| Paper Name : | AIIMS CRE Pharmacist Grade II (Common Recruitment Examination) Official Solved Question Paper with Answer Key & Clinical Explanations |
| Post Update Date : | 24 September 2026 | 10:48 AM |
| Short Information : |
All India Institute of Medical Sciences (AIIMS New Delhi) conducts the centralized Common Recruitment Examination (CRE-AIIMS) for Pharmacist Grade II (Group C, 7th CPC Level-5) across all participating AIIMS institutes (AIIMS New Delhi, Bhopal, Bhubaneswar, Jodhpur, Patna, Raipur, Rishikesh, etc.). This solved model question paper provides authentic CBT questions covering Clinical Pharmacy, Hospital Drug Store Management, Pharmacology, Bio-Pharmaceutics, and Hospital Formulary guidelines along with verified answers and explanations.
Verified by Sarkari Pharma Editorial Board • Sarkari Pharma Editorial Board |
| CRE-AIIMS Pharmacist Grade-II CBT Examination Structure | |||
|---|---|---|---|
| Subject Component | Questions | Marks | Exam Time & Negative Marking |
| Domain Specific Pharmacy Knowledge | 40 Questions | 40 Marks | 90 Minutes (Total) Negative: 0.25 Mark per wrong answer |
| General Aptitude & General Knowledge | 20 Questions | 20 Marks | |
| Reasoning, English & Basic Computers | 20 Questions | 20 Marks | |
| Total CBT Paper | 80 Questions | 80 Marks | CBT Online Mode |
Q1: In hospital pharmacy drug distribution, ‘Unit Dose Dispensing System’ (UDDS) provides which major clinical advantage over traditional floor stock systems?
View Answer & Explanation
Explanation: Unit Dose Dispensing System (UDDS) dispenses each dose of medication in an individually packaged, labeled unit container containing the exact dose prescribed for a specific patient. It minimizes medication administration errors, prevents drug pilferage, eliminates nursing calculation errors, and enables tight inventory accounting.
Q2: Which class of cephalosporin antibiotics has significant anaerobic antimicrobial coverage, specifically against Bacteroides fragilis?
View Answer & Explanation
Explanation: Cefoxitin and Cefotetan are second-generation cephamycins with high activity against anaerobic gram-negative organisms like Bacteroides fragilis, making them valuable in intra-abdominal and pelvic surgical prophylaxis.
Q3: Which of the following antineoplastic agents is associated with dose-limiting hemorrhagic cystitis, preventable by co-administering Mesna?
View Answer & Explanation
Explanation: Cyclophosphamide and Ifosfamide produce the urotoxic metabolite Acrolein, which causes severe hemorrhagic cystitis. Mesna (Sodium 2-mercaptoethanesulfonate) binds to acrolein in the urinary tract, detoxifying it and protecting bladder urothelium.
Q4: The Pharmacy and Therapeutics Committee (PTC) in an AIIMS tertiary hospital is primarily chaired by:
View Answer & Explanation
Explanation: The Pharmacy and Therapeutics Committee (PTC) is an advisory body of the medical staff. It is traditionally chaired by a senior physician or Medical Superintendent, while the Chief Hospital Pharmacist serves as the Member Secretary responsible for maintaining the Hospital Formulary.
Q5: The Limulus Amebocyte Lysate (LAL) test is used to detect the presence of:
View Answer & Explanation
Explanation: The LAL test utilizes the aqueous extract of blood cells (amebocytes) from the horseshoe crab (Limulus polyphemus). In the presence of bacterial endotoxins (lipopolysaccharides from gram-negative bacteria), the lysate clots, confirming pyrogen contamination in parenterals.
Q6. Which quaternary ammonium antimicrobial preservative is officially added to multidose ophthalmic eye drops at a standard concentration of 0.01% w/v?
- (A) Chlorobutanol
- (B) Benzalkonium Chloride (BAK)
- (C) Phenylmercuric nitrate
- (D) Methylparaben
Detailed Solution: Benzalkonium Chloride (0.01% w/v) is the most widely utilized preservative in multidose ophthalmic preparations. It acts by disrupting bacterial cell membranes, exerting rapid bactericidal activity against Pseudomonas aeruginosa. However, due to its cationic nature, BAK binds to soft contact lenses and causes corneal epithelial toxicity upon chronic long-term administration.
Q7. Under the Drugs & Cosmetics Rules 1945, Schedule J specifies:
- (A) List of poisonous substances under the poisons rule
- (B) List of diseases and ailments which a drug may not purport to prevent or cure
- (C) Standards for cosmetics and toiletry products
- (D) Guidelines for disposal of biomedical waste
Detailed Solution: Schedule J contains a statutory list of 51 diseases and disorders (including AIDS, cancer, diabetes, epilepsy, cataract, genetic disorders) which no drug can legally claim to prevent or cure. Manufacturing or labeling any medicine with therapeutic claims purporting to cure Schedule J diseases constitutes a punishable offense under the Drugs & Cosmetics Act.
