These questions from the UMKC School of Medicine have a different degree of difficulty, but are useful to review pharmacology of hypertension.
Antihypertensives
Item Number: 11201 correct answer: 4 category: Antihypertensives
1. Gynecomastia, hyperkalemia, and menstrual abnormalities are potential adverse
effects associated with:
A. amiloride
B. captopril
C. triamterene
D. spironolactone
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11218 correct answer: 2 category: Antihypertensives
2. Diuretics which may result in hyperkalemia when used in a patient also
receiving potassium supplementation include:
A. amiloride
B. mannitol
C. triamterene
D. bumetanide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11220 correct answer: 1 category: Antihypertensives
3. Metabolic alkalosis may be a complication of the administration of:
A. hydrochlorothiazide
B. bumetanide
C. furosemide
D. acetazolamide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11244 correct answer: 2 category: Antihypertensives
4. Beta blockers which are relatively cardioselective include:
A. metoprolol
B. pindolol
C. atenolol
D. timolol
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11288 correct answer: 2 category: Antihypertensives
5. Reflex tachycardia is not likely to occur during therapy with:
A. clonidine
B. diazoxide
C. reserpine
D. minoxidil
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11308 correct answer: 3 category: Antihypertensives
6. Beta blockers which may be less likely to produce CNS-related adverse effects
include
A. metoprolol
B. nadolol
C. timolol
D. atenolol
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11316 correct answer: 4 category: Antihypertensives
7. Guanadrel is pharmacologically similar to:
A. clonidine
B. guanabenz
C. methyldopa
D. guanethidine
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11335 correct answer: 1 category: Antihypertensives
8. Adverse effects associated with guanethidine include:
A. orthostatic hypotension
B. enhanced sensitivity to sympathomimetics
C. diarrhea
D. sedation
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11340 correct answer: 2 category: Antihypertensives
9. Adverse effects associated with hydralazine include:
A. reflex tachycardia
B. hypertrichosis
C. lupus syndrome
D. orthostatic hypotension
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11341 correct answer: 2 category: Antihypertensives
10. Risk factors associated with increased risk of toxicity during captopril
therapy include:
A. bilateral renal artery stenosis
B. congestive heart failure
C. systemic lupus erythematosus
D. female gender
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 684 correct answer: 4 category: Antihypertensives
11. Diazoxide, a drug used for treatment of hypertensive crises, is most closely
related to:
1. nitrofuran
2. sulfonamides
3. dopamine antagonists
4. thiazide diuretics
5. nitrates
Item Number: 807 correct answer: 2 category: Antihypertensives
12. Which of the following drugs is(are) known to induce hyperuricemia and
occasionally to bring about an acute gouty attack?
1. salicylates (6 grams per day)
2. chlorothiazide
3. phenytoin
4. spironolactone
5. All of the above
Item Number: 1186 correct answer: 4 category: Antihypertensives
13. Undesirable side effects of reserpine include:
1. bradycardia
2. postural hypotension
3. diarrhea
4. All of the above
5. None of the above
Item Number: 1858 correct answer: 3 category: Antihypertensives
14. Propranolol may cause all of the following EXCEPT:
1. bradycardia
2. bronchiolar constriction
3. hyperglycemia
4. reduced myocardial contractility
5. prevention of the dilation of vessels caused by circulating epinephrine
Item Number: 2883 correct answer: 5 category: Antihypertensives
15. Alpha methyldopa has been used successfully in the control of hypertension.
Side effects include all of the following, EXCEPT:
1. positive direct Coomb’s test
2. diarrhea
3. hemolytic anemia
4. fever
5. nephrotic syndrome
Item Number: 3538 correct answer: 3 category: Antihypertensives
16. A 48-year old salesman with known hypertension complains of a decreasing
annual income, a loss of "drive", and a depressed outlook on life. His blood
pressure is normal on medication. The antihypertensive drug most likely to be
the cause of his new complaints is:
1. hydralazine
2. alpha methyldopa
3. reserpine
4. hydrochlorothiazide
5. guanethidine
Item Number: 6258 correct answer: 1 category: Antihypertensives
17. Side effects of medications are often responsible for a patient not complying
with the prescribed drug regimen. An agent which has somnolence as a primary
side effect is:
1. methyldopa
2. hydralazine
3. guanethidine
4. 1,2
5. 1,3
Item Number: 6259 correct answer: 4 category: Antihypertensives
18. One of the mechanisms for ‘resistance" to an antihypertensive drug regimen is
a retention of salt and water and an increase in extracellular fluid volume.
