34.1 Under physiological conditions the rate limiting enzyme
in the generation of angiotensin II is:
A. Renin
B. Angiotensin converting enzyme
C. Aminopeptidase
D. Angiotensinase
34.2 Angiotensin II causes rise in blood pressure by:
A. Direct vasoconstriction
B. Releasing adrenaline from adrenal medulla
C. Increasing central sympathetic tone
D. All of the above
34.3 Angiotensin III is equipotent to angiotensin II in:
A. Releasing aldosterone from adrenal cortex
B. Promoting Na+ and water reabsorption by direct intrarenal action
C. Causing vasoconstriction
D. Contracting intestinal smooth muscle
34.4 The following is a pressor peptide that can be
generated both in circulation as well as locally in
certain tissues:
A. Bradykinin
B. Angiotensin
C. Kallidin
D. Plasmin
34.5 The following factors enhance renin release from the kidney except:
A. Fall in blood pressure
B. Reduction in blood volume
C. Enhanced sympathetic activity
D. Volume overload
34.6 Angiotensin II plays a key role in the following risk
factor for ischaemic heart disease:
A. Hypercholesterolemia
B. Ventricular hypertrophy
C. Carbohydrate intolerance
D. Cardiac arrhythmia
34.7 Ventricular remodeling after myocardial infarction
involves the mediation of:
A. Angiotensin II
B. Prostaglandin
C. Bradykinin
D. Thromboxane A2
34.8 Captopril pretreatment:
A. Inhibits the pressor action of angiotensin I
B. Inhibits the pressor action of angiotensin II
C. Potentiates the depressor action of bradykinin
D. Both ‘A’ and ‘C’ are correct
34.9 Captopril produces greater fall in blood pressure in:
A. Diuretic treated patients
B. Patients having low plasma renin activity
C. Sodium replete normotensive individuals
D. Untreated CHF patients
34.10 Potentiation of bradykinin appears to play a role in
the following effects of angiotensin converting
enzyme inhibitors except:
A. Fall in BP in the short term
B. Fall in BP in the long term
C. Cough in susceptible individuals
D. Angioedema in susceptible individuals
34.11 Enalapril differs from captopril in that:
A. It blocks angiotensin II receptors
B. It does not produce cough as a side effect
C. It is less liable to cause abrupt first dose hypotension
D. It has a shorter duration of action
34.12 Enalapril differs from captopril in the following features except:
A. It is dose to dose more potent
B. Its oral absorption is not affected by food in stomach
C. It acts more rapidly
D. It has longer duration of action
34.13 The following angiotensin converting enzyme inhibitor
can reduce cardiac contractility:
A. Captopril
B. Enalapril
C. Perindopril
D. Lisinopril
34.14 Advantages of angiotensin converting enzyme inhibitors
as antihypertensive include the following except:
A. They tend to reverse left ventricular hypertrophy
B. Their efficacy is not reduced by nonsteroidal antiinflammatory drugs
C. They do not worsen blood lipid profile
D. They do not impair work performance
34.15 The following drug increases cardiac output in
congestive heart failure without having any direct
myocardial action:
A. Captopril
B. Digoxin
C. Amrinone
D. Dobutamine
34.16 Angiotensin converting enzyme inhibitors reduce
the following haemodynamic parameters in congestive
heart failure except:
A. Systemic vascular resistance
B. Right atrial pressure
C. Cardiac output
D. Heart rate × pressure product
34.17 Angiotensin converting enzyme inhibitors afford
maximum protection against progression of heart
failure when used:
A. At the higher therapeutic dose range over long term
B. At the maximum tolerated dose only till haemodynamic compensation is restored
C. At low doses over long term
D. At low doses along with diuretics/digoxin
34.18 In post-myocardial infarction and other high cardiovascular
risk subjects but without hypertension or
heart failure, prolonged ACE inhibitor medication
has been found to:
A. Increase the chances of sudden cardiac death
B. Reduce the incidence of fatal as well as nonfatal myocardial infarction or stroke
C. Lower the risk of developing heart failure and diabetes
D. Both ‘B‘ and ‘C
34.19 Which of the following statements most closely
describes the current status of angiotensin converting
enzyme inhibitors in congestive heart failure:
A. They are the first choice drugs unless contraindicated
B. They are used when diuretics alone fail
C. They are a substitute for digitalis
D. They are to be used as adjuncts only in resistant cases
34.20 Long term ACE inhibitor therapy may retard the progression of:
A. Diabetic nephropathy
B. Diabetic retinopathy
C. Hypertensive nephropathy
D. All of the above
34.21 The following drug has been demonstrated to retard
progression of left ventricular dysfunction and
prolong survival of congestive heart failure patients:
A. Digoxin
B. Furosemide
C. Enalapril
D. Amrinone
34.22 Losartan is a:
A. Selective AT1 receptor antagonist
B. Selective AT2 receptor antagonist
C. Nonselective AT1 + AT2 receptor antagonist
D. AT1 receptor partial agonist
34.23 Clinically, the angiotensin antagonists share the
following features of angiotensin converting enzyme
inhibitors except:
A. Antihypertensive efficacy
B. Potential to reverse left ventricular hypertrophy
C. Lack of effect on carbohydrate tolerance
D. Potential to induce cough in susceptible
individuals
34.24 Choose the drug that selectively blocks AT1
subtype of angiotensin receptors:
A. Ramipril
B. Lovastatin
C. Candesartan
D. Sumatriptan
34.25 An elderly hypertensive was treated with hydrochlorothiazide
50 mg daily. Even after a month, his
BP was not reduced to the desired level and another
antihypertensive was added. After 2 hours of taking
the other drug his BP fell precipitously. The most
likely other drug given to him is:
A. Atenolol
B. Captopril
C. Methyldopa
D. Amlodipine
34.26 Indications of angiotensin converting enzyme inhibitors
include the following except:
A. Evolving myocardial infarction
B. Diabetic nephropathy
C. Scleroderma crisis
D. Stable angina pectoris
34.27 Losartan differs from enalapril in the following respect:
A. It does not potentiate bradykinin
B. It depresses cardiovascular reflexes
C. It impairs carbohydrate tolerance
D. It does not have fetopathic potential
34.28 Bradykinin and angiotensin II have the following
feature common to both:
A. They both cause fall in BP
B. They both are degraded by Kininase II
C. Their precursor proteins are plasma α2 globulins
D. They both release aldosterone from adrenal cortex
34.29 Select the nonapeptide which can be generated from
plasma globulin by snake venom enzymes, causes
fall in BP and intense pain when applied to blister base:
A. Kallidin
B. Bradykinin
C. Angiotensin II
D. Angiotensin III
34.30 Actions of bradykinin include the following except:
A. Fall in blood pressure
B. Cardiac depression
C. Increase in capillary permeability
D. Bronchoconstriction
34.31 The following kinin action is mediated primarily by the
kinin B1 receptor:
A. Intestinal contraction
B. Bronchoconstriction
C. EDRF release and vasodilatation
D. Production of Interleukin, TNFα and other inflammatory mediators
Ans:
34.1 A 34.2 D 34.3 A 34.4 B 34.5 D 34.6 B 34.7 A 34.8 D 34.9 A 34.10 B 34.11 C 34.12 C 34.13 D 34.14 B 34.15 A 34.16 C 34.17 A 34.18 D 34.19 A 34.20 D 34.21 C 34.22 A 34.23 D 34.24 C 34.25 B 34.26 D 34.27 A 34.28 C 34.29 B 34.30 B 34.31 D
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