1. The action of this drug is dependent on a e. I.

II, and III

colligative property: 7. In terms of mechanism of action, which of
a. Mannitol the following drugs most closely resembles
b. Cocaine that of Clonidine?
c. Reserpine a. Phenylephrine
d. Furosemide b. Reserpine
e. Losartan c. Guanethidine
2. Voltage-gated ion channels serve as site of d. Methyldopa
actions for drugs such as: e. Amlodipine
I. Diltiazem and Nifedipine 8. The activity of this drug is attributed to its
II. Lidocaine and Procaine metabolite which is a false neurotransmitter
III. Captopril and Losartan at the central nervous system:
a. I only a. Guanethidine
b. I and II b. Methyldopa
c. III only c. Propranolol
d. I and III d. Labetalol
e. I, II, and III e. Phenylpropanolamine
3. What type of protein is primarily targeted by 9. Which of the following inotropic agents is
Digitalis glycosides when they exert their most useful for patient with acute heart
effect on the heart? failure complicated by acute reduction in
a. Receptors creatinine clearance?
b. Ion channels a. Epinephrine
c. Enzymes b. Norepinephrine
d. Transporters c. Dopamine
e. Structural proteins d. Dobutamine
4. What is the mechanism of action of e. Digitalis
Sildenafil, a drug popularly known as 10. Which of the following statement/s is/are
Viagra? true regarding the drug, methyldopa:
a. Inhibits phosphodiesterase (PDE) I. Current clinical use is in the
leading to increase cAMP management of hypertension in
b. Inhibits PDE leading to increase pregnancy
cGMP II. It is associated with warm antibody
c. Stimulates adenylyl cyclase leading type of immunophenotypic anemia
to increase cAMP III. Toxic doses are associated with
d. Stimulates guanylyl cyclase leading hepatotoxicity
to increase cGMP a. I only
e. Inhibits phosphodiesterase leading b. I and II
to increase cGMP c. III only
5. Digibind, which effectively terminates the d. I and III
action of Digitalis glycosides is classified as e. I, II, and III
what type of antagonist? 11. What is the clinical use of the Dopamine-1
a. Pharmacodynamic antagonist agonist Fenoldopam?
b. Pharmacokinetic antagonist a. Chronic treatment of Congestive
c. Physiologic antagonist Heart Failure
d. Chemical antagonist b. Acute treatment of
e. Non-competitive antagonist Pheochromocytoma
6. Which of the following effects is/are c. Acute treatment of Hypertension
consistent with the systemic use of the drug d. Chronis treatment of
Clonidine? Supraventricular Tachycardia
I. Initial transient increase in blood e. Acute treatment of Congestive Heart
pressure failure
II. “First-dose” phenomenon 12. Which of the following adrenergic agents
III. Lowering of the blood pressure is/are most useful for hypodynamic septic
a. I only shock with hypotension?
b. I and II I. Dopamine
c. III only II. Dobutamine
d. I and III III. Norepinephrine
 a. I only as continuous IV infusion with rapid
b. I and II achievement of a steady state
c. III only concentration?
d. I and III a. Metoprolol
e. I, II, and III b. Esmolol
13. At what dose should Dopamine be given as c. Atenolol
IV infusion to produce a predominantly d. Propranolol
dopaminergic effect? e. Pindolol
a. 0.5 ug/kg/min 20. Which of the following beta-blockers
b. 5-10ug/kg/min has/have been proven in clinical trials to be
c. 10-20ug/kg/min useful in the management of stable
d. 20-50ug/kg/min congestive heart failure?
e. >50ug/kg/min I. Carvedilol
14. Guanfacine and Guanabenz are primarily II. Bisoprolol
agonists at what receptors? III. Metoprolol
a. Muscarinic-1 a. I only
b. Nicotinic-N b. I and II
c. Presynaptic alpha-2 c. III only
d. Postsynaptic alpha-2 d. I and III
e. α1 e. I, II, and III
15. A new drug is currently being developed 21. In which of the following conditions are beta-
whose mechanism of action is stimulation of blockers found to be useful?
