
 Prokinetic agents
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Ques.2 Define Inflammatory Bowel Disease. Mention its types,
symptoms, & medications also.
Ans- INFLAMMATORY BOWEL DISEASE
 Inflammatory bowel disease (IBD) is a group of chronic relapsing inflammatory disorders
involving the gastrointestinal tract includes Crohn’s disease and ulcerative colitis.
 Ulcerative colitis typically presents with shallow, continuous inflammation extending from the
rectum proximally to include, in many patients, the entire colon, Fistulas, fissures, abscesses and
mall-bowel involvement are absent.
 Unlike ulcerative colitis, Crohn's disease can involve the entire intestinal tract, from the mouth to
the anus, with discontinuous focal ulceration, fistula formation and perianal involvement. The
terminal is most affected, usually with variable degrees of colonic involvement.
Type of IBD
Ulcerative colitis: This condition causes inflammation in the large intestine, or colon. There are several
different classes of ulcerative colitis, depending on location and severity. These are:
 Ulcerative proctitis: This type occurs when inflammation stays within the rectum. It tends to be
the mildest form of ulcerative colitis.
 Universal colitis or pancolitis: This type occurs when inflammation spreads across the entire
colon.
 Proctosigmoiditis: The type occurs when the rectum and lower end of the colon experience
inflammation.
 Distal colitis: This type occurs when inflammation extends from the rectum and up the let colon
 Acute severe ulcerative colitis: This is a rare type that causes inflammation across the entire
colon, leading to severe symptoms.
 Crohn's disease: Crohn's disease can affect any part of the digestive tract between the mouth and
the anus However, it most commonly develops in the final section of the small intestine and colon.
IBD symptoms include:
 Upset stomach & Abdominal (belly) pain.
 Diarrhea (sometimes alternating with constipation) or urgent need to poop (bowel urgency).
 Gas and bloating, Loss of appetite or unexplained weight loss. Mucus or blood in stool.
 Rarely, IBD may also cause.
 Nausea and vomiting, Fatigue, Fever, Itchy, red, painful eyes. Joint pain, Skin rashes and sores
(ulcers), Vision problems.
Medications-
 5-Aminosalicylic Acid Compounds
 Sulfasalazine
 Olsalazine
 Antibiotics
 Corticosteroids
 Immunosuppressant Drugs
 AZATHIOPRINE AND MERCAPTOPURINE
 Methotrexate
Ques.3 Discuss in detailed about Urinary Tract Infections.

Ans- URINARY TRACT INFECTIONS
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A Urinary tract infection (UTI is defined us the presence of microorganisms in the urinary tract which can
invade the theses of the urinary tract. UTI is one of the most prevalent bac infections in women and
elderly individuals.
Infections of the urinary tract represent a wide variety of syndromes, including urethritis, cystitis
prostatitis, and pyelonephritis. They are classified as upper UTIs (pyelonephritis) and lower UT (cystitis,
prostatitis) UTIs can be classified as uncomplicated or complicated.
Uncomplicated infections occur in individuals who lack structural or functional abnormalities of the
urinary tract that interfere with the normal flow of urine or voiding mechanism Infections in males
generally are not classified as uncomplicated because these infections are care and most on represent a
structural or neurologic abnormality.
Complicated UTIs are the result of a predisposing lesion of the urinary tract, such as a congenital
abnormality or distortion of the urinary tract, a stone, indwelling catheter, prostatic hypertrophy,
obstruction, or neurologic deficit that interferes with the normal flow of urine and urinary tract defenses,
Pathophysiology
UTI pathogen may be got entry into the urinary tract via three general routes:
 Through urethra (Ascending route) Through blood (Descending or Hematogenous route),
 Through lymph (Lymphatic route).
 Lower UTIs which are also known as cystitis which is significant prevalent in women than in
men. This is primarily due to anatomic differences, including shorter urethral length and moist
periurethral environment in women.
Diagnosis
 The following test is used to diagnosed a urinary tract infection.
 Urinalysis: Urine is examined for bacteria RBC and WBC. The number of WBC and RBC found
in urine can actually indicate an infection.
 Urine culture: A culture of urine is done to determine the type of bacteria present in urine. Thus
helps to select the appropriate treatment.
 Other tests: If patient does not respond to treatment or if keep getting infections again, the
following tests (ultrasound, cystoscopy and CT scan) may be used to examine your urinary tract
for disease or injury.
Signs and Symptoms Lower UTI
 Dysuria,
 urgency,
 frequency,
 nocturia,
 suprapubic heaviness, Gross hematuria, Upper UTI Flank pain,
 fever,
 nausea,
 vomiting, malaise.
Pharmacologic Therapy
 Nitrofurantoin
 Trimethoprim/Sulfamethoxazole
 Fluoroquinolones
 Fosfomycin Trometamol
 Oral B-Lactam Agents
 Cephalosporins
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 Tetracyclines
Ques.4 Prepare notes on Musculoskeletal disorders.

