Regulation of blood pressure MCQs With Answer

Regulation of blood pressure MCQs With Answer

This concise guide for B.Pharm students covers the physiology and pharmacology of blood pressure regulation. It highlights key mechanisms: baroreceptors, the renin–angiotensin–aldosterone system (RAAS), sympathetic nervous system control, endothelial mediators (NO, endothelin), renal sodium handling, and hormonal influences such as ADH and natriuretic peptides. Clinical and drug-related concepts—ACE inhibitors, ARBs, diuretics, beta‑blockers, calcium channel blockers, and vasodilators—are emphasized to link physiology with therapeutics. Keywords: regulation of blood pressure, blood pressure regulation, RAAS, baroreceptors, antihypertensive drugs, B.Pharm students, MCQs. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which receptor mechanism provides the fastest short-term buffering of acute increases in arterial blood pressure?

• Renal pressure natriuresis
• Baroreceptor reflex in carotid sinus and aortic arch
• RAAS activation with angiotensin II production
• Atrial natriuretic peptide release

Correct Answer: Baroreceptor reflex in carotid sinus and aortic arch

Q2. Activation of the renin–angiotensin–aldosterone system (RAAS) primarily results in which immediate physiological effect?

• Increased urinary sodium excretion
• Systemic vasodilation via nitric oxide
• Increased angiotensin II leading to vasoconstriction and aldosterone release
• Suppression of sympathetic outflow

Correct Answer: Increased angiotensin II leading to vasoconstriction and aldosterone release

Q3. Which antihypertensive drug class directly inhibits conversion of angiotensin I to angiotensin II?

• Angiotensin receptor blockers (ARBs)
• ACE inhibitors
• Direct renin inhibitors
• Mineralocorticoid receptor antagonists

Correct Answer: ACE inhibitors

Q4. Which peptide hormone is released by cardiac atria in response to increased blood volume and promotes natriuresis?

• Vasopressin (ADH)
• Atrial natriuretic peptide (ANP)
• Renin
• Endothelin-1

Correct Answer: Atrial natriuretic peptide (ANP)

Q5. In hypertension pharmacotherapy, which drug class reduces blood pressure by decreasing heart rate and cardiac output through β1 blockade?

• Calcium channel blockers (dihydropyridines)
• ACE inhibitors
• Beta‑blockers
• Thiazide diuretics

Correct Answer: Beta‑blockers

Q6. Which endothelial-derived factor causes vasodilation by increasing cyclic GMP in vascular smooth muscle?

• Endothelin-1
• Nitric oxide (NO)
• Angiotensin II
• Norepinephrine

Correct Answer: Nitric oxide (NO)

Q7. Which physiological change most directly increases mean arterial pressure (MAP)?

• Decrease in total peripheral resistance
• Increase in cardiac output or increase in total peripheral resistance
• Decrease in blood volume
• Reduction in heart rate with constant stroke volume

Correct Answer: Increase in cardiac output or increase in total peripheral resistance

Q8. Which renal mechanism contributes to long-term regulation of blood pressure by adjusting extracellular fluid volume?

• Immediate baroreflex compensation
• Pressure natriuresis and diuresis
• Endothelial shear-stress mediated vasodilation
• Acute chemoreceptor reflex

Correct Answer: Pressure natriuresis and diuresis

Q9. Which class of diuretics acts on the distal convoluted tubule to inhibit sodium-chloride cotransporter and is commonly used for hypertension?

• Loop diuretics
• Thiazide diuretics
• Potassium-sparing diuretics
• Carbonic anhydrase inhibitors

Correct Answer: Thiazide diuretics

Q10. Which receptor subtype on vascular smooth muscle mediates vasoconstriction when activated by norepinephrine?

• Beta‑2 adrenergic receptor
• Beta‑1 adrenergic receptor
• Alpha‑1 adrenergic receptor
• Muscarinic M2 receptor

Correct Answer: Alpha‑1 adrenergic receptor

Q11. A patient on an ACE inhibitor develops a persistent dry cough. Which mechanism explains this side effect?

• Accumulation of bradykinin and substance P in airways
• Excess aldosterone production
• Direct bronchoconstriction from angiotensin II deficiency
• Hypokalemia-induced airway irritation

Correct Answer: Accumulation of bradykinin and substance P in airways

Q12. Which antihypertensive agent blocks the AT1 receptor and prevents angiotensin II action without affecting bradykinin breakdown?

• ACE inhibitor
• Angiotensin receptor blocker (ARB)
• Direct renin inhibitor
• Mineralocorticoid receptor antagonist

Correct Answer: Angiotensin receptor blocker (ARB)

Q13. What is the primary effect of aldosterone on renal tubules that influences blood pressure?

• Inhibition of sodium reabsorption in proximal tubule
• Stimulation of sodium reabsorption and potassium secretion in collecting duct
• Blocking water reabsorption in descending loop of Henle
• Increase in glomerular filtration rate via afferent arteriolar dilation

Correct Answer: Stimulation of sodium reabsorption and potassium secretion in collecting duct

Q14. Orthostatic hypotension after standing is primarily due to failure of which mechanism?

• Renal pressure natriuresis
• Reflex sympathetic vasoconstriction and baroreceptor response
• Increased ANP release
• Enhanced nitric oxide production

Correct Answer: Reflex sympathetic vasoconstriction and baroreceptor response

Q15. Which drug reduces peripheral vascular resistance by blocking L-type calcium channels in vascular smooth muscle?