the β3 receptors. In which condition will this I. Hypothyroidism
drug have most likely usefulness? II. Raynaud’s Phenomenon
a. Obesity III. Initial therapy in Pheochromocytoma
b. Bronchial asthma a. I only
c. Hypertension b. I and II
d. Shock c. III only
e. Acute renal failure d. I and III
16. Which of the following beta-blockers also e. I, II, and III
has peripheral vasodilating effect similar to 22. Among diabetic patients using insulin or oral
Prazosin? hypoglycemic agents (OHAs), why are beta-
a. Propranolol blockers are used with special caution if not
b. Betaxolol totally avoided?
c. Nadolol a. Beta-blockers can induce
d. Bisoprolol hyperglycemia
e. Labetalol b. Beta-blockers can mask
17. Which of the following beta-blockers is hypoglycemic symptoms
considered cardioselective? c. Beta-blockers can attenuate effect of
a. Labetalol insulin and OHAs
b. Propranolol d. Beta-blockers can induce insulin or
c. Pindolol OHA failure
d. Esmolol e. Beta-blockers can increase the risk
e. Timolol of renal failure
18. Rebound tachycardia and hypertension are 23. In which subset/s of patients are beta-
expected complications of abrupt withdrawal blockers used with caution if not avoided?
of beta-blocker therapy. Which of the I. Patients with bronchospastic
following agents has the least likelihood of disease like COPD and bronchial
causing rebound effects when withdrawn? asthma
a. Labetalol II. Patients with peripheral vascular
b. Propranolol disease especially vasospastic type
c. Pindolol III. Patients with recent myocardial
d. Metoprolol infarction
e. Timolol a. I only
19. Which of the following beta-blockers has the b. I and II
shortest duration of action (half-life = 10 c. III only
minutes) making it useful for administration d. I and III
 e. I, II, and III
24. A 44-year-old patient is started a week ago
on the following medications: Metoprolol
100 mg BIB, Diltiazem 30 mg tablet BID and
Indapamide 1.5 mg OD for poorly controlled
hypertension and chronic stable angina
pectoris. She is now admitted at the ICU for
dizziness and two episodes of syncope. Her
heart rate was 45 beats/min. What course of
action would you suggest?
a. Continue her medication and
suggest for a 12-lead ECG
b. Stop Metoprolol and request for a
12-lead ECG
c. Stop Diltiazem and request for a 12-
lead ECG
d. Stop indapamide and Diltiazem and
request for a 12-lead ECG as well as
serum potassium measurement
e. Stop Metoprolol and Diltiazem and
request for a 12-lead ECG
25. Which of the following mechanism may
explain the ability of beta-blockers to reduce
blood pressure in hypertension?
a. Increased compliance of the
capacitance vessels
b. Relaxation of the primary resistance
vessels
c. Inhibition of renin release
d. Direct inhibition of Angiotensin II
receptors
e. Decrease in total body stores of
sodium
26. Which of the following equations describe
the factors that contribute to blood
pressure?
a. BP=SV/SVR
b. BP=COxSVR
c. BP=SVxHR
d. BP=CO/SVR
e. BP=SVxSVR
27. Which of the following mechanism explains
the blood pressure-lowering effect of
thiazide diuretics?
I. Reduction in blood volume and
cardiac output
II. Increased vascular compliance
III. Decreased proximal tubular
reabsorption of water and sodium
a. I only
b. I and II
c. III only
d. I and III
e. I, II, and III
28. Which of the following drugs inhibit enzyme
carbonic anhydrase?
a. Dichlorphenamide
b. Tolazamide
c. Astemizole
d. Selegiline
e. Donepezil
29. What is the primary mechanism of action of
the drug Indapamide?
a. Inhibition of the 2Cl-Na-K
cotransporters in the convoluted
tubule
b. Inhibition of the Na-Cl
contransporters at the convoluted
tubule
c. Inhibition of the Na-Cl cotransporters
at the collecting duct
d. Competitive inhibition of aldosterone
binding to its receptors
e. Competitive inhibition of vasopressin
binding to V2 receptors
30. Which side effect of Chlorthalidone is
prominent especially among the elderly
when Chlorthalidone is given at a dose of at
leats 50mg/day and significantly reduced
when doses are maintained below
50mg/day?