Q8. What is the fundamental rate-limiting enzyme inhibited by competitive lipid-lowering Statins (Atorvastatin, Rosuvastatin) in endogenous cholesterol biosynthesis?
- (A) Squalene epoxidase
- (B) 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase
- (C) Lipoprotein lipase
- (D) Lecithin-cholesterol acyltransferase (LCAT)
Detailed Solution: Statins are structural analogues of HMG-CoA that competitively and reversibly inhibit HMG-CoA reductase, the critical rate-limiting enzyme converting HMG-CoA to mevalonate in hepatic cholesterol synthesis. The resulting depletion of intracellular hepatic cholesterol triggers up-regulation of high-affinity cell-surface LDL receptors, accelerating the clearance of circulating atherogenic LDL-C from blood.
Q9. As per the Indian Pharmacopoeia (IP), what is the maximum permissible disintegration time for Hard Gelatin Capsules?
- (A) 15 Minutes
- (B) 30 Minutes
- (C) 45 Minutes
- (D) 60 Minutes
Detailed Solution: Pharmacopoeial disintegration standards for capsules:
- Hard Gelatin Capsules: Not more than 30 minutes (in water at 37°C ± 2°C).
- Soft Gelatin Capsules: Not more than 60 minutes.
- Enteric Capsules: Resistant to simulated gastric fluid for 2 hours; disintegrates within 60 minutes in simulated intestinal fluid.
Q10. In thermal sterilization kinetics, the ‘D-value’ (Decimal Reduction Time) is mathematically defined as:
- (A) The temperature increase required to reduce the D-value by 90%
- (B) The time in minutes required to kill 90% (1 log reduction) of a microbial population at a specified constant temperature
- (C) The total exposure time required to achieve absolute zero sterility
- (D) The radiation dose required for 100% spore eradication
Detailed Solution: The D-value is the time in minutes required at a given constant temperature to reduce the surviving viable microbial population by 90% (a 1-logarithmic cycle reduction). The Z-value is the temperature change (in °C) required to change the D-value tenfold (by one log). The F0 value is the equivalent lethality expressed in minutes at 121.1°C.
Q11. Why are Angiotensin-Converting Enzyme (ACE) Inhibitors (such as Enalapril, Ramipril) strictly contraindicated during the 2nd and 3rd trimesters of pregnancy?
- (A) They cause premature closure of the fetal ductus arteriosus
- (B) They cause fetal renal dysgenesis, oligohydramnios, pulmonary hypoplasia, and skull defects
- (C) They induce gestational diabetes and maternal ketoacidosis
- (D) They trigger catastrophic placental abruption
Detailed Solution: Fetal renal perfusion in the 2nd and 3rd trimesters is critically dependent on Angiotensin-II maintaining efferent arteriolar tone. ACE inhibitors cross the placenta and cause profound fetal hypotension and renal hypoperfusion, leading to fetal renal agenesis / anuria, oligohydramnios (amniotic fluid deficit), which in turn causes fatal Potter sequence (pulmonary hypoplasia, limb contractures, calvarial hypoplasia). Labetalol, Methyldopa, and Nifedipine are safe alternatives in pregnancy.
Q12. In pharmacokinetics, the theoretical Apparent Volume of Distribution (Vd) is calculated using which formula?
- (A) Vd = Clearance × Half-life
- (B) Vd = Total amount of drug in body (Dose) / Plasma drug concentration (Cp)
- (C) Vd = Area Under Curve (AUC) / Elimination rate constant (Ke)
- (D) Vd = Renal Clearance / Hepatic Clearance
Detailed Solution: The Apparent Volume of Distribution (Vd) is the hypothetical volume of fluid that would be required to contain the total amount of drug in the body at the same concentration as that present in plasma: Vd = Dose / Cp. Drugs with high tissue binding and high lipophilicity (e.g., Digoxin, Chloroquine) exhibit very high Vd values (>500 Liters), far exceeding physical body water (~42 L).
Q13. ‘Fiehe’s Test’ is an official analytical pharmacognostical purity test employed to detect adulteration of Honey with:
- (A) Liquid paraffin
- (B) Commercial Artificial Invert Sugar (Hydroxymethylfurfural)
- (C) Starch and dextrin
- (D) Cane sugar (Sucrose) alone
Detailed Solution: Fiehe’s test detects commercial artificial invert sugar produced by acid hydrolysis of sucrose, which contains the side-product hydroxymethylfurfural (HMF). When the ethereal extract of adulterated honey is treated with resorcinol in concentrated hydrochloric acid, HMF produces an instantaneous transient cherry-red or crimson color, confirming adulteration. Pure natural honey gives no red color.
