front 1 Which broad pathway is central to the drugs in the nitric oxide chapter? A) Histamine release B) NO/cGMP signaling C) Beta receptor blockade D) Folate pathway blockade | back 1 B. NO/cGMP signaling |
front 2 The big-picture effect of increased NO/cGMP signaling is which change? A) Smooth muscle contraction B) Sodium retention C) Increased platelet production D) Smooth muscle relaxation | back 2 D. Smooth muscle relaxation |
front 3 Why does smooth muscle relaxation from NO/cGMP lower vascular pressure? A) Vessels dilate B) Vessels constrict C) Blood volume increases D) Heart rate rises | back 3 A. Vessels dilate |
front 4 Inhaled nitric oxide gas directly activates which enzyme? A) PDE-5 B) ACE C) Soluble guanylyl cyclase D) HMG-CoA reductase | back 4 C. Soluble guanylyl cyclase |
front 5 Activation of soluble guanylyl cyclase increases which second messenger? A) cAMP B) cGMP C) IP3 D) DAG | back 5 B. cGMP |
front 6 Inhaled nitric oxide mostly works in which vascular bed? A) Systemic veins B) Coronary arteries C) Renal arterioles D) Pulmonary vessels | back 6 D. Pulmonary vessels |
front 7 Inhaled nitric oxide lowers which pressure most directly? A) Portal pressure B) Intracranial pressure C) Pulmonary pressure D) Glomerular pressure | back 7 C. Pulmonary pressure |
front 8 Which clinical use matches inhaled nitric oxide? A) Hyperlipidemia B) Pulmonary hypertension C) Acute UTI D) Chronic constipation | back 8 B. Pulmonary hypertension |
front 9 Inhaled nitric oxide can be used in which respiratory condition? A) Hypoxic respiratory failure B) Stable angina only C) Soft tissue infection D) Benign prostatic hyperplasia | back 9 A. Hypoxic respiratory failure |
front 10 Which side effect is specifically listed for inhaled nitric oxide? A) Tendon rupture B) Bone marrow suppression C) Liver dysfunction D) Methemoglobinemia | back 10 D. Methemoglobinemia |
front 11 A patient receives inhaled NO for pulmonary hypertension. Which mediator increases downstream? A) cGMP B) cAMP C) Folate D) LDL receptors | back 11 A. cGMP |
front 12 Which drug form is nitric oxide itself in this chapter? A) Oral nitrate tablet B) Inhaled NO gas C) Transdermal statin D) IV beta blocker | back 12 B. Inhaled NO gas |
front 13 Organic nitrates become what molecule in the body? A) Angiotensin II B) Dopamine C) Nitric oxide D) Acetylcholine | back 13 C. Nitric oxide |
front 14 Which drugs are organic nitrates in these notes? A) Sildenafil and riociguat B) Nitroglycerin and isosorbide mononitrate C) Vericiguat and inhaled NO D) Aliskiren and losartan | back 14 B. Nitroglycerin and isosorbide mononitrate |
front 15 Organic nitrates increase which second messenger? A) cGMP B) cAMP C) IP3 D) DAG | back 15 A. cGMP |
front 16 Organic nitrates especially dilate which blood vessels? A) Arterioles B) Capillaries C) Pulmonary arteries only D) Veins | back 16 D. Veins |
front 17 Venodilation from nitrates decreases which variable? A) LDL B) Preload C) Folate D) Potassium | back 17 B. Preload |
front 18 Decreased preload from nitrates causes which cardiac effect? A) More heart work B) More afterload C) Less heart work D) More pulmonary edema | back 18 C. Less heart work |
front 19 Which clinical use matches organic nitrates? A) Angina B) Toxoplasmosis C) Hyperkalemia D) Osteomyelitis | back 19 A. Angina |
front 20 A patient with angina takes nitroglycerin. Which mechanism explains the benefit? A) Blocks folate synthesis B) Increases cGMP-mediated vasodilation C) Inhibits DNA gyrase D) Activates PPAR-alpha | back 20 B. Increases cGMP-mediated vasodilation |
front 21 Which organic nitrate is listed in the notes? A) Riociguat B) Sildenafil C) Isosorbide mononitrate D) Vericiguat | back 21 C. Isosorbide mononitrate |
front 22 Which organic nitrate is commonly used for angina? A) Nitroglycerin B) Metoprolol C) Ezetimibe D) Aliskiren | back 22 A. Nitroglycerin |
front 23 Which side effect is a main concern for nitric oxide vasodilator drugs overall? A) Hypertension B) Hypotension C) Hyperlipidemia D) Hyperglycemia | back 23 B. Hypotension |
front 24 Sildenafil belongs to which nitric oxide-related drug class? A) Organic nitrate B) PDE-5 inhibitor C) Soluble cyclase activator D) Inhaled gas | back 24 B. PDE-5 inhibitor |