Ans- Musculoskeletal Disorders
 The musculoskeletal system consists of two different systems 1. The skeletal system and 2. The
muscular system.
 The system includes bones of the skeleton, their joints and the skeleton muscle. The
musculoskeletal system is also known as the locomotor system. Musculoskeletal system is
responsible for the shape, posture, stability, and body movement.
 The human skeletal system is the body system composed of bones, cartilage, tendons and
ligaments and other connective tissues that perform essential function for the human body.
Altogether, the skeleton makes up about 20% of person's body weight.
 The human skeleton system is composed of around 270 bones at birth which is decreased to
around 206 bones by adulthood after some bones get fused.
 The human skeleton can be divided into the Axial skeleton and the appendicular skeleton.
 The axial skeleton is formed by the vertebral column, the rib cage, the skull and others associated
bones.
 The appendicular skeleton, which is attached to the axial skeleton, is formed by the shoulder
girdle, the pelvic girdle and the bones of the upper and lower limb. muscles keep bones in the
place and also play a role in their movement.
 There are about 650 Muscles in the human body and responsible for the movement. To allow
motion, different bones are connected by articulating joints. Joint are articulations of bones.
Joints are classified into three type:

 Fibrous joints: It is immovable joint.
 Cartilaginous joints: Some of cartilaginous joint are immovable while most are slightly
moveable.
 Synovial joints: These are freely moveable. These joints are mainly responsible for various body
movements. The articulating end of the bones of synovial joint are covered with cartilage hyaline
cartilage which prevents the bone ends from rubbing directly onto each other during the
movement.
 Musculoskeletal conditions are typically characterized by persistent pain and limitations in
mobility which affects the overall level of functioning and reducing people's ability to work.
Musculoskeletal disorders include conditions that affect:

 Joints such as osteoarthritis, rheumatoid arthritis, and gout.
 Bones such as osteoporosis, osteopenia and associated fragility fractures, traumatic fractures.
 Muscles such as sarcopenia and the spine, such as back and neck pain.
Ques.5 Differentiate between Rheumatoid Arthritis &

Osteoarthritis.
Ans- RHEUMATOID ARTHRITIS
Rheumatoid arthritis is the most common systemic inflammatory disease, and is characterized by
polyarticular symmetrical joint involvement. It a autoimmune disease which leads to swelling of various
joints. The swelling destroys joints and can causes permanent deformities.
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PATHOPHYSIOLOGY
Chronic inflammation of the synovial tissue lining the joint capsule results in the proliferation of this
tissue. The inflamed proliferating synovium characteristic of rheumatoid arthritis is called pannus. This
pannus invades the cartilage and eventually the bone surface, producing erosions of bone and cartilage
and leading to destruction of the joint.
SIGNS AND SYMPTOMS

 The joints in RA are swollen, tender, slightly warm and stiff. Muscle pain, Joint pain and stiffness
of more than 6 weeks' duration.
 Patients with RA usually have profound and prolonged morning stiffness, fatigue, anemia of
chronic disease, fever, vasculitis, pericarditis, and myocarditis, are common.
 Patients may also experience fatigue, weakness, low-grade fever, and loss of appetite. Distribution
of joint involvement is frequently symmetrical. Rheumatoid nodules may also be present. Joint
deformity is generally seen late in the disease.
Treatment
 Methotrexate
 Leflunomide
 Non-steroidal anti-inflammatory drugs
 Hydroxychloroquine
 Sulfasalazine
 Inhibitors of tnf-alpha or biologic agents
 Etanercept
 Infliximab
 Cytotoxic agents
 Corticosteroids
OSTEOARTHRITIS
 The most common form of arthritis is osteoarthritis (OA).
 It is a degenerative joint disorder and it is characterized by a gradual loss of cartilage from the
joints and, in some people, joint inflammation.
 It can occur in any joint, mainly targeting the major joints (knee, hip, and back), it can also affect
hands, elbows, and ankles.
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PATHOPHYSIOLOGY
Synovial fluid along with articular cartilage are responsible for almost frictionless movement of synovial
joint bones. Normal adult articular cartilage is made up of extracellular matrix (water, collagen,
proteoglycans, and a very small component of calcium salt) and chondrocytes. Chondrocytes synthesize
these components.
Treatment
 Currently, there is no cure for OA. Existing treatments aim to reduce pain and symptoms, as well
as improve joint functional capacity.
 The goals of treatment for osteoarthritis are to control pain and swelling, minimize disability,
improve the quality of life.
Pharmacotherapy
 NSAIDS
 OPIOID ANALGESICS
 Tramadol
 SNRIS
 IA INJECTIONS OF CORTICOSTEROIDS
 Intra-articular Glucocorticoids and Hyaluronate
 VITAMIN D SUPPLEMENTS
 ALTERNATIVE THERAPY SUPPLEMENTS
 Glucosamine sulfate
 Chondroition sulfate
Ques.6 Discuss in detail about alcoholic liver disease.

