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PHCL 3504 : Cardiovascular system----- 18 Nov 2009- 50mins (e) Digoxin

Section A: Multiple Choice (Choose the ONE best answer) 8. The peripheral α-blockers, doxazosin is best for the treatment of which of the following conditions?
(a) Hypertension in diabetic patients
1. Which of the following is NOT a contra-indication of β-adrenoceptor antagonists (b) Hypertension in patients with renal insufficiency
(a) Asthma (c) Hypertension in patients with gout
(b) Acute Heart failure (d) Hypertension in patients with benign prostatic hypertrophy
(c) Second degree heart block (e) Hypertension in patients with asthma
(d) Migraine 9. A 42 year old diabetic male with moderate hypertension will be recommended to take which of the
(e) Bradycardia following groups of anti-hypertensive drugs?
2. Captopril, an angiotensin-converting enzyme (ACE) inhibitor: (a) Non selective β-blocker
(a) Increases concentrations of angiostensin II (b) Thiazide diuretic
(b) Increases concentration of bradykinin
(c) Increases noradrenaline release from sympathetic nerve terminals
(c) Angiostensin Converting Enzyme Inhibitor
(d) Loop diuretic
(d) Increases aldosterone secretion
(e) Blocks angiotensin II receptors (e) Anti-aldosterone diuretic
3. All of the following mechanisms of action correctly match the corresponding drug 10. Which of the following is NOT correct as concerns the clinical use of Calcium channel blockers?
EXCEPT (a) They are generally used to treat essential hypertension
(a) Quinidine: Blocks Na+ channels (b) Diltiazem is indicated for Angina pectoris
(b) Verapamil: blocks Ca++ channels (c) They are generally used for the treatment of Hypertension
(d) Nefidipine is used to treat certain forms of arrhythmias
(c) Amiodarone: Blocks Na+ channels (e) Mild to moderate chronic heart failure could treated with certain calcium channel
(d) Lidocaine: blocks Na+ channels blockers
(e) Propranolol: blocks β-adrenoceptors 11. Bronchocontriction as an adverse effect of some β-adrenoceptor antagonists is mainly determined by
4. Which of the following most directly describes the mechanism of action of digoxin? which of the following properties?
(a) Decrease intracellular sodium concentration (a) Lipophilicity
(b) Inhibits sodium-potassium ATPase (b) Hydrophilicity
(c) Cardioselectivity
(c) Increases the intracellular level of ATP
(d) Affinity to α1-adrenoceptors
(d) Stimulates production cAMP
(e) Intrinsic Sympathomimetic Activity
(e) Decreases release of Calcium from the sacroplasm reticulum
12. The hypolipemic agent Ezetimibe is an inhibitor of cholesterol absorption. Which of the following
5. Digoxin is useful in the treatment of which of the following?
is(are) it adverse effect(s)?
(a) Ventricular arrhythmias
(a) Increase in transaminases
(b) Supra-ventricular arrhythmias
(b) Rhabdomyolysis
(c) Sinus arrest
(c) Constipation
(d) Heart blocks
(d) All of the above
(e) Acute Arrhythmia following myocardial infarction
(e) None of the above
6. Which of the following families of diuretics is best recommended as the First-Line drug
13. Which of the following vasodilating hypotensive agents is best indicated for the treatment of
for the treatment of mild to moderate hypertension?
hypertensive crisis in pregnancy?
(a) Thiazides diuretics
(a) Methyldopa
(b) Loop diuretics
(b) Sodium Nitroprusside
(c) Potassium sparing diuretics
(c) Hydralazine
(d) Inhibitors of carbonic anhydrase
(d) Isosorbide dinitrate
(e) Osmotic diuretic
(e) Glyceryl trinitrate
7. Which of the following agents is indicated for the treatment of significantly low cardiac
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output observed in ventricular failure that follows myocardial infarction or septic shock?
Section B: (6pts). Open Questions
(a) Adrenaline
(b) Atropine
14. Specify the differences between Angiotensin Converting Enzymes Inhibitors (ACEI) and Angiotensin
(c) Propranolol
Receptor blockers (ARB) with reference to: (i).The prototype drug of each family; (ii).The site and
(d) Dobutamine

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mechanism of action; (iii).The pharmacological effects; (iv).The therapeutic uses; and
(v).The common adverse effects. (5pts)
15. With reference to the pharmacologic action of diuretics, what explains their anti-
hypertensive effects? (2pts)

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