38.1 The antihypertensive action of calcium channel blockers is characterized by the following except:
A. Delayed onset; blood pressure starts falling after 1–2 weeks therapy
B. Lack of central side effects
C. No compromise of male sexual function
D. Safety in peripheral vascular diseases
38.2 Higher incidence of myocardial infarction and increased
mortality has been noted with the use of the following antihypertensive drug:
A. Nifedipine
B. Verapamil
C. Diltiazem
D. Lisinopril
38.3 Choose the correct statement about long acting calcium channel blocking drugs as antihypertensives:
A. They are the most effective drugs in suppressing hypertensive left ventricular hypertrophy
B. They are as effective as diuretics or β blockers in reducing cardiovascular/total mortality
C. They compromise quality of life more than β blockers
D. They have no beneficial effect in hypertensive/ diabetic nephropathy
38.4 Choose the most suitable antihypertensive drug for a 45-year-old male company executive who has a travelling job. His blood pressure is 160/100 mm Hg, and he is a diabetic controlled with glibenclamide 5 mg twice a day:
A. Propranolol
B. Enalapril
C. Clonidine
D. Hydrochlorothiazide
38.5 Persistent dry cough may occur as a side effect of the
following antihypertensive drug:
A. Enalapril
B. Atenolol
C. Diltiazem
D. Methyldopa
38.6 Loss of taste sensation can be a side effect of the
following antihypertensive drug:
A. Clonidine
B. Captopril
C. Verapamil
D. Prazosin
38.7 Shortacting nifedipine formulation is not recommended
now for treatment of hypertension because:
A. It tends to increase heart rate and cardiac work
B. It invokes pronounced reflex sympathetic discharges
C. It can impair haemodynamics in patients with diastolic dysfunction
D. All of the above
38.8 The most likely mechanism of antihypertensive action
of thiazide diuretics in the long-term is:
A. Reduction of circulating blood volume
B. Reduction in cardiac output
C. Decreased sympathetic tone
D. Reduction in total peripheral vascular resistance and improved compliance of resistance
vessels
38.9 The following is not a feature of thiazide diuretics used as antihypertensive:
A. They do not cause symptomatic postural hypotension
B. The dose has to be titrated over a wide range according to the response
C. They restore responsiveness to other antihypertensives when tolerance has developed
D. They decrease renal calcium excretion which
may improve calcium balance in elderly patients
38.10 Furosemide is to be preferred over hydrochlorothiazide
when hypertension is accompanied by:
A. Asthma
B. Hyperuricaemia
C. Diabetes
D. Congestive heart failure
38.11 Thiazide diuretics do not potentiate the antihypertensive
action of one of the following drugs:
A. Metoprolol
B. Nifedipine
C. Hydralazine
D. Captopril
38.12 As antihypertensives the thiazide diuretics have the
following advantages except:
A. High ceiling antihypertensive action
B. Absence of CNS side effects
C. Absence of tolerance development
D. Low cost
38.13 Low dose therapy with the following category of
antihypertensive drugs has been found to be more
advantageous in the long-term than high dose therapy
with the same drugs:
A. β adrenergic blockers
B. α1 adrenergic blockers
C. Central sympatholytics
D. Diuretics
38.14 Thiazide diuretics are the preferred first line antihypertensives
for the following category of patients:
A. Young hypertensives
B. Physically and sexually active male hypertensives
C. Elderly obese hypertensives
D. Diabetic hypertensives
38.15 Indapamide differs from other diuretics in that:
A. It has selective antihypertensive action at
doses which cause little diuresis
B. It is a more efficacious antihypertensive
C. Its antihypertensive action develops more
rapidly
