Introduction: Introduction to cardiovascular pharmacology MCQs With Answer is a focused review designed for B. Pharm students to master essential concepts in cardiovascular pharmacology. This resource emphasizes drug classes such as beta-blockers, ACE inhibitors, ARBs, calcium channel blockers, diuretics, vasodilators, antiarrhythmics, anticoagulants, antiplatelets, and lipid-lowering agents. It integrates pharmacodynamics, pharmacokinetics, adverse effects, drug interactions, therapeutic uses, and monitoring parameters to build clinical reasoning. Questions probe mechanisms of action, indications, contraindications and dose-related safety, preparing students for exams and practical dispensing. Clear explanations reinforce rational drug selection and patient safety. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. What is the primary mechanism of action of ACE inhibitors in lowering blood pressure?
- Direct blockade of beta-adrenergic receptors
- Inhibition of angiotensin-converting enzyme reducing angiotensin II formation
- Blocking calcium influx into vascular smooth muscle
- Increasing renal sodium reabsorption
Correct Answer: Inhibition of angiotensin-converting enzyme reducing angiotensin II formation
Q2. Which adverse effect is classically associated with ACE inhibitors due to increased bradykinin?
- Dry cough
- Hyperglycemia
- Hypokalemia
- Peripheral neuropathy
Correct Answer: Dry cough
Q3. Which drug class directly blocks the angiotensin II AT1 receptor and is an alternative for patients intolerant to ACE inhibitors?
- Beta-blockers
- Calcium channel blockers
- Angiotensin receptor blockers (ARBs)
- Loop diuretics
Correct Answer: Angiotensin receptor blockers (ARBs)
Q4. Which diuretic class is most effective for rapid reduction of extracellular fluid in acute pulmonary edema?
- Thiazide diuretics
- Loop diuretics
- Potassium-sparing diuretics
- Carbonic anhydrase inhibitors
Correct Answer: Loop diuretics
Q5. Which antihypertensive can cause hyperkalemia and is contraindicated in pregnancy?
- ACE inhibitors
- Thiazide diuretics
- Alpha-1 blockers
- Hydralazine
Correct Answer: ACE inhibitors
Q6. Which property best describes selective beta-1 blockers like metoprolol?
- Preferential blockade of pulmonary beta receptors
- Greater affinity for cardiac (beta-1) receptors than beta-2 receptors
- Activation of nitric oxide synthase
- Inhibition of angiotensin II formation
Correct Answer: Greater affinity for cardiac (beta-1) receptors than beta-2 receptors
Q7. Which calcium channel blocker class primarily affects vascular smooth muscle and is used for hypertension?
- Non-dihydropyridines (verapamil, diltiazem)
- Dihydropyridines (amlodipine, nifedipine)
- Cardioselective calcium antagonists
- Sodium channel blockers
Correct Answer: Dihydropyridines (amlodipine, nifedipine)
Q8. Which anticoagulant acts by enhancing antithrombin III activity to inhibit factor Xa and thrombin?
- Warfarin
- Heparin
- Aspirin
- Clopidogrel
Correct Answer: Heparin
Q9. Warfarin’s anticoagulant effect is best monitored by which laboratory test?
- Activated partial thromboplastin time (aPTT)
- Prothrombin time / INR
- Platelet count
- Serum fibrinogen
Correct Answer: Prothrombin time / INR
Q10. Which antiplatelet agent irreversibly inhibits cyclooxygenase-1 (COX-1) in platelets?
- Clopidogrel
- Aspirin
- Ticagrelor
- Abciximab
Correct Answer: Aspirin
Q11. Which lipid-lowering drug class reduces LDL by inhibiting HMG-CoA reductase?
- Bile acid sequestrants
- Statins
- Fibrates
- PCSK9 inhibitors
Correct Answer: Statins
Q12. A major adverse effect of statins that requires monitoring is:
- Hepatotoxicity and myopathy
- QT prolongation
- Hypokalemia
- Hyperuricemia
Correct Answer: Hepatotoxicity and myopathy
Q13. Which antiarrhythmic class (Vaughan-Williams Class III) primarily prolongs cardiac action potential by blocking potassium channels?
- Sodium channel blockers
- Beta-blockers
- Potassium channel blockers (e.g., amiodarone)
- Calcium channel blockers
Correct Answer: Potassium channel blockers (e.g., amiodarone)
Q14. Digoxin exerts its positive inotropic effect by inhibiting which membrane protein?
