Cardiovascular

1-Which is the least likely to cause postural hypotension?

a)Direct vasodilators
b)Diuretics
c)Alpha blockers
d)B blocker

2-Which of these used in emergency and cause prompt hypotensive

effect Sod Nitroprusside
2’- Drug for hypertension emergency NA nitroprusside
2”-Which drug contains Iron and CN in its structure and decreases
emergency blood pressure
Na nitroprusside

3-The " first dose" effect is characterized by marked hypotension and

syncope on taking the first few doses of medication, this effect is
seen with the use of :
A) doxazosin ( Cardura) 
B)  enalapril ( Vasotec ) 
C) sotalol ( Betapace)

4- Patient with hypertension and gout which antihypertensive drug

suitable for him:
a. Chlorthiazide
 b. Torsemide
c. Metolazone
d. Tenormin,,,,atenolol ,,,bb
Ans,,,,d

5-Thiazide diuretics should Not be used as first line treatment

for HTN in patient suffering from?
a) Hyperlipidemia
b) Heart failure
c) COPD
d) Gout
e) Peripheral artery disease

6-Patient with hypertension and congestive heart failure with ejection fraction
28% which suitable antihypertensive for him:
a. Clonidine
b. Gaunithidine
c. Diltiazem
d. Nisoldipine

7-70 yr old diabetic pt on oral hypoglycemica and suffering from

hypertension ; Which of the following antihypertensive drugs is not
recommended : 
1- losartan
2- enalapril
3- Hydrochlorothiazide
4- Atenolol

NB.  In patient having HTN & DM 

Losartan & enalapril are (ARBs/ACE) which are the first line since they provide
nephroprotection 
Thiazides are recommended as second line ..  
Beta blockers are indicated and are as effectively as ACE .. But used with caution as they
can

7’- Patient with HTN and DM having arrhythmia what would be the best
choice for him?
Verapamil
Sotalol

8-Patient suffered from emergency hypertension with angina he

undergo surgery, he is taking hydrochlorothiazide and after surgery he
was under some ventilation;

 What is best antihypertensive drug to give him;

hydralazine , metoprolol
After treating with hydralazine what medicine can be given to
cover or treat angina; a. Na nitoprusside
b. Nitroglycerin
c. Nicardipine

 What is the most drug associated with life threating condition of

hyperkalemia; spironolactone(k sparing diuretic)
NB. (This is still discussed but some chose Hydralazine because action should be fast &
consequences are known & been ready for counteraction as the following question)
NB. Hydralazine also aggravates angina so metoprolol makes more sense

9-patient with hypertension put on antihypertensive drug, after few

months developed heart failure manifested as reduction in heart rate
and contraction, which antihypertensive drug patient put on:
a. Lisinopril
b. verpamil
c. prozosin
d. Thiazide diuretic

10-Minoxidil used in ttt of hypertension what is its action

a. decreased heart rate & increased contractility
b. decreased arterial pressure & decreased contractility
c. increased heart rate & decreased contractility

10’-Case about a patient came to emergency with high blood pressure

and they gave him minoxidil what the Mechanism of Action:
A-decrease HR and decrease contractility
B-decrease arterial pressure and increase contractility
C-Increase HR and increase contractility
D-....
NB. MoA of minoxidil :_1_decrease arterial pressure
2_increase heart rate
3_increase contractility
11- timolol is contraindicated in all the following except
A.HTN
b. Congestive Heart failure
c- Bronchial asthma

11’- Beta blocker use in all except: Bronchial asthma

12-hosptalized patient with angina which antihypertensive is suitable

for him
-metoprolol
-hydralazine
-methyldopa
-clonidine

NB. Because metoprolol reduce mortality /hospitalization in patients with heart diseases
already receiveing diuretics or ACE inhibitors or digoxin.
Also in Lipincott the DOC for HTN with angina is B-Blockers then Ca channel blockers
followed by Diuretics or ACE inhibitors.

13-Pregnant woman having HTN which of the following can be used :

Ans (labetalol)

NB. first methyldopa, second nifidipine, third labetalol

14-Nifedipine not used in

a. pre_eclampsia
b. early abortion
c. HTV
d. angina
14’-Nifedepine is used in all except:

a) Hypertensiom

b) Angina

c) Pre eclampsia

d) Premature Labor

14”- Nifedepine is used in all except:

a) Hypertension
b) Angina pectoris
c) Pre eclampsia
d) Premature Labor

NB. Nfidipine not used in 

1_early abortion
2_ angina pectoris  ( but used in prinzmetal angina)
3_preclampsia for the answering you will choose by this order if more than one of
them is there

