Q.1 Which class of drugs is primarily used to treat hypertension by inhibiting the enzyme that converts angiotensin I to angiotensin II?
ACE inhibitors
Beta-blockers
Calcium channel blockers
Diuretics
Explanation - Angiotensin-converting enzyme (ACE) inhibitors block the conversion of angiotensin I to angiotensin II, which is a vasoconstrictor. This lowers blood pressure by relaxing blood vessels.
Correct answer is: ACE inhibitors
Q.2 Which of the following is a common side effect of beta-blockers?
Hypoglycemia
Bradycardia
Hyperkalemia
Hypotension
Explanation - Beta-blockers reduce heart rate by blocking beta receptors in the heart, which can lead to bradycardia (slow heart rate).
Correct answer is: Bradycardia
Q.3 What is the primary mechanism of action of calcium channel blockers in treating cardiovascular conditions?
Blocking the entry of calcium into cardiac and smooth muscle cells
Inhibiting the conversion of angiotensin I to angiotensin II
Increasing renal sodium excretion
Increasing heart rate
Explanation - Calcium channel blockers prevent calcium ions from entering the cells, leading to relaxation of vascular smooth muscles and a reduction in heart rate.
Correct answer is: Blocking the entry of calcium into cardiac and smooth muscle cells
Q.4 Which drug is considered the first-line treatment for acute heart failure due to its ability to improve cardiac output?
Digoxin
Furosemide
Enalapril
Lisinopril
Explanation - Digoxin increases the force of heart contraction, improving cardiac output in heart failure patients.
Correct answer is: Digoxin
Q.5 Which of the following is NOT an effect of nitrates on the cardiovascular system?
Vasodilation of veins
Decreased preload
Increased afterload
Vasodilation of arteries
Explanation - Nitrates primarily cause venodilation, reducing preload. They also cause arterial dilation, but do not increase afterload.
Correct answer is: Increased afterload
Q.6 Which drug class is most commonly used to treat hyperlipidemia?
Statins
ACE inhibitors
Beta-blockers
Diuretics
Explanation - Statins are used to lower cholesterol levels by inhibiting HMG-CoA reductase, the enzyme responsible for cholesterol production in the liver.
Correct answer is: Statins
Q.7 Which of the following is a common contraindication for the use of ACE inhibitors?
Pregnancy
Hypertension
Diabetes
Asthma
Explanation - ACE inhibitors are contraindicated during pregnancy due to the risk of fetal harm, including renal and developmental issues.
Correct answer is: Pregnancy
Q.8 Which of the following drugs is commonly used as an antidote for heparin overdose?
Protamine sulfate
Vitamin K
Warfarin
Aspirin
Explanation - Protamine sulfate is used to reverse the anticoagulant effects of heparin by binding to it and neutralizing its activity.
Correct answer is: Protamine sulfate
Q.9 What is the primary action of diuretics in the treatment of hypertension?
Decrease heart rate
Increase sodium and water excretion
Dilate blood vessels
Inhibit sodium reabsorption
Explanation - Diuretics help lower blood pressure by promoting the excretion of sodium and water, which reduces blood volume and, in turn, lowers blood pressure.
Correct answer is: Increase sodium and water excretion
Q.10 Which drug is often used to treat arrhythmias by inhibiting potassium channels?
Amiodarone
Lisinopril
Verapamil
Atenolol
Explanation - Amiodarone is a class III antiarrhythmic drug that inhibits potassium channels, prolonging the action potential duration and helping to treat arrhythmias.
Correct answer is: Amiodarone
Q.11 Which of the following is a common side effect of calcium channel blockers?
Constipation
Diarrhea
Hypertension
Hypoglycemia
Explanation - Calcium channel blockers commonly cause constipation due to their relaxing effect on smooth muscles, including those in the gastrointestinal tract.
Correct answer is: Constipation
Q.12 Which of the following drugs is known for its use in preventing blood clots in patients with atrial fibrillation?
Warfarin
Aspirin
Clopidogrel
Atorvastatin
Explanation - Warfarin is an anticoagulant used to prevent blood clots in patients with atrial fibrillation, reducing the risk of stroke.
Correct answer is: Warfarin
Q.13 What is the main effect of antiplatelet drugs like aspirin?
Prevention of platelet aggregation
Vasodilation
Inhibition of thrombin
Increase in fibrinogen
Explanation - Antiplatelet drugs such as aspirin inhibit platelet aggregation, preventing clot formation and reducing the risk of heart attack or stroke.
