Common cardiovascular disorders MCQs With Answer provide B. Pharm students a focused review of clinical pharmacology, pathophysiology, and therapeutic decision-making in cardiovascular care. This set emphasizes key topics such as hypertension, ischemic heart disease, heart failure, arrhythmias, antihypertensives, antianginals, anticoagulants, antiplatelets, and lipid-lowering agents. Each question addresses drug mechanisms, adverse effects, contraindications, monitoring parameters, and evidence-based choices relevant to pharmacy practice. Questions are crafted to deepen understanding beyond basics and connect pharmacology with patient-centered management. Use these MCQs to strengthen exam preparation, clinical reasoning, and safe medication use in cardiovascular disorders. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which drug class lowers blood pressure primarily by inhibiting conversion of angiotensin I to angiotensin II?
- Beta blockers
- ACE inhibitors
- Calcium channel blockers
- Thiazide diuretics
Correct Answer: ACE inhibitors
Q2. Which adverse effect is most characteristically associated with ACE inhibitors?
- Peripheral edema
- Dry, persistent cough
- Hyperglycemia
- Torsades de pointes
Correct Answer: Dry, persistent cough
Q3. Which antihypertensive is contraindicated in pregnancy due to teratogenicity?
- Labetalol
- Methyldopa
- ACE inhibitors
- Nifedipine
Correct Answer: ACE inhibitors
Q4. Which diuretic acts on the distal convoluted tubule and is useful in mild hypertension while causing hypokalemia?
- Loop diuretics (furosemide)
- Thiazide diuretics (hydrochlorothiazide)
- Potassium-sparing diuretics (spironolactone)
- Carbonic anhydrase inhibitors
Correct Answer: Thiazide diuretics (hydrochlorothiazide)
Q5. Which drug is a selective beta-1 blocker commonly used in ischemic heart disease with fewer bronchospastic effects?
- Propranolol
- Metoprolol
- Carvedilol
- Nadolol
Correct Answer: Metoprolol
Q6. Which lipid-lowering agent inhibits HMG-CoA reductase and requires monitoring of liver enzymes?
- Fenofibrate
- Statins (e.g., atorvastatin)
- Colestipol
- Ezetimibe
Correct Answer: Statins (e.g., atorvastatin)
Q7. Which antiplatelet agent irreversibly inhibits cyclooxygenase-1 (COX-1) reducing thromboxane A2 synthesis?
- Clopidogrel
- Aspirin
- Ticagrelor
- Abciximab
Correct Answer: Aspirin
Q8. For acute ST-elevation myocardial infarction, which class of drugs is used to dissolve an occlusive thrombus when PCI is unavailable within the appropriate window?
- Beta blockers
- Thrombolytics (tPA)
- ACE inhibitors
- Statins
Correct Answer: Thrombolytics (tPA)
Q9. Which anticoagulant acts by potentiating antithrombin III and requires monitoring with aPTT when unfractionated heparin is used?
- Warfarin
- Low molecular weight heparin (enoxaparin)
- Unfractionated heparin
- Dabigatran
Correct Answer: Unfractionated heparin
Q10. Which oral anticoagulant directly inhibits thrombin (factor IIa)?
- Rivaroxaban
- Apixaban
- Dabigatran
- Warfarin
Correct Answer: Dabigatran
Q11. Which drug is a potassium-sparing diuretic that antagonizes aldosterone receptors and is beneficial in congestive heart failure for mortality reduction?
- Spironolactone
- Amiloride
- Hydrochlorothiazide
- Furosemide
Correct Answer: Spironolactone
Q12. Digoxin exerts its primary positive inotropic effect by inhibiting which membrane protein?
- Na+/K+ ATPase
- H+/K+ ATPase
- Ca2+ ATPase
- Na+/Ca2+ exchanger
Correct Answer: Na+/K+ ATPase
Q13. Which adverse effect is most associated with digoxin toxicity and is exacerbated by hypokalemia?
- Hyperreflexia
- Ventricular arrhythmias
- Neutropenia
- Hypotension only
Correct Answer: Ventricular arrhythmias
Q14. Which antianginal drug primarily reduces preload through venodilation and is given sublingually for acute angina?
- Isosorbide dinitrate (sublingual)
- Amlodipine
- Metoprolol
- Ranolazine
Correct Answer: Isosorbide dinitrate (sublingual)
Q15. Which calcium channel blockers are more potent vasodilators and commonly used for hypertension but may cause peripheral edema?