NB. (Nifidipine is Ca channel blocker not used in angina pectoris..it causes coronary steel
syndrome and worsen the case..But it can be used in prinzematal angina only)

note:
Pre-eclampsia iscondition in pregnancy characterized by high blood pressure,
sometimes with fluid retention and proteinuria.
nifedipine is used only in urgent cases of pre_eclampsia , it’s not the first choice ,
it’s a second choice

DOC (first line)

for pre_eclampsia hypertension is methyldopa
(second line) ( for urgent control of sever hypertension in pregnancy ) are ….
1. labetalol …. ( and its side effect is … may be associated with fetal growth
restriction )
2. nifedipine … ( and its side effect is .. may inhibit labour ( may be beneficial as
tocolytic agent .. agent that delalys premature labor )

15-A stomach upset radiating to be chest pain is:

Angina 
Myocardial infarction

15’-gastric pain after heavy meal radiating to the neck and lower jaw:
A.atypical angina 
B.duodenal ulcer
C.gastritis
D.gastric cancer

16-prinzmetal angina:-
a-sudden spasm and may occur at rest
b-sudden spasm with atherosclerosis

16’- prinzmetal angina:

a-sudden spasm
b-sudden spasm with atherosclerosis
c-sudden spasm with atherosclerosis and not responsive to CCBs and
nitroglycerin
d- sudden spasm ,with atherosclerosis, and respond to CCBs and
nitroglycerin
16”-patient admitted to ER with chest pain, diagnosed as prinzmetal
angina ,regarding this angina which is true :
a.Occur at rest not associated with p hysical activity
b.Associated with artery spasm
c.Associated with atherosclerosis
d.Not responsive to nitroglycerin and CCB
Answer...all true except D

17-which of the following not used in prinzmetal angina??

atenolol
nifedipine
nitroglycerin
dilitazem

17’- Which is contraindicated in prinzmetal angina

a- Nitroglycerin
b- BB

18- Not use in angina

Losartan
NB.( Angina treatment 1st line Nitrates then CCBs or BBs avoid ARBs & ACIs)

18’-Not used in angina

A- Losartan
B- CCBS
C- Verapamil
D- Nitrates

19-A-ICU patient with cardiovascular disease , Angina and was given

Hydralazine, Drug that may decrease his Blood pressure in 2 hours can
be 
-B-blockers
-Captopril
-ARBs

19-B-Which drug can counteract the increased risk of angina caused by

use of hydralazine for this patient
-nitroglycerin
-nifedipine

20- AD is a 58 year old male with diabetes, angina and erectile

dysfunction. His physician
consults the pharmacist in order to decide if AD would be a good
candidate for sildenafil.
The use of sildenafil is CONTRAINDICATED for AD if he takes:
a. isosorbide 5-mononitrate.
b. metoprolol.
c. glyburide.
d. ASA.
e. enalapril.

21- a patient attended ICU with high blood pressure and previous
angina, he then had a cardiac surgery and put on a mechanical
ventilator :used in mechanical ventilation to reduce UN wanted
respiratory movement
A-pancronium
b- Succinylcholine
C-baclofen

22- Which drug if used aggravates angina and causes ischemic

tachycardia
a- metoprolol
b- hydralazine
c- ccb

23-In the treatment of cardiac arrhythmias, amiodarone (cordarone) is

most similar in action to
1.tocainide
2.verapamil
3.sotalol
4.digoxin
5.flecainide

NB. As amiodarone is Class 3 (K channel blocker) & Sotalol have both class 2&3 actions
24- years old Male patient , he is a smoker and he is taking an
antiarrhythmic medications , which of the following drugs should be
avoided :
A. Digoxin
B. Verapamil (insulin, heparin, warfarin, clopidogrel, nsaids, flecainide,
propranolol, caffeine TCA, BNZ, antipsychotics, duloxetine, alprazolam,
opoids, paracetamol, cortocosteoirs, oral contraceptives, theophylline
C. Amiodrone
D. lidocaine

NB. Verapamil is avoided with smoking 

 Smoking - drugs interaction list :
Insulin, Warfarin, Heparin 
Caffeine, Alprazolam, Duloxtine ( snri )
Fluoxamine ( ssri), TCA, BNZ
Antipsychotics, Opioids, Nsaids, Acetaminophen
Verapamil, Corticosteroids
Oral contraceptives, Clopidogrel
Propranolol, Theophylline, Flecainide

25-years old patient had a myocardial infarction which one of the

following appropriate prophylactic anti arrhythmia??
1-lidocaine 
2-metoprolol
3-quindine
4-procainamide
5-verpamil

26-Antiarrythmic used for patient with atrial fibrillation:

-Lidocaine
- propofol
- quanidine
-sotalol
26’- which drug used in atrial fibrillation
-lidocaine
-propafenon
- sotalol

