4.

Compare the half-life of digoxin and the half-life of digitoxin:

a. Digoxin is greater than digitoxin

b. Digitoxin is greater than digoxin

5. All of the following statements regarding cardiac glycosides are true EXCEPT.

a. They inhibit the activity of the Na+/K+-ATPase /

b. They decrease intracellular concentrations of calcium in myocytes

c. They increase vagal tone 1

d. They have a very low therapeutic index

6. The most cardiac manifestation of glycosides intoxication is:

a. Atrioventricular junctional rhythm

b. Second-degree atrioventricular blockade

c. Ventricular tachycardia

d. All the above

7. For digitalis-induced arrhythmias the following drug is favored:

a. Verapamil

b. Amiodarone

c. Lidocaine

d. Propanolol

8. In severe digitalis intoxication best choice is to use:

a. Lidocaine

b. Digbind (Digoxin immune fab)

c. Oral potassium supplementation

11. This drug inhibits breakdown CAMP in vascular smooth muscle:

a. Digoxin

b. Dobutamine

c. Amrinone
d. Dopamine

12. This drug acts by inhibiting type Ill cyclic nucleotide phosphodiesterase:

a. Amiodarone

b. Milrinone

c. Propanolol

d. Enalapril

13. Drugs most used in chronic heart failure are:

a. Cardiac glycosides

b. Diuretics

c. Angiotensin-converting enzyme inhibitors

d. All the above

14. Hypertensive drugs most prescribed to pregnancy

a. Losartan

b. Captopril

c. Methyldopa

d. Amlodipine

15. All of the following statements concerning angiotensin converting enzyme (ACE) inhibitors are true EXCEPT:

a. They act by inhibiting the ablity of renin to convert angiotensinogen to angiotensin I

b. Enalapril is a prodrug that is converted to an active metabolite c They reduce secretion of aldosterone

d. They can produce hyperkalemia in combination with a potassium-sparing diuretic

16. This drug is a Class IA antiarrhythmic drug

a. Sotalol

b. Propranolol

c. Verapamil

d. Quinidine
17. This drug is a Class IA antiarrhythmic drug:

a. Debrisoquine

b. Propranolol

c. Verapamil

d. Quinidine

18. This drug is associated with Torsades de pointes.

a. Flecainide

b. Sotalol

c. Lidocaine

d. Quinidine

19. It is an irregular heartbeat, is a problem with the rate or rhythm of your heartbeat.

a, Hypertension

b. Hyperglycemia

c. Arrhythmia

d. Angina

20. The actual time required for enough sodium channels to recover from inactivation in order that a new
propagated response can be generated.

a. Hyperpolarization

b. Resting potential

c. Refractory period

d. Depolarization

21. The property of the heart cells to transmit spontaneous impulses starting from the sinoatrial (SA) node,
activating all parts of the heart muscle almost spontaneously.

a. Contractility

b. Conductivity

c. Automaticity
22. AV node impulse per minute

a. 40-50 impulses per minute

b. 10-20 impluse per minute

c. 60-100 impulse per minute

23. It is the property of the heart cells to undergo spontaneous depolarization during relaxation.

a. Contrachlity

b. Conductivity

c. Automaticity

d. All of the above

24. Cardiac action potential is illustrated below. Which of the following statements is correct.

26. It is the measure of conduction time from atrium to ventricle.

a. PR interval

b. QRS duration

c. QT interval

d. None of the above

27. It reflects the duration of the ventricular action potential.

a. PR interval

b. QRS duration

c. QT interval

d. None of the above

28. It indicates the time required for all the ventricular cells to be activated.
a. PR interval

b. QRS duration

C. QT interval

d. None of the above

29. What is the result when there's an increasing extracellular potassium shifts the equilibrium potential in a
positive direction.

a. Hyperpolarization

b. Resting potenti Cue goof

c. Refractory

d. Depolarization

30. This rhythm as seen on electrocardiogram is read and diagnosed as:

a. Normal sinus rhythm

b. Atrial flutter

c. Ventricular fibrillation

d. Ventricular tachycardia

31. Drugs that prolong action potential and dissociate from the channel with intermediate kinetics.

a. Propafenone

b. Procainamide

c. Propranolol

d. Phenytoin

32. This rhythm as seen on electrocardiogram is read and diagnosed as:

a. Normal sinus rhythm

b. Atrial flutter
c. Ventricular fibrillation

d. Ventricular tachycardia

33. Anti-arrhythmic drugs that is used in caution in patients with thyroid problem

a. Procainamide

b. Debrisoquine

C. Amiodarone

d. Celivarone

34. The drug of choice for prompt conversion of paroxysmal supraventricular tachycardia to sinus rhythm because
of its high efficacy (90-95%) and very short duration of action.