front 25 Sildenafil directly blocks which enzyme? A) PDE-5 B) ACE C) Renin D) PCSK9 | back 25 A. PDE-5 |
front 26 PDE-5 normally breaks down which second messenger? A) cAMP B) IP3 C) cGMP D) DAG | back 26 C. cGMP |
front 27 Blocking PDE-5 causes cGMP to do what? A) Disappear faster B) Convert to folate C) Leave the intestine D) Stay longer | back 27 D. Stay longer |
front 28 When cGMP stays longer after sildenafil, what increases? A) Smooth muscle contraction B) Smooth muscle relaxation C) LDL receptor degradation D) Bacterial DNA copying | back 28 B. Smooth muscle relaxation |
front 29 Sildenafil causes vasodilation because it increases persistence of which mediator? A) cGMP B) VLDL C) Folate D) Angiotensin II | back 29 A. cGMP |
front 30 Which clinical use matches sildenafil? A) Osteomyelitis B) Erectile dysfunction C) Torsades de pointes D) Lower UTI | back 30 B. Erectile dysfunction |
front 31 Sildenafil is also used for which vascular condition? A) Pulmonary hypertension B) Hypertriglyceridemia C) Atrial fibrillation D) Soft tissue infection | back 31 A. Pulmonary hypertension |
front 32 Which side effect is a main concern with sildenafil’s vasodilating action? A) Ototoxicity B) Myopathy C) Hypotension D) Lupus-like syndrome | back 32 C. Hypotension |
front 33 Riociguat and vericiguat belong to which class? A) PDE-5 inhibitors B) Organic nitrates C) Soluble guanylyl cyclase activators D) Inhaled gases | back 33 C. Soluble guanylyl cyclase activators |
front 34 Which memory clue helps identify riociguat and vericiguat? A) “guat” B) “flozin” C) “AD SID” D) “three Cs” | back 34 A) “guat” |
front 35 Riociguat and vericiguat directly activate which enzyme? A) PDE-5 B) Soluble guanylyl cyclase C) HMG-CoA reductase D) DNA gyrase | back 35 B. Soluble guanylyl cyclase |
front 36 Direct soluble guanylyl cyclase activation increases which molecule? A) cAMP B) IP3 C) DAG D) cGMP | back 36 D. cGMP |
front 37 More guanylyl cyclase activity causes which downstream effect? A) Smooth muscle relaxation B) Smooth muscle contraction C) LDL receptor breakdown D) Folate depletion | back 37 A. Smooth muscle relaxation |
front 38 Riociguat and vericiguat cause vasodilation by increasing which pathway? A) Folate synthesis B) NO/cGMP signaling C) LDL receptor degradation D) Sodium-glucose reabsorption | back 38 B. NO/cGMP signaling |
front 39 Which clinical use matches soluble guanylyl cyclase activators A) Pulmonary hypertension B) Acute UTI C) Toxoplasmosis D) High LDL | back 39 A. Pulmonary hypertension |
front 40 Vericiguat is listed for which clinical condition? A) Anthrax B) Heart failure C) Osteomyelitis D) Arrhythmia only | back 40 B. Heart failure |
front 41 A patient receives riociguat for pulmonary hypertension. Which mechanism best explains its effect? A) Blocks PDE-5 B) Directly activates soluble guanylyl cyclase C) Becomes NO in veins D) Blocks cholesterol absorption | back 41 B. Directly activates soluble guanylyl cyclase |
front 42 Which side effect is a main concern with riociguat and vericiguat? A) Tendon rupture B) Hyperkalemia C) Constipation D) Hypotension | back 42 D. Hypotension |
front 43 Which drug becomes nitric oxide in the body to increase cGMP? A) Nitroglycerin B) Sildenafil C) Riociguat D) Vericiguat | back 43 A. Nitroglycerin |
front 44 Which drug prevents cGMP breakdown rather than making or activating it? A) Vericiguat B) Sildenafil C) Nitroglycerin D) Inhaled NO | back 44 B. Sildenafil |
front 45 Which drug directly activates soluble guanylyl cyclase rather than blocking PDE-5? A) Isosorbide mononitrate B) Nitroglycerin C) Vericiguat D) Sildenafil | back 45 C. Vericiguat |
front 46 Nitrogen dioxide formed from inhaled nitric oxide is harmful because it acts as what? A) Renal toxin B) Liver toxin C) Pulmonary irritant D) Bone marrow toxin | back 46 C. Pulmonary irritant |
front 47 Which side effect set best matches inhaled nitric oxide gas from the table? A) Constipation and bloating B) Myopathy and liver dysfunction C) Rash and hyperkalemia D) Hypotension, methemoglobinemia, nitrogen dioxide | back 47 D. Hypotension, methemoglobinemia, nitrogen dioxide |
