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E2. Which of the following diuretics produce hypokalemia as a side effect? A. Hydrochlorothiazide (AQUAZIDE) B. Enalapril (VASOTEX) C. Furosemide (LASIX) D. Eplerenone (INSPRA) E. A and C, above. A7. Thiazides reduce blood pressure by: A. Increasing Na and water excretion leading to reduced blood volume B. Decreasing the secretion and effect of renin and the synthesis and effect of angiotensinII C. Reducing Na absorption from the gastrointestinal tract D. Causing vasodilation by actions on the vascular smooth muscle E. A and C, above. A12. Which of these drug classes or drugs is used in treatment of congestive heart failure because it reduces blood volume but does not have direct actions in the kidney? A. “-pril” drugs B. “Thiazide” drugs C. “Loop diuretic” drugs D. “Pore blocker” drugs E. A and C, above. A17. Which class of diuretic drugs is associated with development of hyperuricemia and gout? A. Loop diuretics B. Pore blockers C. ACE Inhibitors D. Mineralocorticoid receptor antagonists E. A and C, above. A22. Carbonic anhydrase inhibitors may be used to: A. Increase urine pH and consequently increase the rate of excretion of weak acid drugs such as aspirin B. Decrease urine pH and consequently reduce the rate of excretion of weak base drugs C. Increase urine production tenfold over normal D. Increase blood pressure by reducing urine output E. A and C, above. B27. Triamterene (DYRENIUM): A. Blocks pores in the membrane of cells of the collecting ducts and consequently prevents K movement from the lumen of the renal tubule into the cytoplasm of cells lining the tubule B. Is a potassium sparing diuretic C. Is an aldosterone receptor antagonist D. Is a cancer chemotherapeutic agent E. A and C, above. A32. Thiazide diuretics: A. Are potassium wasting diuretics B. Produce significant change of urine pH C. Are the diuretic drugs of choice in hypertensive patients with a history of gout D. Are aldosterone receptor antagonists E. A and C, above.
B37. Which of the following drug classes will counteract the physiologically appropriate activation of the renin angiotensin system when blood pressure is reduced? A. Thiazide drugs B. “-pril” drugs C. Loop diuretic drugs D. Pore blocker drugs E. None of the above. B4. Which drug affects cardiac function by blocking sodium channels but does not affect action potential duration (the Q-T interval in the electrocardiogram) or the refractory period in ventricular muscle cells? A. Verapamil (CALAN) B. Lidocaine (XYLOCAINE) C. Quinidine (QUINIDEX) D. Propranolol (INDERAL) E. None of the above. C9. Which drug affects cardiac function by blocking potassium channels and increasing action potential duration (the Q-T interval in the electrocardiogram) and refractory period in ventricular muscle cells? A. Mexiletine (MEXTIL) B. Propranolol (INDERAL) C. Amiodarone (CORDARONE) D. Diltiazem (CARDIZEM) E. None of the above. E14. In the heart, diltiazem (CARDIZEM): A. Blocks sodium channels B. Slows/delays the membrane repolarization phase of the action potential generated by heart muscle cells C. Blocks sympathetic input D. Increases the refractory period in ventricular muscle cells E. None of the above. B19. Which of the following is a class IV antiarrythmic drug? A. Procainamide (PRONESTRYL) B. Nifedipine (PROCARDIA) C. Lidocaine (XYLOCAINE) D. Propranolol (INDERAL) E. A and C, above. A24. Diltiazem (CARDIZEM) and nifedipine (PROCARDIA): A. Are used prophylactically to treat atrial fibrillation B. Are used to treat an ongoing episode of atrial fibrillation C. Should not be used to treat atrial fibrillation because they increase the incidence of formation of blood clots D. Are used exclusively to treat ventricular arrhythmias E. A and, C, above.
