front 1 A patient with hypertension is started on hydrochlorothiazide. Which transporter is directly inhibited? A) Na/K/2Cl transporter B) Na/Cl transporter C) Vesicular amine transporter D) L-type calcium channel | back 1 B. Na/Cl transporter |
front 2 Chlorthalidone lowers blood pressure by acting primarily in which nephron segment? A) Collecting tubule B) Proximal tubule C) Loop of Henle D) Distal convoluted tubule | back 2 D. Distal convoluted tubule |
front 3 Which drug pair belongs to the thiazide diuretic class? A) Hydrochlorothiazide and chlorthalidone B) Furosemide and torsemide C) Spironolactone and eplerenone D) Captopril and losartan | back 3 A. Hydrochlorothiazide and chlorthalidone |
front 4 Thiazide diuretics lower blood pressure primarily through which overall effect? A) Increased blood volume B) Increased vascular tone C) Decreased blood volume D) Increased cardiac output | back 4 C. Decreased blood volume |
front 5 A patient taking hydrochlorothiazide urinates more frequently. Which mechanism best explains the blood pressure reduction? A) Blocks alpha-1 receptors B) Releases nitric oxide C) Promotes sodium and water loss D) Opens potassium channels | back 5 C. Promotes sodium and water loss |
front 6 Which name clue helps identify hydrochlorothiazide and chlorthalidone as thiazide-type drugs? A) They contain “th” B) They end in “pril” C) They end in “olol” D) They contain “dopam” | back 6 A. They contain “th” |
front 7 Furosemide lowers blood pressure and volume by blocking which transporter? A) Na/Cl transporter B) Calcium channel C) Aldosterone receptor D) Na/K/2Cl transporter | back 7 D. Na/K/2Cl transporter |
front 8 Furosemide acts primarily in which renal region? A) Collecting tubule B) Loop of Henle C) Distal convoluted tubule D) Proximal tubule | back 8 B. Loop of Henle |
front 9 A patient taking furosemide develops hearing-related toxicity. Which adverse effect is most likely? A) Ototoxicity B) Gynecomastia C) Angioedema D) Bronchoconstriction | back 9 A. Ototoxicity |
front 10 Which listed antihypertensive is a loop diuretic? A) Chlorthalidone B) Eplerenone C) Furosemide D) Aliskiren | back 10 C. Furosemide |
front 11 Loop diuretics lower blood pressure mainly by producing which effect? A) Increased afterload B) Decreased blood volume C) Increased vascular tone D) Decreased potassium retention | back 11 B. Decreased blood volume |
front 12 A drug blocks the Na/K/2Cl transporter in the loop of Henle. Which drug matches this mechanism? A) Losartan B) Methyldopa C) Prazosin D) Furosemide | back 12 D. Furosemide |
front 13 Spironolactone and eplerenone directly block which receptor? A) Beta receptor B) Alpha-1 receptor C) D1 receptor D) Aldosterone receptor | back 13 D. Aldosterone receptor |
front 14 Aldosterone receptor blockers act primarily in which nephron region? A) Collecting tubule B) Loop of Henle C) Proximal tubule D) Distal convoluted tubule | back 14 A. Collecting tubule |
front 15 Blocking aldosterone receptors causes which electrolyte pattern? A) Sodium retention, potassium loss B) Calcium retention, sodium loss C) Sodium loss, potassium retention D) Chloride retention, calcium loss | back 15 C. Sodium loss, potassium retention |
front 16 Why does sodium loss from aldosterone blockade lower blood pressure? A) Calcium leaves cardiac cells B) Water follows sodium out C) Renin directly increases D) Bronchi relax directly | back 16 B. Water follows sodium out |
front 17 A man develops gynecomastia after starting an aldosterone blocker. Which drug is most likely responsible? A) Eplerenone B) Spironolactone C) Losartan D) Aliskiren | back 17 B. Spironolactone |
