AI generated questions

Question 1

Which enzyme is responsible for converting angiotensin I to angiotensin II?
A) Renin
B) Aldosterone
C) ACE
D) Angiotensinogen

Answer 1

C) ACE

ACE stands for Angiotensin-Converting Enzyme.

Question 2

What is the mechanism of action of ACE inhibitors like lisinopril?
A) Blocking angiotensin II receptors
B) Preventing conversion of angiotensinogen to angiotensin I
C) Inhibiting aldosterone secretion
D) Blocking ACE, preventing conversion of angiotensin I to angiotensin II

Answer 2

D) Blocking ACE, preventing conversion of angiotensin I to angiotensin II

ACE inhibitors are commonly used in hypertension management.

Question 3

Which drug class is associated with a dry cough and angioedema?
A) ARBs
B) ACE inhibitors
C) Aldosterone antagonists
D) Direct renin inhibitors

Answer 3

B) ACE inhibitors

These side effects are due to increased bradykinin levels.

Question 4

What dental implication is most commonly shared across RAAS-acting drugs?
A) Risk of excessive bleeding
B) Gingival hyperplasia
C) Orthostatic hypotension
D) Xerostomia

Answer 4

C) Orthostatic hypotension

This can lead to dizziness during dental procedures.

Question 5

Which mediator causes vasodilation by increasing cGMP levels?
A) Endothelin-1
B) Nitric oxide
C) Angiotensin II
D) Endothelin-3

Answer 5

B) Nitric oxide

Nitric oxide is a potent vasodilator in the vascular system.

Question 6

Which of the following drugs works by opening KATP channels to induce vasodilation?
A) Minoxidil
B) Amlodipine
C) Hydralazine
D) Nitroprusside

Answer 6

A) Minoxidil

Minoxidil is often used for severe hypertension.

Question 7

Which vasodilator is associated with gingival hyperplasia?
A) Hydralazine
B) Amlodipine
C) Minoxidil
D) Nitroprusside

Answer 7

B) Amlodipine

Amlodipine is a calcium channel blocker.

Question 8

What is a proposed mechanism of action for hydralazine?
A) Blocking ACE
B) Inhibiting IP3-mediated Ca++ release from sarcoplasmic reticulum
C) Stimulating nitric oxide synthesis
D) Activating beta receptors

Answer 8

B) Inhibiting IP3-mediated Ca++ release from sarcoplasmic reticulum

This action leads to vascular smooth muscle relaxation.

Question 9

Which medication is classified as a PDE5 inhibitor used for pulmonary hypertension?
A) Bosentan
B) Selexipag
C) Sildenafil
D) Riociguat

Answer 9

C) Sildenafil

Sildenafil is also used for erectile dysfunction.

Question 10

Which drug blocks endothelin receptors to reduce pulmonary artery pressure?
A) Riociguat
B) Bosentan
C) Treprostinil
D) Sildenafil

Answer 10

B) Bosentan

Bosentan is an endothelin receptor antagonist.

Question 11

What unique dental side effect is associated with prostacyclin analogues like treprostinil?
A) Dry mouth
B) Gingival overgrowth
C) Jaw pain on first bite
D) Oral ulcers

Answer 11

C) Jaw pain on first bite

This side effect can complicate dental procedures.

Question 12

Which drug increases both endogenous NO sensitivity and directly stimulates guanylyl cyclase?
A) Bosentan
B) Sildenafil
C) Riociguat
D) Selexipag

Answer 12

C) Riociguat

Riociguat is used for treating pulmonary arterial hypertension.

Question 13

Which hormone is released by the liver and serves as a precursor in the RAAS?
A) Renin
B) Aldosterone
C) Angiotensinogen
D) Vasopressin

Answer 13

C) Angiotensinogen

Angiotensinogen is converted to angiotensin I by renin.

Question 14

Aliskiren (Tekturna®) exerts its antihypertensive effects by:
A) Blocking aldosterone receptors
B) Inhibiting ACE activity
C) Blocking angiotensin II at AT1 receptors
D) Inhibiting renin’s action on angiotensinogen

Answer 14

D) Inhibiting renin’s action on angiotensinogen

Aliskiren is a direct renin inhibitor.

Question 15

Which of the following is a contraindication for ACE inhibitors?
A) Hyperlipidemia
B) Unilateral renal artery stenosis
C) Pregnancy
D) Type 2 Diabetes

Answer 15

C) Pregnancy

ACE inhibitors can harm fetal development.

Question 16

What adverse reaction is more likely to occur with spironolactone than with eplerenone?
A) Hyperkalemia
B) Hypotension
C) Gynecomastia
D) Dry mouth

Answer 16

C) Gynecomastia

Spironolactone is a non-selective aldosterone antagonist.

Question 17

Which direct vasodilator works by increasing intracellular nitric oxide?
A) Hydralazine
B) Minoxidil
C) Sodium nitroprusside
D) Amlodipine

Answer 17

C) Sodium nitroprusside

Sodium nitroprusside is often used in hypertensive emergencies.