Q14. What is the major Excitatory Neurotransmitter responsible for synaptic plasticity, memory, and fast transmission across the mammalian brain?
- (A) Gamma-aminobutyric acid (GABA)
- (B) Glutamate
- (C) Glycine
- (D) Dopamine
Detailed Solution: L-Glutamate is the primary fast excitatory neurotransmitter in over 50% of central nervous system synapses, acting on ionotropic receptors (NMDA, AMPA, Kainate) and metabotropic receptors (mGluRs). Excessive extracellular glutamate accumulation triggers neurotoxic intracellular calcium influx (Excitotoxicity), contributing to ischemic stroke and epileptic brain injury. GABA is the principal inhibitory neurotransmitter in the brain, and Glycine in the spinal cord.
Q15. The classical formulation known as the ‘Universal Antidote’ is composed of Activated Charcoal, Magnesium Oxide, and Tannic Acid in what gravimetric ratio?
- (A) 1 : 1 : 1
- (B) 2 : 1 : 1
- (C) 1 : 2 : 1
- (D) 4 : 2 : 1
Detailed Solution: The traditional Universal Antidote comprises:
- 2 parts Powdered Activated Charcoal (adsorbs alkaloids, glycosides, and organic toxins).
- 1 part Magnesium Oxide (neutralizes gastric mineral acids and acts as a mild cathartic).
- 1 part Tannic Acid (precipitates heavy metals and unabsorbed alkaloids).
Q16. Which biological indicator organism is standardly used to validate Steam Sterilization (Autoclaving) cycles at 121°C?
- (A) Bacillus subtilis var. niger
- (B) Geobacillus stearothermophilus (spores)
- (C) Clostridium sporogenes
- (D) Pseudomonas aeruginosa
Detailed Solution: Geobacillus stearothermophilus (formerly Bacillus stearothermophilus ATCC 7953) endospores exhibit extreme thermal resistance and serve as the official biological indicator for validating moist heat sterilization (Autoclaving at 121°C). For dry heat sterilization (hot air oven) and ethylene oxide sterilization, Bacillus atrophaeus (Bacillus subtilis var. niger) is employed. For ionizing radiation, Bacillus pumilus is standard.
Q17. The ‘Limulus Amebocyte Lysate’ (LAL) test for bacterial endotoxins uses an aqueous extract derived from the circulating amebocytes of which marine organism?
- (A) Sepia officinalis (Cuttlefish)
- (B) Limulus polyphemus (Horseshoe crab)
- (C) Pinctada margaritifera (Pearl oyster)
- (D) Penaeus monodon (Giant tiger prawn)
Detailed Solution: The LAL (Limulus Amebocyte Lysate) test utilizes an aqueous extract of amoebocytes from the Atlantic horseshoe crab (Limulus polyphemus). Bacterial endotoxins (lipopolysaccharides from Gram-negative bacterial cell walls) trigger an enzyme cascade in the lysate causing gel-clot formation or turbidimetric/chromogenic reaction. It detects minute pyrogen quantities with far greater sensitivity and speed than the traditional rabbit pyrogen test.
Q18. Which class of immunoglobulins is the most abundant in human blood plasma and uniquely capable of crossing the placental barrier?
- (A) Immunoglobulin A (IgA)
- (B) Immunoglobulin M (IgM)
- (C) Immunoglobulin G (IgG)
- (D) Immunoglobulin E (IgE)
Detailed Solution: IgG constitutes roughly 75% to 80% of total circulating antibodies in adult serum. Due to specific Fc-receptor-mediated active transport (neonatal Fc receptor, FcRn) in syncytiotrophoblasts, IgG is the only immunoglobulin class that crosses the human placenta to confer vital passive immunity to the developing fetus and newborn during the early months of life.
Q19. In acute Paracetamol (Acetaminophen) toxicity, N-acetylcysteine (NAC) acts as an antidote primarily by:
- (A) Inhibiting gastric absorption of paracetamol
- (B) Replenishing depleted hepatic Glutathione stores to conjugate toxic NAPQI
- (C) Inducing CYP2E1 microsomal enzymes in the liver
- (D) Directly acidifying systemic urine to accelerate renal elimination
Detailed Solution: In paracetamol overdose, hepatic glucuronidation and sulfation pathways become saturated. Excess paracetamol is shunted via CYP2E1 into the highly reactive, hepatotoxic intermediate NAPQI (N-acetyl-p-benzoquinone imine). Once endogenous glutathione is depleted below 70%, NAPQI covalently binds to hepatic macromolecules causing centrilobular necrosis. N-acetylcysteine (NAC) supplies cysteine to replenish glutathione and binds directly to NAPQI as a nontoxic conjugate.
