1) What is the primary mechanism by which reducing heart rate improves coronary artery blood flow in IHD?

2) A patient on minoxidil for refractory hypertension presents with new-onset hirsutism. What is the mechanism behind this effect?

3) Re-entrant circuits causing arrhythmias require:

4) Statins exert their primary lipid-lowering effect by inhibiting which enzyme?

5) A major limitation of sustained nitrate therapy (e.g., patches, infusions) for chronic angina is:

6) Statins are recommended for use in patients with type 1 diabetes primarily because they:

7) Dabigatran is classified as a:

8) Sotalol has combined actions of:

9) Refractoriness during the cardiac action potential prevents:

10) Bosentan, an endothelin-receptor antagonist, is primarily used for:

11) The plateau phase (Phase 2) of the cardiac action potential is maintained by:

12) A key adverse effect of digoxin exacerbated by hypokalaemia is:

13) A 45-year-old woman with resistant hypertension is started on spironolactone. What is the main mechanism by which this drug helps reduce blood pressure?

14) Which mechanism is described as a “slower, more sustained mechanism” in BP regulation due to changes in total body water?

15) What is the major side effect of minoxidil that limits its use in first-line HTN therapy?

16) Sympathetic activation in early heart failure is compensatory because it:

17) Why are antiplatelet drugs generally more effective at preventing arterial thrombosis than venous thrombosis?

18) What is the primary trigger for the Intrinsic Pathway?

19) Which endothelium-derived substance is a potent vasoconstrictor?

20) Which class is typically recommended as first-line treatment for hypertension in a younger diabetic patient?

21) Which class of drugs primarily treats IHD by slowing the heart rate, reducing contractility, and thereby decreasing myocardial oxygen consumption?

22) Clopidogrel and Prasugrel exert their antiplatelet effect by:

23) What is the primary mechanism of action of ACE inhibitors in HTN treatment?

24) Why is Streptokinase typically used only once in a patient’s lifetime?

25) Which drug class directly inhibits the enzyme responsible for converting Angiotensin I to Angiotensin II, making it a key target in hypertension?

26) Which anti-arrhythmic agent is most pro-arrhythmic and should be avoided in patients with structural heart disease or previous MI due to risk of fatal arrhythmias from ectopic foci?

27) How does heparin primarily exert its anticoagulant effect?

28) Lidocaine (Class Ib) is effective only in:

29) Amiodarone’s primary mechanism of action is:

30) Why are nitrate vasodilators such as glyceryl trinitrate (GTN) not suitable for long-term monotherapy in HTN?

31) Vasodilators benefit angina pectoris by which of the following actions?

32) Why are Thiazide diuretics considered to have a sustained effect in hypertension beyond their initial diuretic action?

33) Which of the following drugs slows conduction through the AV node and is most effective for re-entrant supraventricular tachycardia?

34) Spironolactone is effective in hypertension and heart failure primarily because it:

35) Why do PDE inhibitors (e.g., milrinone) improve contractility without increasing heart rate?

36) What is the term for abnormal pacemaker activity originating outside the SA node?

37) Fibrinolytic drugs are most effective when administered:

38) A 70-year-old woman presents with atrial fibrillation due to an ectopic focus in the atria. Which agent is most suitable to control ventricular rate by slowing AV nodal conduction?

39) What is the primary mechanism by which β-blockers help reduce blood pressure, specifically regarding the RAAS?

40) Which of the following is a CONTRAINDICATION for statin use?

41) . What initiates the “vicious cycle” in heart failure?

42) Which vessel type is primarily responsible for controlling systemic blood pressure (BP) due to its high smooth muscle content?

43) Vitamin K is essential for the hepatic synthesis of which clotting factors?

44) Which drug class is a cornerstone in heart failure treatment due to its effects on preload, afterload, and SNS activity?

45) Alteplase and Tenecteplase are:

46) Which natural anticoagulant, produced by endothelial cells, is a key inhibitor of both thrombin and activated Factor X?

47) A 48-year-old hypertensive patient started on thiazide diuretics has improved BP but develops muscle weakness and fatigue. Labs show hypokalemia. What is the likely explanation?

48) What is the key enzyme responsible for dissolving the fibrin clot?

49) Why is sublingual administration critical for GTN’s rapid effect in acute angina?

50) What is a key vascular side effect of non-selective beta-blockers like propranolol, and what is its mechanism?

51) Digoxin can be useful in atrial fibrillation by:

52) Apixaban and Rivaroxaban are classified as:

53) Which of the following is NOT a primary goal of drug therapy in IHD?

54) ACEIs are preferred over ARAs in heart failure unless:

55) Why must heparin (unfractionated or LMW) be administered parenterally (injected)?

56) Platelet activation and aggregation at an injury site is a classic example of:

57) Which class is typically preferred as first-line treatment for hypertension in an older non-diabetic patient?

58) A patient with HTN develops angioedema after starting an antihypertensive. Which of the following is the most likely cause?

59) How do diuretics (e.g., furosemide) benefit heart failure?

60) Atrial flutter due to a re-entrant mechanism is best controlled with which of the following, especially if structural heart disease is present?

61) Adenosine must be avoided in asthma because it:

62) Why are Adenosine-receptor antagonists (like Clopidogrel) often used in combination with Aspirin?

63) Digoxin’s mechanism in heart failure includes:

64) Which drug interaction increases digoxin toxicity risk?

65) Amiodarone’s half-life is approximately:

66) Minoxidil is reserved for severe, resistant hypertension primarily because it:

67) Nicorandil treats angina through a dual mechanism involving:

68) Which equation correctly represents systemic blood pressure regulation?