Agents which have been shown to cause retention of salt and water include:
1. methyldopa
2. clonidine
3. guanethidine
4. All of the above
5. 1,2
Item Number: 6273 correct answer: 4 category: Antihypertensives
19. Clonidine hydrochloride lowers blood pressure by reducing sympathetic tone.
It is believed to act by inhibiting sympathetic outflow from the vasomotor
center in the medulla. A potentially serious adverse reaction that has been
reported is:
1. ventricular fibrillation
2. anaphylaxis
3. irreversible nephrotoxicity
4. withdrawal syndrome resembling hypertensive crisis
5. systemic lupus erythematosus
Item Number: 6274 correct answer: 4 category: Antihypertensives
20. Propranolol produces most of its important effects by antagonizing the beta
adrenergic effects of catecholamines released by sympathetic nerve stimulation
or from the adrenal medulla. It therefore results in all of the following
EXCEPT:
1. negative inotropic effect on the heart
2. bronchoconstriction
3. lowering plasma renin activity
4. hyperglycemia
5. negative chronotropic effect on the heart
Item Number: 7929 correct answer: 3 category: Antihypertensives
21. The antihypertensive agent most likely to increase cardiac output is:
1. chlorothiazide
2. reserpine
3. hydralazine
4. alpha-methyldopa
5. guanethidine
Item Number: 8117 correct answer: 1 category: Antihypertensives
22. An agent which produces its antihypertensive effect by blocking autonomic
ganglia, thus lowering the sympathetic tone of blood vessels, is:
1. trimethaphan
2. diazoxide
3. phenoxybenzamine
4. reserpine
5. alpha-methyldopa
Item Number: 8236 correct answer: 1 category: Antihypertensives
23. The most useful drugs in the long-term treatment of essential hypertension
are:
1. thiazide diuretics
2. osmotic diuretics
3. mercurial diuretics
4. carbonic anhydrase inhibitors
5. xanthine diuretics
Item Number: 8321 correct answer: 5 category: Antihypertensives
24. Antihypertensive agents that act primarily at arterioles include:
1. hydralazine
2. minoxidil
3. diazoxide
4. nitroglycerin
5. 1,2,3
Item Number: 8332 correct answer: 1 category: Antihypertensives
25. Antihypertensive agents have different modes of action. The expected
onset of action of IV nitroprusside is:
1. seconds
2. several minutes
3. 15 to 30 minutes
4. several hours
5. 12 to 24 hours
Item Number: 8354 correct answer: 4 category: Antihypertensives
26. Antihypertensive agents must be used with caution. The medical condition for
which methyldopa is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. mental depression
4. liver disease
5. asthma
Item Number: 8364 correct answer: 2 category: Antihypertensives
27. Antihypertensive agents must be used with caution. The medical condition for
which hydralazine is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. mental depression
4. liver disease
5. asthma
Item Number: 8375 correct answer: 3 category: Antihypertensives
28. Antihypertensive agents must be used with caution. The medical condition for
which reserpine is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. mental depression
4. liver disease
5. asthma
Item Number: 9618 correct answer: 5 category: Antihypertensives
29. Reduced tissue levels of norepinephrine may result from long-term treatment
with:
1. guanethidine
2. reserpine
3. alpha-methyl-tyrosine
4. All of the above
5. 1,2
Item Number: 11387 correct answer: 1 category: Antihypertensives
30. Propranolol is a potent blocker of beta-adrenergic sympathetic activity. It
has been found to be detrimental, however, in patients with:
1. bronchial asthma
2. hypertension
3. hyperthyroidism
4. atrial fibrillation
5. ventricular arrhythmias
Item Number: 13199 correct answer: 4 category: Antihypertensives
31. It is important to understand the mechanism of action of the various drugs
used in the treatment of hypertension. The antihypertensive action of
propranolol involves all of the following EXCEPT:
1. decreased stroke volume
2. inhibition of renin release
3. central nervous system effect
4. depletion of catecholamines
5. decreased heart rate
Item Number: 13202 correct answer: 4 category: Antihypertensives
32. It is important to understand the side effects of the various antihypertensive
agents. Drugs such as guanethidine that block the function of postganglionic
adrenergic neurons may produce all of the following EXCEPT:
1. orthostatic hypotension
2. bradycardia
3. retrograde ejaculation
4. constipation
5. dry mouth
Item Number: 13701 correct answer: 4 category: Antihypertensives
33. Propranolol is contraindicated in all of the following EXCEPT:
1. bronchial asthma
2. sinus bradycardia
3. second or third degree heart block
4. migraine headache prophylaxis
5. congestive heart failure
Item Number: 13713 correct answer: 4 category: Antihypertensives
34. Which of the following diuretics has a greater antihypertensive activity?
1. hydrochlorothiazide 50 mg
2. chlorothiazide 500 mg
3. spironolactone 100 mg
4. all are equivalent antihypertensive agents
5. 1,2
Item Number: 13717 correct answer: 2 category: Antihypertensives
35. A patient complains of headache and his blood pressure is 120/80. His
medications include hydrochlorothiazide and hydralazine. Which of the
following would seem most likely?