E14. Isosorbide dinitrate (ISORDIL): A. Acts as a source for nitric oxide B. Decreases coronary blood flow C. Is used, by sublingual administration, in treatment of an ongoing anginal episode D. Is used as an antihypertensive drug because it induces diuresis E. A and C, above. E19. Which of the following drugs is a source of nitric oxide and is a drug used in treatment of angina? A. Isosorbide nitrate (ISORDIL) B. Nifedipine (PROCARDIA) C. Nitroglycerin (NITROSTAT) D. Verapamil (CALAN) E. A and C, above. A2. The mechanism(s) by which prazosin (MINIPRESS) will bring about its antihypertensive action is: A. Reduced sympathetic influence on vascular smooth muscle B. Calcium channel blockade C. Stimulation of renin release D. Potassium channel blockade E. None of the above. C7. Which of the following antihypertensive drugs is likely to prevent reflex tachycardia resulting from a decrease of blood pressure? A. Captopril (CAPOTEN) B. Hydralazine (APRESOLINE) C. Atenolol (TENORMIN) D. Losartan (COZAAR) E. None of the above. E12. The following drugs produce a decrease of blood pressure. Which drug(s) produces this effect by actions in the heart and does not have a (direct or indirect) vasodilator effect: A. Labetalol (NORMODYNE) B. Diltiazem (CARDIZEM) C. Captopril (CAPTOTEN) D. Minoxidil (ROGAINE) E. None of the above. D17. Which of the following drugs or drug classes used to treat hypertension are contraindicated in pregnant women because they are teratogens (i.e. produce abnormalities of fetal development)? A. a 1 antagonists B. b 1 antagonists C. b 2 antagonists D. ACE inhibitors E. None of the above. C22. Which of the following antihypertensive drugs is likely to prevent both reflex tachycardia and reflex activation of the renin-angiotensin system following a decrease of blood pressure? A. Captopril (CAPOTEN) B. Hydralazine (APRESOLINE) C. Atenolol (TENORMIN) D. Losartan (COZAAR) E. None of the above.
B27. A drug initially developed for and effective to treat hypertension but actually only used therapeutically for the treatment of erectile dysfunction: A. Minoxidil (ROGAINE) B. Sildenafil (VIAGRA) C. Prazosin (MINIPRESS) D. Propranolol (INDERAL) E. A and C, above. E32. Which drug has antihypertensive effect because it is synthesized into a “false transmitter” in the brain? A. Labetalol (NORMODYNE) B. Losartan (COZAAR) C. Phentolamine (REGITINE) D. Enalapril (VASOTEC) E. Methyldopa (ALDOMET). E37. Carvedilol (COREG) is effective as an antihypertensive because it: A. Binds b 1 adrenoreceptors in the heart and thus blocks the sympathetic tone to the heart B. Reduces stores of norepinephrine and therefore reduces sympathetic tone to the heart and blood vessels C. Binds a 1 adrenoreceptors in the vasculature producing vasodilation D. Activates muscarinic cholinergic receptors in the heart and thus reduces cardiac output E. A and C, above. A1. The overall strategy in treating hypercholesteremia is to: A. Deprive the liver of sources of cholesterol required to synthesize very low density lipoprotein (VLDL) B. Reduce the plasma concentration of high density lipoprotein (HDL) C. Increase the uptake of plasma high density lipoprotein (HDL) by the liver D. Maintain the plasma concentration of high density lipoprotein (HDL) the same as the plasma concentration of low density lipoprotein (LDL) E. A and C, above. A2. In the treatment of hypercholesterolemia: A. A major objective is to reduce (synthesis/presence of) cholesterol in the liver so that synthesis of very low density lipoprotein (VLDL) is reduced B. A major objective is to increase plasma concentration of high density lipoprotein (HDL) C. A major objective is to increase the synthesis of very low density lipoprotein (VLDL) D. The primary objective is to decrease the plasma concentration of high density lipoprotein (HDL) E. A and C above. B6. Colestipol (COLESTID) is effective in the treatment of hypercholesterolemia because it: A. Inhibits HMG reductase - an enzyme important in the production of very low density lipoprotein (VLDL) B. Inhibits cholesterol (derived from the diet) from being absorbed from the gastrointestinal tract into the blood C. Inhibits re-uptake of cholesterol-containing bile acids from the gastrointestinal tract D. Inhibits synthesis of high density lipoprotein (HDL) E. A and C, above.