a. Hyperuricemia
b. Hyperglycemia
c. Increased in serum LDL
d. Allergic reactions
e. Hyponatremia
31. What is the rationale behind the
combination of Amiloride and
Hydrochlorothiazide (HCTZ)?
a. Minimize hyperglycemia due to
HCTZ
b. Reduce risk of renal stone formation
with HCTZ
c. Reduce hyperkalemia with amiloride
d. Minimize bicarbonaturia with HCTZ
e. Minimize hypokalemia due to HCTZ
32. The action of the drug Eplerenone most
closely resembles which of the following
agents?
a. Spironolactone
b. Amiloride
c. Triamterene
d. Metolazone
e. Quinethazone
33. Which of the following agents exhibits
pharmacodynamic interaction with the
thiazide diuretics leading to a reduced
diuretic effect?
a. Furosemide
b. Amiloride
c. Enalapril
d. Hydralazine
e. Digoxin
34. Which of the following mechanism explain effect after about 2-4 weeks of
the effects of the drug Torsemide and therapy
Bumetanide? II. Long-term use leads to improved
a. Inhibition of carbonic anhydrase at blood vessel compliance
the proximal convoluted tubule III. Has modest vasodilating property
b. Inhibition of the Na-K-2Cl co- a. I only
transporter at the thick ascending b. II only
limb of the Loop of Henle c. I and III
c. Inhibition of the Na-Cl co-transporter d. II and III
at the thin ascending limb of the e. I, II, and III
Loop of Henle 40. Which of the following agents maybe
d. Inhibition of the Na-Cl co-transporter associated with ototoxicity which may have
at the distal convoluted tubule increased risk of occuring when patient also
e. Inhibition of the Na-Cl co-transporter receive aminoglycoside antibiotic?
at the distal tubule and collecting a. Furosemide
duct b. Chlorthalidone
35. Which of the following is/are accepted c. Dorzolamide
indication/s for the drug Spironolactone? d. Amiloride
I. Adjunct in the management of CHF e. Spironolactone
II. Conn’s Syndrome 41. Which of the following mechanisms explains
III. Nephrogenic Diabetes Insipidus best the action of drug methyldopa?
a. I only a. The molecule releases
b. III only norepinephrine in the presynaptic
c. I and II vesicles and is released by nerve
d. II and III stimulation to interact with
e. I, II, and III postsynaptic adrenergic receptors
36. Which of the following is/are accepted b. The molecule is converted first to
indication/s for the drug Furosemide? alpha-methyldopamine and alpha-
I. Infusion-diuresis in hypercalcemia methylnorepinephrine which replace
II. Oliguric acute renal failure norepinephrine in the presynaptic
III. Acute pulmonary edema vesicles and are released by nerve
a. I only stimulation to interact with
b. III only postsynaptic adrenergic receptors
c. I and II c. The molecule is converted first to
d. II and III alpha-methyldopamine and alpha-
e. I, II, and III norepinephrine which stimulate
37. Which of the following agents is primarily central alpha receptors
indicated for the management of increased d. The molecule is converted first to
intracranial pressure? alpha-methyldopamine and alpha-
a. Mannitol norepinephrine which inhibit central
b. Acetazolamide alpha receptors
c. Furosemide e. The molecule directly inhibits
d. Chlorthalidone peripheral alpha and beta receptors
e. Bumetanide 42. What is the most frequent side effect of
38. Which of the following agents is most useful Methyldopa which can be seen particularly
for the management of nephrolithiasis due at the onset of treatment?