1. The headaches are secondary to thiazide-induced hypokalemia
2. The headaches are secondary to hydralazine therapy
3. The headaches are probably unrelated to drug therapy
4. The headaches are related to hydralazine-induced agranulocytosis
5. 1,2
Item Number: 13718 correct answer: 4 category: Antihypertensives
36. A patient is admitted to the hospital for surgery and has been taking 2.4 mg
of clonidine plus 50 mg hydrochlorothiazide daily for several months prior to
surgery. You would expect in this patient:
1. A low likelihood of problems if the clonidine is continued
2. A possibility of markedly increased blood pressure if the clonidine is
stopped
3. Severe postural hypotension if clonidine is discontinued abruptly
4. 1,2
5. 1,3
Item Number: 13719 correct answer: 5 category: Antihypertensives
37. Drugs which may have their effectiveness diminished if the patient
concomitantly receives a tricyclic antidepressant include:
1. hydralazine
2. guanethidine
3. clonidine
4. 1,2
5. 2,3
Item Number: 13720 correct answer: 4 category: Antihypertensives
38. Tachycardia is a prominent side effect of:
1. diazoxide
2. hydralazine
3. clonidine
4. 1,2
5. 2,3
Item Number: 13722 correct answer: 2 category: Antihypertensives
39. All of the following statements concerning the use of sodium nitroprusside are
true EXCEPT:
1. it is metabolized to thiocyanate
2. it must be given by rapid IV push injection
3. it dilates both arterial and venous vessels
4. 1,3
5. 2,3
Item Number: 488 correct answer: 2 category: Antihypertensives
40. Chronic administration of ethacrynic acid without proper electrolyte
management produces:
1. potassium retention
2. metabolic alkalosis
3. metabolic acidosis
4. excessive inhibition of carbonic anhydrase
5. respiratory alkalosis
Item Number: 578 correct answer: 3 category: Antihypertensives
41. A diuretic agent which has been associated with hearing loss when given
intravenously is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. sucrose
Item Number: 579 correct answer: 1 category: Antihypertensives
42. A diuretic agent which has a steroid-like nucleus is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. sucrose
Item Number: 580 correct answer: 1 category: Antihypertensives
43. The diuretic agent which acts by inhibiting aldosterone at the distal tubular
renal cell is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. bumetanide
Item Number: 581 correct answer: 2 category: Antihypertensives
44. A diuretic agent which is potassium-sparing and does not depend upon the
adrenal cortex for action is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. sucrose
Item Number: 583 correct answer: 4 category: Antihypertensives
45. Which of the following diuretic agents may produce hypokalemic alkalosis but
is a very useful drug in the treatment of volume-dependent hypertension?
1. spironolactone
2. triamterene
3. amiloride
4. chlorothiazide
5. sucrose
Item Number: 2787 correct answer: 2 category: Antihypertensives
46. Hypercalcemia following thiazide administration is characterized by which of
the following?
1. hypercalciuria
2. hypocalciuria
3. increased serum phosphorus
4. decreased serum phosphorus
5. increased urinary phosphorus
Item Number: 2804 correct answer: 2 category: Antihypertensives
47. The diuretic agent, furosemide, is known to produce:
1. decreased renin production and aldosterone release
2. increased renal blood flow and glomerular filtration rate
3. redistribution of blood from the renal cortex to the medulla
4. All of the above
5. 1,3
Item Number: 3241 correct answer: 2 category: Antihypertensives
48. Complications of treatment of edema with thiazides include all of the
following EXCEPT:
1. hyperuricemia
2. hyperkalemia
3. hyperglycemia
4. hyponatremia
5. alkalosis
Item Number: 3449 correct answer: 3 category: Antihypertensives
49. Possible consequences of chlorothiazide administration include all of the
following EXCEPT:
1. thrombocytopenia and agranulocytosis
2. jaundice, skin eruptions, and photosensitivities
3. hypoglycemia
4. hypokalemic nephropathy
5. hyperuricemia
Item Number: 3543 correct answer: 4 category: Antihypertensives
50. Which of the following diuretics may cause hyperkalemia:
1. ethacrynic acid
2. mercurials
3. thiazides
4. triamterene
5. acetazolamide
Item Number: 3911 correct answer: 3 category: Antihypertensives
51. The dominant action of the thiazide diuretics (e.g. hydrochlorothiazide)is to
increase the renal excretion of sodium and chloride and an accompanying volume
of water. This results from:
1. alterations in acid-base balance
2. an indirect renal effect
3. inhibition of the tubular mechanisms of electrolyte transport
4. increased glomerular filtration rate
5. inhibition of carbonic anhydrase
Item Number: 3919 correct answer: 3 category: Antihypertensives
52. The oral diuretics are an effective group of drugs in the treatment of
hypertension. The mechanism of action mainly responsible for the reduction of
blood pressure after 2 months of treatment is:
1. reduction in plasma volume
2. reduction in cardiac output
3. drug-induced saluresis
4. reduction in serum potassium concentration
5. effects on the neurotransmission at adrenergic ganglions
Item Number: 4308 correct answer: 4 category: Antihypertensives
53. About 20 percent of adults in north America have arterial blood pressures
above the normal range. The aldosterone antagonist, spironolactone, has been
used to treat hypertension with some success. Side effects of spironolactone
include:
1. hyponatremia
2. azotemia
3. gynecomastia
4. all of the above
5. 1,3
Item Number: 4437 correct answer: 3 category: Antihypertensives
54. The effectiveness of which of the following diuretics is diminished in
metabolic acidosis?