A5. Levonorgestrel (MIRENA, NORPLANT): A. Inhibits ovulation subsequent to actions in the pituitary gland B. Mimics estradiol C. Is an antagonist at estrogen receptors D. Has different side effects when used as a contraceptive pill than when used as a contraceptive patch E. A and C above. A9. Mifepristone (RU486): A. Is not a contraceptive but is known as a medicinal abortifacient B. Is an estrogen receptor antagonist C. Is a progesterone receptor agonist D. Prevents uterine contractions induced by progesterone E. A and C, above. D14. Raloxifene (EVISTA) is used to treat: A. Hypertension B. Type II diabetes C. Angina pectoris D. Osteoporosis E. A and C, above E20. Ethinyl estradiol: A. Is used in “daily pill” oral contraceptives in combination with a progestin B. Is currently used in “emergency, day after” PLAN B oral contraceptives C. Slows/prevents development of osteoporosis D. Has the same mechanism of action as mifepristone (MIFEPREX) E. A and C, above. D24. Mifepristone (MIFEPREX): A. Is an estrogen receptor antagonist B. Prevents uterine contractions induced by progesterone C. Inhibits ovulation D Is a progesterone receptor antagonist E. A and C above. B2. Hyperthyroidism: A. Is associated with increased TSH concentration in the plasma of individuals with deficiency of dietary iodide B. Is associated with heat intolerance C. May be associated with increased size of the thyroid gland (non toxic goiter) D. Can be treated successfully with levothyroxine (SYNTHROID) E. A and C, above. C4. Individuals with hypothyroidism are: A. Treated with radioactive iodine B. Heat intolerant C. Treated with levothyroxine (SYNTHROID) D. Treated with cortisol (CORTEF) E. A and C, above.
C6. Which of the following drugs increases T3 and T4 concentrations in the blood and is used in treating hypothyroidism: A. Radioactive iodine B. Metformin (GLUCOPHAGE) C. Levothyroxine (SYNTHROID) D. Methimazole (TAPAZOLE) E. A and C, above. A8. Propylthioruracil (PTU) A. Reduces T3 and T4 synthesis in the thyroid gland B. Is used to treat hypothyroidism C. Inhibits secretion (but not synthesis) of T3 and T4 from the thyroid gland D. Stimulates secretion of T3 and T4 from the thyroid gland E. A and C, above. E13. Oral contraceptives containing an estrogen and a progestin (directly or indirectly): A. Prevent follicle maturation in the ovaries B. Inhibit ovulation C. Decrease secretion of follicle stimulating hormone and luteinizing hormone from the pituitary gland D. Promote changes in the endometrium which do not favor implantation of the fertilized ovum E. All of the above. E4. Individuals with Type I or Juvenile-onset diabetes: A. Have chronically low plasma glucose concentration when untreated B. Can be treated successfully with oral glyburide (DIABETA) C. Are treated successfully with repaglanide (PRANDIN) D. Are treated successfully with pioglitazone (ACTOS) without any other medication E. None of the above. E18. Which class of diuretic drugs is associated with development of hyperuricemia and gout? A. Osmotic diuretics B. Pore blockers C. ACE Inhibitors D. Mineralocorticoid receptor antagonists E. None of the above. A2. In the treatment of hypercholesterolemia: A. A major objective is to reduce (synthesis/presence of) cholesterol in the liver so that synthesis of very low density lipoprotein (VLDL) is reduced B. A major objective is to increase plasma concentration of high density lipoprotein (HDL) C. A major objective is to increase the synthesis of very low density lipoprotein (VLDL) D. The primary objective is to decrease the plasma concentration of high density lipoprotein (HDL) E. A and C above. For each of the following multiple choice questions, choose the single most appropriate answer.