69) Prazosin and Doxazosin reduce blood pressure primarily by:

70) A 67-year-old man with a history of myocardial infarction presents with sustained ventricular tachycardia. Which drug is most appropriate to break a re-entrant circuit in this setting?

71) A 35-year-old woman with pulmonary arterial hypertension is treated with bosentan. What serious adverse effect should be regularly monitored?

72) What is a critical reason ACEIs and ARBs should NEVER be co-prescribed?

73) Compared to ACEIs, Angiotensin Receptor Blockers (ARBs – e.g., losartan) have the main advantage of:

74) Which drug prolongs the AV nodal action potential and delays conduction?

75) Which ion influx primarily causes depolarization in the SA and AV nodes?

76) A patient develops ventricular tachycardia after a myocardial infarction. What is the most likely underlying electrophysiologic mechanism?

77) Why does the anticoagulant effect of warfarin take several days to develop fully?

78) Beta-blockers are generally not preferred first-line for hypertension unless there are additional indications because:

79) Adenosine’s key anti-arrhythmic action is:

80) Compared to arterial thrombi, venous thrombi typically contain a higher proportion of:

81) What is the specific reversal agent for life-threatening bleeding caused by dabigatran?

82) What substance, naturally produced in the body and also used clinically, powerfully stimulates the activity of Antithrombin?

83) Which drug is contraindicated in patients with heart failure or post-MI?

84) What is the primary trigger for the Extrinsic Pathway?

85) What is the specific reversal agent for life-threatening bleeding caused by warfarin?

86) A 65-year-old man with type 2 diabetes and proteinuria is diagnosed with stage 1 hypertension. Which medication is most appropriate to initiate?

87) A 58-year-old hypertensive man is given hydralazine. Which of the following is a common reflex response to its vasodilator action?

88) Warfarin exerts its anticoagulant effect by:

89) What defines a cardiac arrhythmia?

90) Why is digoxin especially useful in heart failure with atrial fibrillation?

91) Reducing preload in IHD primarily helps by:

92) The Final Common Pathway of coagulation involves the activation of:

93) Which fibrinolytic drug is derived from bacterial sources and carries a significant risk of allergic reaction and antibody formation?

94) How does aspirin achieve its antiplatelet effect?

95) Ezetimibe lowers cholesterol levels by:

96) Heparin-Induced Thrombocytopenia (HIT) is caused by:

97) A 58-year-old man with hypertension presents with a persistent dry cough after starting antihypertensive therapy 3 weeks ago. Which drug is the most likely cause?

98) The proposed mechanism for statin-induced muscle pain involves:

99) A 72-year-old woman with isolated systolic hypertension is prescribed amlodipine. What is the most likely mechanism of its antihypertensive effect?

100) A 70-year-old woman with a history of angina complains of frequent headaches and facial flushing after starting a new medication. She takes a sublingual drug during chest pain. What is the likely medication?

101) A 56-year-old woman with hypertension and heart failure is prescribed an ACE inhibitor. What beneficial effect beyond BP lowering is expected?

102) A patient with HTN is on aliskiren monotherapy. Which clinical condition requires caution or avoidance of this drug in combination with ACEIs or ARBs?

103) According to the equation BP = CO x TPR, what does the Sympathetic Nervous System (SNS) primarily increase via β-receptors and α-receptors, respectively?

104) The characteristic dry cough associated with ACEIs is primarily attributed to:

105) The synergistic action of combining Ezetimibe with a Statin results in:

106) What is the specific reversal agent for bleeding caused by unfractionated heparin?

107) A patient on combination antihypertensive therapy is found to have dangerously low GFR and hyperkalemia. Which drug combination is most likely responsible?

108) A 60-year-old male is started on nifedipine for hypertension. Two weeks later, he reports swollen ankles. What is the most likely cause of this symptom?

109) Which of the following drugs is a K + -channel agonist used as a vasodilator in IHD?

110) Calcium Channel Blockers (CCBs) like nifedipine and amlodipine cause vasodilation and reduce BP by:

111) What is the primary function of healthy vascular endothelium in preventing inappropriate clotting?

112) What is the primary endogenous mediator responsible for the vasodilator effect of Glyceryl Trinitrate (GTN)?

113) A patient with premature ventricular contractions (PVCs) originating from an ectopic ventricular focus after MI is treated. Which drug is preferred?

114) A key reason ACEIs (like ramipril) are beneficial in diabetic nephropathy is that they:

115) Which of the following β-blockers is noted for also producing vasodilation by blocking vascular α-receptors?

116) The antiplatelet effect of a single dose of aspirin lasts several days primarily because:

117) Dronedarone is preferred over amiodarone for some patients because it:

118) Spironolactone is considered a useful second-line agent in resistant hypertension primarily because:

119) A patient on antihypertensive treatment experiences cold hands and feet. He is likely taking which medication?

120) Aliskiren is unique among RAAS-targeting drugs because it is a:

121) Why must β-blockers be used cautiously in heart failure?

122) Which molecule, released by activated platelets and sticking via specific receptors, forms the fibrous network trapping cells?

123) Which drug causes antimuscarinic side effects (e.g., dry mouth, constipation)?

124) A 64-year-old man with HTN and benign prostatic hyperplasia (BPH) is started on prazosin. Which of the following is the most likely early adverse effect to monitor?

125) A patient is started on losartan for HTN. Which advantage does losartan have over enalapril?