to idiopathic hypercalciuria? a. Sedation
a. Ethacrynic acid b. Depression
b. HCTZ c. Extrapyramidal signs
c. Dorzolamide d. (+) Coomb’s test
d. Vasopressin e. Galactorrhea
e. Triamterene 43. A 45-year-old female in Clonidine
39. Which of the following statements correctly 1.0mg/day for the last four weeks was
describes the characteristics of Indapamide brought to the hospital for 1-day history of
as a drug for hypertension? nervousness, tachycardia and abrupt
I. Its diuretic effect is self-limiting, and increase in her blood pressure to
may not account for its hypertensive 180/130mmHg. Her last intake of clonidine
 was last 2 days prior to admission. Which of d. Guanethidine
the following is/are appropriate interventions e. Reserpine
that you can suggest for the patient? 50. Constipation, urinary retention, tachycardia,
I. Start patient on Propranolol 50 mg mydriasis and anhidrosis are expected
BID effects based on the mechanism of action of
II. Re-institute Clonidine 1.0 mg/day which of the following drugs?
III. Start Labetalol 200 mg/day a. Clonidine
a. I only b. Trimethaphan
b. III only c. Reserpine
c. I and II d. Sodium nitroprusside
d. II and III e. Nicardipine
44. Which of the following side effects is/are 51. Which of the following drugs may be used
common to the three drugs: Hydralazine, safely for the control of hypertension in
Diazoxide, and Minoxidil? pregnant patients with pre-eclampsia?
a. Hypertrichosis I. Magnesium sulfate
b. Glucose intolerance II. Methyldopa
c. Reflex tachycardia III. Hydralazine
d. Lupus-like side effect a. I only
e. Dyslipidemia b. II only
45. In which subset of patients should c. I and II
Hydralazine be avoided or used with d. II and III
caution? e. I, II, and III
a. Patients with arrythmias 52. Which of the following mechanisms explains
b. Patient with hypertension the action of the drug Sodium nitroprusside?
c. Patients with DM a. Activation of guanylyl cyclase with
d. Patients with Ischemic Heart disease increase of cGMP
e. Patients with CHF b. Release of N20 with subsequent
46. Which of the following drugs if combined increase in cAMP
with Minoxidil may minimize latter drug’s c. Inhibition of the secretion of renin
side effect? d. Stimulation of A1 receptors
a. Hydralazine + HCTZ e. Increase conductance of outward
b. Guanethidine + Reserpine potassium channels
c. Metoprolol + Chlorthalidone 53. Which of the following agents is pure
d. Amlodipine arteriolar vasodilator?
e. Amlodipine + Prazosin a. Prazosin
47. In the management of paroxysmal b. Sodium nitroprusside
hypertension in pheochromocytoma, which c. Diazoxide
of the following drugs is the most d. Phentolamine
appropriate initial therapy? e. Pindolol
a. Phentolamine 54. Which of the following agents can be used
b. Metoprolol for hypertensive emergencies?
c. Guanfacine I. Enalaprilat
d. Reserpine II. Diazoxide
e. Clonidine III. Sodium nitroprusside
48. Orthostatic hypotension and syncope are a. I only
manifestations of a phenomenon associated b. II only
with the first dose of which agent? c. I and II
a. Labetalol d. II and III
b. Methyldopa e. I, II, and III
c. Fenoldopam 55. The decrease in arterial tone due to
d. Irbesartan vasorelaxant action of Sodium nitroprusside
e. Doxazosin is associated with:
49. The mechanism of action of the drug a. Increase in smooth muscle cGMP
clonidine most closely resembles that of: levels
a. Methyldopa b. Increase in smooth muscle cAMP
b. Propranolol levels
c. Carvedilol
 c. A decrease in calcium entry through 61. In which subset of patients which are ACE
L-type channels inhibitors avoided as treatment option?
d. A local anesthetic effect on smooth I. Patients with bilateral renal artery
muscle cells stenosis
e. Stimulation of inward K-channel II. Patients with hyperkalemia
56. Which of the following effects can be III. Pregnant patients in their 2nd and 3rd
attributed to Angiotensin II? trimesters of pregnancy
I. Stimulation of release of nitric oxide a. I only
II. Stimulation of synthesis and release b. II only
of Aldosterone c. I and II
III. Stimulation of release of d. II and III
Norepinephrine e. I, II, and III
a. I only 62. Which of the following calcium channel
b. II only blockers has greater activity on calcium
c. I and II channels in myocardial tissues than calcium
d. II and III channels in the vascular smooth muscles?