front 18 Which name clue helps identify spironolactone and eplerenone? A) They end in “one” B) They end in “pril” C) They end in “olol” D) They end in “pine” | back 18 A. They end in “one” |
front 19 Captopril lowers blood pressure by directly inhibiting which enzyme? A) Renin B) Aldosterone synthase C) Vesicular transporter D) ACE | back 19 D. ACE |
front 20 Captopril prevents which conversion in the renin-angiotensin system? A) Angiotensinogen to angiotensin I B) Angiotensin I to angiotensin II C) Aldosterone to angiotensin II D) Renin to angiotensinogen | back 20 B. Angiotensin I to angiotensin II |
front 21 Which suffix commonly identifies ACE inhibitors such as captopril? A) “pril” B) “sartan” C) “olol” D) “pine” | back 21 A. “pril” |
front 22 ACE inhibition with captopril causes which downstream change? A) Increased aldosterone signaling B) Increased angiotensin II C) Decreased angiotensin II D) Increased vasoconstriction | back 22 C. Decreased angiotensin II |
front 23 A patient with bilateral renal artery stenosis starts captopril. Which complication is most concerning? A) Bronchoconstriction B) Worsened renal function C) Ototoxicity D) Prostatic relaxation | back 23 B. Worsened renal function |
front 24 ACE inhibitors can lower GFR in renal artery stenosis by reducing which support mechanism? A) Proximal bicarbonate secretion B) Afferent arteriole dilation C) Collecting duct sodium loss D) Efferent arteriole constriction | back 24 D. Efferent arteriole constriction |
front 25 Losartan belongs to which antihypertensive drug class? A) Angiotensin receptor blocker B) ACE inhibitor C) Renin inhibitor D) Alpha-1 blocker | back 25 A. Angiotensin receptor blocker |
front 26 Which suffix commonly identifies angiotensin receptor blockers such as losartan? A) “pril” B) “sartan” C) “sin” D) “ren” | back 26 B. “sartan” |
front 27 Losartan lowers blood pressure mainly by blocking which effect? A) Dopamine-mediated vasodilation B) Aldosterone receptor blockade C) Angiotensin-mediated vasoconstriction D) Vesicular amine storage | back 27 C. Angiotensin-mediated vasoconstriction |
front 28 Compared with ACE inhibitors, ARBs are less associated with which adverse effects? A) Ototoxicity and vertigo B) Gynecomastia and impotence C) Bronchospasm and wheezing D) Cough and angioedema | back 28 D. Cough and angioedema |
front 29 A patient develops cough while taking captopril. Which related drug is less likely to cause cough? A) Losartan B) Furosemide C) Prazosin D) Clonidine | back 29 A. Losartan |
front 30 Which drug directly inhibits renin enzyme activity? A) Captopril B) Aliskiren C) Losartan D) Fenoldopam | back 30 B. Aliskiren |
front 31 Which name clue helps identify aliskiren as a renin inhibitor? A) “sin” in the name B) “pine” in the name C) “ren” in the name D) “olol” in the name | back 31 C. “ren” in the name |
front 32 Renin inhibition with aliskiren causes which downstream effect? A) Increased angiotensin II B) Increased aldosterone signaling C) Increased norepinephrine stores D) Decreased angiotensin I and II | back 32 D. Decreased angiotensin I and II |
front 33 Aliskiren most directly reduces activity in which pathway? A) Renin-angiotensin pathway B) Nitric oxide pathway C) Dopamine receptor pathway D) Calcium channel pathway | back 33 A. Renin-angiotensin pathway |
front 34 Which drug pair consists of centrally acting sympathoplegics? A) Reserpine and guanethidine B) Clonidine and methyldopa C) Prazosin and terazosin D) Verapamil and diltiazem | back 34 B. Clonidine and methyldopa |
front 35 Clonidine and methyldopa lower blood pressure by activating which receptor? A) Beta-1 receptor B) D1 receptor C) Alpha-2 receptor D) Alpha-1 receptor | back 35 C. Alpha-2 receptor |
