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

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

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

4) Alteplase and Tenecteplase are:

5) Digoxin’s mechanism in heart failure includes:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

28) 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?

29) Prazosin and Doxazosin reduce blood pressure primarily by:

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

31) 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?

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

33) Dabigatran is classified as a:

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

35) Amiodarone’s half-life is approximately:

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

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

38) Re-entrant circuits causing arrhythmias require:

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

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

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

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

43) Amiodarone’s primary mechanism of action is:

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

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

46) Fibrinolytic drugs are most effective when administered:

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

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

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

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

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

52) Apixaban and Rivaroxaban are classified as:

53) 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?

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

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

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

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

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

59) Digoxin can be useful in atrial fibrillation by:

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

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

62) Warfarin exerts its anticoagulant effect by:

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

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

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

66) 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?

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

68) Which equation correctly represents systemic blood pressure regulation?

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

70) How does aspirin achieve its antiplatelet effect?

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

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

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

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

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

76) 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?

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

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

79) What defines a cardiac arrhythmia?

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

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

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

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

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

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

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

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

88) How does heparin primarily exert its anticoagulant effect?

89) 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?

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

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

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

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

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

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

96) Ezetimibe lowers cholesterol levels by:

97) Reducing preload in IHD primarily helps by:

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

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

100) Clopidogrel and Prasugrel exert their antiplatelet effect by:

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

102) 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?

103) 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?

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

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

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

107) Which drug interaction increases digoxin toxicity risk?

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

109) Adenosine must be avoided in asthma because it:

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

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

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

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

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

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

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

117) Nicorandil treats angina through a dual mechanism involving:

118) Refractoriness during the cardiac action potential prevents:

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

120) Sotalol has combined actions of:

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

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

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

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

125) 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?