e. I, II, and III a. Diltiazem
57. What is the primary advantage of b. Verapamil
Angiotensin II receptor blockers over the c. Nifedipine
ACE inhibitors? d. Amlodipine
a. Lesser incidence of coughs e. Felodipine
b. Absence of risk interstitial nephritis 63. What is the mechanism of action of the
c. Safe for pregnant patients with dihydropyridine calcium channel blockers?
hypertension a. Inhibit the L-type calcium channels
d. Faster onset of action in the arteriolar smooth muscles
e. Lesser incidence of hyperkalemia b. Inhibit the L-type calcium channels
58. Which of the following ACE inhibitors in the anteriolar and venous smooth
require hydrolysis to the active metabolite/s muscles
in the body to produce effects? c. Equally inhibit the L-type calcium
I. Enalapril channels in the vascular and cardiac
II. Ramipril tissues
III. Perindopril d. Inhibit the S-type calcium channels
a. I only in the arteriolar smooth muscles
b. II only e. Inhibit the S-type calcium channels
c. I and II in the anteriolar and venous smooth
d. II and III muscles
e. I, II and III 64. In the long-term management of
59. In which of the following conditions are ACE hypertensiion, which of the following agents
inhibitors found to be clinically useful as is/are considered as appropriate
first-line treatment? maintenance therapy?
I. Angina pectoris I. Regular Nifedipine capsules
II. CHF II. Enalapril tablets
III. Diabetic Nephropathy III. Indapamide tablets
a. I only a. I only
b. II only b. II only
c. I and II c. I and II
d. II and III d. II and III
e. I, II, and III e. I, II, and III
60. The efficacy of ACE inhibitors in the 65. What is the most common side effect of
management of hypertension may be Enalapril?
reduced in the presence of certain drugs a. Angioedema
such as: b. Interstitial nephritis
a. Ibuprofen c. Coughs
b. Felodipine d. Hypotension
c. Indapamide e. Drug fever
d. Eprenolone 66. Which of the following anti-hypertensive
e. Hydralazine agents is the most appropriate for elderly
 male patients with benign prostatic c. Amyl nitrite
hyperplasia? d. Glyceryl trinitrate
a. Prazosin e. All undergo significant first pass
b. Amlodipine effect when given orally
c. Metoprolol 72. Which of the following statements most
d. HCTZ closely describes the primary mechanism of
e. Enalapril action of the nitrovasodilator?
67. Which of the following anti-hypertensive a. Denitrification by glutathione S-
agents may be more appropriate to use for transferase leads to release of nitrite
diabetic patients with evidence of renal ion which is then converted to nitric
disease? oxide, a molecule that activates
a. Prazosin adenylyl cyclase leading to increase
b. Amlodipine cAMP
c. Metoprolol b. Denitrification by glutathione S-
d. HCTZ transferase leads to release of nitrite
e. Enalapril ion which is then converted to nitric
68. Chinese patients are most likely to be more oxide, a molecule that activates
sensitive to effects of which of the following guanylyl cyclase leading to increase
drugs for hypertension that lower doses may cGMP
have to be used? c. Nitrate ion released upon
a. Prazosin denitrification directly stimulas
b. Amlodipine outward K-channels leading to
c. Metoprolol hyperpolarization of the vascular
d. HCTZ smooth muscles
e. Enalapril d. Nitrate ion released upon
69. In the management of hypertensive denitrification directly stimulas
emergencies, which of the following goals or outward K-channels leading to
interventions is/are correct? hyperpolarization of the vascular
I. Rapid normalization of the blood smooth muscles
pressure within 24 hours e. Nitrate ion released upon
II. Lowering of the mean arterial denitrification stimulates the
pressure by about 25% production of prostacyclin leading to
III. Initiation of oral hypertensives early vasodilation
as soon adequate blood pressure 73. Which of the following tissues exhibit the
lowering has been achieved greatest sensitivity to nitrovasodilators at
a. I only the lowest effective doses?