Q20. Under the Drugs and Cosmetics Rules, 1945, what is the maximum permissible shelf-life (expiry period) that can be assigned to a newly formulated drug unless validated stability data proves otherwise?
- (A) 24 months (2 years)
- (B) 36 months (3 years)
- (C) 60 months (5 years)
- (D) 120 months (10 years)
Detailed Solution: Under Rule 96 and Schedule P of the Drugs and Cosmetics Rules, the period of expiry of a drug specified in Schedule P cannot exceed that specified in the schedule, and in all other cases, no drug shall bear an expiry date exceeding 60 months (5 years) from the date of manufacture unless the Licensing Authority is satisfied with real-time stability evidence.
Q21. Which parenteral antidiabetic formulation is the ONLY insulin preparation that can be administered intravenously in Diabetic Ketoacidosis (DKA)?
- (A) Isophane NPH Insulin
- (B) Insulin Glargine (Lantus)
- (C) Regular (Soluble) Crystalline Human Insulin
- (D) Insulin Degludec (Tresiba)
Detailed Solution: Regular (Soluble) Insulin is a clear, zinc-insulin solution that can be administered both subcutaneously and intravenously. Because long-acting suspensions (NPH, Glargine, Detemir) contain protamine, zinc microcrystals, or form subcutaneous hexamers, they are strictly prohibited from IV use due to risk of microembolism. Regular insulin IV infusion provides rapid, titratable glucose and ketone suppression in DKA and Hyperosmolar Hyperglycemic State (HHS).
Q22. Dimercaprol (British Anti-Lewisite / BAL) is formulated as an intramuscular injection in peanut oil specifically for chelating which heavy metals?
- (A) Iron and Aluminum
- (B) Arsenic, Mercury, and Gold
- (C) Copper and Zinc
- (D) Silver and Barium
Detailed Solution: Dimercaprol (BAL, 2,3-dimercapto-1-propanol) contains two sulfhydryl (-SH) groups that avidly bind heavy metal cations, forming stable, non-toxic five-membered heterocyclic ring chelates excreted in urine. It is the drug of choice for acute Arsenic, Mercury (inorganic), and Gold poisoning. For Iron, Deferoxamine is used; for Copper (Wilson’s disease), Penicillamine is used.
Q23. In Hospital Pharmacy drug distribution, what is the principal clinical benefit of the ‘Unit Dose Dispensing System’ (UDDS)?
- (A) Increased stock of bulk bottles in ward medicine rooms
- (B) Drastic reduction in medication administration errors and reduced drug wastage
- (C) Elimination of the need for registered pharmacists in the hospital
- (D) Permitting nursing staff to formulate custom dosages at bedside
Detailed Solution: In a Unit Dose Dispensing System (UDDS), medications are packaged, labeled, and dispensed by the central hospital pharmacy in individually sealed, ready-to-administer patient doses (for 24 hours). This eliminates nursing dose preparation errors, prevents contamination, allows easy return of unused credits, and provides the safest hospital drug distribution framework globally.
Q24. In the secondary hemostasis coagulation cascade, the final enzymatic cleavage of soluble Fibrinogen into insoluble Fibrin is catalyzed directly by:
- (A) Factor Xa
- (B) Thrombin (Factor IIa)
- (C) Factor VIIa
- (D) Plasmin
Detailed Solution: Thrombin (Factor IIa) is a serine protease generated from prothrombin by the prothrombinase complex (FXa, FVa, Ca2+, phospholipids). Thrombin proteolytically cleaves fibrinopeptides A and B from fibrinogen (Factor I), converting it into soluble fibrin monomers which polymerize and are cross-linked by Factor XIIIa into a stable fibrin clot.
Q25. Which specific competitive antagonist is administered intravenously to rapidly reverse acute Opioid overdose and respiratory depression?
- (A) Flumazenil
- (B) Naloxone
- (C) Naltrexone
- (D) Physostigmine
Detailed Solution: Naloxone (Narcan) is a pure competitive opioid receptor antagonist (blocking mu, kappa, and delta receptors with high affinity). Administered IV, IM, or intranasally, it reverses opioid-induced coma and apnea within 1 to 2 minutes. Because its plasma half-life (~30–90 minutes) is much shorter than most opioids (e.g., Methadone, Morphine), repeat doses or continuous infusion are frequently required.
Q26. In the Lyophilization (freeze-drying) process of thermolabile biologics, primary drying involves water removal primarily through which physical mechanism?