1. triamterene
2. spironolactone
3. acetazolamide
4. All of the above
5. 1,3
Item Number: 4775 correct answer: 3 category: Antihypertensives
55. The inhibition of carbonic anhydrase in proximal renal tubular cells caused by
acetazolamide causes a loss in urine of:
1. hydrogen ions
2. glucose
3. bicarbonate ions
4. glycine
5. None of the above
Item Number: 7278 correct answer: 4 category: Antihypertensives
56. Complications common to ethacrynic acid and thiazides include:
1. alkalosis
2. potassium depletion
3. hyperuricemia
4. All of the above
5. 1,3
Item Number: 7930 correct answer: 5 category: Antihypertensives
57. Hypokalemia may result from all of the following EXCEPT:
1. flumethiazide
2. hydrochlorothiazide
3. chlorthalidone
4. bendroflumethiazide
5. triamterene
Item Number: 8226 correct answer: 5 category: Antihypertensives
58. Hypochloremic alkalosis may result from prolonged use of:
1. furosemide
2. mannitol
3. ethacrynic acid
4. All of the above
5. 1,3
Item Number: 8320 correct answer: 2 category: Antihypertensives
59. Triamterene:
1. antagonizes aldosterone
2. can produce systemic hyperkalemia
3. is classified as a sodium-sparing diuretic
4. is of no clinical usefulness
5. interferes with the diuretic activity of spironolactone
Item Number: 8365 correct answer: 1 category: Antihypertensives
60. Antihypertensive agents must be used with caution. The medical condition for
which spironolactone is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. central depression
4. liver disease
5. asthma
Item Number: 8418 correct answer: 1 category: Antihypertensives
61. With which of the following side effects is spironolactone most closely
identified with?
1. hyperkalemia
2. metabolic acidosis
3. metabolic alkalosis
4. hypoglycemia
5. hypokalemia
Item Number: 8822 correct answer: 3 category: Antihypertensives
62. A diuretic which acts by inhibition of the sodium-hydrogen exchange is:
1. furosemide
2. chlormerodrin
3. acetazolamide
4. mannitol
5. triamterene
Item Number: 10292 correct answer: 2 category: Antihypertensives
63. To achieve smooth reduction of blood pressure, all of the oral diuretics
must be administered at least once daily. Maximum effectiveness is achieved only
after:
1. 1 to 2 weeks
2. 3 to 4 weeks
3. 5 to 6 weeks
4. 7 to 8 weeks
5. 9 to 10 weeks
Item Number: 10293 correct answer: 3 category: Antihypertensives
64. Diuretics may reduce blood pressure through several mechanisms. The critical
effect, however, appears to be:
1. reduction of vascular smooth muscle reactivity
2. effect on autonomic control of vascular tone
3. reduction of total body sodium content
4. effect on electrolyte content of arterial tissues
5. reduction of plasma renin activity
Item Number: 11201 correct answer: 4 category: Antihypertensives
65. Gynecomastia, hyperkalemia, and menstrual abnormalities are potential adverse
effects associated with:
A. amiloride
B. captopril
C. triamterene
D. spironolactone
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11218 correct answer: 2 category: Antihypertensives
66. Diuretics which should not be used in a patient also receiving potassium
supplementation include:
A. amiloride
B. mannitol
C. triamterene
D. bumetanide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11220 correct answer: 1 category: Antihypertensives
67. Metabolic alkalosis is a complication of the administration of:
A. hydrochlorothiazide
B. bumetanide
C. furosemide
D. acetazolamide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 13710 correct answer: 3 category: Antihypertensives
68. Which of the following drugs may be hazardous if give to a patient receiving
spironolactone?