Ans- Alcoholic Liver Disease (ALD)
 Chronic and excessive alcohol consumption is a global healthcare problem, which leads to clinical
illness and pathological changes causing alcohol-associated liver disease.
 Alcoholic liver disease (ALD) is also called alcohol-related liver disease (ARLD) includes fatty
liver, alcoholic hepatitis, and chronic hepatitis with liver fibrosis or cirrhosis.
 The susceptibility to develop ALD among heavy drinkers depends on genetic and environmental
factors. At similar levels of ethanol consumption, some patients only develop macro vesicular
steatosis, while others develop progressive fibrosis and cirrhosis.
Sign and Symptom

The most common sign of alcoholic hepatitis is yellowing of the skin and whites of the eyes (jaundice)
Other signs and symptoms include:
 Loss of appetite
 Nausea and vomiting
 Abdominal pain and tenderness Fever, often low grade
 Fatigue and weakness
 Spider nevi, jaundice
Additional signs and symptoms that occur with severe alcoholic hepatitis include:
 Fluid accumulation in abdomen (ascites)
 Confusion and behavior change due to a buildup of toxins normally broken down and eliminated
by the liver.
 Kidney and liver failure
Pathogenesis
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 Alcohol is a direct hepatotoxin and its ingestion causes the initiation of numerous metabolic
responses that influence the final hepatotoxic response. Chronic intake of alcohol initiates a
pathogenic process that involves the production of protein-aldehyde metabolites and release of
cytokines.
 Continuous ingestion of alcohol leads to fat accumulation all through the entire hepatic lobule.
Diagnosis
ALD is often asymptomatic in the early stages and can only be identified by laboratory findings.
Diagnosis of ALD is based on the history of alcohol consumption, physical examination, und laboratory
findings.
Aspartate Transaminase
Aspartate transaminase (AST) also called scrum glutamic oxaloacetic transaminase (SGOT) or aspartate
aminotransferase (ASAT), ALT is usually considered to be more specifically related to liver problems.
The ratio of AST to ALT is sometimes useful in differentiating between causes of liver damage.
Alanine Transaminase (ALT)

It is also known as scrum glutamic pyruvic transaminase (SGPT). Large amounts of ALT occur liver
cells. When the liver is injured or inflamed (as in hepatitis), the blood level of ALT usually rises. The
normal reference range for ALT is 20-40 IU/L.
Gamma-glutamyl transpeptidase (GGTP)
GGT is an enzyme found throughout the body, but it is mostly found in the liver. High levels of GGT in
the blood may be a sign of liver disease or damage to the bile ducts. The normal range for adults is 5 to 40
U/L.
Pharmacotherapy
 ALD is preventable and reversible by timely treatment. Therapy of ALD depends upon the
spectrum of liver injury that causes fatty liver, hepatitis, and cirrhosis.
 Liver transplant: A liver transplant may be required in severe cases where the liver has sapped
functioning and does not improve event when patient stop drinking alcohol.
 Nutrition: Malnutrition is a major complication of ALD and this has been studied, especially in
patients with alcoholic hepatitis, Malnutrition worsens clinical outcome in ALD, and nutritional
support improves nutritional status and may improve clinical outcome.
Medications:
 Disulfiram
 Baclofen
 Acamprosate
 Naltrexone
 Corticosteroids
Ques.7 Give the epidemiology of the following-

a) Psoriasis
b) Hepatitis
d) Pneumonia
e) Scabies
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g) Eczema
Ans-
a) Psoriasis
Epidemiology- The disorder occurs in all racial groups but is most prevalent in Caucasians. It is
equally common in males and females. The greatest incidence of psoriasis has been seen between
20 and 30 years with a smaller peak occurs between 50 and 60 years of age.
b) Hepatitis
Epidemiology- The World Health Organization (WHO) estimates that 354 million people
currently live with chronic hepatitis B and C globally.