b. II only a. Arteries
c. I and II b. Arterioles
d. II and III c. Capillaries
e. I, II, and III d. Veins
70. Which of the following are important e. Myocardial tissues
considerations regarding the proper 74. Which of the following statements correctly
handling of Nitroglycerin tablets? explains the primary mechanism of relief of
I. Formulations used in the medicine angina pectoris with the use of
are explosive nitrovasodilators when given at usual
II. Sublingual tablets lose their potency doses?
when stored in plastic containers a. Peripheral dilation of the veins
III. These are sensitive to light leading to reduction in cardiac
a. I only preload and myocardial oxygen
b. II only demand
c. I and II b. Vasodilation of epicardial coronary
d. II and III arteries leading to improved oxygen
e. I, II, and III delivery to myocardial tissues
71. Which of the available nitrovasodilators has c. Increase in diastolic perfusion time
a bioavailability of about 100%? leading to improved perfusion to
a. Isosorbide mononitrate ischemic myocardium
b. Isosorbide dinitrate
 d. Decrease total peripheral resistance
with arteriolar vasodilation
e. Decrease in myocardial contractility
leading to reduction in myocardial
oxygen demand
75. Which of the following agents classified as
nitrovasodilators is useful in the
management of cyanide poisoning?
a. Sodium nitrite
b. Amyl nitrite
c. Sodium thiosulfate
d. Nitroglycerin
e. Isosorbide mononitrate
76. Which of the following nitrovasodilators may
induce conversion of hemoglobin to
methemoglobin (methemoglobinemia) which
can lead to cyanosis?
a. Nitroglycerin
b. Isosorbide mononitrate
c. Isosorbide dinitrate
d. Tetraethyl trinitrate
e. Amyl nitrite
77. This side effect of nitrovasodilators is
explained in part by the depletion of
sulfhydryl moieties in vascular smooth
muscles with continuous use of the drugs,
and may be partly reversed by sulfhydryl-
regenerating compounds.
a. Tolerance
b. Increased intracranial pressure
c. Reflex tachycardia
d. Methemoglobenia
e. Carcinogenicity
78. Which of the following agents is/are
considered useful as single agent in the
acute treatment of vasospastic angina
pectoris?
I. Nitrovasodilators
II. Beta-blockers
III. Calcium channel blockers
a. I only
b. II only
c. I and II
d. II and III
e. I, II, and III
79. What is the primary limitation with the use of
Dihydropyridine Calcium Channel Blockers
in the management of angina pectoris?
a. Tendency to reduce cardiac preload
b. Tendency to cause reflex
tachycardia
c. Tendency to induce reflex
vasospasm when stopped
d. Tendency to cause peripheral
edema
e. Tendency to reduce cardiac end-
diastolic pressure
80. What is the most important role of beta-
blockers in the management of angina
pectoris?
a. Causes coronary artery
vasodilatation thus useful in the
management of acute anginal
attacks
b. Dilates the epicardial coronary
vessels thus useful in patients with
ongoing Prinzmetal angina
c. Reduces myocardial oxygen
demand by reducing the total
peripheral resistance making it
useful for chronic stable angina
pectoris
d. Reduces myocardial oxygen
demand by reducing myocardial
perfusion time making it useful for
chronic stable angina pectoris
e. Reduces myocardial oxygen
demand by decreasing myocardial
perfusion time making it useful for all
types of angina pectoris
81. Which of the following drugs or drug
combination is/are useful in the
management of chronic stable angina
pectoris?
I. Regular release Nifedipine capsule
II. Metoprolol tablet
III. Metoprolol tablet + Diltiazem tablet
a. I only
b. II only
c. I and III
d. II and III
e. I, II, and III
82. What is the principal mechanism of action of
cardiac glycosides?
a. Stimulate the release of calcium for
the sarcoplasmic reticulum leading
to release in an increase intracellular
calcium
b. Inhibition of the cell membrane
outward calcium transporter
preventing calcium extrusion
c. Stimulation of inward calcium
transporter leading to an increase in
intracellular calcium
d. Inhibition of the Na-K-ATPase
leading to increase in intracellular
sodium and preventing calcium
extrusion
e. Inhibition of the Na-Ca exchanger in
the sarcoplasmic reticulum leading
to increase in intracellular calcium
83. Which of the following statements on
pharmacokinetic parameters must be
considered for patients taking Digoxin?