D. Increased cardiac work(load) E. A and C, above. B3. Individuals with hypothyroidism are: A. Treated with radioactive iodine B. Cold intolerant C. Treated with methimazole (TAPAZOLE) D. Treated with cortisol (CORTEF) E. A and C, above. E23. Progestin side effects include: A. Induction of miscarriage in pregnant women B. Increased incidence of osteoporesis in women using a daily contraceptive pill containing a progestin and an estrogen C. Increased incidence of blood clot formation and of heart attack and/or stroke D. Reduced incidence of osteoporosis in women using a daily contraceptive pill containing a progestin alone (i.e. not containing an estrogen) E. None of the above. A7. Propylthioruracil (PTU) A. Is used to treat hyperthyroidism B. Is used to treat hypothyroidism C. Inhibits secretion (but not synthesis) of T3 and T4 from the thyroid gland D. Stimulates secretion of T3 and T4 from the thyroid gland E. A and C, above. C28. K sparing diuretics reduce excretion of K in the urine. These drugs act in: A. The proximal tubule of the kidney nephrons B. The Loop of Henle of the kidney nephrons C. The collecting duct of the kidney nephrons D. The distal tubule of the kidney nephrons E. A and C, above. E13. Isosorbide dinitrate (ISORDIL): A. Increases coronary blood flow B. Acts as a source for nitrous oxide C. Is used, by sublingual administration, in treatment of an ongoing anginal episode D. Is used as an antihypertensive drug because it induces diuresis E. A and C, above.
A13. Refractory period: A. Is defined as the period of time after an action potential before another action potential can be generated B. Is a measure of the time required for an anti-hypertensive drug to have effect C. Is decreased by Class IA anti-arrhythmic drugs D. Is a measure of the time required for a diuretic drug to have effect E. A and C, above. B23. Which of the following antiarrythmic drugs will also produce vasodilation? A. Procainamide (PRONESTRYL) B. Nifedipine (PROCARDIA) C. Lidocaine (XYLOCAINE) D. Propranolol (INDERAL) E. A and C, above. A3. Hydrochlorothiazide (AQUAZIDE H) is administered to patients with heart failure, because it: A. Reduces blood volume and thus reduces work done by the heart B. Increases the refractory period in ventricular muscle C. Enhances parasympathetic influence on the heart thus workload on the heart is increased D. Increases myocardial contractility E. A and C, above. C33. Thiazide diuretics: A. Are potassium sparing diuretics B. Produce significant change of urine pH C. Should be used cautiously in hypertensive patients with a history of gout D. Are aldosterone receptor antagonists E. A and C, above. D13. Which of these drug classes or drugs is used in treatment of congestive heart failure because it reduces blood volume but does not have direct actions (on sodium and water reabsorption) in the kidney? A. “Thiazide” drugs B. “Loop diuretic” drugs C. “Pore blocker” drugs D. Atenolol (TENORMIN) E. None of the above.
