37.1 The following drug is used to reduce the frequency of
angina pectoris as well as to terminate an acute attack:
A. Isosorbide dinitrate
B. Pentaerythritol tetranitrate
C. Diltiazem
D. Dipyridamole
37.2 Antianginal drugs afford the following benefit/benefits:
A. Terminate anginal attacks
B. Decrease the frequency of anginal attacks
C. Retard the progression of coronary artery disease
D. Both ‘A’ and ‘B’ are correct
37.3 Choose the correct statement about the action of
nitrates on coronary vessels:
A. They mitigate angina pectoris by increasing total coronary flow
B. They preferentially dilate conducting arteries
without affecting resistance arterioles
C. They preferentially dilate autoregulatory
arterioles without affecting the larger arteries
D. They increase subepicardial blood flow without
affecting subendocardial blood flow
37.4 Organic nitrates have predominantly venodilator action because:
A. They are selectively concentrated in veins
B. Veins express larger quantities of enzymes
that generate nitric oxide from nitrates
C. Venous smooth muscle has greater capacity to relax
D. All of the above are correct
37.5 Organic nitrates relax vascular smooth muscle by:
A. Increasing intracellular cyclic GMP
B. Increasing intracellular cyclic AMP
C. Decreasing intracellular cyclic AMP
D. Both ‘A’ and ‘C’ are correct
37.6 Blood flow in the following vascular bed generally
decreases under the influence of glyceryl trinitrate:
A. Coronary
B. Cutaneous
C. Renal
D. Cranial
37.7 Select the organic nitrate which undergoes minimal
first-pass metabolism in the liver:
A. Glyceryl trinitrate
B. Isosorbide dinitrate
C. Isosorbide mononitrate
D. Erythrityl tetranitrate
37.8 The primary mechanism of beneficial effect of glyceryl
trinitrate in classical angina pectoris is:
A. Increase in total coronary blood flow
B. Redistribution of coronary blood flow
C. Reduction of cardiac preload
D. Reduction of cardiac afterload
37.9 Nitrate tolerance is least likely to develop with the use of:
A. Sustained release oral glyceryl trinitrate
B. Sublingual glyceryl trinitrate
C. Transdermal glyceryl trinitrate
D. Oral pentaerythritol tetranitrate
37.10 Glyceryl trinitrate is administered by the following routes except:
A. Oral
B. Sublingual
C. Intramuscular
D. Intravenous
37.11 Select the drug which can markedly potentiate the
vasodilator action of organic nitrates:
A. Propranolol
B. Fluoxetine
C. Hydrochlorothiazide
D. Sildenafil
37.12 A patient of acute myocardial infarction being treated
in intensive care unit developed left ventricular failure
with raised central venous pressure. It was decided to
use glyceryl trinitrate. Which route/method of administration
would be most suitable:
A. Sublingual
B. Oral
C. Intravenous bolus injection
D. Slow intravenous infusion
37.13 A patient suffers from episodic pain diffusely localized
over the chest and upper abdomen, which is relieved
by sublingual glyceryl trinitrate. He could be suffering
from:
A. Angina pectoris
B. Biliary colic
C. Esophageal spasm
D. Any of the above
37.14 Started within 4-6 hours of acute myocardial infarction,
which of the following drug(s) can reduce the
area of necrosis and the attendant mortality:
A. Propranolol
B. Glyceryl trinitrate
C. Lignocaine
D. Both ‘A’ and ‘B’ are correct
37.15 The dihydropyridines block the following type of
calcium channels:
A. L-type voltage sensitive channels
B. T-type voltage sensitive channels
C. N-type voltage sensitive channels
D. Receptor operated calcium channels
37.16 The antidotal effect of sodium nitrite in cyanide
poisoning is dependent upon:
A. Chemical combination of sodium nitrite with
cyanide
B. Vasodilatation caused by sodium nitrite
C. Conversion of haemoglobin to methaemoglobin
by sodium nitrite
D. Facilitation of cyanocobalamine formation
by sodium nitrite
37.17 Which of the following drugs is most likely to accentuate
varient (Prinzmetal) angina:
A. Propranolol
B. Atenolol
C. Verapamil
D. Dipyridamole
37.18 The characteristic feature(s) of dihydropyridine calcium
channel blockers is/are:
A. They have minimal negative inotropic action
on the heart
B. They have no effect on A-V conduction