front 36 Activation of alpha-2 adrenoceptors causes which sympathetic effect? A) Increased norepinephrine release B) Increased vasoconstriction C) Increased cardiac stimulation D) Decreased norepinephrine release | back 36 D. Decreased norepinephrine release |
front 37 How do alpha-2 agonists such as clonidine lower blood pressure? A) Reduce sympathetic output B) Increase cardiac contractility C) Increase aldosterone release D) Block calcium entry | back 37 A. Reduce sympathetic output |
front 38 A pregnant patient is treated with methyldopa for hypertension. Which receptor action explains its effect? A) Blocks alpha-1 receptors B) Activates alpha-2 receptors C) Blocks beta receptors D) Activates D1 receptors | back 38 B. Activates alpha-2 receptors |
front 39 Which drug group blocks sympathetic nerve terminals by depleting transmitter stores? A) ACE inhibitors B) Calcium channel blockers C) Sympathetic nerve terminal blockers D) Aldosterone receptor blockers | back 39 C. Sympathetic nerve terminal blockers |
front 40 Reserpine lowers blood pressure by blocking which transporter in noradrenergic nerves? A) Na/Cl transporter B) L-type calcium channel C) Na/K/2Cl transporter D) Vesicular amine transporter | back 40 D. Vesicular amine transporter |
front 41 Blocking vesicular amine transporters causes which effect in noradrenergic nerves? A) Depleted transmitter stores B) Increased norepinephrine storage C) Increased angiotensin II release D) Increased calcium entry | back 41 A. Depleted transmitter stores |
front 42 Which drug is a sympathetic nerve terminal blocker? A) Atenolol B) Guanethidine C) Diltiazem D) Eplerenone | back 42 B. Guanethidine |
front 43 Guanadrel lowers blood pressure mainly by reducing which physiologic output? A) Dopamine renal effects B) Aldosterone adrenal effects C) Cardiovascular sympathetic effects D) Parasympathetic cardiac effects | back 43 C. Cardiovascular sympathetic effects |
front 44 Which set contains sympathetic nerve terminal blockers from the notes? A) Prazosin, terazosin, doxazosin B) Captopril, losartan, aliskiren C) Verapamil, diltiazem, amlodipine D) Reserpine, guanethidine, guanadrel | back 44 D. Reserpine, guanethidine, guanadrel |
front 45 Which drug pair consists of selective alpha-1 blockers? A) Prazosin and terazosin B) Metoprolol and atenolol C) Clonidine and methyldopa D) Aliskiren and captopril | back 45 A. Prazosin and terazosin |
front 46 Which suffix clue is shared by prazosin, terazosin, and doxazosin? A) “pril” B) “sin” C) “olol” D) “sartan” | back 46 B. “sin” |
front 47 Alpha-1 blockers lower blood pressure by preventing which sympathetic effect? A) Bronchodilation B) Renin inhibition C) Vasoconstriction D) Calcium blockade | back 47 C. Vasoconstriction |
front 48 A patient with hypertension and BPH is started on prazosin. Which additional effect explains the BPH benefit? A) Blocks renal sodium reabsorption B) Inhibits angiotensin conversion C) Opens vascular potassium channels D) Relaxes prostatic smooth muscle | back 48 D. Relaxes prostatic smooth muscle |
front 49 Which adverse effect is especially important with alpha-1 blockers such as terazosin? A) Orthostatic hypotension B) Ototoxicity C) Dry cough D) Gynecomastia | back 49 A. Orthostatic hypotension |
front 50 Which drug group contains beta blockers from the notes? A) Prazosin and terazosin B) Captopril and losartan C) Clonidine and methyldopa D) Metoprolol and atenolol | back 50 D. Metoprolol and atenolol |
front 51 Which suffix commonly identifies beta blockers such as propranolol? A) “olol” B) “sartan” C) “pril” D) “pine” | back 51 A. “olol” |
front 52 Beta blockers lower blood pressure by blocking which receptor type? A) Alpha-1 receptors B) Beta receptors C) D1 receptors D) Aldosterone receptors | back 52 B. Beta receptors |