C1. Diabetes mellitus and diabetes insipidus are diseases with a single common factor. This common factor is: A. A lack of or lack of effect of insulin B. A lack of or lack of effect of vasopressin C. Production of a larger than normal volume of urine D. Production of sweet tasting urine E. A and C, above. D17. Which of the following drugs or drug classes used to treat hypertension are contraindicated in pregnant women because they are teratogens (i.e. produce abnormalities of fetal development)? A. a 1 antagonists B. b 1 antagonists C. b 2 antagonists D. ACE inhibitors E. None of the above. C5. Which of the following drugs will be most useful in an individual with Type II diabetes who has developed insulin resistance? A. Insulin B. Exanetide (BYETTA) C. Metformin (GLUCOPHAGE) D. Glyburide (DIABETA) E. A and C, above. B8. Exenatide (BYETTA): A. Is effective when administered orally B. Induces insulin release from pancreatic b-cells C. Increases sensitivity of insulin receptors (to insulin) D. Activates insulin receptors E. A and C, above. B8. Which drug is a pharmacological antagonist and has antihypertensive effect through action at receptors for angiotensin II? A. Labetalol (NORMODYNE) B. Losartan (COZAAR) C. Phentolamine (REGITINE) D. Captopril (CAPOTEN) E. MethylDOPA (ALDOMET). A8. Which drug affects cardiac function by blocking potassium channels and by increasing action potential duration (the Q-T interval in the electrocardiogram) and refractory period in ventricular muscle cells? A. Amiodarone (CORDARONE) B. Mexiletine (MEXTIL) C. Diltiazem (CARDIZEM) D. Propranolol (INDERAL) E. None of the above.
B18. Which of the following drugs may be used to prevent miscarriage? A. Tamoxifen (NOLVADEX) B. Hydroxyprogesterone (DELALUTIN; MAKENA) C. Clomiphene (CLOMID) D. Mifepristone (MIFEPREX) E. A and C, above. A18. Which of the following drugs is a source of nitric oxide and is a drug used in treatment of angina? A. Isosorbide nitrate (ISORDIL) B. Nifedipine (PROCARDIA) C. Propranolol (INDERAL) D. Verapamil (CALAN) E. A and C, above. E28. Oral contraceptives that contain a progestin (but not an estrogen): A. Prevent follicle maturation in the ovaries B. Prevent ovulation C. Decrease secretion of follicle stimulating hormone and luteinizing hormone from the pituitary gland D. Promote changes in the endometrium which reduce the potential of implantation of a fertilized egg (ovum) E. All of the above. C1. Hyperthyroidism: A. Is associated with increased TSH concentration in the plasma of individuals with deficiency of dietary iodide B. Is associated with cold intolerance C. Is treated with radioactive forms of iodide D. Is associated with increased size of the thyroid gland (non toxic goiter) E. A and C, above. B33. Use of calcium channel blocking drugs such as diltiazem (CARDIZEM) or nifedipine (PROCARDIA) to treat hypertension is effective primarily because: A. Cardiac output is increased by these drugs B. Total peripheral resistance is decreased by these drugs C. Angiotensin II effects are enhanced by these drugs D These drugs induce a diuresis induced decrease of blood volume E. A and C, above. E5. Which of the following drugs decreases T3 and T4 concentrations in the blood and is used in treating hyperthyroidism: A. Radioactive iodine B. Metformin (GLUCOPHAGE) C. Methimazole (TAPAZOLE) D. Levothyroxine (SYNTHROID) E. A and C, above.
E8. “-pril” drugs reduce blood pressure by: A. Decreasing Na and water excretion leading to reduced blood volume B. Decreasing the secretion and effect of renin and the synthesis and effect of angiotensinII C. Reducing Na absorption from the gastrointestinal tract D. Causing vasodilation by direct action on the vascular smooth muscle E. None of the above. D8. In congestive heart failure, the prime objective of drug therapy is: A. To reduce blood volume B. To address the imbalance of oxygen use by the heart (muscle) and of oxygen supply to the heart (muscle) C. To increase work done by (and oxygen use of) the heart muscle D. To improve the ability of the heart to supply sufficient blood (and oxygen) to all organs and tissues of the body E. To reduce sympathetic input to the heart. B12. Metformin (GLUCOPHAGE): A. Causes release of insulin from the pancreas B. Decreases glucose absorption from the gastrointestinal tract and reduces glucose release into the blood from the liver C. Activates insulin receptors D. Increases the affinity of insulin for its receptors E. A and C, above.