1. epinephrine
2. propranolol
3. potassium chloride
4. monoamine oxidase inhibitors
5. All of the above
Item Number: 13715 correct answer: 1 category: Antihypertensives
69. A side effect of spironolactone, when utilized to treat hypertension is:
1. hyperkalemia
2. acne
3. hypomagnesemia
4. male pattern baldness
5. bronchospasm
Item Number: 13823 correct answer: 1 category: Antihypertensives
70. The principle site of action of furosemide is the:
1. ascending loop of Henle
2. descending loop of Henle
3. proximal tubule
4. distal tubule
5. None of the above
Item Number: 13824 correct answer: 3 category: Antihypertensives
71. The site of action of mannitol is:
1. ascending loop of Henle
2. descending loop of Henle
3. proximal tubule
4. distal tubule
5. None of the above
Item Number: 14202 correct answer: 5 category: Antihypertensives
72. A diuretic which is contraindicated in a patient with hyperkalemia is:
1. acetazolamide
2. chlorothiazide
3. ethacrynic acid
4. furosemide
5. spironolactone
Antihypertensives
Item Number: 11201 correct answer: 4 category: Antihypertensives
1. Gynecomastia, hyperkalemia, and menstrual abnormalities are potential adverse
effects associated with:
A. amiloride
B. captopril
C. triamterene
D. spironolactone
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11218 correct answer: 2 category: Antihypertensives
2. Diuretics which may result in hyperkalemia when used in a patient also
receiving potassium supplementation include:
A. amiloride
B. mannitol
C. triamterene
D. bumetanide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11220 correct answer: 1 category: Antihypertensives
3. Metabolic alkalosis may be a complication of the administration of:
A. hydrochlorothiazide
B. bumetanide
C. furosemide
D. acetazolamide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11244 correct answer: 2 category: Antihypertensives
4. Beta blockers which are relatively cardioselective include:
A. metoprolol
B. pindolol
C. atenolol
D. timolol
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11288 correct answer: 2 category: Antihypertensives
5. Reflex tachycardia is not likely to occur during therapy with:
A. clonidine
B. diazoxide
C. reserpine
D. minoxidil
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11308 correct answer: 3 category: Antihypertensives
6. Beta blockers which may be less likely to produce CNS-related adverse effects
include
A. metoprolol
B. nadolol
C. timolol
D. atenolol
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11316 correct answer: 4 category: Antihypertensives
7. Guanadrel is pharmacologically similar to:
A. clonidine
B. guanabenz
C. methyldopa
D. guanethidine
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11335 correct answer: 1 category: Antihypertensives
8. Adverse effects associated with guanethidine include:
A. orthostatic hypotension
B. enhanced sensitivity to sympathomimetics
C. diarrhea
D. sedation
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11340 correct answer: 2 category: Antihypertensives
9. Adverse effects associated with hydralazine include:
A. reflex tachycardia
B. hypertrichosis
C. lupus syndrome
D. orthostatic hypotension
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11341 correct answer: 2 category: Antihypertensives
10. Risk factors associated with increased risk of toxicity during captopril
therapy include:
A. bilateral renal artery stenosis
B. congestive heart failure
C. systemic lupus erythematosus
D. female gender
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 684 correct answer: 4 category: Antihypertensives
11. Diazoxide, a drug used for treatment of hypertensive crises, is most closely
related to:
1. nitrofuran
2. sulfonamides
3. dopamine antagonists
4. thiazide diuretics
5. nitrates
Item Number: 807 correct answer: 2 category: Antihypertensives
12. Which of the following drugs is(are) known to induce hyperuricemia and
occasionally to bring about an acute gouty attack?
1. salicylates (6 grams per day)
2. chlorothiazide
3. phenytoin
4. spironolactone
5. All of the above
Item Number: 1186 correct answer: 4 category: Antihypertensives
13. Undesirable side effects of reserpine include:
1. bradycardia
2. postural hypotension
3. diarrhea
4. All of the above
5. None of the above
Item Number: 1858 correct answer: 3 category: Antihypertensives
14. Propranolol may cause all of the following EXCEPT:
1. bradycardia
2. bronchiolar constriction
3. hyperglycemia
4. reduced myocardial contractility
5. prevention of the dilation of vessels caused by circulating epinephrine
Item Number: 2883 correct answer: 5 category: Antihypertensives
15. Alpha methyldopa has been used successfully in the control of hypertension.
Side effects include all of the following, EXCEPT:
1. positive direct Coomb’s test
2. diarrhea
3. hemolytic anemia
4. fever
5. nephrotic syndrome
Item Number: 3538 correct answer: 3 category: Antihypertensives
16. A 48-year old salesman with known hypertension complains of a decreasing
annual income, a loss of "drive", and a depressed outlook on life. His blood
pressure is normal on medication. The antihypertensive drug most likely to be
the cause of his new complaints is:
1. hydralazine
2. alpha methyldopa
3. reserpine
4. hydrochlorothiazide
5. guanethidine
Item Number: 6258 correct answer: 1 category: Antihypertensives
17. Side effects of medications are often responsible for a patient not complying
with the prescribed drug regimen. An agent which has somnolence as a primary
side effect is:
1. methyldopa
2. hydralazine
3. guanethidine
4. 1,2
5. 1,3
Item Number: 6259 correct answer: 4 category: Antihypertensives
18. One of the mechanisms for ‘resistance" to an antihypertensive drug regimen is
a retention of salt and water and an increase in extracellular fluid volume.