C. They do not affect the activation-inactivation
kinetics of the calcium channels
D. All of the above
37.19 Frequency dependent cardiac calcium channel
blockade is exhibited by:
A. Verapamil
B. Nifedipine
C. Felodipine
D. Amlodipine
37.20 The following calcium channel blocker is specifically
indicated to counteract cerebral vasospasm and
neurological sequelae following subarachnoid
haemorrhage:
A. Lacidipine
B. Nimodipine
C. Nicardipine
D. Nitrendipine
37.21 The following calcium channel blocker should not be
used in patients with ischaemic heart disease:
A. Verapamil sustained release tablet
B. Amlodipine tablet
C. Nifedipine soft geletin capsule
D. Nifedipine extended release tablet
37.22 The following antianginal drug is most likely to produce
tachycardia as a side effect:
A. Amlodipine
B. Nifedipine
C. Diltiazem
D. Verapamil
37.23 The cardiac response to verapamil and nifedipine in
human subjects is:
A. Verapamil causes tachycardia while nifedipine
causes bradycardia
B. Both cause bradycardia
C. Verapamil causes bradycardia while nifedipine
causes tachycardia
D. Both cause tachycardia
37.24 The following is true of nifedipine except:
A. It can aggravate urine voiding difficulty in elderly males with prostatic hypertrophy
B. It promotes Na+ retention by a renal tubular action to cause ankle oedema as side effect
C. It can inhibit insulin release from pancreas
D. At high doses it can paradoxically increase the frequency of angina pectoris
37.25 Which of the following is not an attribute of amlodipine:
A. Generation of an active metabolite
B. Large volume of distribution
C. High and consistent oral bioavailability
D. Long elimination half life
37.26 Propranolol should not be prescribed for a patient of
angina pectoris who is already receiving:
A. Nifedipine
B. Felodipine
C. Verapamil
D. Isosorbide mononitrate
37.27 The short acting dihydropyridine preparations can
aggravate myocardial ischaemia by invoking:
A. Coronary vasospasm
B. Thrombus formation
C. Vagal activation
D. Reflex sympathetic discharge to the heart
37.28 Which of the following drugs is a potassium channel opener:
A. Nicorandil
B. Hydralazine
C. Glibenclamide
D. Amiloride
37.29 Though nitrates and calcium channel blockers are
both vasodilators, they are used concurrently in angina
pectoris, because:
A. They antagonise each other’s side effects
B. Nitrates primarily reduce preload while calcium channel blockers primarily reduce
after-load
C. Nitrates increase coronary flow while calcium
channel blockers reduce cardiac work
D. Both ‘B’ and ‘C’ are correct
37.30 Select the drug which is a potassium channel opener
as well as nitric oxide donor:
A. Diazoxide
B. Sodium nitroprusside
C. Minoxidil
D. Nicorandil
37.31 Select the drug that may improve myocardial
tolerance to ischaemia and reduce anginal attacks
without altering heart rate, blood pressure or
myocardial O2 consumption:
A. Trimetazidine
B. Nicorandil
C. Dipyridamole
D. Nicotinic acid
37.32 Choose the correct statement about trimetazidine:
A. It is a novel calcium channel blocker
B. It improves tissue perfusion by modifying rheological property of blood
C. It is an antianginal drug which acts by nonhaemodynamic mechanisms
D. Both 'A' and 'B' are correct
37.33 A drug which preferentially dilates autoregulatory
coronary arterioles with little effect on large conducting
vessels is likely to:
A. Evoke coronary steal phenomenon
B. Mitigate classical angina but not variant angina
C. Decrease total coronary blood flow in healthy subjects
D. Avert ECG changes of ischaemia
37.34 ‘Coronary steal phenomenon’ has been noted most
frequently with:
A. Glyceryl trinitrate
B. Dipyridamole
C. Propranolol
D. Diltiazem
37.35 The following drug is believed to improve
microcirculation in peripheral vascular diseases by
promoting RBC flexibility:
A. Cyclandelate
B. Theophylline
C. Pentoxiphylline
D. Nicotinic acid
Ans:
37.1 A 37.2 D 37.3 B 37.4 B 37.5 A 37.6 C 37.7 C 37.8 C 37.9 B 37.10 C 37.11 D 37.12 D 37.13 D 37.14 D 37.15 A 37.16 C 37.17 A 37.18 D 37.19 A 37.20 B 37.21 C 37.22 B 37.23 C 37.24 B 37.25 A 37.26 C 37.27 D 37.28 A 37.29 B 37.30 D 37.31 A 37.32 C 37.33 A 37.34 B 37.35 C