Correct answer is: Prevention of platelet aggregation
Q.14 Which of the following is a major adverse effect of using nitrates for angina?
Hypotension
Hyperkalemia
Bradycardia
Cough
Explanation - Nitrates cause vasodilation, which can lead to a drop in blood pressure, resulting in hypotension, especially when standing.
Correct answer is: Hypotension
Q.15 Which drug class is commonly used to manage chronic heart failure by blocking the effects of the sympathetic nervous system?
Beta-blockers
Diuretics
Calcium channel blockers
Angiotensin receptor blockers
Explanation - Beta-blockers block the effects of the sympathetic nervous system on the heart, reducing heart rate and preventing excessive heart workload in chronic heart failure.
Correct answer is: Beta-blockers
Q.16 Which of the following is a primary goal of antiarrhythmic therapy?
Restoring normal heart rhythm
Increasing heart rate
Reducing blood volume
Decreasing blood pressure
Explanation - Antiarrhythmic drugs aim to restore a normal heart rhythm and prevent the occurrence of arrhythmias.
Correct answer is: Restoring normal heart rhythm
Q.17 Which class of drugs is most commonly used as the first-line therapy for hypertension?
Beta-blockers
ACE inhibitors
Calcium channel blockers
Thiazide diuretics
Explanation - Thiazide diuretics are often recommended as the first-line therapy for hypertension due to their efficacy, cost-effectiveness, and ability to reduce cardiovascular risk.
Correct answer is: Thiazide diuretics
Q.18 Which of the following is a cardioselective beta-blocker?
Propranolol
Atenolol
Carvedilol
Labetalol
Explanation - Atenolol is cardioselective, meaning it preferentially blocks β1 receptors in the heart, whereas propranolol blocks both β1 and β2.
Correct answer is: Atenolol
Q.19 Which drug inhibits the conversion of angiotensin I to angiotensin II?
Losartan
Captopril
Aliskiren
Spironolactone
Explanation - Captopril is an ACE inhibitor, which blocks the conversion of angiotensin I to the potent vasoconstrictor angiotensin II.
Correct answer is: Captopril
Q.20 What is the primary mechanism of action of nitroglycerin?
Calcium channel blockade
Beta-adrenergic blockade
Increase in nitric oxide
ACE inhibition
Explanation - Nitroglycerin releases nitric oxide, which activates guanylyl cyclase and increases cGMP, leading to vasodilation.
Correct answer is: Increase in nitric oxide
Q.21 Which of the following calcium channel blockers primarily affects the heart rather than blood vessels?
Nifedipine
Amlodipine
Verapamil
Felodipine
Explanation - Verapamil is a non-dihydropyridine calcium channel blocker that acts mainly on the myocardium to reduce heart rate and contractility.
Correct answer is: Verapamil
Q.22 Which drug is a direct renin inhibitor?
Losartan
Captopril
Aliskiren
Hydralazine
Explanation - Aliskiren directly inhibits renin, preventing the conversion of angiotensinogen to angiotensin I.
Correct answer is: Aliskiren
Q.23 Which diuretic is most effective in treating pulmonary edema due to heart failure?
Hydrochlorothiazide
Furosemide
Spironolactone
Amiloride
Explanation - Furosemide is a loop diuretic that rapidly reduces fluid overload, making it ideal for pulmonary edema.
Correct answer is: Furosemide
Q.24 What is the antidote for nitroprusside-induced cyanide toxicity?
Sodium bicarbonate
Methylene blue
Thiosulfate
Atropine
Explanation - Thiosulfate provides a sulfur donor for detoxification of cyanide generated from nitroprusside metabolism.
Correct answer is: Thiosulfate
Q.25 Which vasodilator causes reflex tachycardia most prominently?
Hydralazine
Minoxidil
Nitroglycerin
Amlodipine
Explanation - Hydralazine causes arteriolar dilation leading to reflex tachycardia due to baroreceptor activation.
Correct answer is: Hydralazine
Q.26 Which antiarrhythmic drug is classified as a Class III potassium channel blocker?
Amiodarone
Lidocaine
Propranolol
Verapamil
Explanation - Amiodarone prolongs repolarization by blocking potassium channels, classifying it as a Class III antiarrhythmic.
Correct answer is: Amiodarone
Q.27 Which of the following agents reduces mortality in chronic heart failure?