Agents which have been shown to cause retention of salt and water include:
1. methyldopa
2. clonidine
3. guanethidine
4. All of the above
5. 1,2
Item Number: 6273 correct answer: 4 category: Antihypertensives
19. Clonidine hydrochloride lowers blood pressure by reducing sympathetic tone.
It is believed to act by inhibiting sympathetic outflow from the vasomotor
center in the medulla. A potentially serious adverse reaction that has been
reported is:
1. ventricular fibrillation
2. anaphylaxis
3. irreversible nephrotoxicity
4. withdrawal syndrome resembling hypertensive crisis
5. systemic lupus erythematosus
Item Number: 6274 correct answer: 4 category: Antihypertensives
20. Propranolol produces most of its important effects by antagonizing the beta
adrenergic effects of catecholamines released by sympathetic nerve stimulation
or from the adrenal medulla. It therefore results in all of the following
EXCEPT:
1. negative inotropic effect on the heart
2. bronchoconstriction
3. lowering plasma renin activity
4. hyperglycemia
5. negative chronotropic effect on the heart
Item Number: 7929 correct answer: 3 category: Antihypertensives
21. The antihypertensive agent most likely to increase cardiac output is:
1. chlorothiazide
2. reserpine
3. hydralazine
4. alpha-methyldopa
5. guanethidine
Item Number: 8117 correct answer: 1 category: Antihypertensives
22. An agent which produces its antihypertensive effect by blocking autonomic
ganglia, thus lowering the sympathetic tone of blood vessels, is:
1. trimethaphan
2. diazoxide
3. phenoxybenzamine
4. reserpine
5. alpha-methyldopa
Item Number: 8236 correct answer: 1 category: Antihypertensives
23. The most useful drugs in the long-term treatment of essential hypertension
are:
1. thiazide diuretics
2. osmotic diuretics
3. mercurial diuretics
4. carbonic anhydrase inhibitors
5. xanthine diuretics
Item Number: 8321 correct answer: 5 category: Antihypertensives
24. Antihypertensive agents that act primarily at arterioles include:
1. hydralazine
2. minoxidil
3. diazoxide
4. nitroglycerin
5. 1,2,3
Item Number: 8332 correct answer: 1 category: Antihypertensives
25. Antihypertensive agents have different modes of action. The expected
onset of action of IV nitroprusside is:
1. seconds
2. several minutes
3. 15 to 30 minutes
4. several hours
5. 12 to 24 hours
Item Number: 8354 correct answer: 4 category: Antihypertensives
26. Antihypertensive agents must be used with caution. The medical condition for
which methyldopa is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. mental depression
4. liver disease
5. asthma
Item Number: 8364 correct answer: 2 category: Antihypertensives
27. Antihypertensive agents must be used with caution. The medical condition for
which hydralazine is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. mental depression
4. liver disease
5. asthma
Item Number: 8375 correct answer: 3 category: Antihypertensives
28. Antihypertensive agents must be used with caution. The medical condition for
which reserpine is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. mental depression
4. liver disease
5. asthma
Item Number: 9618 correct answer: 5 category: Antihypertensives
29. Reduced tissue levels of norepinephrine may result from long-term treatment
with:
1. guanethidine
2. reserpine
3. alpha-methyl-tyrosine
4. All of the above
5. 1,2
Item Number: 11387 correct answer: 1 category: Antihypertensives
30. Propranolol is a potent blocker of beta-adrenergic sympathetic activity. It
has been found to be detrimental, however, in patients with:
1. bronchial asthma
2. hypertension
3. hyperthyroidism
4. atrial fibrillation
5. ventricular arrhythmias
Item Number: 13199 correct answer: 4 category: Antihypertensives
31. It is important to understand the mechanism of action of the various drugs
used in the treatment of hypertension. The antihypertensive action of
propranolol involves all of the following EXCEPT:
1. decreased stroke volume
2. inhibition of renin release
3. central nervous system effect
4. depletion of catecholamines
5. decreased heart rate
Item Number: 13202 correct answer: 4 category: Antihypertensives
32. It is important to understand the side effects of the various antihypertensive
agents. Drugs such as guanethidine that block the function of postganglionic
adrenergic neurons may produce all of the following EXCEPT:
1. orthostatic hypotension
2. bradycardia
3. retrograde ejaculation
4. constipation
5. dry mouth
Item Number: 13701 correct answer: 4 category: Antihypertensives
33. Propranolol is contraindicated in all of the following EXCEPT:
1. bronchial asthma
2. sinus bradycardia
3. second or third degree heart block
4. migraine headache prophylaxis
5. congestive heart failure
Item Number: 13713 correct answer: 4 category: Antihypertensives
34. Which of the following diuretics has a greater antihypertensive activity?
1. hydrochlorothiazide 50 mg
2. chlorothiazide 500 mg
3. spironolactone 100 mg
4. all are equivalent antihypertensive agents
5. 1,2
Item Number: 13717 correct answer: 2 category: Antihypertensives
35. A patient complains of headache and his blood pressure is 120/80. His
medications include hydrochlorothiazide and hydralazine. Which of the
following would seem most likely?
