Angiotensin MCQs With Answer

Angiotensin MCQs With Answer

This concise set of Angiotensin MCQs with answers is designed for B.Pharm students to deepen understanding of the renin-angiotensin system, angiotensin II biology, ACE inhibitors, ARBs, and clinical pharmacology. Questions cover synthesis of angiotensin peptides, enzymatic conversions (renin, ACE, ACE2), receptor pharmacodynamics (AT1, AT2, Mas), physiological effects (vasoconstriction, aldosterone release, sodium retention), therapeutic uses, adverse effects (hyperkalemia, cough, teratogenicity), and monitoring parameters. Emphasis is on mechanistic insights and clinical implications relevant to pharmacotherapy of hypertension, heart failure, and diabetic nephropathy. Clear, exam-focused items will reinforce core concepts and application. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which enzyme catalyzes the conversion of angiotensinogen to angiotensin I?

• Angiotensin-converting enzyme (ACE)
• Renin
• ACE2
• Neprilysin

Correct Answer: Renin

Q2. Angiotensin II primarily exerts its vasoconstrictive effects through activation of which receptor?

• AT1 receptor
• AT2 receptor
• Beta-1 adrenergic receptor
• Mas receptor

Correct Answer: AT1 receptor

Q3. Which peptide is produced when ACE converts angiotensin I?

• Angiotensin-(1-7)
• Angiotensin II
• Angiotensinogen
• Bradykinin

Correct Answer: Angiotensin II

Q4. Blockade of ACE commonly causes a persistent dry cough because ACE normally degrades which substrate?

• Endothelin
• Bradykinin
• Vasopressin
• Angiotensinogen

Correct Answer: Bradykinin

Q5. Which drug class directly blocks the AT1 receptor to inhibit angiotensin II action?

• ACE inhibitors
• Beta-blockers
• Angiotensin receptor blockers (ARBs)
• Calcium channel blockers

Correct Answer: Angiotensin receptor blockers (ARBs)

Q6. Aliskiren acts in the renin-angiotensin pathway by:

• Inhibiting ACE activity
• Blocking AT1 receptors
• Directly inhibiting renin
• Activating ACE2

Correct Answer: Directly inhibiting renin

Q7. Angiotensin-(1-7) exerts vasodilatory effects mainly via which receptor?

• AT1 receptor
• Mas receptor
• AT2 receptor
• Mineralocorticoid receptor

Correct Answer: Mas receptor

Q8. Which of the following is a major renal effect of angiotensin II?

• Inhibition of sodium reabsorption in proximal tubule
• Stimulation of aldosterone release leading to sodium retention
• Decrease in efferent arteriolar tone
• Increased urinary sodium excretion

Correct Answer: Stimulation of aldosterone release leading to sodium retention

Q9. ACE2 differs from ACE by converting angiotensin II into which peptide?

• Angiotensin III
• Angiotensin-(1-7)
• Angiotensin I
• Aldosterone

Correct Answer: Angiotensin-(1-7)

Q10. Which adverse effect is most characteristic of ACE inhibitor therapy?

• Hypokalemia
• Persistent dry cough
• Hyperglycemia
• Thrombocytopenia

Correct Answer: Persistent dry cough

Q11. In pregnancy, ACE inhibitors and ARBs are contraindicated primarily due to risk of:

• Maternal hypotension only
• Fetal renal dysgenesis and teratogenicity
• Gestational diabetes
• Increased maternal heart rate

Correct Answer: Fetal renal dysgenesis and teratogenicity

Q12. Which laboratory parameter should be monitored after initiating an ACE inhibitor or ARB?

• Serum potassium and creatinine
• Serum calcium and bilirubin
• Platelet count and hemoglobin
• Fasting blood glucose only

Correct Answer: Serum potassium and creatinine

Q13. Angiotensin II stimulates secretion of aldosterone from which part of the adrenal gland?

• Adrenal medulla
• Zona glomerulosa of adrenal cortex
• Zona fasciculata
• Zona reticularis

Correct Answer: Zona glomerulosa of adrenal cortex

Q14. Which statement about AT2 receptors is correct?

• They mediate most classical vasoconstrictive effects of angiotensin II
• They are associated with vasodilation, anti-proliferation, and tissue repair
• They are the primary site of aldosterone action
• They are blocked by ACE inhibitors

Correct Answer: They are associated with vasodilation, anti-proliferation, and tissue repair

Q15. Which angiotensin peptide is an octapeptide and the main effector hormone?

• Angiotensin I (decapeptide)
• Angiotensin II (octapeptide)
• Angiotensin-(1-7) (heptapeptide)
• Angiotensin III (nonapeptide)

Correct Answer: Angiotensin II (octapeptide)

Q16. Combining an ACE inhibitor with an ARB is generally discouraged because it increases the risk of:

• Hypokalemia and gout
• Hyperkalemia, renal dysfunction, and hypotension
• Hypoglycemia and bradycardia
• Excessive diuresis

Correct Answer: Hyperkalemia, renal dysfunction, and hypotension

Q17. Which clinical condition is a primary indication for ACE inhibitors due to mortality benefit?