Question 18

Which of the following contributes to vascular smooth muscle relaxation by increasing intracellular cAMP?
A) Endothelin-1
B) Angiotensin II
C) Prostaglandin I2 (PGI2)
D) Calcium

Answer 18

C) Prostaglandin I2 (PGI2)

PGI2 is a vasodilator produced by endothelial cells.

Question 19

Which medication is most likely to cause photosensitivity as an adverse effect?
A) Amlodipine
B) Hydralazine
C) Minoxidil
D) Lisinopril

Answer 19

C) Minoxidil

Photosensitivity can complicate sun exposure.

Question 20

Dihydropyridine calcium channel blockers are more selective for:
A) Myocardial calcium channels
B) Central nervous system vasculature
C) Peripheral vascular smooth muscle
D) Renal tubules

Answer 20

C) Peripheral vascular smooth muscle

This selectivity reduces cardiac side effects.

Question 21

Which drug is a selective prostacyclin IP receptor agonist used in pulmonary hypertension?
A) Treprostinil
B) Selexipag
C) Bosentan
D) Riociguat

Answer 21

B) Selexipag

Selexipag is used to improve exercise capacity.

Question 22

Which class of drugs for pulmonary hypertension has a pregnancy category X?
A) PDE5 inhibitors
B) Endothelin receptor antagonists
C) Prostacyclin analogues
D) Soluble guanylate cyclase stimulators

Answer 22

B) Endothelin receptor antagonists

These drugs are contraindicated in pregnancy.

Question 23

Which pulmonary hypertension drug class works by inhibiting PDE5 to elevate cGMP levels?
A) Endothelin receptor antagonists
B) Prostacyclin analogues
C) PDE5 inhibitors
D) Guanylate cyclase stimulators

Answer 23

C) PDE5 inhibitors

This class includes sildenafil and tadalafil.

Question 24

Which adverse effect is uniquely associated with prostacyclin pathway drugs like selexipag and treprostinil?
A) Liver toxicity
B) Jaw pain
C) Proteinuria
D) Cough

Answer 24

B) Jaw pain

This side effect can affect patient compliance.

Question 25

Which lipoprotein is considered 'good cholesterol' due to its role in reverse cholesterol transport? A) LDL B) HDL C) VLDL D) Chylomicrons

Answer 25

B) HDL ## Footnote HDL helps to remove cholesterol from the arteries.

Question 26

What is considered the optimal LDL cholesterol level in adults? A) ≤ 150 mg/dL B) ≤ 200 mg/dL C) ≤ 70 mg/dL D) ≤ 100 mg/dL

Answer 26

D) ≤ 100 mg/dL ## Footnote Lower LDL levels are associated with reduced cardiovascular risk.

Question 27

Which of the following is not a risk factor for atherosclerotic cardiovascular disease (ASCVD)? A) Smoking B) Hypertension C) High HDL levels D) Diabetes mellitus

Answer 27

C) High HDL levels ## Footnote High HDL levels are generally protective.

Question 28

The initial cellular event in the formation of an atherosclerotic plaque is: A) Smooth muscle proliferation B) Endothelial injury C) HDL uptake D) Fibrous cap formation

Answer 28

B) Endothelial injury ## Footnote Endothelial injury leads to lipid accumulation and inflammation.

Question 29

Statins lower cholesterol primarily by inhibiting which enzyme? A) PCSK-9 B) CETP C) HMG-CoA reductase D) ATP-citrate lyase

Answer 29

C) HMG-CoA reductase ## Footnote This enzyme is crucial for cholesterol synthesis.

Question 30

Which of the following is a high-intensity statin dose? A) Simvastatin 20 mg B) Atorvastatin 40 mg C) Pravastatin 10 mg D) Rosuvastatin 5 mg

Answer 30

B) Atorvastatin 40 mg ## Footnote High-intensity statin therapy is effective for secondary prevention.

Question 31

Which is a known pleiotropic benefit of statin therapy? A) Hyperglycemia B) Improved endothelial function C) Increased LDL synthesis D) Increased platelet aggregation

Answer 31

B) Improved endothelial function ## Footnote Statins also have anti-inflammatory properties.

Question 32

Which adverse effect is associated with statins and may present as weakness when chewing or brushing teeth? A) Hepatotoxicity B) Rhabdomyolysis C) Myopathy D) Orthostatic hypotension

Answer 32

C) Myopathy ## Footnote Myopathy can lead to muscle pain and weakness.

Question 33

What is the mechanism of action of PCSK-9 inhibitors? A) Block cholesterol absorption in intestines B) Stimulate HDL production C) Prevent degradation of LDL receptors D) Inhibit HMG-CoA reductase

Answer 33

C) Prevent degradation of LDL receptors ## Footnote This increases LDL receptor availability and lowers LDL cholesterol.