front 53 Metoprolol lowers blood pressure mainly by decreasing which cardiac variables A) Venous tone and preload B) Sodium filtration and excretion C) Heart rate and contractility D) Prostatic tone and resistance | back 53 C. Heart rate and contractility |
front 54 Which adverse effect is most concerning when giving propranolol to a patient with asthma? A) Ototoxicity B) Angioedema C) Gynecomastia D) Bronchoconstriction | back 54 D. Bronchoconstriction |
front 55 Which drug group contains calcium channel blockers from the notes? A) Verapamil and diltiazem B) Captopril and losartan C) Reserpine and guanethidine D) Spironolactone and eplerenone | back 55 A. Verapamil and diltiazem |
front 56 Calcium channel blockers used for hypertension block which channel type? A) T-type calcium channels B) L-type calcium channels C) Sodium leak channels D) Chloride ligand channels | back 56 B. L-type calcium channels |
front 57 Why are L-type calcium channels important for cardiac antihypertensive effects? A) They store norepinephrine B) They activate renin C) They support cardiac contraction D) They block sodium excretion | back 57 C. They support cardiac contraction |
front 58 Which calcium channel blockers contain the “-pine” clue? A) Verapamil and diltiazem B) Captopril and aliskiren C) Prazosin and doxazosin D) Nifedipine and amlodipine | back 58 D. Nifedipine and amlodipine |
front 59 A patient taking amlodipine has reduced blood pressure. Which mechanism best explains the effect? A) L-type calcium channel blockade B) Vesicular transporter blockade C) Aldosterone receptor blockade D) Alpha-2 receptor activation | back 59 A. L-type calcium channel blockade |
front 60 Which listed drug is a calcium channel blocker? A) Losartan B) Diltiazem C) Atenolol D) Hydralazine | back 60 B. Diltiazem |
front 61 Which listed drug is a non-dihydropyridine calcium channel blocker? A) Nifedipine B) Amlodipine C) Verapamil D) Losartan | back 61 C. Verapamil |
front 62 Hydralazine lowers blood pressure through which mechanism? A) Blocks beta receptors B) Opens potassium channels C) Blocks angiotensin receptors D) Causes nitric oxide release | back 62 D. Causes nitric oxide release |
front 63 Hydralazine affects which vessels more strongly? A) Arterioles more than veins B) Veins more than arterioles C) Capillaries more than arteries D) Venules more than arteries | back 63 A. Arterioles more than veins |
front 64 Hydralazine lowers blood pressure primarily by decreasing which hemodynamic variable? A) Plasma potassium B) Vascular resistance C) Bronchial resistance D) Renal oncotic pressure | back 64 B. Vascular resistance |
front 65 A patient receives hydralazine and develops increased heart rate. Which mechanism best explains this response? A) Direct beta stimulation B) Direct D1 activation C) Reflex tachycardia D) Direct ACE inhibition | back 65 C. Reflex tachycardia |
front 66 Which pair lowers blood pressure by opening potassium channels in vascular smooth muscle? A) Captopril and losartan B) Verapamil and diltiazem C) Prazosin and terazosin D) Minoxidil and diazoxide | back 66 D. Minoxidil and diazoxide |
front 67 Opening potassium channels in vascular smooth muscle causes which blood pressure-lowering effect? A) Vasodilation B) Vasoconstriction C) Bronchoconstriction D) Prostatic contraction | back 67 A. Vasodilation |
front 68 A patient is treated with diazoxide. Which mechanism explains its antihypertensive effect? A) Blocks ACE B) Opens potassium channels C) Blocks beta receptors D) Activates alpha-2 receptors | back 68 B. Opens potassium channels |