a. Moricizine

b. Adenosine

c. Magnesium

d. Ivabradine

36. Elevation of this activity is an important determinant of the ischemic threshold in patients with coronary artery
disease and a prognostic indicator in patients with congestive heart failure.

a. HR

b. SV

c. TPR

d. SVR

37. It is a multi-ion channel blocker causes frequency- and voltage dependent block of the early and late
components of the sodium current produces only mild QT-interval prolongation. Though this does not produce
torsades de pointes, it not yet approved by the FDA.

a. Ranolazine

b. Magnesium

c. Ivabradine

d. Vernakalant
38. It has a mechanism of action on the maintenance or restoration of sinus rhythm in atrial fibrillation and has a
dose-dependent blockade of the rapid component of the delayed rectifier potassium current (lks). This drug has
100% bioavailability.

a. Amiodarone

b. Sotalol

c. Dofetilide

d. Dysopyramide

39. A discomfort caused by an imbalance between oxygen supply (decreased coronary blood flow) and oxygen
demand (increased myocardial oxygen consumption), which leads to a decrease in the oxygen supply/demand
ratio and myocardial hypoxia.

a. Hypertension

b. Hyperglycemia

c. Arrhythmia

d. Angina

40. Which of the following nitrates and nitrite drugs is a short-acting drug?

a. Nitroglycerin, 2% ointment (Nitrol)

b. Nitroglycerin, oral sustained-release (Nitrong)

c. Amyl nitrite, inhalant (Aspirols, Vaporole)

d. ISMN

41. Which of the following cardiovascular system effects refers to a calcium channel blocker?

a. The reduction of peripheral vascular resistance

b. The reduction of cardiac contractility and, in some cases, cardiac output

c. Relief of coronary artery spasm

d. All of the above

42. Main clinical use of calcium channel blockers is:

a. Angina pectoris

b. Hypertension

c. Supraventricular tachyarrhythmias d. All of the above

a. These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting
relaxation and in a cardiac muscle with a reduction in contractility.

b. These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve
endings

c. Beneficial effects of these agents are related primarily to their hemodynamic effects - decreased heart rate,
blood pressure, and contractility - which decrease myocardial oxygen requirements at rest and during exercise.

d. These agents increase the permeability of K channels, probably AT-dependent K channels, that results in
stabilizing the membrane potential of excitable cells near the resting potential.

44. All of the following statements regarding angiotensin Il are true EXCEPT:

4. It is a peptide hormone

b. It stimulates the secretion of aldosterone

c. Angiotensin I is almost as potent as angiotensin I|

d. It is a potent vasoconstrictor

45. This drug is contraindicated in patients with bronchial asthma:

a. Propranolol

b. Clonidine

c. Enalapril

d. Nifedipine

46. This drug is converted to an active metabolite after absorption:

a. Labetalol

b. Clonidine

c. Enalapril

d. Nifedipine

47. All of the following statements regarding verapamil are true EXCEPT:

a. It blocks L-type calcium channels

b. It increases heart rate

c. It relaxes coronary artery smooth muscle

48. Hydralazine (a vasodilator) can produce:

a. Seizures, extrapyramidal disturbances

b. Tachycardia, lupus erhythromatosis

c. Acute hepatitis

d. Aplastic anemia

49. Choose the vasodilator which releases NO:

a. Nifedipine

b. Hydralazine

c. Minoxidil

d. Sodium nitroprusside

48. Hydralazine (a vasodilator) can produce:

a. Seizures, extrapyramidal disturbances

b. Tachycardia, lupus erhythromatosis

c. Acute hepatitis

d. Aplastic anemia

49. Choose the vasodilator which releases NO:

a. Nifedipine

b. Hydralazine

c. Minoxidil

d. Sodium nitroprusside

50. The reason of diuretics administration for hypertension treatment is:

a. Block the adrenergic transmission

b. Diminishing of blood volume and amount of Na+ ions in the vessels

c. Depression of rennin-angiotensin-aldosterone system

d. Depression of the vasomotor center

failure.