front 48 Which endogenous substances are listed as nitric oxide synthase activators? A) Acetylcholine and histamine B) Nitroglycerin and nitroprusside C) Riociguat and vericiguat D) Sildenafil and tadalafil | back 48 A. Acetylcholine and histamine |
front 49 Nitric oxide synthase activators increase which signaling molecule first in the pathway? A) cGMP B) cAMP C) IP3 D) DAG | back 49 C. IP3 |
front 50 In NOS activator signaling, increased IP3 causes an increase in which intracellular ion? A) Sodium B) Calcium C) Potassium D) Chloride | back 50 B. Calcium |
front 51 Increased intracellular calcium activates which enzyme? A) Nitric oxide synthase B) HMG-CoA reductase C) DNA gyrase D) PDE-5 | back 51 A. Nitric oxide synthase |
front 52 Activated nitric oxide synthase converts arginine into which products? A) Citrulline plus NO B) Ornithine plus urea C) Glutamate plus ammonia D) Angiotensin plus aldosterone | back 52 A. Citrulline plus NO |
front 53 Which sequence best describes NOS activator signaling? A) cGMP → PDE-5 → calcium B) IP3 → calcium → NOS activation C) LDL receptors → PCSK9 blockade D) Folate blockade → DNA failure | back 53 B. IP3 → calcium → NOS activation |
front 54 Acetylcholine and histamine increase NO production by activating which enzyme pathway? A) Soluble guanylyl cyclase directly B) Nitric oxide synthase pathway C) PDE-5 degradation pathway D) HMG-CoA reductase pathway | back 54 B. Nitric oxide synthase pathway |
front 55 Which class includes nitroglycerin, other nitrates, and nitroprusside? A) Nitric oxide donors B) NOS activators C) PDE-5 inhibitors D) PCSK9 inhibitors | back 55 A. Nitric oxide donors |
front 56 Nitric oxide donors increase cGMP by doing what? A) Blocking cGMP breakdown only B) Activating beta receptors C) Releasing nitric oxide D) Blocking calcium channels | back 56 C. Releasing nitric oxide |
front 57 Nitrates release nitric oxide primarily in which tissue? A) Blood only B) Smooth muscle C) Bone marrow D) Kidney glomerulus | back 57 B. Smooth muscle |
front 58 Nitroprusside releases nitric oxide primarily in which location according to the table? A) Blood B) Intestine C) Liver D) Prostate | back 58 A. Blood |
front 59 Nitroglycerin causes smooth muscle relaxation by increasing synthesis of which second messenger? A) cAMP B) IP3 C) DAG D) cGMP | back 59 D. cGMP |
front 60 Nitroprusside causes vasodilation through which broad mechanism? A) NO release and cGMP increase B) Folate pathway blockade C) LDL receptor preservation D) Beta receptor blockade | back 60 A. NO release and cGMP increase |
front 61 Which pairing is correct based on the table? A) Acetylcholine—NO donor B) Nitroglycerin—NO donor C) Sildenafil—NOS activator D) Riociguat—organic nitrate | back 61 B. Nitroglycerin—NO donor |
front 62 Which pairing is correct based on the table? A) Histamine—NOS activator B) Nitroprusside—PDE-5 inhibitor C) Inhaled NO—bile acid binder D) Nitroglycerin—folate antagonist | back 62 A. Histamine—NOS activator |
front 63 Which pairing is correct based on the table? A) Nitroprusside—NO donor B) Acetylcholine—organic nitrate C) Histamine—PDE-5 inhibitor D) Inhaled NO—PCSK9 inhibitor | back 63 A. Nitroprusside—NO donor |
front 64 Which pathway directly explains smooth muscle relaxation from nitric oxide donors? A) Less VLDL secretion B) Increased cGMP synthesis C) Increased folate blockade D) Less LDL receptor breakdown | back 64 B. Increased cGMP synthesis |
front 65 What does cGMP stand for? A) Cyclic guanosine monophosphate B) Calcium-gated membrane protein C) Cytosolic glucose metabolism pathway D) Cyclic glycerol messenger phosphate | back 65 A. Cyclic guanosine monophosphate |
front 66 Which of the following is an endogenous inhibitor/inactivator
| back 66 Heme and hemoglobin inactivate NO. The answer is D. |
front 67 Which of the following is a recognized effect of nitric oxide
| back 67 (E) Pulmonary vasodilation |
front 68 The primary endogenous substrate for the enzyme nitric | back 68 (C) Arginine |
front 69 The inducible isoform of nitric oxide synthase (iNOS, | back 69 The inducible form of NOS is associated with inflammation, |
front 70 Which one of the following is not a nitric oxide donor but
| back 70 (A) Acetylcholine |