- (A) Evaporation above 100°C
- (B) Sublimation (direct solid ice to vapor transition) under reduced pressure
- (C) Spray convection
- (D) Centrifugal sedimentation
Detailed Solution: Lyophilization (Freeze-drying) operates below the triple point of water (0.01°C and 4.58 mmHg). The product is frozen, and during the primary drying stage, chamber pressure is reduced below ice vapor pressure, allowing ice to transform directly into water vapor via sublimation without melting into liquid. Secondary drying then desorbs bound moisture.
Q27. Under Schedule M of the Drugs and Cosmetics Rules, what is the maximum permissible number of airborne non-viable particles (≥ 0.5 µm) per cubic meter in a Grade A cleanroom at rest?
- (A) 3,520 particles/m³
- (B) 352,000 particles/m³
- (C) 3,520,000 particles/m³
- (D) Zero particles
Detailed Solution: In GMP sterile manufacturing (Schedule M / WHO guidelines):
- Grade A (Critical Aseptic Workstation): At rest: maximum 3,520 particles/m³ (≥ 0.5 µm) and 20 particles/m³ (≥ 5.0 µm). In operation: also 3,520 particles/m³.
- Grade B (Grade A background room): At rest: 3,520 particles/m³; In operation: 352,000 particles/m³.
Q28. Which macrolide antibiotic acts as an agonist at Motilin receptors in the gastrointestinal tract, causing prominent prokinetic cramping and diarrhea?
- (A) Clarithromycin
- (B) Azithromycin
- (C) Erythromycin
- (D) Roxithromycin
Detailed Solution: Erythromycin binds directly to gastrointestinal motilin receptors, triggering coordinated antral and duodenal migrating motor complexes (MMCs). While this causes epigastric distress, cramping, and loose stools as a common side effect, low doses of Erythromycin are clinically exploited off-label as a prokinetic agent in diabetic gastroparesis.
Q29. What is the molecular mechanism of positive inotropic action exerted by Digoxin in heart failure?
- (A) Direct stimulation of beta-1 adrenergic receptors
- (B) Reversible inhibition of myocardial cell membrane Na+/K+-ATPase pump
- (C) Blockade of L-type calcium channels
- (D) Activation of phosphodiesterase-3 (PDE-3)
Detailed Solution: Digoxin specifically inhibits the sarcolemmal Na+/K+-ATPase enzyme, preventing extracellular potassium entry and causing intracellular sodium accumulation. The rise in intracellular Na+ slows down the Na+/Ca2+ antiporter exchanger (NCX), leading to elevated intracellular calcium storage in the sarcoplasmic reticulum. Upon depolarization, more Ca2+ is released, producing increased myocardial contractility (positive inotropism).
Q30. In hospital pharmacy inventory management, ‘VED Analysis’ classifies pharmaceuticals based upon which operational parameter?
- (A) Total annual consumption expenditure
- (B) Criticality and indispensability to patient survival
- (C) Expiry rate and shelf-life
- (D) Procurement lead time
Detailed Solution: VED analysis categorizes inventory based on clinical criticality:
- V (Vital): Life-saving drugs whose absence causes patient death within minutes to hours (e.g., Adrenaline, Atropine, Oxygen). Zero stock-out tolerated.
- E (Essential): Drugs required to prevent serious illness or severe discomfort (e.g., Antibiotics, Insulin).
- D (Desirable): Supportive or symptomatic relief drugs (e.g., Multivitamins, Antacids).
Q31. Which loop diuretic functions by selectively inhibiting the luminal Na+/K+/2Cl− symporter in the thick ascending limb of Henle’s loop?
- (A) Hydrochlorothiazide
- (B) Furosemide
- (C) Spironolactone
- (D) Acetazolamide
Detailed Solution: Furosemide (Lasix) binds to the chloride-binding site of the Na+/K+/2Cl− cotransporter (NKCC2) in the luminal membrane of the medullary and cortical thick ascending limb of Henle. This blocks solute reabsorption, abolishes the corticomedullary osmotic gradient, and produces high-ceiling natriuresis and kaliuresis, accompanied by increased calcium and magnesium urinary excretion.
Q32. Amphotericin B exerts its fungicidal effect primarily through which molecular mechanism?
- (A) Inhibition of squalene epoxidase
- (B) Binding to fungal cell membrane Ergosterol to create fatal transmembrane ion pores
- (C) Inhibition of fungal 1,3-beta-D-glucan synthase
- (D) Inhibition of fungal mitotic spindle microtubules
Detailed Solution: Amphotericin B is a polyene macrolide that binds with high affinity to ergosterol present in fungal cell membranes. Several amphotericin molecules assemble into a barrel-like transmembrane aqueous pore, causing uncontrolled leakage of essential intracellular monovalent ions (K+, Na+) and cellular death. Azoles (Fluconazole) inhibit 14-alpha-demethylase, and Echinocandins (Caspofungin) inhibit glucan synthesis.