Epidemiology- A recent report from the World Health Organization indicates that 3.3 million
deaths (6% of all global deaths) are attributable to alcohol use, and that alcohol abuse is a risk
factor in about 50% of cases of cirrhosis.
d) Pneumonia
Epidemiology- Pneumonia is the single largest infectious cause of death in children worldwide.
Pneumonia killed 740 180 children under the age of 5 in 2019, accounting for 14% of all
deaths of children under five years old but 22% of all deaths in children aged 1 to 5.
Pneumonia affects children and families.
e) Scabies
Epidemiology- The estimated worldwide prevalence of scabies is 300 million infected individuals
each year. Scabies occurs worldwide but is most prevalent in tropical hot countries and in areas of
high population density Africa, Southeast Asia and South America, Australia. The high prevalence
correlates with poverty, poor nutritional status, homelessness, and inadequate hygiene.
Epidemiology- Rheumatoid arthritis (RA) affects about 0.92% of the adult population in India.
The disease as predilection for small proximal joints, although virtually every peripheral joint in
the can be involved. RA strikes women, usually of childbearing age, three times more than it does
men.
g) Eczema
Epidemiology- AD is a common chronic or recurrent inflammatory skin disease. It is
characterized by extreme itching and a typical eczematous morphology and body distribution. It is
affecting around 2.1-4.9% of adult population, and 15-20% of children.
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Short Answers
Ques.1 Write a short note on pneumonia.
Ans- PNEUMONIA
 Pneumonia is a acute respiratory infection in which one or both lungs can be affected.
 It is caused by bacteria, viruses, or fungi. Pneumonia causes inflammation in the air sacs (alveoli)
of the lungs.
 The alveoli are filled with fluid or pus which makes breathing painful and limits oxygen intake.
Risk groups
People over the age of 65 and infants under age 2.
The weakening immune system of older people and developing immunity of infants making them more
susceptible to infection.
People with a weakened immune system due to:
 Pregnancy
 HIV/AIDS patient
 Transplanted organ recipients
 People drinking heavy amounts of alcohol,
Pharmacotherapy
First-line antibiotics include the macrolide antibiotics (Le azithromycin or clarithromycin or the
tetracycline (i.e., doxycycline) Other appropriate antibiotics may include:
 Macrolide Antibiotic
 Azithromycin
 Clarithromycin
 Fluoroquinolones
Tetracycline
Ques.2 What is scabies. Give its pathophysiology also.

Ans- SCABIES
 Scabies is caused by an infestation of the skin by the human itch mite.
 Scabies is derived from a LATTIN word "scabere" meaning "to scratch".
 The scabies mite usually is spread by direct, prolonged; skin-to-skin contact with a person who
has scabies.
 Scabies occurs worldwide and affects people of all races and social classes.
Pathophysiology
 There are many complex immunological and inflammatory pathways which involved in
pathogenesis of scabies. The symptoms of scabies are caused by an allergic reaction of the host's
body to mite proteins.
 The mite proteins are present from the gut, in mite feces, which are deposited under the skin. The
allergic reaction is both delayed cell-mediated & immediate (humoral antibody mediated) type.
Ques.3 Give the diagnosis of gonorrhoea & syphilis.

Ans- Diagnosis of Gonorrhoea
 N gonorrhoeae is usually diagnosed by culture or nucleic acid amplification tests (NAATIL
culture, or a nucleic acid-based test of genital fluids, blood, or joint fluids).
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 Gram stain in some instances (urethral discharge gonorrhea in men) Gram stain is specific and
sensitive test. Bacteria are detected via microscopic examination using Gram stain.
 Nucleic acid amplification tests (NAATs) NAATs are highly sensitive and specific diagnostic
tests. It may be done on a wide range of samples including urine, cervical on vulvovaginal genital
rectal, or oral swabs. NAATs have a higher sensitivity (90%) than the culture (>85%).
Diagnosis of Syphilis
 Serologic tests are the mainstay in the diagnosis of syphilis and are categorized as nontreponemal
or treponemal.
 Common nontreponemal tests include the Venereal Disease Research Laboratory (VDRL) slide
test, rapid plasma regains (RPR) card test, unheated serum regain (USR) test, and the toluidine red
unheated serum test (TRUST).
 Nontreponemal tests, which are inexpensive and easily performed, rely on the detection of
treponemal antibodies directed against an alcoholic solution of cardiolipin, lecithin, and
cholesterol contained in these tests.
Ques.4 What is malaria. Give its treatment along with the