Digoxin
Furosemide
Carvedilol
Hydrochlorothiazide
Explanation - Carvedilol, a beta-blocker, improves survival in chronic heart failure, unlike diuretics or digoxin which mainly improve symptoms.
Correct answer is: Carvedilol
Q.28 Which ACE inhibitor has a sulfhydryl group and is associated with a metallic taste?
Enalapril
Captopril
Ramipril
Lisinopril
Explanation - Captopril contains a sulfhydryl group that can cause a metallic taste and skin rash.
Correct answer is: Captopril
Q.29 Which antihypertensive drug is contraindicated in pregnancy?
Methyldopa
Labetalol
ACE inhibitors
Hydralazine
Explanation - ACE inhibitors are teratogenic and contraindicated in pregnancy due to risk of fetal renal damage.
Correct answer is: ACE inhibitors
Q.30 Which potassium-sparing diuretic is also an aldosterone antagonist?
Triamterene
Amiloride
Spironolactone
Indapamide
Explanation - Spironolactone antagonizes aldosterone, reducing sodium reabsorption and potassium excretion.
Correct answer is: Spironolactone
Q.31 Which nitrate preparation is used for prophylaxis of angina?
Sublingual nitroglycerin
Isosorbide dinitrate (oral)
Amyl nitrite
Nitroprusside
Explanation - Oral isosorbide dinitrate has a longer duration of action, making it useful for angina prophylaxis.
Correct answer is: Isosorbide dinitrate (oral)
Q.32 Which antihypertensive agent acts centrally on alpha-2 receptors?
Clonidine
Prazosin
Metoprolol
Nifedipine
Explanation - Clonidine stimulates central α2 adrenergic receptors, decreasing sympathetic outflow and lowering BP.
Correct answer is: Clonidine
Q.33 Which drug causes lupus-like syndrome as an adverse effect?
Hydralazine
Propranolol
Captopril
Verapamil
Explanation - Hydralazine is known to cause a lupus-like syndrome, particularly in slow acetylators.
Correct answer is: Hydralazine
Q.34 What is the main mechanism of action of digoxin?
Beta-adrenergic blockade
Na+/K+ ATPase inhibition
ACE inhibition
Calcium channel blockade
Explanation - Digoxin inhibits Na+/K+ ATPase, increasing intracellular calcium and enhancing cardiac contractility.
Correct answer is: Na+/K+ ATPase inhibition
Q.35 Which drug is both a beta-blocker and alpha-blocker used in hypertensive emergencies?
Carvedilol
Propranolol
Labetalol
Metoprolol
Explanation - Labetalol blocks both α and β receptors, making it useful in hypertensive crises.
Correct answer is: Labetalol
Q.36 Which drug prolongs survival in patients with heart failure by antagonizing aldosterone?
Amiloride
Spironolactone
Furosemide
Hydrochlorothiazide
Explanation - Spironolactone reduces mortality in heart failure by blocking aldosterone-mediated myocardial fibrosis and sodium retention.
Correct answer is: Spironolactone
Q.37 Which drug is most likely to cause dry cough as a side effect?
Losartan
Captopril
Amlodipine
Hydralazine
Explanation - ACE inhibitors like captopril cause cough due to accumulation of bradykinin in the lungs.
Correct answer is: Captopril
Q.38 Which antiarrhythmic drug blocks fast sodium channels and is a Class IB agent?
Quinidine
Lidocaine
Amiodarone
Sotalol
Explanation - Lidocaine is a Class IB antiarrhythmic that blocks fast sodium channels, used especially in ventricular arrhythmias.
Correct answer is: Lidocaine
Q.39 Which antihypertensive is also used in benign prostatic hyperplasia (BPH)?
Metoprolol
Clonidine
Prazosin
Nifedipine
Explanation - Prazosin is an α1-blocker that relaxes smooth muscle in both blood vessels and the prostate, benefiting patients with BPH.
Correct answer is: Prazosin
Q.40 Which drug is used in hypertensive emergencies and releases nitric oxide?
Nitroglycerin
Nitroprusside
Hydralazine
Minoxidil
Explanation - Nitroprusside releases NO directly and is used intravenously for rapid blood pressure control in hypertensive emergencies.
Correct answer is: Nitroprusside
Q.41 Which calcium channel blocker is least likely to cause reflex tachycardia?
Nifedipine
Amlodipine
Verapamil
Felodipine
Explanation - Verapamil directly suppresses AV node conduction and heart rate, reducing the chance of reflex tachycardia.
Correct answer is: Verapamil