27-Not used for atrial fibrillation

quinidine, 
lidocaine, 
procainamide, 
flecaninde

NB. used in AF: Propafenone, sotalol, flecanide, amidarone & Labetolol

except lidocaine (used for ventricular arrhythmias)
DOC….1-B-blocker if not 2-Calcium Channel blockers ..if not 3- amiodarone ,lefocanide ..4-
sotalol

No t used for atrial fibrillation; quinidine, lidocaine, procainamide, flecaninde:

28- Patient with arrhythmia discharged from the hospital which

medication used to control his condition :- verapamil

29-Common side effects of arrhythmic drug:

torsade de pointe

29’-side effect of all anti-arrhythmic drugs:-

a-blurred vision
b-torsade de points
NB. There is no agreed answer for this Q as both are SE
30- CASE About Arrhythmia ( statements ) :
a-most cause of recurrent arrhythmia due to reentry
b-Most Of them is Calcium and sodium blocker
c-SA node is the pace maker ( something like that )
d.anti-arrythmic safer than operation

30’-Case about pt. have arrhythmia come to ICU all true except
a- Antiarrhythmic safer than surgery
b. Antiarrhythmic MOA is sodium and calcium blockers
c. Arrhythmia is happened due to reentry
31- Patient with arrhythmia given medication that decrease the
velocity and force of contractility which one of this drugs :
a. Verapamil
b. enalapril

32-Digoxin mechanism of action include

a- affect vagal rate of transmission
b- cause some atrioventricular block
c- Inhibit Na channels
D-all

32’-Mechanism of action of digitalis all true except: 

a - increase contractility
b- decrease vascular resistance 
c- have modify effect on autonomic nervous system
d- maintain ventricular rate in atrial fibrillation
32”-Mechanism of action of Digitalis all is true expect : 
a-Incrrease contractility
b-decrease vascular resistance
c- have modify effect on central nervous system ?
d-maintain ventricular rate in atrial fibralltion 

32””-digoxin act on Na/k atpase

33- Digoxin is CI in?

Complete heart block
ventricular arrhythmia

33’-Digoxin can be given in all except:

-Complete cardiac block

34-Increase renal clearance of digoxin

Verpamil or phenytoin

NB.Verapamil,Quindine and amiodarone …etc decrease the renal clearance of digoxin

35-Which drug induces bradycardia? 

verapamil
digoxin
atenolol/betablocker 
All

NB. Digoxin: Positive inotropic, Negative chronotropic so decrease heart rate

36-all of the following are side effects of digoxin toxicity except
1-visual disturbances
2-confusion
3-ventricular arrhythmia
4-acute renal failure
Drugs that cause digoxi toxicity are verapamil, quinidine, amiodarone,
ttc, thiazide, loop, corticosteorids, erthyromycin, ttc
Factors that increase toxicity are hypokalemia, hypercalcemia,
hypomagnesaemia, hypothyroidism, hypoxia, renal failure, myocarditis.
37-Secondary prevention for reinfarction:
A- Aspirin

38-Case Patient with glaucoma and blood pressure 220/110 and

hypertensive crisis and ask which to avoid :-
a-nicardipine
b-fenoldopam
c-Na nitroprusside
d-labetalol
NB. Fenoldopam is D1 agonist increase IOP so not used in glaucoma

39-Niacin Has the Highest effect on HDL

39’- case about patient have lowered HDL :

Niacin ..
Simvastatin
Fenofibrates

39”-patient diagnosed with Hyperlipidemia and decreased HDL , what is

the drug useful in his condition ?
A) Niacin 
B) Clofibrate
C) Cholestyramine 
D) Rousavastatin

40-Lipitor is used for which type of hyperlipidemia markers :

IIA AND IIB

41-Case about a patient took lovastatin all of the following are side
effect except:
A-myopathy
B-rhabdomyolysis
C-renal dysfunction
D-hepatic dysfunction

42-atorvastatin 10mg =20 mg simvastatin

43-Simvastatin causes serious interaction with:

 a. Amiodar (mention trade name of amiodarone)
b. Verapamil
c. Aspirin

44-CI of loop diuretic except:- renal impairment

45- Patient with hypertension and renal failure which diuretic suitable
for him:
a. Chlorthiazide (Thiazide)
b. Triametrene (K sparing)
c. Furosemide (loop)
d. Spironolactone (K sparing)

46-Thiazide diuretic doesn’t cause

1. hyperkalemia 
2. hypokalemia 
3. hypocalcemia 
4. Hyponatremia

NB. It causes K depletion, hypercalcemia & hyperurecemia so can cause gout also

47-which drug cause high elevation in potassium?

