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

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

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

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

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

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

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

8) Prazosin and Doxazosin reduce blood pressure primarily by:

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

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

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

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

13) 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?

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

15) How does aspirin achieve its antiplatelet effect?

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

17) Which equation correctly represents systemic blood pressure regulation?

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

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

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

21) Re-entrant circuits causing arrhythmias require:

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

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

24) 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?

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

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

27) Amiodarone’s half-life is approximately:

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

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

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

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

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

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

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

35) 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?

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

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

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

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

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

41) Dabigatran is classified as a:

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

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

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

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

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

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

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

49) What defines a cardiac arrhythmia?

50) Amiodarone’s primary mechanism of action is:

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

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

53) Apixaban and Rivaroxaban are classified as:

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

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

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

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

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

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

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

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

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

63) Sotalol has combined actions of:

64) Refractoriness during the cardiac action potential prevents:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

81) Digoxin can be useful in atrial fibrillation by:

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

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

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

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

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

87) 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?

88) Which drug interaction increases digoxin toxicity risk?

89) Adenosine must be avoided in asthma because it:

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

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

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

93) Digoxin’s mechanism in heart failure includes:

94) Clopidogrel and Prasugrel exert their antiplatelet effect by:

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

96) Warfarin exerts its anticoagulant effect by:

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

98) Ezetimibe lowers cholesterol levels by:

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

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

101) Reducing preload in IHD primarily helps by:

102) 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?

103) Nicorandil treats angina through a dual mechanism involving:

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

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

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

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

108) Alteplase and Tenecteplase are:

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

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

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

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

113) 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?

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

115) 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?

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

117) 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?

118) How does heparin primarily exert its anticoagulant effect?

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

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

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

122) Fibrinolytic drugs are most effective when administered:

123) 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?

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

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