 a. In about 10% of patients, use of II. Useful in controlling the rate of
antibiotics can lead to increased oral ventricular response in atrial
bioavailability fibrillation
b. Renal clearance of the drug is III. Useful in pregnant patients with CHF
inversely proprtional to the creatinine a. I only
clearance b. II only
c. Half-life is long, at about 168 hours c. I and III
due in part to extensive d. II and III
enterohepatic recirculation e. I, II, and III
d. Hepatic metabolism accounts for 88. What is the major mechanism of interaction
more than 80% of the elimination of between Digoxin and Quinidine?
the drug a. Displacement of digoxin from tissue
e. It is primarily distributed within the binding site
intravascular space due to its high b. Decreased hepatic metabolism of
protein binding digoxin
84. Which of the following is/are mechanical c. Decreased renal clearance of
effects of digoxin on myocardial tissues? digoxin
I. Increase in contractility of d. Increase binding of digoxin with ion
myocardial tissues transporters in the myocardium
II. Increase in conduction velocity in the e. Increase intestinal absorption of
AV node digoxin
III. A positive inotropic effect 89. A 50-year-old male patient with CHF was
a. I only started on the following medications: digoxin
b. II only 0.25 mg OD, Hydralazine 10mg BID,
c. I and III furosemide 20mg OD, and ISMN 60mg OD.
d. II and III 1 week after initiating therapy, the patient
e. I, II, and III was admitted for blurring of vision and
85. Which of the following is/are expected palpitation. He feels nauseated and has
electrical effect/s of digoxin on myocardial problems discriminating colors. Which of the
tissues? following sourses of action is appropriate?
I. Decrease in the refractory period of a. Suggest discontinuing Hydralazine
atrial muscles and starting patient on amlodipine
II. Increase in the refractory period of b. Suggest giving of metoclopramide
the AV node for the nausea and examining the
III. A positive inotropic effect probable eye problem
a. I only c. Suggest starting patient on beta-
b. II only blocker therapy
c. I and III d. Suggest discontinuing digoxin and
d. II and III furosemide and checking for serum
e. I, II, and III K levels for necessary correction
86. Which of the following condition may e. Suggest discontinuing all
augment the effect of digitalis glycosides in medications and starting patient
myocardial tissues? instead on an ACE inhibitor,
I. Concurrent use of captopril vasodilator and a thiazide
II. Reduced oxygenation of myocardial 90. Which of the following intervention may be
tissues appropriate in the management of severe
III. Concurrent administration of calcium cases of digitalis intoxication such as in
gluconate children and in suicidal overdose?
a. I only I. Administration of digoxin immune
b. II only fab
c. I and III II. Administration of KCl
d. II and III III. Administration of MgSO4
e. I, II, and III a. I only
87. Which of the following is/are the primary b. II only
indication/s of Digitalis Glycosides? c. I and III
I. First line drug for the initial d. II and III
management of CHF e. I, II, and III
91. What is considered as the toxic plasma 96. Which of the following statements correctly
concentration of digoxin? describe/s the appropriate use of drugs for
a. >0.5mg/mL CHF?
b. >150mgng/mL I. Beta-blockers when used for
c. >10ng/mL patients with stable CHF can be
d. >5ng/mL given at doses similar to the dose
e. >2ng/mL used for hypertension
92. What is the primary use of drugs like II. ACE inhibitor dose must be carefully
Inamrinone and Milrinone? titrated to the maximum allowable or
I. Alternative to digoxin in patients with tolerable dose
chronic CHF III. Spironolactone has been found to be
II. Management for acute heart failure most useful as initial drug therapy for
III. Management of exacerbation of CHF even prior to the use of ACE
chronic CHF inhibitors or vasodilators
a. I only a. I only
b. II only b. II only
c. I and III c. I and III
d. II and III d. II and III
e. I, II, and III e. I, II, and III
93. What is the mechanism of action of 97. Which of the following drugs or drug
Inamrinone and Milrinone in the combinations can reduce both the cardiac
management of heart failure? preload and afterload in CHF?