Q33. Which schedule of the Drugs and Cosmetics Rules, 1945 outlines regulations, protocol guidelines, and ethical requirements for Clinical Trials and New Drug Approvals in India?
- (A) Schedule M
- (B) Schedule U
- (C) Schedule Y
- (D) Schedule X
Detailed Solution: Schedule Y of the Drugs and Cosmetics Rules, 1945 specifies the requirements and guidelines for permission to import and/or manufacture new drugs for sale or to undertake clinical trials (Phases I, II, III, and IV) in India. (Note: Supplemented now by the New Drugs and Clinical Trials Rules, 2019).
Q34. What is the official temperature range defined for ‘Cold Storage’ (Refrigeration) in the Indian Pharmacopoeia for thermolabile pharmaceuticals (such as Vaccines and Insulin)?
- (A) −20°C to 0°C
- (B) 2°C to 8°C
- (C) 8°C to 15°C
- (D) 15°C to 25°C
Detailed Solution: According to the Indian Pharmacopoeia (IP):
- Cold (Refrigeration): Any temperature between 2°C and 8°C.
- Cool: Any temperature between 8°C and 25°C.
- Room Temperature: 15°C to 30°C (Working temp: 20°C to 25°C).
- Warm: Any temperature between 30°C and 40°C.
Q35. In UV-Visible spectrophotometric analysis, the Beer-Lambert law defines Absorbance (A) as:
- (A) A = ε × c × b (where ε is molar absorptivity, c is concentration, b is path length)
- (B) A = ε / (c × b)
- (C) A = c × b / ε
- (D) A = log(Incident Intensity × Transmitted Intensity)
Detailed Solution: The Beer-Lambert Law states that absorbance is directly proportional to both the concentration (c) of absorbing solute and the path length (b) of the radiation beam through the medium: A = ε × c × b. Transmittance (T) is related by A = −log10(T) = log10(I0 / I).
Q36. Which atypical second-generation antipsychotic mandates weekly to monthly monitoring of Absolute Neutrophil Count (ANC) due to risk of fatal Agranulocytosis?
- (A) Risperidone
- (B) Olanzapine
- (C) Clozapine
- (D) Aripiprazole
Detailed Solution: Clozapine carries a black-box warning for severe, potentially fatal agranulocytosis (severe drop in absolute neutrophil count <500/µL) in ~1% of patients, primarily during the first 18 weeks. Strict blood count monitoring (weekly for the first 6 months, then biweekly) is mandatory before dispensing clozapine in hospital pharmacy practice.
Q37. Which first-line anti-tubercular drug causes peripheral neuropathy due to drug-induced Pyridoxine (Vitamin B6) deficiency?
- (A) Rifampicin
- (B) Isoniazid (INH)
- (C) Pyrazinamide
- (D) Ethambutol
Detailed Solution: Isoniazid (INH) structurally resembles pyridoxine. It combines with pyridoxal phosphate to form inactive hydrazones and inhibits pyridoxal phosphokinase, dramatically accelerating renal excretion of Vitamin B6. This leads to symmetrical peripheral sensory neuropathy, preventable by prophylactic co-administration of Pyridoxine (10–25 mg daily).
Q38. In pharmacognostical qualitative chemical evaluation, ‘Dragendorff’s Reagent’ is composed of which chemical complex?
- (A) Potassium mercuric iodide
- (B) Potassium bismuth iodide
- (C) Saturated solution of picric acid
- (D) Iodine dissolved in potassium iodide
Detailed Solution: Dragendorff’s Reagent is Potassium Bismuth Iodide solution, yielding an orange-red or reddish-brown precipitate with alkaloids.
- Mayer’s Reagent: Potassium mercuric iodide (Cream precipitate).
- Wagner’s Reagent: Iodine in potassium iodide (Reddish-brown precipitate).
- Hager’s Reagent: Saturated picric acid solution (Yellow crystalline precipitate).
Q39. In Total Parenteral Nutrition (TPN) compounding, precipitation between which two incompatible electrolyte ions poses a fatal pulmonary microembolism hazard?
- (A) Sodium and Chloride
- (B) Calcium and Phosphate (Dibasic calcium phosphate)
- (C) Potassium and Acetate
- (D) Magnesium and Sulfate
Detailed Solution: Calcium and inorganic phosphate can combine in TPN admixtures to form insoluble dibasic calcium phosphate (CaHPO4) microcrystals. If infused into circulation, these crystals precipitate in the pulmonary capillary bed, causing fatal diffuse alveolar damage and pulmonary embolism. Pharmacists prevent this by adding phosphate early, adding calcium near the end, maintaining acidic pH, and employing 1.2-micron in-line filters.