D. All of the above
38.16 A 40-year-old politician suffered from attacks of
chest pain diagnosed as angina pectoris. He had a
tense personality, resting heart rate was 96/min,
blood pressure 170/104 mm Hg, but blood sugar level
and lipid profile were normal. Select the most suitable
antihypertensive for initial therapy in his case:
A. Nifedipine
B. Hydrochlorothiazide
C. Atenolol
D. Methyldopa
38.17 In the treatment of hypertension the beta adrenergic
blockers have the following advantage:
A. They have minimal effect on work capacity,
sleep quality and libido
B. They do not cause postural hypotension
C. Used alone, they have high ceiling antihypertensive
efficacy
D. They can be used in combination with any
other antihypertensive drug
38.18 Which of the following feature(s) limit(s) the use of
prazosin as a first line antihypertensive drug:
A. Higher incidence of disturbing side effects
B. Unfavourable metabolic effects
C. Development of tolerance when used alone
D. Both ‘A’ and ‘C’ are correct
38.19 The following antihypertensive drug has a favourable
effect on plasma lipid profile:
A. Prazosin
B. Propranolol
C. Hydrochlorothiazide
D. Furosemide
38.20 The following drug has been found to improve urine
flow in elderly males with benign prostatic hypertrophy:
A. Nifedipine
B. Prazosin
C. Disopyramide
D. Imipramine
38.21 Rapid intravenous injection of clonidine causes rise in BP due to:
A. Stimulation of vasomotor centre
B. Release of noradrenaline from adrenergic nerve endings
C. Agonistic action on vascular α2 adrenergic receptors
D. Cardiac stimulation
38.22 Rebound hypertension on sudden stoppage of medication
is most likely to occur with:
A. Hydrochlorothiazide
B. Prazosin
C. Clonidine
D. Lisinopril
38.23 The following antihypertensive drug has been found
to suppress certain manifestations of morphine
withdrawal syndrome and to block postoperative pain
when injected intrathecally:
A. Prazosin
B. Clonidine
C. Reserpine
D. Ketanserin
38.24 Methyldopa lowers BP by:
A. Inhibiting dopa decarboxylase in adrenergic
nerve endings
B. Generating α-methyl noradrenaline in brain
which reduces sympathetic tone
C. Generating α-methyl noradrenaline which
acts as a false transmitter in peripheral
adrenergic nerve endings
D. Activating vascular dopamine receptors
38.25 Methyldopa differs from clonidine in the following respect:
A. It is less likely to cause rebound hypertension
on sudden discontinuation
B. It does not reduce plasma renin activity
C. It has a central as well as peripheral site of
antihypertensive action
D. It does not produce central side effects
38.26 Used alone the following antihypertensive drug tends
to increase cardiac work and can precipitate angina:
A. Clonidine
B. Hydralazine
C. Captopril
D. Prazosin
38.27 Hydralazine is a directly acting vasodilator, but is not
used alone as an antihypertensive because:
A. By itself, it is a low efficacy antihypertensive
B. Effective doses cause marked postural hypotension
C. Tolerance to the antihypertensive action develops
early due to counterregulatory mechanisms
D. It primarily reduces systolic blood pressure
with little effect on diastolic blood pressure
38.28 Long-term hydralazine therapy is likely to cause:
A. Gynaecomastia
B. Thrombocytopenia
C. Haemolytic anaemia
D. Lupus erythematosus
38.29 The following antihypertensive is used topically to
treat alopacia areata:
A. Hydralazine
B. Prazosin
C. Minoxidil
D. Indapamide
38.30 The following vasodilator(s) act(s) by opening K+
channels in the vascular smooth muscle:
A. Dipyridamole
B. Minoxidil
C. Diazoxide
D. Both ‘B’ and ‘C’
38.31 Diazoxide is an effective hypotensive, but is not used
in the long-term treatment of hypertension because:
A. It impairs glucose tolerance by inhibiting
insulin release