• ACE inhibitor
• Hydralazine
• Calcium channel blocker (dihydropyridine)
• Beta‑blocker

Correct Answer: Calcium channel blocker (dihydropyridine)

Q16. Vasopressin (ADH) increases blood pressure primarily by which actions?

• Increasing renal sodium excretion and vasodilation
• Binding V1 receptors causing vasoconstriction and V2 receptors increasing water reabsorption
• Blocking aldosterone receptors
• Stimulating atrial stretch receptors to release ANP

Correct Answer: Binding V1 receptors causing vasoconstriction and V2 receptors increasing water reabsorption

Q17. Chronic hypertension leads to structural changes in resistance arteries termed vascular remodeling. Which process is involved?

• Reduced smooth muscle cell growth
• Increased extracellular matrix deposition and medial hypertrophy
• Loss of collagen and vessel thinning
• Permanent dilation of arterioles

Correct Answer: Increased extracellular matrix deposition and medial hypertrophy

Q18. Which laboratory change is most commonly associated with thiazide diuretic therapy?

• Hyperkalemia
• Hypokalemia and hyperglycemia
• Metabolic acidosis
• Hypouricemia

Correct Answer: Hypokalemia and hyperglycemia

Q19. Which central mechanism lowering blood pressure is targeted by clonidine?

• Peripheral beta‑blockade at the heart
• Central alpha‑2 adrenergic agonism reducing sympathetic outflow
• Blocking calcium influx in vascular smooth muscle
• Inhibiting renin release from kidney directly

Correct Answer: Central alpha‑2 adrenergic agonism reducing sympathetic outflow

Q20. Which measurement best estimates mean arterial pressure (MAP) in clinical practice?

• Systolic pressure × 2
• Diastolic pressure × 2 plus systolic pressure divided by 3 (DBP×2 + SBP)/3
• Simple average of systolic and diastolic pressures
• Pulse pressure multiplied by heart rate

Correct Answer: Diastolic pressure × 2 plus systolic pressure divided by 3 (DBP×2 + SBP)/3

Q21. In heart failure with reduced ejection fraction, RAAS activation worsens hypertension by which mechanisms?

• Promoting vasodilation and natriuresis
• Increasing vasoconstriction, sodium retention, and adverse remodeling
• Reducing sympathetic tone
• Enhancing ANP production to lower blood volume

Correct Answer: Increasing vasoconstriction, sodium retention, and adverse remodeling

Q22. Which technique increases baroreflex sensitivity and is sometimes used experimentally to lower blood pressure?

• Renal denervation
• Carotid sinus baroreceptor activation therapy
• Administration of mineralocorticoid receptor agonists
• Loop diuretic infusion

Correct Answer: Carotid sinus baroreceptor activation therapy

Q23. Which antihypertensive is contraindicated in pregnancy due to teratogenic effects on the fetus?

• Methyldopa
• Labetalol
• ACE inhibitors
• Nifedipine

Correct Answer: ACE inhibitors

Q24. Which compensatory response follows an acute drop in arterial pressure to maintain cerebral perfusion?

• Decreased sympathetic tone
• Increased baroreceptor firing
• Reflex tachycardia and peripheral vasoconstriction
• Increased ANP secretion

Correct Answer: Reflex tachycardia and peripheral vasoconstriction

Q25. What is the main antihypertensive mechanism of spironolactone when used in resistant hypertension?

• Direct vasodilation via nitric oxide
• Blockade of aldosterone receptors reducing sodium retention
• Inhibition of renin production
• Beta‑1 receptor blockade in the heart

Correct Answer: Blockade of aldosterone receptors reducing sodium retention

Q26. Endothelin-1 contributes to hypertension through which primary action?

• Endothelial-mediated vasodilation
• Potent vasoconstriction and promotion of vascular smooth muscle proliferation
• Inhibition of sympathetic neurotransmission
• Promotion of renal sodium excretion

Correct Answer: Potent vasoconstriction and promotion of vascular smooth muscle proliferation

Q27. A hypertensive emergency with malignant features requires which immediate intervention?

• Rapid but controlled reduction of blood pressure with IV antihypertensives
• Oral ACE inhibitor only
• Observation and outpatient follow-up
• Administering high-dose thiazide diuretics orally

Correct Answer: Rapid but controlled reduction of blood pressure with IV antihypertensives

Q28. Which receptor blockade decreases renin release from juxtaglomerular cells by inhibiting β1 stimulation?

• Alpha‑1 adrenergic blockade
• Beta‑1 adrenergic blockade
• Beta‑2 adrenergic blockade
• Muscarinic receptor blockade

Correct Answer: Beta‑1 adrenergic blockade

Q29. Which physiological parameter primarily determines pulse pressure?

• Diastolic duration only
• Difference between systolic and diastolic pressures influenced by stroke volume and arterial compliance
• Renal blood flow exclusively
• Plasma renin activity directly

Correct Answer: Difference between systolic and diastolic pressures influenced by stroke volume and arterial compliance

Q30. Renal sympathetic nerve activation raises blood pressure by which combined effects?

• Reducing renin release and enhancing natriuresis
• Increasing renin release, enhancing sodium reabsorption, and reducing renal blood flow
• Decreasing proximal sodium reabsorption only
• Stimulating ANP release from the atria

Correct Answer: Increasing renin release, enhancing sodium reabsorption, and reducing renal blood flow

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