430 - AIIMS NOVEMBER 2011 Mcqs with answers - part 2

6.Which is true about octreotide?
a.Stimulates growth hormone
b.Used in secretory diarrhea
c.Used orally
d.Contraindicated in acromegaly

answer b.Used in secretory diarrhoea

OCTREOTIDE:

Currently, the most widely used somatostatin analog is octreotide (SANDOSTATIN), an 8-amino-acid synthetic derivative of somatostatin that has a longer half-life and binds preferentially to SSTR2 and SSTR5 receptors. Typically, octreotide (100 g) is administered subcutaneously three times daily; bioactivity is virtually 100%, peak effects are seen within 30 minutes, serum half-life is approximately 90 minutes, and duration of action is approximately 12 hours. The goal of treatment is to decrease GH levels to less than 2 ng/ml after an oral glucose tolerance test and to bring IGF-1 levels to within the normal range for age and gender. Depending on the biochemical response, higher or lower octreotide doses may be used in individual patients. In addition to its effect on GH secretion, octreotide can decrease tumor size—although tumor growth generally resumes after octreotide treatment is stopped. Octreotide also has significant inhibitory effects on thyrotropin secretion, and it is the treatment of choice for patients who have thyrotrope adenomas that oversecrete TSH and who are not good candidates for surgery. Gastrointestinal side effects—including diarrhea, nausea, and abdominal pain—occur in up to 50% of patients receiving octreotide. In most patients, these symptoms diminish over time and do not require cessation of therapy. Approximately 25% of patients receiving octreotide develop gallstones, presumably due to decreased gallbladder contraction and gastrointestinal transit time. In the absence of symptoms, gallstones are not a contraindication to continued use of octreotide. Compared to somatostatin, octreotide reduces insulin secretion to a lesser extent and only infrequently affects glycemic control. The need to inject octreotide three times daily poses a significant obstacle to patient compliance. A long-acting, slow-release form (SANDOSTATIN LAR) is a more convenient alternative that can be administered intramuscularly once every 4 weeks; the recommended dose is 20 or 30 mg. The long-acting preparation is at least as effective as the regular formulation and is used in patients who have responded favorably to a trial of the shorter-acting formulation of octreotide. Like the shorter-acting formulation, the longer-acting formulation of octreotide generally is well tolerated and has a similar incidence of side effects (predominantly gastrointestinal and/or discomfort at the injection site) that do not require cessation of therapy.

7.Regular drinking of which of the following prevents UTI?
a.Grape juice
b.Raspberry juice
c.Cranberry juice
d.Orange juice

answer c.Cranberry juice

8.Following artery damage will cause least effect on body while doing surgery?
a.Superior Mesenteric artery
b.Inferior Mesenteric artery
c.Coeliac axis
d.Renal artery

answer b.Inferior Mesenteric artery

9.Liver plate includes all except
a.Hilar plate
b.Cystic plate
c.Umbilical plate
d.Ductal plate

answer d.Ductal plate

10.Dopamine, Norepinephrine and Serotonin; all have which of the following type of receptors?
a.2 pass
b.6 pass
c.7 pass
d.4 pass

answer c.7 pass.