a. Furosemide

b. Spironolactone

c. Hydrochlorothiazide

d. Indapamide

52. Anti hypertensive drug that is also used to treat migraines.

a. Nitrates

b. Beta blockers

c. Diuretics

d. Alpha agonists

53. Organic nitrates relax vascular smooth muscle by:

a. Increasing intracellular cyclic GMP

b. Increasing intracellular cyclic AMP

c. Decreasing intracellular cyclic GMP

d. Both 'A' and 'C' are correct

54. Under physiological conditions the rate limiting enzyme in the generation of angiotensin Il is:

a. Renin

b. Angiotensin converting enzyme

c. Aminopeptidase

d. Angiotensinase

55. Angiotensin II causes rise in blood pressure by:

a. Direct vasoconstriction

b. Releasing adrenaline from adrenal medulla

c. Increasing central sympathetic tone d. All of the above

56. The following factors enhance renin release from the kidney, except:
a. Fall in blood pressure

b. Reduction in blood volume

c. Enhanced sympathetic activity

d. Volume overload

57. Angiotensin I plays a key role in the following risk factor for ischaemic heart disease:

a. Hypercholesterolemia

b. Ventricular hypertrophy

c. Carbohydrate intolerance

d. Cardiac arrhythmia

58. Ventricular remodeling after myocardial infarction involves the mediation of

a. Angiotensin II

b. Prostaglandin

c. Bradykinin

d. Thromboxane A2

59. Captopril pretreatment

a. Inhibits the pressor action of angiotensin I

b. Inhibits the pressor action of angiotensin I c Potentiates the depressor action of bradykinin

d. Both 'A and 'C' are correct

60. Captopril produces greater fall in blood pressure in:

a. Diuretic treated patients

b. Patients having low plasma renin activity

c. Sodium replete normotensive individuals

d. Untreated CHF patients

61. The following drug increases cardiac output in congestive heart failure without having any direct myocardial
action:
a. Captopril

b. Digoxin

c. Amrinone

d. Dobutamine

62. Choose the drug that selectively blocks AT1 subtype of angiotensin receptors:

a, Ramipril

b. Lovastatin

c. Candesartan

d. Sumatriptan

63. An elderly hypertensive was treated with hydrochlorothiazide 50 mg daily. Even after a month, his BP was not
reduced to the desired level and another antihypertensive was added. After 2 hours of taking the other drug his BP
fell precipitously. The most likely other drug given to him is:

a. Atenolol

b. Captopril

c. Methyldopa

d. Amlodipine

64. Digitalis slows the heart in congestive heart failure by:

a. Increasing vagal tone

b. Decreasing sympathetic overactivity

c. Direct depression of sinoatrial node

d. All of the above

65. The principal action common to all class I antiarrhythmic drugs is:

a. Na+ channel blockade

b. K+ channel opening

c. Depression of impulse conduction

d. Prolongation of effective refractory period

a. Disopyramide

b. Quinidine

c. Procainamide

d. Lignocaine

67. The following is true of propafenone except:

a. It is a weak Na channel blocker

b. It markedly delays recovery of myocardial Nat channels

c. it has additional adrenergic blocking property

d. it slows anterograde as well as retrograde conduction in the WW bypass tract

68. Choose the correct statements) about dofetilide:

a. It is a pure class Ill antiarrhythmic

b. It has no adrenergic/cholinergic receptor blocking property

c. It selectively depresses the rapid component of delayed rectifier K+ current in myocardial fibres

d. All of the above

69. The dihydropyridines block the following type of calcium channels:

a. L-type voltage sensitive channels

b. T-type voltage sensitive channels

c. N-type voltage sensitive channels

d. Receptor operated calcium channels

70. Select the drug which can markedly potentiate the vasodilator action of organic nitrates:

a. Propranolol

b. Fluoxetine

c. Hydrochlorothiazide

d. Sildenafil
71. The following calcium channel blocker is specifically indicated to counteract cerebral vasospasm and
neurological sequelae following subarachnoid hemorrhage:

a. Lacidipine

b. Nimodipine

c. Nicardipine

72. It is the stiffening and loss of adequate relaxation playing a major role in reducing filling and cardiac output
though ejection fraction is normal

a. HFpEF

b. HFrEF

c. Systolic dysfunction

d. Two of the above

73. It is the rare form of heart failure.

a. Low output Failure

b. Mid output Failure

c. High output Failure

d. Ultra High output Failure

74. The demands of the body are so great that even increased cardiac output is insufficient. It results from
hyperthyroidism, beriberi, anemia, and arteriovenous shunts.

a. Low output Failure

b. Mid output Failure

c. High output Failure

d. Ultra High output Failure

75. Pulmonary edema results from

a. Left side Heart failure

b. Right side heart failure

c. Any above

d. NOTA
76. It is used as a surrogate marker for the presence and severity of heart failure.

a. NT-proBNP

b. NT-proCNP

c. NT-prOANB

d. NT-ProWTH

77. The following statements elaborates the result when there's an excessive beta activation in the heart, except?

a. Excessive B activation can lead to leakage of calcium from the SR via Ry channels and contributes to stiffening of
the ventricles and arrhythmias.

b. Prolonged B activation also increases caspases, the enzymes responsible for apoptosis.

c. Increased angiotensin Il production leads to decrease aldosterone secretion (with sodium and water
retention), to increased afterload, and to remodeling of both heart and vessels.

d. Reuptake of Ca2+ into the SR by SERCA may be impaired.