medications.
Ans- Malaria-
 Malaria is one of the major public health problems of the worldwide. India reports around one
million malaria cases annually.
 In India, P. falciparum and P. vivax are the most common species causing malaria, their
proportion being around 50% each. Plasmodium vivax is more prevalent in the plain areas, while
P. falciparum predominates in forested and hilly areas.
Treatment
 Malaria is curable if effective treatment is started early. Any delay in treatment may causes
serious consequences sometimes death. Prompt and effective treatment is also important for
controlling the transmission of malaria.
 Antimalarial drugs are used for the treatment and prevention of malaria infection. Mos
antimalarial drugs target the erythrocytic stage of malaria infection, which is the phase of infection
that causes symptomatic illness.
Medications-
 Quinoline derivatives
 4-aminoquinolines
 Mefloquine
 Proguanil
 Amodiaquine
 Quinine
 Doxycycline
 Mefloquine
Ques.5 Define eczema. Give its signs & symptoms.

Ans- ECZEMA
The word "eczema is derived from the Greek for 'boiling. In the early acute stages of this disorder usually
there is the appearance of the tiny vesicles (bubbles).
There are several types of eczema. The commonest form is atopic or allergic eczema or atopic dermatitis
(AD).
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Signs and symptoms
Eczema usually starts on the face followed by the hands and feet. Older children tend to be affected in the
elbow and knee creases, neck, wrists, ankles, and feet. The hands and feet tend to be the most affected
areas in adults.
The classic symptoms of eczema are:
 Itching, Redness which is caused by extra blood flowing to the affected area through the blood
vessels.
 A grainy appearance to the skin, caused by tiny fluid-filled blister.
 Weeping after bursting the blisters, Crusts or scabs which is formed form when the fluid dries.
Pale patches of skin may appear because eczema can disturb the production of pigment.
Ques.6 Write a short note on HIV and opportunistic infections.

Ans- HIV AND OPPORTUNISTIC INFECTIONS
 AIDS is the most common immuno-deficiency disorder of the world. It is caused by the Human
Immunodeficiency Virus (HIV). Transmission of HIV from person to person occurs due to sexual
intercourse, blood transfusion and sharing of contaminated needles by drug addicts is responsible
for.
 Opportunistic infections (OIs) are variety of illnesses which may occur more frequently and are
more severe in HIV infected people. These infections occur due to damaged immune systems. A
variety of causative agent such as viruses, bacteria, fungi, and parasites are responsible for these.
HIV Types
There are two types of HIV that cause AIDS: HIV type 1 (HIV-1) and HIV-2.
 HIV-1 is responsible for most of HIV infections worldwide.
 HIV-2 appears to be less virulent than HIV-1.
Transmission is usually
 Sexual: Direct transmission through sexual intercourse.
 Needle or instrument-related: Sharing of blood-contaminated needles or exposure to
 contaminated instruments.
 Transfusion- or transplant-related
Ques.7 What is hepatitis & give its etiology also.

Ans- HEPATITIS
Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are
injured or infected. It can damage the liver. The five main viral of hepatitis are hepatitis A B, C, D, and E.
Etiology
There are different types of hepatitis, with different causes:
 Viral hepatitis is the most common type. It is caused by one of several viruses-hepatitis viruses A,
B, C, D and E.
 Hepatitis B infection is caused by the hepatitis B virus (HBV), an enveloped DNA virus that
infects the liver and causes hepatocellular necrosis and inflammation.
 HBV us spread predominantly by percutaneous or mucosal exposure to infected blood and various
body fluids, including saliva, menstrual, vaginal, and seminal fluids.
 Alcoholic hepatitis is caused by heavy alcohol use.
 Toxic hepatitis can be caused by certain poisons, chemicals, medicines, or supplements.
Autoimmune hepatitis is a chronic type in which your body's immune system attacks your liver
The cause is not known, but genetics and your environment may play a role.
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Ques.8 What are the risk factors & medical risk factors of
tuberculosis.
Ans- Risk Factors of Tuberculosis
Risk groups for tuberculosis include
(a) People from countries with a high prevalence of tuberculosis (greater than 40/100 000 population)
(b) Close contacts of patients with sputum smear-positive pulmonary tuberculosis disease
(c) Alcoholism.
(d) Low socioeconomic status.
(e) Crowded living conditions.
(f) Recent Tubercular infection (within last 2 year)
(h) Children exposed to high-risk adults.
(j) Other immunosuppressive therapy. Low body weight (10% or more below the ideal).
Medical risk factors

(a) Patients with CRF
(b) Diabetes mellitus
(c) People having HIV infection
(d) Person on immunosuppressants like steroid
Ques.9 Define iron deficiency. What is the sign & symptoms of it.
Ans- IRON DEFICIENCY ANEMIA
Anemias are a group of diseases which are characterized by a decrease in either the hemoglobin (Hgb) or
the volume of red blood cells (RBCs)which results in decreased oxygen-carrying capacity of the blood.
Sign and Symptoms

 Decreased exercise tolerance
 Fatigue
 Dizziness
 Weakness
 Palpitations
 Vertigo
Ques.10 What is peptic ulcer. Mention its diagnosis also.