B. It inhibits uric acid excretion
C. It causes marked Na+ and water retention
leading to development of tolerance
D. All of the above
38.32 Select the vasodilator that is administered only by
slow intravenous infusion and dilates both resistance
as well as capacitance vessels:
A. Minoxidil
B. Diazoxide
C. Sodium nitroprusside
D. Glyceryl trinitrate
38.33 The following antihypertensive drug tends to lower
plasma renin activity:
A. Clonidine
B. Hydralazine
C. Nifedipine
D. Captopril
38.34 Tolerance does not develop to the vasodilator action
of sodium nitroprusside while it develops to glyceryl
trinitrate because:
A. Intact sod. nitroprusside molecule acts like
nitric oxide
B. Enzymes which generate nitric oxide from
nitroprusside are different
C. Sod. nitroprusside has a long duration of action
D. Sod. nitroprusside has additional K+ channel
opening action
38.35 The principles of antihypertensive drug usage
enunciated in JNC VI and WHO-ISH guidelines include
the following except:
A. Therapy for grade I and II hypertension
should be initiated with a single drug
B. Dose of thiazide diuretic should be 12.5-25
mg hydrochlorothiazide or equivalent per day
C. All subjects with BP higher than 140/90
mmHg should be put on antihypertensive
medication immediately
D. If the drug chosen initially fails to lower BP,
it should be replaced by a drug/combination
from another class
38.36 Select the correct statement about combining antihypertensive drugs:
A. Antihypertensive combinations should
always be preferred over single drugs
B. Combinations of antihypertensives with similar
pattern of haemodynamic action are superior
to those with dissimilar pattern
C. Antihypertensives which act on different
regulatory systems maintaining blood
pressure should be combined
D. A diuretic must be included whenever antihypertensives
are combined
38.37 The following antihypertensive combination is
irrational, and therefore should not be used:
A. Nifedipine + hydralazine
B. Amlodipine + atenolol
C. Enalapril + clonidine
D. Enalapril + hydrochlorothiazide
38.38 Angiotensin converting enzyme inhibitors are contraindicated in:
A. High renin hypertensives
B. Diabetics
C. Congestive heart failure patients
D. Pregnant women
38.39 A woman in the 28th week of pregnancy has developed
pregnancy induced hypertension with a blood pressure
reading of 150/100 mm Hg. Select the most appropriate
antihypertensive drug for her:
A. Furosemide
B. Methyldopa
C. Propranolol
D. Captopril
38.40 The following procedure for rapid lowering of BP in
hypertensive urgency/emergency has been abandoned:
A. Sublingual/oral nifedipine
B. Intravenous glyceryl trinitrate infusion
C. Intravenous sodium nitroprusside infusion
D. Intravenous esmolol injection
38.41 Use of sublingual/oral nifedipine soft geletine capsule
for rapid BP lowering in hypertensive urgency has
been discarded because of:
A. Delayed onset of action
B. Inability to control the rate and extent of fall in BP
C. Reports of adverse/fatal outcome
D. Both 'B' and 'C'
38.42 A semiconscious patient of haemorrhagic cerebral
stroke has been brought to the emergency. His blood
pressure is 240/120 mmHg. Select the procedure to
lower his blood pressure as rapidly as possible:
A. Sublingual nifedipine
B. Intramuscular injection of hydralazine
C. Intravenous infusion of sodium nitroprusside
D. Intravenous injection of clonidine
Ans:
38.1 A 38.2 A 38.3 B 38.4 B 38.5 A 38.6 B 38.7 D 38.8 D 38.9 B 38.10 D 38.11 B 38.12 A 38.13 D 38.14 C 38.15 A 38.16 C 38.17 B 38.18 D 38.19 A 38.20 B 38.21 C 38.22 C 38.23 B 38.24 B 38.25 A 38.26 B 38.27 C 38.28 D 38.29 C 38.30 D 38.31 D 38.32 C 38.33 A 38.34 B 38.35 C 38.36 C 38.37 A 38.38 D 38.39 B 38.40 A 38.41 D 38.42 C
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