- Na+/K+ ATPase
- Voltage-gated calcium channel
- Beta-adrenergic receptor
- ACE enzyme
Correct Answer: Na+/K+ ATPase
Q15. Which drug is indicated for acute management of supraventricular tachycardia and acts by activating adenosine receptors?
- Adenosine
- Atropine
- Digoxin
- Propranolol
Correct Answer: Adenosine
Q16. Which antihypertensive class can cause reflex tachycardia when used as a potent arteriolar vasodilator?
- ACE inhibitors
- Hydralazine
- Thiazide diuretics
- Beta-blockers
Correct Answer: Hydralazine
Q17. Which medication is first-line for reducing mortality in systolic heart failure by neurohormonal blockade?
- Loop diuretics alone
- ACE inhibitors or ARBs combined with beta-blockers
- Calcium channel blockers
- Nitrates only
Correct Answer: ACE inhibitors or ARBs combined with beta-blockers
Q18. Which antihypertensive is contraindicated in pregnancy due to teratogenicity?
- Labetalol
- Methyldopa
- ACE inhibitors
- Nifedipine
Correct Answer: ACE inhibitors
Q19. Which laboratory parameter must be monitored when a patient is started on spironolactone?
- Serum calcium
- Serum potassium
- PT/INR
- Serum uric acid only
Correct Answer: Serum potassium
Q20. Which drug class reduces preload and afterload via nitric oxide donation and is used in acute heart failure?
- Organic nitrates (e.g., nitroglycerin)
- ACE inhibitors
- Calcium channel blockers
- Statins
Correct Answer: Organic nitrates (e.g., nitroglycerin)
Q21. Which antiplatelet agent blocks the P2Y12 ADP receptor on platelets?
- Aspirin
- Clopidogrel
- Heparin
- Warfarin
Correct Answer: Clopidogrel
Q22. Which drug used for dyslipidemia primarily lowers triglycerides by activating PPAR-alpha?
- Statins
- Fibrates (e.g., fenofibrate)
- Bile acid sequestrants
- Ezetimibe
Correct Answer: Fibrates (e.g., fenofibrate)
Q23. Which antihypertensive effect is most linked to thiazide diuretics?
- Inhibition of carbonic anhydrase
- Blockade of epithelial sodium channels in collecting duct
- Inhibition of Na-Cl transporter in distal convoluted tubule
- Loop of Henle Na-K-2Cl inhibition
Correct Answer: Inhibition of Na-Cl transporter in distal convoluted tubule
Q24. Which drug interaction increases digoxin toxicity risk?
- Co-administration with rifampicin
- Co-administration with verapamil or amiodarone
- Co-administration with laxatives
- Co-administration with vitamin C
Correct Answer: Co-administration with verapamil or amiodarone
Q25. Which effect is a common adverse reaction of nitrates when used sublingually or intravenously?
- Bradycardia
- Severe hyperkalemia
- Headache due to cerebral vasodilation
- Renal failure
Correct Answer: Headache due to cerebral vasodilation
Q26. Which antiarrhythmic drug is known for a very long half-life and multiple organ toxicities including pulmonary fibrosis and thyroid dysfunction?
- Procainamide
- Amiodarone
- Lidocaine
- Flecainide
Correct Answer: Amiodarone
Q27. Which oral anticoagulant acts by inhibiting vitamin K epoxide reductase and affects clotting factor synthesis?
- Heparin
- Direct thrombin inhibitors
- Warfarin
- Fondaparinux
Correct Answer: Warfarin
Q28. In managing hyperlipidemia, which combination is contraindicated due to increased risk of myopathy?
- Statin plus ezetimibe
- Statin plus fibrate (gemfibrozil)
- Statin plus bile acid sequestrant
- Fibrate plus bile acid sequestrant
Correct Answer: Statin plus fibrate (gemfibrozil)
Q29. Which monitoring parameter is essential for patients on chronic heparin therapy to avoid bleeding complications?
- Serum cholesterol
- Activated partial thromboplastin time (aPTT)
- Blood glucose
- Serum creatinine only
Correct Answer: Activated partial thromboplastin time (aPTT)
Q30. Which pharmacokinetic property is most relevant when choosing a cardiovascular drug for a patient with severe renal impairment?
- Hepatic extraction ratio only
- Route of excretion and renal clearance
- Oral bioavailability in healthy volunteers only
- Protein binding in cerebrospinal fluid
Correct Answer: Route of excretion and renal clearance
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