1. The headaches are secondary to thiazide-induced hypokalemia
2. The headaches are secondary to hydralazine therapy
3. The headaches are probably unrelated to drug therapy
4. The headaches are related to hydralazine-induced agranulocytosis
5. 1,2
Item Number: 13718 correct answer: 4 category: Antihypertensives
36. A patient is admitted to the hospital for surgery and has been taking 2.4 mg
of clonidine plus 50 mg hydrochlorothiazide daily for several months prior to
surgery. You would expect in this patient:
1. A low likelihood of problems if the clonidine is continued
2. A possibility of markedly increased blood pressure if the clonidine is
stopped
3. Severe postural hypotension if clonidine is discontinued abruptly
4. 1,2
5. 1,3
Item Number: 13719 correct answer: 5 category: Antihypertensives
37. Drugs which may have their effectiveness diminished if the patient
concomitantly receives a tricyclic antidepressant include:
1. hydralazine
2. guanethidine
3. clonidine
4. 1,2
5. 2,3
Item Number: 13720 correct answer: 4 category: Antihypertensives
38. Tachycardia is a prominent side effect of:
1. diazoxide
2. hydralazine
3. clonidine
4. 1,2
5. 2,3
Item Number: 13722 correct answer: 2 category: Antihypertensives
39. All of the following statements concerning the use of sodium nitroprusside are
true EXCEPT:
1. it is metabolized to thiocyanate
2. it must be given by rapid IV push injection
3. it dilates both arterial and venous vessels
4. 1,3
5. 2,3
Item Number: 488 correct answer: 2 category: Antihypertensives
40. Chronic administration of ethacrynic acid without proper electrolyte
management produces:
1. potassium retention
2. metabolic alkalosis
3. metabolic acidosis
4. excessive inhibition of carbonic anhydrase
5. respiratory alkalosis
Item Number: 578 correct answer: 3 category: Antihypertensives
41. A diuretic agent which has been associated with hearing loss when given
intravenously is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. sucrose
Item Number: 579 correct answer: 1 category: Antihypertensives
42. A diuretic agent which has a steroid-like nucleus is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. sucrose
Item Number: 580 correct answer: 1 category: Antihypertensives
43. The diuretic agent which acts by inhibiting aldosterone at the distal tubular
renal cell is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. bumetanide
Item Number: 581 correct answer: 2 category: Antihypertensives
44. A diuretic agent which is potassium-sparing and does not depend upon the
adrenal cortex for action is:
1. spironolactone
2. triamterene
3. ethacrynic acid
4. chlorothiazide
5. sucrose
Item Number: 583 correct answer: 4 category: Antihypertensives
45. Which of the following diuretic agents may produce hypokalemic alkalosis but
is a very useful drug in the treatment of volume-dependent hypertension?
1. spironolactone
2. triamterene
3. amiloride
4. chlorothiazide
5. sucrose
Item Number: 2787 correct answer: 2 category: Antihypertensives
46. Hypercalcemia following thiazide administration is characterized by which of
the following?
1. hypercalciuria
2. hypocalciuria
3. increased serum phosphorus
4. decreased serum phosphorus
5. increased urinary phosphorus
Item Number: 2804 correct answer: 2 category: Antihypertensives
47. The diuretic agent, furosemide, is known to produce:
1. decreased renin production and aldosterone release
2. increased renal blood flow and glomerular filtration rate
3. redistribution of blood from the renal cortex to the medulla
4. All of the above
5. 1,3
Item Number: 3241 correct answer: 2 category: Antihypertensives
48. Complications of treatment of edema with thiazides include all of the
following EXCEPT:
1. hyperuricemia
2. hyperkalemia
3. hyperglycemia
4. hyponatremia
5. alkalosis
Item Number: 3449 correct answer: 3 category: Antihypertensives
49. Possible consequences of chlorothiazide administration include all of the
following EXCEPT:
1. thrombocytopenia and agranulocytosis
2. jaundice, skin eruptions, and photosensitivities
3. hypoglycemia
4. hypokalemic nephropathy
5. hyperuricemia
Item Number: 3543 correct answer: 4 category: Antihypertensives
50. Which of the following diuretics may cause hyperkalemia:
1. ethacrynic acid
2. mercurials
3. thiazides
4. triamterene
5. acetazolamide
Item Number: 3911 correct answer: 3 category: Antihypertensives
51. The dominant action of the thiazide diuretics (e.g. hydrochlorothiazide)is to
increase the renal excretion of sodium and chloride and an accompanying volume
of water. This results from:
1. alterations in acid-base balance
2. an indirect renal effect
3. inhibition of the tubular mechanisms of electrolyte transport
4. increased glomerular filtration rate
5. inhibition of carbonic anhydrase
Item Number: 3919 correct answer: 3 category: Antihypertensives
52. The oral diuretics are an effective group of drugs in the treatment of
hypertension. The mechanism of action mainly responsible for the reduction of
blood pressure after 2 months of treatment is:
1. reduction in plasma volume
2. reduction in cardiac output
3. drug-induced saluresis
4. reduction in serum potassium concentration
5. effects on the neurotransmission at adrenergic ganglions
Item Number: 4308 correct answer: 4 category: Antihypertensives
53. About 20 percent of adults in north America have arterial blood pressures
above the normal range. The aldosterone antagonist, spironolactone, has been
used to treat hypertension with some success. Side effects of spironolactone
include:
1. hyponatremia
2. azotemia
3. gynecomastia
4. all of the above
5. 1,3
Item Number: 4437 correct answer: 3 category: Antihypertensives
54. The effectiveness of which of the following diuretics is diminished in
metabolic acidosis?