K sparing diuretic: spironolactone
47’-Triamterene and Spironolactone are:
k sparing diuretic

48- Which is used in patient with pulmonary edema and heart failure:
- furosemide
- mannitol
49-Which not caused by furosemide
Hypokalemia
Hypomagnesaemia
Metabolic acidosis
Metabolic alkalosis

50- bumetanide true about it :

a. cause Ototoxicity
b. Need potassium treatment with it
c. Contraindicated with sulphonamide sensitivity
d. All of the above

NB. Bumetanide is loop diuretic

51-All are route of administration of nitroglycerin except :-oral

51’-Nitroglycerin not use in route of administration :

or .(about nitroglycerin least favorable route of administration :)
a. oral
b. buccal
c.Transdermal
d. sublingual

52-When a patient is prescribed Glyceryl trinitrate (nitroglycerin)

tablets
they must;
a): store them in a tightly closed glass bottle
b): keep a couple of tablets in their pocket or purse for emergency use
c): swallow them whole with a glass of water
d): take them regularly e.g. 8 hourly

NB. Nitroglycerin is highly sensitive to light and moisture , so if you will put it in a
pocket , it will lose their efficiency and when the time will come and the patient
need to use it , it will not be effective 

53-The role of B-blocker in MI is all of the following except:

a-Decrease mortality and morbidity
b- decrease infract size
c- Increase O2 demand

54- The cough in ACE inhibitors: EXCEPT:

A. Accumulation of bradykinin
B. In women more than men
C. Appears in 6 months
D. Dose related

55-patient on Thiazide and was given additional antihypertensive which

have resulted in decrease in blood pressure in first 2 hours
-atenolol
-ACEI
-CcB

56-drug should be monitored with elderly pt

A.propranolol 
NB.  it lipophylic so increase accumulation
57-drugs acts as enzyme inhibitor on the first dose
diazepam
enalapril
captopril

58-which one is a pro drug:

A .enalapril 

59-Patient undergo cardiac surgery they gave him dobutamine infusion,

the rule of infusion is;

antagonize the alpha and beta receptor

release nor epinephrine in the neuron synapse

antagonist the dopamine receptor, all .

Answer: none of them as it alpha and beta agonist

NB. Dobutamine act as beta 1 receptor agonist which have sympathomimetic effect used
for heart failure

59’-dobutamine act by 

-Direct action on beta1 and alpha receptor

60-Propranolol not used in:

Partial AV block.
Cardiomyopathy
61-Optimum blood pressure for hypertensive patient, not suffers from
any other problem?

A-> 140 ……>90 mmHg (True)

62-Which drug is not fully excreted by kidney

* enalapril
*fosinopril

63-Patient is taking hydrochlorothiazide\ amiloride …which interact

with them: Enalapril
There is no losartan in choices so this is the right one if losartan isn't present

64-Inderal is generic name for: Propranolol

65-treatment of anemia is :
* folic a * iron * vit B12 *erythropoietin * all

66- Case with low no of RBCs & low Hb content, which drug can be given
with Iron for him__
*erythropoietin * vit B12 * Folic acid * all

67- medicine or vitamin or mineral as iron that increase hemoglobin

conc. in blood ; it is called : 
1) Hematinic .
2)Hematopoietic
3)Hemorheologic
4)Hemostatic

68-medicine that increase blood cell formation , it is called :

Hematinic , Hematopoietic , Hemorheologic , Hemostatic

69-medicine that improve blood viscosity :

Hematinic , Hematopoietic , Hemorheologic ,Hemostatic

70-medicine that comprises platelet aggregation and fibrinolysis :

Hematinic , Hematopoietic , Hemorheologic ,Hemostatic

71-megaloblastic anemia give :

A. Vit.B12
B. Iron
C. Folic acid

NB. In lipincott megaloblastic anemia shouldn’t be treated with folic acid alone but with
vitamin B12 and folic acid

72- Patient with sickle cell anemia is given a blood transfusion, and
signs of liver failure begin to appear, this is due to overdose of:
a) iron (toxicity: vomiting, nausea, confusion, abdominal pain, diarrhea,
drowsiness, liver failure, shokc, hypotension, metabolic, acidosis, liver
cirrhosis, seizures, coma)
b) erythropoietin
c) folic acid
d) vitamin b12

73-primary mechanism of action of warfarin :

 Vitamin k reductase inhibitor

74-Erythropiotin known as increase hemoglobin … which following not

used in
A-severe anemia due to acute bleeding
B- something about cancer related

75- which fibrinolytic cause hypersensitivity:

a- Altepase:
b- Fondaparinux
c- Streptokinase
d-Urokinase

76- which considered fibrin selective:

a- Altepase:
b- Fondaparinux
c- Streptokinase

d- Urokinase

77- Which antiplatelet cause agranulocytosis, thrombocytopenia and

aplastic anemia:
a. Ticlopedine
b. Clopidogril
c. Aspirin
d. Abciximab

78-outpatient needs anticoagulant

*heparin
* low molecular weight heparin
* Low molecular weight heparin and fondaparinux