WORLD HEART DAY | MCQ WITH EXPLANATIONS


1. Which of the following is NOT a front line antihypertensive agent ?

a. Enalapril

b. Hydrochlorthiazide

c. Amlodipine

d. Atenolol

Answer: d. Atenolol

Explanation: Beta blockers are no longer considered to be the first line antihypertensive agents. According to JNC-8, ACE inhibitors, calcium channel blockers and diuretics are first line agents.


2. Diuretic that is useful in mild to moderate hypertension is : 

a. Loop diuretics

b. Thiazides

c. Osmotic diuretics

d. Potassium sparing diuretics 

Answer: b. Thiazides

Explanation: Thiazides are not only diuretics of choice for mild to moderate hypertension but also the first line antihypertensive drugs in these patients.


3. Which among the following is the best inotrope drug used in right heart failure?

a. Dobutamine

b. Digoxin

c. Dopamine

d. Milrinone 

Answer: d. Milrinone

Explanation: Inotropic drugs are not used for treatment of right sided heart failure where the major treatment is diuretics and vasodilators. Milrinone being a phosphodiesterase inhibitor act as an inodilator. Thus, this is the only inotropic drug that should be used in right sided failure due to its ability to produce vasodilation. It is indicated in right heart failure with pulmonary hypertension.


4. All of the following drugs are used for the treatment of congestive heart failure except:

a. Nitroglycerine

b. Spironolactone

c. Nesiritide

d. Trimetazidine

Answer: d. Trimetazidine

Explanation: Trimetazidine is a partial fatty acid oxidation inhibitor used for angina pectoris.


5. Which of the following antihypertensive drugs are contraindicated in pregnancy?

a. Amlodipine

b. Labetalol

c. Enalapril

d. Hydralazine

Answer: Enalapril

Explanation: ACE inhibitors and ARB are absolutely contraindicated in pregnancy.


6. Best antihypertensive drug in pulmonary hypertension is: 

a. Bosentan

b. Amlodipine

c. Digoxin

d. Furosemide

Answer: a.Bosentan

Explanation:  Among the given options, only 2 drugs i.e. bosentan and amlodipine are indicated in pulmonary hypertension. Calcium channel blockers like amlodipine are indicated only in those patients which has positive intravenous vasodilator challenge (less than 5% patients). If the patient has negative test, then endothelin antagonists are indicated like bosentan, macitentan and ambrisentan.


7. Alpha methyldopa is primarily used for: 

a. Pregnancy induced hypertension

b. Renovascular hypertension 

c. First line agent in hypertension

d. Refractory hypertension

Answer: a. Pregnancy induced hypertension

Explanation: Methyl-dopa was widely used in past but now only used primarily for hypertension in pregnancy.


8.Which of the following drugs should NOT be used in set ting of severe hypertension in elderly on empirical basis? 

(a) Enalapril 

(b) Amlodipine 

(c) Chlorthiazide 

(d) Prazosin

Answer: d. Prazosin 

Explanation: Prazosin should be avoided as first choice as because of risk of postural hypotension 


9. A 60-year-old hypertensive patient on angiotensin II receptor antagonist (losartan) is posed for hernia repair surgery. The antihypertensive drug should be:

(a) Continued till the day of operation

(b) Discontinued 24 hrs preoperatively

(c) Discontinued one week preoperatively

(d) Administered in an increased dosage on the day of operation

Answer: (a) Continued till the day of operation. 

Explanation: Before surgery, antihypertensive drugs should be continued till the day of surgery.


10. Digoxin toxicity is increased by all except: 

a. Renal impairment

b. Hyperkalemia

c. Hypercalcaemia

d. Hypomagnesemia

Answer: Hyperkalemia

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