MCQs-Cardiovascular Drugs part 5 I Pharmacology KD Tripathi mcqs part 38

 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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