Ans- PEPTIC ULCER
Peptic ulcer disease is the common disease that damages the mucosa of esophagus, stomach, and small
intestine i.e., of the duodenum and jejunum.
Diagnosis
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Tests For H. Pylori can be made using endoscopic or non-endoscopic tests.
 The endoscopic tests include serologic antibody detection tests, the urea breath test (UBT), and
the stool antigen test. These tests are more convenient and less expensive than the endoscopic test.
 Serologic testing provides a quick (within 15 minutes) office-based assessment of exposure to H.
pylori, but it cannot differentiate active infection from previously treated infection.
 Patients can remain seropositive for years after eradication. Serologic testing is recommended in
patients with recent or current antibiotic or acid-suppressive therapy.
Ques.11 Write a short note on gastro intestinal disorders.

Ans- Gastrointestinal (GI)Tract-
 The Gastrointestinal (GI) tract is a tube-like structure which extends from mouth to the anus. It is
about 5-7 m long which includes the mouth, pharynx, esophagus, stomach, small intestine, and
large intestine.
 The accessory digestive organs include the teeth, tongue, salivary glands, liver, gallbladder, and
pancreas. The GI tract is located mainly in abdominopelvic cavity which is surrounded by serous
membrane (visceral peritoneum).
 The wall of the alimentary canal consists of 4 layers serosa, muscular layer, submucosa, and
mucous layer.
 There are various accessory glands which secrete various juices that help in the process of
digestion.
 There are three types of salivary glands (Parotids, Sublingual and parotids glands) which
secrete saliva.
 Saliva contains 99.5% water and 0.5% solutes. Among the solutes are ions, including sodium,
potassium, chloride, bicarbonate, and phosphate. Mucus, immunoglobulin A, the bacteriolytic
enzyme lysozyme and salivary amylase, a digestive enzyme that acts on starch.
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Very Short Answers
1. What are the factors that contribute to unsuccessful eradication of H pylory associated ulcers?
Ans- Poor adherence and antibiotic resistance are the 2 major risk factors for H. pylori eradication
failure. Other risk factors include high gastric acidity, high bacterial load, lack of sensitivity of the
specific strain of H.
2. Define Gastroesophageal reflux disease (GERD).

Ans- Gastroesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into
the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the
lining of your esophagus. Many people experience acid reflux from time to time.
3. What is the function of bile?

Ans- Bile helps with digestion. It breaks down fats into fatty acids, which can be taken into the body by
the digestive tract. Bile contains: Mostly cholesterol.
4. Urea breath test is used for the diagnosis of_______.

Ans- H.Pylori
5. How non-steroidal anti-inflammatory drugs is responsible for the induction of peptic ulcer.
Ans- Peptic ulcer disease is a well-recognised complication of NSAID use. Inhibition of COX-1 in the
gastrointestinal tract leads to a reduction of prostaglandin secretion and its cytoprotective effects in
gastric mucosa. This therefore increases the susceptibility to mucosal injury.
6. Adverse effect of PPIs.

Ans- In general, PPIs are believed to have few adverse effects, as they are generally well tolerated.
Patients have experienced few minor side effects of short-term PPI use, such as headache, rash,
dizziness, and gastrointestinal symptoms including nausea, abdominal pain, flatulence,
constipation, and diarrhea.
7. What is Erythropoiesis?
Ans- The formation of red blood cells in blood-forming tissue. In the early development of a fetus,
erythropoiesis takes place in the yolk sac, spleen, and liver. After birth, all erythropoiesis occurs in the
bone marrow.
8. Write the role of Intrinsic factor in the RBC production.

Ans- Intrinsic factor binds to vitamin B12. After attaching, intrinsic factor and B12 travel to the
intestines to be absorbed into the bloodstream. Vitamin B12 is needed for red blood cells to form and
grow. Some people do not make enough intrinsic factor or have a condition that destroys it.
9. Dietary nonheme iron is usually present in the ferric state

Ans- Dietary iron is absorbed in the duodenum from heme and nonheme sources but by different
mechanisms. Nonheme iron is usually in the ferric (Fe+++) form, which is easily complexed with
anions, thereby reducing its solubility and absorption. Absorption is increased by glucose, fructose,
some amino acids, and vitamin C.
10. Pernicious anemia occur due to the deficiency or absence of..(True/False)

Ans- Intrinsic Factor
11. Write the function of transferrin.
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Ans- Transferrin is a blood plasma glycoprotein that plays a central role in iron metabolism and is
responsible for ferric-ion delivery. Transferrin functions as the most critical ferric pool in the body. It
transports iron through the blood to various tissues, such as the liver, spleen, and bone marrow.
12. Iron is stored in two forms and

Ans- Ferritin and Hemosiderin
13. What is Hematocrit?