• Acute asthma exacerbation
• Heart failure with reduced ejection fraction
• Stable angina without hypertension
• Essential tremor

Correct Answer: Heart failure with reduced ejection fraction

Q18. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce the antihypertensive effect of ACE inhibitors by:

• Increasing renin release
• Inhibiting prostaglandin synthesis leading to decreased renal perfusion
• Enhancing ACE activity
• Blocking AT1 receptors

Correct Answer: Inhibiting prostaglandin synthesis leading to decreased renal perfusion

Q19. In the context of the renin-angiotensin system, plasma renin activity is most directly influenced by:

• Sympathetic beta-1 stimulation, renal perfusion pressure, and sodium delivery to macula densa
• ACE activity only
• Aldosterone levels exclusively
• Hepatic angiotensinogen clearance

Correct Answer: Sympathetic beta-1 stimulation, renal perfusion pressure, and sodium delivery to macula densa

Q20. Which drug is an ACE inhibitor?

• Losartan
• Lisinopril
• Aliskiren
• Spironolactone

Correct Answer: Lisinopril

Q21. Angiotensin III primarily contributes to which effect compared to angiotensin II?

• No biological activity
• Similar aldosterone-stimulating effect but weaker vasoconstriction
• Stronger vasoconstriction and no aldosterone effect
• Only diuretic effects

Correct Answer: Similar aldosterone-stimulating effect but weaker vasoconstriction

Q22. Which molecular change occurs when ACE inhibitors block ACE?

• Decrease in bradykinin levels
• Decrease in angiotensin II formation
• Increase in aldosterone synthesis
• Activation of AT1 receptors

Correct Answer: Decrease in angiotensin II formation

Q23. A patient on an ARB develops hyperkalemia. Which concomitant medication most likely contributed?

• Hydrochlorothiazide
• Spironolactone
• Loop diuretic furosemide
• Sublingual nitroglycerin

Correct Answer: Spironolactone

Q24. Which statement about ACE2 is accurate and clinically relevant?

• ACE2 converts angiotensin I into angiotensin II
• ACE2 degrades bradykinin causing cough
• ACE2 produces angiotensin-(1-7), which opposes angiotensin II actions
• ACE2 inhibition is a common antihypertensive strategy

Correct Answer: ACE2 produces angiotensin-(1-7), which opposes angiotensin II actions

Q25. Which adverse event is most associated with angiotensin receptor blockers compared to ACE inhibitors?

• Higher incidence of dry cough
• Lower incidence of bradykinin-mediated cough and angioedema
• More frequent hyperkalemia than ACE inhibitors
• Increased risk of thrombocytopenia

Correct Answer: Lower incidence of bradykinin-mediated cough and angioedema

Q26. Which physiological effect of angiotensin II supports increased blood pressure during hypovolemia?

• Dilation of efferent arteriole in kidney
• Enhanced sympathetic neurotransmission and vasoconstriction
• Inhibition of ADH release
• Reduction of aldosterone secretion

Correct Answer: Enhanced sympathetic neurotransmission and vasoconstriction

Q27. In diabetic nephropathy, ACE inhibitors are beneficial primarily because they:

• Increase intraglomerular pressure
• Reduce proteinuria and slow progression of renal disease by lowering efferent arteriolar constriction
• Stimulate glucose uptake into renal cells
• Cause natriuresis by blocking ENaC channels

Correct Answer: Reduce proteinuria and slow progression of renal disease by lowering efferent arteriolar constriction

Q28. Which measurement best reflects renin-angiotensin system activity clinically?

• Plasma renin activity or concentration
• Serum ACE concentration only
• Urinary sodium excretion exclusively
• Plasma aldosterone unrelated to renin

Correct Answer: Plasma renin activity or concentration

Q29. Which drug interaction increases the risk of angioedema when combined with an ACE inhibitor?

• Metformin
• Dipeptidyl peptidase-4 (DPP-4) inhibitors
• Statins
• Beta-2 agonists

Correct Answer: Dipeptidyl peptidase-4 (DPP-4) inhibitors

Q30. Which clinical effect distinguishes angiotensin-(1-7) from angiotensin II?

• Pro-fibrotic and pro-hypertrophic actions
• Vasodilatory, anti-proliferative, and anti-fibrotic effects
• Strong stimulation of aldosterone release
• Powerful vasoconstriction via AT1 receptor

Correct Answer: Vasodilatory, anti-proliferative, and anti-fibrotic effects

G S Sachin

I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.

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