- Verapamil
- Diltiazem
- Dihydropyridines (e.g., amlodipine)
- Digoxin
Correct Answer: Dihydropyridines (e.g., amlodipine)
Q16. Which antiarrhythmic is class III, prolongs action potential duration, and has multi-organ toxicities including pulmonary fibrosis and thyroid dysfunction?
- Amiodarone
- Procainamide
- Lidocaine
- Metoprolol
Correct Answer: Amiodarone
Q17. Which lipid agent activates PPAR-alpha and is especially useful for lowering triglycerides but may interact with statins causing myopathy?
- Niacin
- Fibrates (fenofibrate)
- Bile acid sequestrants
- Ezetimibe
Correct Answer: Fibrates (fenofibrate)
Q18. Which antidote is used to reverse warfarin-induced over-anticoagulation in an urgent bleeding scenario?
- Vitamin K and prothrombin complex concentrate (PCC)
- Protamine sulfate
- Fresh frozen plasma only
- Tranexamic acid
Correct Answer: Vitamin K and prothrombin complex concentrate (PCC)
Q19. Which drug combination is specifically indicated for African American patients with advanced heart failure to improve outcomes?
- Hydralazine and isosorbide dinitrate
- Lisinopril and amlodipine
- Spironolactone and furosemide
- Digoxin and verapamil
Correct Answer: Hydralazine and isosorbide dinitrate
Q20. Sacubitril/valsartan (ARNI) improves heart failure outcomes by inhibiting neprilysin and blocking which receptor?
- Beta-1 adrenergic receptor
- Angiotensin II receptor (AT1)
- Mineralocorticoid receptor
- Calcium channel receptor
Correct Answer: Angiotensin II receptor (AT1)
Q21. Which mnemonic or initial therapy is commonly used in suspected acute coronary syndrome for immediate management (unless contraindicated)?
- MONA-B: Morphine, Oxygen, Nitrates, Aspirin, Beta-blocker
- ABCDE: Airway, Breathing, Circulation
- RICE: Rest, Ice, Compression, Elevation
- GLP-1 agonist therapy
Correct Answer: MONA-B: Morphine, Oxygen, Nitrates, Aspirin, Beta-blocker
Q22. Which laboratory test should be monitored regularly in patients on long-term statin therapy to detect a severe adverse effect?
- Serum creatinine kinase (CK)
- Serum amylase
- Thyroid-stimulating hormone
- Serum magnesium
Correct Answer: Serum creatinine kinase (CK)
Q23. Which antihypertensive class can precipitate heart block when combined with beta-blockers due to negative chronotropic effects?
- Dihydropyridine calcium channel blockers
- ACE inhibitors
- Non-dihydropyridine calcium channel blockers (verapamil, diltiazem)
- Thiazide diuretics
Correct Answer: Non-dihydropyridine calcium channel blockers (verapamil, diltiazem)
Q24. Which drug used in angina acts by inhibiting late inward sodium current and can reduce ischemia-related diastolic wall tension without major hemodynamic changes?
- Ranolazine
- Nitroglycerin
- Atenolol
- Nicorandil
Correct Answer: Ranolazine
Q25. Which monitoring parameter is essential for patients on spironolactone or ACE inhibitors due to a risk of hyperkalemia?
- Serum potassium
- Serum calcium
- Urine specific gravity
- Serum phosphate
Correct Answer: Serum potassium
Q26. Which adverse effect should be watched for with nitroprusside infusion used for hypertensive emergencies?
- Cyanide toxicity
- Hyponatremia
- Tendon rupture
- Platelet dysfunction
Correct Answer: Cyanide toxicity
Q27. Which agent is a platelet P2Y12 receptor inhibitor often given with aspirin after coronary stenting?
- Clopidogrel
- Dipyridamole
- Warfarin
- Heparin
Correct Answer: Clopidogrel
Q28. Which class of antiarrhythmic drugs blocks sodium channels and is used for ventricular arrhythmias, with lidocaine as an example?
- Class I (sodium channel blockers)
- Class II (beta blockers)
- Class III (potassium channel blockers)
- Class IV (calcium channel blockers)
Correct Answer: Class I (sodium channel blockers)
Q29. Which monitoring is recommended for patients starting on warfarin to guide dose adjustments?
- Prothrombin time / INR
- Activated partial thromboplastin time (aPTT)
- Serum fibrinogen
- Thrombin time
Correct Answer: Prothrombin time / INR
Q30. Which strategy reduces nitrate tolerance when using long-acting nitrates for chronic angina?
- Continuous 24-hour infusion
- Daily nitrate-free interval (overnight)
- Co-administration with sildenafil
- High-dose aspirin co-therapy
Correct Answer: Daily nitrate-free interval (overnight)
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