Ans- the ratio of the volume of red blood cells to the total volume of blood.
14. Write the Etiology of Megaloblastic Anemia.

Ans- The most common causes of megaloblastic states are:
(a) Vitamin B12 deficiency
(b) Defective utilization of vitamin B12
(c) Folate deficiency
15. What is mantoux test?

Ans- a test for immunity to tuberculosis using intradermal injection of tuberculin
16. What is latent tuberculosis infection?

Ans- TB bacteria can live in the body without making you sick. This is called latent TB infection. In
most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop
them from growing. People with latent TB infection: Have no symptoms.
17. Write the full form of HIV.

Ans- Human immunodeficiency viruses
18. Tuberculosis is caused by.5. Malaria is a protozoal disease. (True/False)

Ans- M. tuberculosis
19. COVID-19 is caused by bacteria. (True/False)

Ans- False
20…………. is the most common cause of bacterial pneumonia in children.

Ans- Streptococcus pneumoniae
21. What do you understand by uncomplicated urinary tract infections.

Ans- A UTI is classified as uncomplicated if there are no functional or anatomical anomalies in the
urinary tract, no renal functional impairment, and no concomitant disease that would promote the
UTI.
22. Serum glutamic oxaloacetic transaminase (SGOT) is another name of...

Ans- Aspartate Transaminase (AST)
23. Write the etiology of pneumonia.

Ans- A number of infectious agents which include bacteria, viruses, and fungi are responsible for
pneumonia infection. The most common are:
 Streptococcus Pneumonia: it is the most common cause of bacterial pneumonia in children.
 Haemophilus Influenzae: type b (Hib) it is the second most common cause of bacterial
pneumonia.
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 Pneumocystis Jiroveci: It is one of the most common causes of pneumonia in HIV infected infants
and responsible for at least one quarter of all pneumonia deaths in HIV-infected infants.
24. Rheumatoid arthritis is autoimmune disease. (True/False)

Ans- True
25. C-reactive proteins (CRP) is used to measure.

Ans- Inflammation.
26. Define osteoarthritis.

Ans- A type of arthritis that occurs when flexible tissue at the ends of bones wears down. The wearing
down of the protective tissue at the ends of bones (cartilage) occurs gradually and worsens over time.
Joint pain in the hands, neck, lower back, knees or hips is the most common symptom.
27. Write the treatment goal of osteoporosis.

Ans- The goals of treatment are four-fold: (1) reduce bone loss, (2) prevent fracture, (3) control pain,
and (4) prevent disability. Alendrontate (Fosamax®) and Raloxifene (Evista®) are among drugs
available by prescription to help control bone loss and reduce the risk for future fracture.
28. Write the name of four drugs used in the treatment of psoriasis
Ans-
 Cyclosporine
 Immunomodulators
 Methotrexate
 Mycophenolate Mofetil
29. Scabies is a highly contagious disease. (True/False)

Ans- True
30. What is the role of TNF in psoriasis?

Ans- It is known that TNF alpha is elevated in both the skin and synovium of psoriatic patients and
the effectiveness of its blockade by these two agents in psoriasis and PsA confirms its role in their
pathogenesis.
31. Write the role of emollients in psoriasis treatment.

Ans- Emollients reduce scaling and itching, soften cracks and improve the penetration of other
topical drugs
32. Role of keratolytics in psoriasis.

Ans- Keratolytics. Keratolytics are compounds that break down the outer layers of the skin and can
decrease the thickness of psoriatic plaques. This class of compounds includes salicylic acid (2%–10%),
urea (20%–40%), and alpha-hydroxy acids (glycolic and lactic acids).
33. What is balenotherapy?

Ans- Balneotherapy is a method of treating diseases by bathing, a traditional medicine technique usually
practiced at spas. Since ancient times, humans have used hot springs, public baths and thermal medicine
for therapeutic effects.
34. What is the first line treatment of psoriasis?

Ans- Topical Therapy: First-Line Agents
LIVE CHANNEL
 Keratolytic
 Corticosteroids
 Vitamin D Analogues
 Tazarotene
35. Which bacteria causes scabies?

Ans- Mite Sarcoptes Scabiei.
36. Explain the role of methotrexate in the management of psoriasis.