79. This receptor is a calcium-activated calcium channel in the membrane of the SR that is triggered to release
stored calcium.

a. SERCA

b. NCX

c. Ca-Lvoltage gated

d. ryancdine RyR2 receptor

80. A stage of heart failure according to ACC/AHA, where it show symptoms with severe exercise and is usually
treated with ACE, ARBs, beta blocker and diuretics.

a. A

b. B

c. C

d. D

81. Stage A heart failure is also known as what class according to NYHA Class?

a. I

b. Prefailure
c. Post failure

d. la

82. Actions of the heart can either be diastole or systole. Which of the two occurs when the heart contracts to
pump blood out.

a. Systole

b. Diastole

c. Both

d. None

83. This determines the capacity of the venous circulation and controls the amount of blood sequestered in the
venous system versus the amount returned to the heart.

a. Arteriolar tone

b. Capillary tone

c. Venous tone

d. All of the following

84. The following are mechanisms are ways on how a drug can relax a vascular smooth muscle, except:

a. Increasing cGMP

b. Increasing intracellular Ca2+

c Stabilizing or preventing depolarization of the vascular smooth muscle cell membrane:

d. Increasing cAMP in vascular smooth muscle cells

85. What electrolytes that are important for heart function?

a Na

b. K

c. Ca

d. All of the following

86. How does beta blocker treats patient with angina?

a. decrease myocardial oxygen requirement by decreasing one or more of the major determinants of oxygen
demand esp Heart rate
b. may cause a redistribution of coronary flow and increase oxygen delivery to ischemic tissue

c. Releases NO to increase vasodilation

d. All of the following

87. The following are antidotes of Cyanide poisoning, except:

c. Sodium nitroprusside

d. sodium nitrite

88. Selective T-type calcium channel blocker that was introduced for antiarrhythmic use but has been withdrawn.

a. Mibefradil

b. Bepridil

c. Verapamil

d. Diltiazem

89. This is a prodrug that is converted to a nitric oxide-releasing metabolite and is not a subject to tolerance.
Recent studies even suggests that it may reduce cerebral vasospasm in stroke.

a. Molsidomine

b. Nicorandil

c. Sodium nitroprusside

d. Amyl nitrite

90. Protetype of dihydrepyridine class of vasedilaters.

a. Verapamil

b. Nifedipine

c. Amledipine

d. Diltiazem

91. Which of the following vasedilater protype has a diphenyl alkylamine.

a. Verapamil

b. Nifedipine

c. Amledipine
d. Diltiazem

92. This anti-hypertensive drug had her advantage in treating patient with hypertension associated with
tachycardia due to its short duration of action that can be discontinued quickly.

a, Nebivolol

b. Timolol

c. Esmolol

d. Propranolol

93. This anti-hypertensive drug is a highly $1-selective blocker with vasodilating properties that are not mediated
by a blockade.

a. Nebivolol

b. Timolo

C. Esmolol

d. Propranolol

94. The following Betablocker drugs has anesthetic like effect, except:

a. Pindolol

b. Acebutolol

c. Labetalol

d. Betaxolol

95. This anti-hypertensive drug shows a positive result in Coombs test

a. Clonidine

b. Methyldopa

C. Alfuzosin

d. Propranolol

96. Diuretics increase urine excretion mainly by decreasing reabsorption of salts and water from kidney tubules.
Which of the following promotes diuretic activity but does not belong to the drug category?

a. Water

b. Caffeine
c. Theophylline

d. All of the above

97. Diuretics works by increasing urine output thereby decreasing plasma and stroke volume that leads to
decreasing cardiac output and blood pressure. Excessive diuretic usage may lead to a decrease in the effective
arterial blood volume which causes a reduchon in the perfusion of vital organs. Which of the following corelates to
this statement?

a. The use of diuretics to treat edema requires careful monitoring of the patient's hemedynamic status

b. The decrease in blood volume can lead to hypotension and collapse

c. Blood viscosity rises due to an increase in erythro- and thrombocyte concentration, which could lead to an
increased risk of intravascular coagulation or thrombosis.

d. All of the above

e. None of the above

98. Prototype of Carbonic anhydrase inhibitor and is used for high altitude mountain sickness,

a. Acetazolamide

b. Dorzolamide

C. Brinzolamide

d. All of the above

99. Diuretics that inhibit the NaCl reabsorption in thick ascending limb of Henle’s loop and is known as High ceiling
diuretics.

a. Thiazides

b. Cal’s

c. Loop diuretics

d. K-sparing

100. Loop diuretics that is not a sulfamide.

a. Furesomide

b. Bumetanide

c. Torsemide

d. Ethacrynic acid