Q40. Under the Drugs and Cosmetics Rules, Schedule H1 mandates that retail chemist prescription registers must be preserved for a minimum period of:
- (A) 6 months
- (B) 1 year
- (C) 2 years
- (D) 5 years
Detailed Solution: Schedule H1 was introduced in 2013 to restrict indiscriminate sale of 46 critical drugs (cephalosporins, fluoroquinolones, carbapenems, and habit-forming psychoactive agents like Zolpidem, Alprazolam). The registered retail pharmacist must record patient name, prescriber details, drug name, and quantity in a separate register and preserve these records for a minimum period of 2 years for regulatory inspection.
Q41. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) produce anti-inflammatory, analgesic, and antipyretic actions primarily by inhibiting which enzyme?
- (A) Lipoxygenase (5-LOX)
- (B) Cyclooxygenase (COX-1 and COX-2)
- (C) Phospholipase A2
- (D) Xanthine oxidase
Detailed Solution: NSAIDs inhibit the Cyclooxygenase (COX) enzyme (prostaglandin H2 synthase), blocking conversion of arachidonic acid into pro-inflammatory prostaglandins (PGE2, PGF2a) and thromboxane A2. COX-1 is constitutive (gastric mucosal protection and platelet function), while COX-2 is induced at inflammatory sites. Aspirin irreversibly acetylates serine residues of COX.
Q42. In renal clinical physiology, what is the normal physiological Glomerular Filtration Rate (GFR) in a healthy young adult male?
- (A) 25 mL/min
- (B) 60 mL/min
- (C) 125 mL/min (~180 Liters/day)
- (D) 250 mL/min
Detailed Solution: Normal GFR in a healthy adult male is approximately 125 mL/min per 1.73 m² body surface area (or ~180 Liters per day). Since roughly 99% of filtrate is reabsorbed along the nephron tubules, daily urine volume excreted is ~1.5 Liters. GFR is clinically estimated using Inulin or Creatinine clearance equations (Cockcroft-Gault, MDRD, CKD-EPI).
Q43. Which chemical reagent is officially specified in the Limit Test for Iron according to the Indian Pharmacopoeia?
- (A) Barium sulfate
- (B) Thioglycolic acid (mercaptoacetic acid)
- (C) Diphenylamine
- (D) Silver nitrate
Detailed Solution: The official Limit Test for Iron in the IP relies on the reaction of iron with Thioglycolic acid in the presence of citric acid and ammonia. Thioglycolic acid reduces Fe3+ to Fe2+ and reacts with ferrous ions to form ferrous thioglycolate, which exhibits a characteristic purple or pale-pink color in ammoniacal medium. Citric acid prevents iron precipitation by ammonia.
Q44. ‘Red Man Syndrome’ (diffuse erythematous flushing of the neck, face, and torso with hypotension) is an adverse histamine-release reaction caused by rapid IV infusion of which antibiotic?
- (A) Linezolid
- (B) Vancomycin
- (C) Ciprofloxacin
- (D) Daptomycin
Detailed Solution: Red Man Syndrome (Vancomycin Flushing Syndrome) is an anaphylactoid reaction triggered when Vancomycin is infused rapidly (less than 60 minutes). It is NOT IgE-mediated; instead, vancomycin triggers direct degranulation of mast cells and basophils, releasing histamine. It is prevented by slow IV infusion over at least 60 to 120 minutes and pre-treatment with antihistamines.
Q45. In industrial tablet manufacturing, the defect characterized by partial or complete horizontal separation of the top or bottom crown of a tablet from the main body is termed:
- (A) Mottling
- (B) Capping
- (C) Sticking
- (D) Picking
Detailed Solution: Capping is the partial or complete separation of the top or bottom crown of a tablet from the main tablet body during or immediately following ejection from the die, predominantly caused by air entrapment in granules, excessive fines, or low moisture. Lamination is separation into two or more distinct horizontal layers. Mottling refers to unequal color distribution.
Q46. Which human organ is the exclusive site of synthesis of plasma Albumin and Vitamin K-dependent clotting factors (II, VII, IX, X)?
- (A) Spleen
- (B) Liver
- (C) Pancreas
- (D) Kidneys
Detailed Solution: Hepatocytes in the Liver synthesize nearly all circulating plasma proteins (except immunoglobulins synthesized by plasma B-cells). Albumin (the primary determinant of oncotic pressure and acidic drug carrier) and the vitamin K-dependent clotting factors (Factors II, VII, IX, X, Protein C, and Protein S) are produced exclusively in the liver. Liver cirrhosis results in hypoalbuminemia and coagulopathy.