Ans- Methotrexate is a strong medicine. The US Food and Drug Administration (FDA) approved it to
treat adults with severe, disabling psoriasis that cannot be controlled with medicine applied to the skin or
light treatments. Methotrexate works by suppressing the overactive immune system that causes
psoriasis.
37. Write a note on non-pharmacologic therapy for psoriasis.

Ans- Several treatments that are recommended for this disease include nutritional advice, lifestyle
modifications, and manipulation therapy such as wet cupping (Hijamah), leech therapy, and
phlebotomy (Fasd). These recommendations may help to prevent recurrence and be useful in improving
psoriasis.
38. Write a note on topical therapy in psoriasis.

Ans- Topical Therapy: First-Line Agents
 Keratolytic
 Corticosteroids
 Vitamin D Analogues
 Tazarotene
Topical Therapy: Second-Line Agents
 Coal Tar
 Anthralin
39. Enumerate the clinical signs and symptoms of eczema.

Ans-
 Itching, Redness which is caused by extra blood flowing to the affected area through the blood
vessels.
 A grainy appearance to the skin, caused by tiny fluid-filled blister.
 Weeping after bursting the blisters, Crusts or scabs which is formed form when the fluid dries.
Pale patches of skin may appear because eczema can disturb the production of pigment.
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PHARMACEUTICAL CHEMISTRY

Ques.3 Discuss in detailed about Urinary Tract Infections.

Ques.4 Prepare notes on Musculoskeletal disorders.

Ques.5 Differentiate between Rheumatoid Arthritis & Osteoarthritis.

Ques.6 Discuss in detail about alcoholic liver disease.

Ques.7 Give the epidemiology of the following-

Ques.2 What is scabies. Give its pathophysiology also.

Ques.3 Give the diagnosis of gonorrhoea & syphilis.

Ques.5 Define eczema. Give its signs & symptoms.

Ques.6 Write a short note on HIV and opportunistic infections.

Ques.7 What is hepatitis & give its etiology also.

Ques.10 What is peptic ulcer. Mention its diagnosis also.

Ques.11 Write a short note on gastro intestinal disorders.

Ques.3 Discuss in detailed about Urinary Tract Infections.

Ques.4 Prepare notes on Musculoskeletal disorders.

Joints are classified into three type:

Musculoskeletal disorders include conditions that affect:

Ques.5 Differentiate between Rheumatoid Arthritis &

SIGNS AND SYMPTOMS

Ques.6 Discuss in detail about alcoholic liver disease.

Sign and Symptom

Alanine Transaminase (ALT)

Ques.7 Give the epidemiology of the following-

c) Alcoholic Liver Disease

Ques.2 What is scabies. Give its pathophysiology also.

Ques.3 Give the diagnosis of gonorrhoea & syphilis.

Ques.4 What is malaria. Give its treatment along with the

Ques.5 Define eczema. Give its signs & symptoms.

Ques.6 Write a short note on HIV and opportunistic infections.

Ques.7 What is hepatitis & give its etiology also.

Medical risk factors

Sign and Symptoms

Ques.10 What is peptic ulcer. Mention its diagnosis also.

Ques.11 Write a short note on gastro intestinal disorders.

2. Define Gastroesophageal reflux disease (GERD).

3. What is the function of bile?

4. Urea breath test is used for the diagnosis of_______.

6. Adverse effect of PPIs.

8. Write the role of Intrinsic factor in the RBC production.

9. Dietary nonheme iron is usually present in the ferric state

10. Pernicious anemia occur due to the deficiency or absence of..(True/False)

11. Write the function of transferrin.

12. Iron is stored in two forms and

13. What is Hematocrit?

14. Write the Etiology of Megaloblastic Anemia.

15. What is mantoux test?

16. What is latent tuberculosis infection?

17. Write the full form of HIV.

18. Tuberculosis is caused by.5. Malaria is a protozoal disease. (True/False)

19. COVID-19 is caused by bacteria. (True/False)

20…………. is the most common cause of bacterial pneumonia in children.

21. What do you understand by uncomplicated urinary tract infections.

22. Serum glutamic oxaloacetic transaminase (SGOT) is another name of...

23. Write the etiology of pneumonia.

24. Rheumatoid arthritis is autoimmune disease. (True/False)

25. C-reactive proteins (CRP) is used to measure.

26. Define osteoarthritis.

27. Write the treatment goal of osteoporosis.

29. Scabies is a highly contagious disease. (True/False)

30. What is the role of TNF in psoriasis?

31. Write the role of emollients in psoriasis treatment.

32. Role of keratolytics in psoriasis.

33. What is balenotherapy?