a. Increase the levels of cAMP by I. Hydralazine + Nitrovasodilators
activating the enzyme adenylyl II. Beta-blockers + Loop diuretics
cyclase III. Loop diuretics + Digitalis
b. Increase the levels of cAMP by a. I only
inhibiting the enzyme b. II only
phosphodiesterase III c. I and III
c. Increase the levels of cGMP by d. II and III
inhibiting the enzyme guanylyl e. I, II, and III
cyclase 98. Which of the following interventions may be
d. Inhibit the outward calcium flux beneficial in the management of CHF?
leading to increased intracellular I. Replacement of chronic digoxin
calcium dose with ACE inhibitors
e. Primarily cause peripheral II. Add-on therapt with Aldosterone
vasodilation leading to reduced antagonist on patients already on
cardiac preload digoxin or ACE-inhibitors
94. Inotropic activity on the heart in CHF can be III. Use of calcium channel blockers in
increased by which of the following agents? patient who cannot receive beta-
I. Bipyridines blockers
II. ACE inhibitors a. I only
III. Beta-1 agonists b. II only
a. I only c. I and III
b. II only d. II and III
c. I and III e. I, II, and III
d. II and III 99. Which of the following drugs is a sodium
e. I, II, and III channel blocker that can prolong the
95. Which of the following agents for the heart duration of the action potential and
failure may be associated with arrythmia, dissociates from the channel with
thrombocytopenia, aand hepatotoxicity intermediate kinetics?
which limit their use in patients with chronic a. Lidocaine
CHF? b. Flecainide
a. Bipyridines c. Quinidine
b. Digitalis glycosides d. Bretylium
c. Beta-1 agonists e. Diltiazem
d. ACE inhibitors 100. Which of the following drugs is a
e. Angiotensin II antagonists sodium channel blocker which has no
 significant effect on the duration of the c. Amiodarone
action potential and dissociate from the d. Bretylium
channel with slow kinetics? e. Adenosine
a. Lidocaine 107. What is the primary mechnism of
b. Flecainide action of the drug Amiodarone?
c. Quinidine a. Prolong the action potential with
d. Bretylium block of the sodium channels
e. Sotalol b. Shorten the action potential with
101. Which of the following beta-blockers block of the sodium channels
have been found to be most useful as anti- c. Prolong the action potential with
arrhythmic agent/s? block of the potassium channels
I. Esmolol d. Shorten the action potential with
II. Metoprolol block of the potassium channels
III. Propranolol e. Inhibit intrinsic sympathetic
a. I only stimulation by preventing activation
b. II only of the enzyme adenylyl cyclase
c. I and III 108. What side effect/s may be expected
d. II and III with the use of Amiodarone?
e. I, II, and III I. Hypothyroidism or Hyperthyroidism
102. Which of the following anti-arrythmic II. Fatal pulmonary fibrosis
agents has been associated with lupus-like III. Symptomatic bradycardia and heart
side effects? block particularly in patients with
a. Quinidine atrioventricular nodal disease
b. Lidocaine a. I only
c. Propafenone b. II only
d. Amiodarone c. I and III
e. Procainamide d. II and III
103. What is the drug of choice for the e. I, II, and III
management of sustained ventricular 109. Measurement of the serum ALT prior
arrythmia associated with acute myocardial to and during therapy of arrythmia is
infarction? indicated when which of the following drugs
a. Procainamide for arrythmia is/are used?
b. Lidocaine a. Propafenone
c. Amiodarone b. Moricizine
d. Verapamil c. Amiodarone
e. Adenosine d. Flecainide
104. What is the preferred drug for the e. Diltiazem
management of ventricular arrythmias 110. Which of the following calcium
associated with digitalis intoxication? channel blockers is most useful in arrythmia
a. Procainamide therapy?
b. Lidocaine a. Verapamil
c. Amiodarone b. Diltiazem
d. Verapamil c. Nifedipine
e. Adenosine d. Lidocaine
105. What is the preferred drug for the e. Propafenone
management of acute episodes of
supraventricular tachycardia?
a. Quinidine
b. Verapamil
c. Amiodarone
d. Bretylium
e. Adenosine
106. What is the preferred drug for the
management of chronic paroxysmal
supraventricular tachycardia?
a. Quinidine
b. Verapamil