1. triamterene
2. spironolactone
3. acetazolamide
4. All of the above
5. 1,3
Item Number: 4775 correct answer: 3 category: Antihypertensives
55. The inhibition of carbonic anhydrase in proximal renal tubular cells caused by
acetazolamide causes a loss in urine of:
1. hydrogen ions
2. glucose
3. bicarbonate ions
4. glycine
5. None of the above
Item Number: 7278 correct answer: 4 category: Antihypertensives
56. Complications common to ethacrynic acid and thiazides include:
1. alkalosis
2. potassium depletion
3. hyperuricemia
4. All of the above
5. 1,3
Item Number: 7930 correct answer: 5 category: Antihypertensives
57. Hypokalemia may result from all of the following EXCEPT:
1. flumethiazide
2. hydrochlorothiazide
3. chlorthalidone
4. bendroflumethiazide
5. triamterene
Item Number: 8226 correct answer: 5 category: Antihypertensives
58. Hypochloremic alkalosis may result from prolonged use of:
1. furosemide
2. mannitol
3. ethacrynic acid
4. All of the above
5. 1,3
Item Number: 8320 correct answer: 2 category: Antihypertensives
59. Triamterene:
1. antagonizes aldosterone
2. can produce systemic hyperkalemia
3. is classified as a sodium-sparing diuretic
4. is of no clinical usefulness
5. interferes with the diuretic activity of spironolactone
Item Number: 8365 correct answer: 1 category: Antihypertensives
60. Antihypertensive agents must be used with caution. The medical condition for
which spironolactone is most contraindicated is:
1. renal insufficiency
2. coronary insufficiency
3. central depression
4. liver disease
5. asthma
Item Number: 8418 correct answer: 1 category: Antihypertensives
61. With which of the following side effects is spironolactone most closely
identified with?
1. hyperkalemia
2. metabolic acidosis
3. metabolic alkalosis
4. hypoglycemia
5. hypokalemia
Item Number: 8822 correct answer: 3 category: Antihypertensives
62. A diuretic which acts by inhibition of the sodium-hydrogen exchange is:
1. furosemide
2. chlormerodrin
3. acetazolamide
4. mannitol
5. triamterene
Item Number: 10292 correct answer: 2 category: Antihypertensives
63. To achieve smooth reduction of blood pressure, all of the oral diuretics
must be administered at least once daily. Maximum effectiveness is achieved only
after:
1. 1 to 2 weeks
2. 3 to 4 weeks
3. 5 to 6 weeks
4. 7 to 8 weeks
5. 9 to 10 weeks
Item Number: 10293 correct answer: 3 category: Antihypertensives
64. Diuretics may reduce blood pressure through several mechanisms. The critical
effect, however, appears to be:
1. reduction of vascular smooth muscle reactivity
2. effect on autonomic control of vascular tone
3. reduction of total body sodium content
4. effect on electrolyte content of arterial tissues
5. reduction of plasma renin activity
Item Number: 11201 correct answer: 4 category: Antihypertensives
65. Gynecomastia, hyperkalemia, and menstrual abnormalities are potential adverse
effects associated with:
A. amiloride
B. captopril
C. triamterene
D. spironolactone
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11218 correct answer: 2 category: Antihypertensives
66. Diuretics which should not be used in a patient also receiving potassium
supplementation include:
A. amiloride
B. mannitol
C. triamterene
D. bumetanide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 11220 correct answer: 1 category: Antihypertensives
67. Metabolic alkalosis is a complication of the administration of:
A. hydrochlorothiazide
B. bumetanide
C. furosemide
D. acetazolamide
1. A,B,C
2. A,C
3. B,D
4. D only
5. All are correct
Item Number: 13710 correct answer: 3 category: Antihypertensives
68. Which of the following drugs may be hazardous if give to a patient receiving
spironolactone?
1. epinephrine
2. propranolol
3. potassium chloride
4. monoamine oxidase inhibitors
5. All of the above
Item Number: 13715 correct answer: 1 category: Antihypertensives
69. A side effect of spironolactone, when utilized to treat hypertension is:
1. hyperkalemia
2. acne
3. hypomagnesemia
4. male pattern baldness
5. bronchospasm
Item Number: 13823 correct answer: 1 category: Antihypertensives
70. The principle site of action of furosemide is the:
1. ascending loop of Henle
2. descending loop of Henle
3. proximal tubule
4. distal tubule
5. None of the above
Item Number: 13824 correct answer: 3 category: Antihypertensives
71. The site of action of mannitol is:
1. ascending loop of Henle
2. descending loop of Henle
3. proximal tubule
4. distal tubule
5. None of the above
Item Number: 14202 correct answer: 5 category: Antihypertensives
72. A diuretic which is contraindicated in a patient with hyperkalemia is:
1. acetazolamide
2. chlorothiazide
3. ethacrynic acid
4. furosemide
5. spironolactone
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