front 69 Which listed drug lowers blood pressure by opening vascular smooth muscle potassium channels? A) Methyldopa B) Metoprolol C) Minoxidil D) Losartan | back 69 C. Minoxidil |
front 70 Nitroprusside rapidly lowers blood pressure by releasing which mediator? A) Angiotensin II B) Norepinephrine C) Aldosterone D) Nitric oxide | back 70 D. Nitric oxide |
front 71 Which antihypertensive is described as producing powerful rapid vasodilation? A) Nitroprusside B) Chlorthalidone C) Prazosin D) Eplerenone | back 71 A. Nitroprusside |
front 72 A patient in hypertensive emergency receives nitroprusside. Which mechanism best explains the rapid BP decrease? A) Aldosterone receptor blockade B) Nitric oxide-mediated vasodilation C) Beta receptor blockade D) Renin enzyme inhibition | back 72 B. Nitric oxide-mediated vasodilation |
front 73 Which drug activates dopamine D1 receptors to lower blood pressure? A) Labetalol B) Nebivolol C) Fenoldopam D) Hydralazine | back 73 C. Fenoldopam |
front 74 Which clue helps connect fenoldopam to its receptor target? A) “pril” suggests ACE inhibition B) “sartan” suggests angiotensin blockade C) “sin” suggests alpha blockade D) “dopam” suggests dopamine | back 74 D. “dopam” suggests dopamine |
front 75 Which adverse effect is associated with fenoldopam? A) Ototoxicity B) Reflex tachycardia C) Gynecomastia D) Dry cough | back 75 B. Reflex tachycardia |
front 76 Labetalol lowers blood pressure by blocking which receptor groups? A) D1 and D2 receptors B) ACE and renin enzymes C) Aldosterone and calcium receptors D) Alpha and beta receptors | back 76 D. Alpha and beta receptors |
front 77 Labetalol lowers blood pressure through which combined effect? A) Increased diuresis and cough B) Decreased resistance and cardiac stimulation C) Decreased potassium and sodium D) Increased calcium and contractility | back 77 B. Decreased resistance and cardiac stimulation |
front 78 Which clue helps distinguish labetalol from typical “olol” beta blockers in the notes? A) “sartan” instead of “pril” B) “ren” instead of “sin” C) “alol” instead of “olol” D) “pine” instead of “one” | back 78 C. “alol” instead of “olol” |
front 79 A 32-year-old woman with hypertension wishes to become
| back 79 (B) Losartan ACE inhibitors and ARBs (choice B) have |
front 80 A patient is admitted to the emergency department with | back 80 (D) Minoxidil minoxidil, a very efficacious vasodilator, causes severe
tachycardia that must be controlled with β |
front 81 Which one of the following is characteristic of nifedipine
| back 81 (D) Decreases calcium influx into smooth muscle Nifedipine is a prototype L-type calcium channel blocker and
|
front 82 A 73-year-old man with a history of a recent change in his
| back 82 (B) Alpha1-selective receptor blockers postural hypotension is the same thing as orthostatic hypotension |
front 83 A significant number of patients started on ACE inhibitor
| back 83 (D) Incessant cough |
front 84 Which one of the following is a significant unwanted effect | back 84 (A) Constipation with verapamil Verapamil (choice A) often causes constipation, probably by blocking L-type calcium channels in the colon. |
front 85 Comparison of prazosin with atenolol shows that | back 85 (D) Both increase sympathetic outflow from the CNS by reducing blood flow |
front 86 A patient with hypertension and angina is referred for treatment.
Metoprolol and verapamil are among
the drugs considered. Both metoprolol and verapamil are associated
with | back 86 (C) Increased PR interval |
front 87 A 45-year-old man is brought to the emergency department | back 87 (C) Fenoldopam Fenoldopam, nitroprusside, and propranolol are the drugs |
front 88 Which of the following is very short acting and acts by releasing
nitric oxide? | back 88 (H) Nitroprusside |