Q47. The specific heavy metal chelating agent administered intravenously for severe acute and chronic Lead poisoning (Plumbism) is:
- (A) Deferasirox
- (B) Calcium Disodium Edetate (CaNa2-EDTA)
- (C) N-acetylcysteine
- (D) Pralidoxime (2-PAM)
Detailed Solution: Calcium Disodium Edetate (CaNa2-EDTA) is the parenteral chelator of choice for lead poisoning. Plain disodium EDTA (Na2-EDTA) must NEVER be used because it chelates serum calcium, causing fatal hypocalcemic tetany. In CaNa2-EDTA, lead displaces calcium because lead has higher chelate stability, and the water-soluble lead chelate is rapidly cleared through renal excretion.
Q48. Under the Drugs and Cosmetics Rules, 1945, Schedule X specifically regulates which category of pharmaceuticals?
- (A) Biological and microbiological products
- (B) Narcotic drugs and psychotropic substances prone to high misuse (e.g., Amphetamines, Barbiturates)
- (C) Ophthalmic solutions and ointments
- (D) Ayurvedic and Siddha medicines
Detailed Solution: Schedule X contains psychotropic substances with high addiction/abuse potential (e.g., Amphetamine, Secobarbital, Methaqualone, Methylphenidate). Schedule X drugs require duplicate prescriptions (one kept by retailer for 2 years), separate locked storage, special manufacturing/retail licenses, and prominent ‘Schedule X Drug’ labeling inside a red box with ‘Rx’ symbol.
Q49. What is the official maximum limit for ‘Disintegration Time’ for Uncoated Compressed Tablets according to the Indian Pharmacopoeia?
- (A) 5 minutes
- (B) 15 minutes
- (C) 30 minutes
- (D) 60 minutes
Detailed Solution: As per the Indian Pharmacopoeia (IP):
- Uncoated tablets: Disintegrate within 15 minutes in water at 37°C ± 2°C.
- Film-coated tablets: Disintegrate within 30 minutes.
- Sugar-coated tablets: Disintegrate within 60 minutes.
- Dispersible tablets: Disintegrate within 3 minutes.
- Soluble / Effervescent tablets: Disintegrate within 3 to 5 minutes.
Q50. Which broad-spectrum anthelmintic drug acts by binding glutamate-gated chloride ion channels, inducing hyperpolarization and flaccid paralysis in nematodes and ectoparasites?
- (A) Albendazole
- (B) Praziquantel
- (C) Ivermectin
- (D) Piperazine
Detailed Solution: Ivermectin selectively binds with high affinity to glutamate-gated chloride ion channels in invertebrate nerve and muscle cells. This increases chloride membrane permeability, causing cell hyperpolarization and tonic/flaccid paralysis resulting in parasite death. It is the drug of choice for Onchocerciasis (River Blindness), Strongyloidiasis, Filariasis (with DEC), and Scabies.
| Useful Study & Previous Paper Links | |
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| RRB Railway Pharmacist Solved Paper with Answer Key | View RRB Solved Paper » |
| Practice Top 100 Repeated Govt Pharmacist MCQs | Practice Top 100 MCQs » |
| AIIMS CRE Pharmacist Grade-II Syllabus & Pattern | View AIIMS Syllabus » |
| Master Govt Pharmacist Previous Year Papers Hub | Download All Papers Hub » |
| Central Govt Pharmacist Level-5 Salary Slip Guide | Salary Slip Breakdown » |
Frequently Asked Questions (FAQ) — AIIMS CRE Pharmacist Solved Papers:
Q1: Is AIIMS CRE Pharmacist Grade-II a central government permanent post?
Answer: Yes. Pharmacist Grade-II recruited via Common Recruitment Examination (CRE-AIIMS) is a Group ‘C’ regular permanent appointment in the 7th CPC Pay Matrix Level-5 (Basic ₹29,200 – ₹92,300) with Central Govt allowances.
Q2: What is the qualifying cut-off percentage in CRE-AIIMS CBT?
Answer: As per AIIMS examination guidelines, minimum qualifying marks are 50% for General / EWS, 45% for OBC, and 40% for SC / ST candidates in the Computer Based Test.
Q3: Can candidates from any state pharmacy council apply for AIIMS CRE?
Answer: Yes. AIIMS is an Institute of National Importance under the Ministry of Health & Family Welfare. Candidates holding live registration with ANY recognized State Pharmacy Council in India or Pharmacy Council of India (PCI) are eligible.