Question 34

Which medication inhibits cholesterol absorption by blocking the NPC1L1 transport protein? A) Bempedoic acid B) Niacin C) Ezetimibe D) Colesevelam

Answer 34

C) Ezetimibe ## Footnote Ezetimibe is often used in combination with statins.

Question 35

Which agent may cause flushing that can be reduced by premedication with aspirin? A) Fenofibrate B) Niacin C) Lomitapide D) Evinacumab

Answer 35

B) Niacin ## Footnote Flushing is a common side effect of niacin use.

Question 36

Which lipid-lowering drug class is associated with GI side effects such as constipation and should be taken separately from other medications? A) PCSK-9 inhibitors B) Statins C) Bile acid binding agents D) Fibrates

Answer 36

C) Bile acid binding agents ## Footnote These agents can interfere with the absorption of other drugs.

Question 37

Which agent is a small interfering RNA (siRNA) that inhibits PCSK9 production in the liver? A) Evolocumab B) Inclisiran C) Lomitapide D) Bempedoic acid

Answer 37

B) Inclisiran ## Footnote Inclisiran is a newer class of cholesterol-lowering medication.

Question 38

Which lipoprotein carries the highest proportion of triglycerides? A) LDL B) VLDL C) Chylomicrons D) HDL

Answer 38

C) Chylomicrons ## Footnote Chylomicrons are formed in the intestines after fat ingestion.

Question 39

Which condition contributes most directly to the formation of foam cells in atherosclerotic plaques? A) HDL accumulation B) LDL uptake by macrophages C) VLDL synthesis in the liver D) Chylomicron breakdown

Answer 39

B) LDL uptake by macrophages ## Footnote Foam cells are a hallmark of atherosclerosis.

Question 40

According to the 2018 guidelines, which HDL value is considered optimal? A) ≥ 40 mg/dL B) ≥ 60 mg/dL C) ≤ 100 mg/dL D) ≤ 200 mg/dL

Answer 40

B) ≥ 60 mg/dL ## Footnote Higher HDL levels are associated with lower cardiovascular risk.

Question 41

Which process describes HDL removing cholesterol from vessel walls and transporting it back to the liver? A) Forward cholesterol transport B) Lipogenesis C) Reverse cholesterol transport D) Cholesterol hydrolysis

Answer 41

C) Reverse cholesterol transport ## Footnote This process is critical for maintaining vascular health.

Question 42

Which of the following statins is considered least likely to cause CYP450-mediated drug interactions? A) Simvastatin B) Atorvastatin C) Rosuvastatin D) Lovastatin

Answer 42

C) Rosuvastatin ## Footnote Rosuvastatin has fewer interactions compared to other statins.

Question 43

What is the primary clinical role of statins in secondary prevention? A) Lower triglycerides B) Increase HDL C) Reduce recurrence of cardiovascular events D) Improve glucose metabolism

Answer 43

C) Reduce recurrence of cardiovascular events ## Footnote Statins are essential for patients with a history of cardiovascular disease.

Question 44

Which adverse effect is a serious but rare complication of statin therapy? A) Dry mouth B) Gout C) Rhabdomyolysis D) Hypercalcemia

Answer 44

C) Rhabdomyolysis ## Footnote Rhabdomyolysis can lead to kidney damage.

Question 45

Statins are contraindicated in which population? A) Diabetics B) Elderly men C) Pregnant women D) Smokers

Answer 45

C) Pregnant women ## Footnote Statins can cause fetal harm and are not safe during pregnancy.

Question 46

Which agent reduces LDL levels by inhibiting ATP-citrate lyase, an enzyme upstream of HMG-CoA reductase? A) Ezetimibe B) Bempedoic acid C) Alirocumab D) Niacin

Answer 46

B) Bempedoic acid ## Footnote Bempedoic acid is used for patients who cannot tolerate statins.

Question 47

Which class of medications may increase triglyceride levels while lowering LDL? A) PCSK-9 inhibitors B) Bile acid binding agents C) Statins D) Fibrates

Answer 47

B) Bile acid binding agents ## Footnote This class can have varying effects on lipid profiles.

Question 48

Which of the following drugs may cause vision disturbances and requires caution with dental lighting? A) Ezetimibe B) Fenofibrate C) Inclisiran D) Colesevelam

Answer 48

B) Fenofibrate ## Footnote Fenofibrate can affect visual acuity.

Question 49

Which agent used for homozygous familial hypercholesterolemia works by inhibiting MTP and reducing apoB-containing lipoproteins? A) Lomitapide B) Evinacumab C) Alirocumab D) Bempedoic acid

Answer 49

A) Lomitapide ## Footnote Lomitapide is a specific treatment for this rare condition.

Question 50

Which lipid-lowering medication may worsen blood glucose control and should be used cautiously in diabetics? A) Fenofibrate B) Niacin C) Colesevelam D) Atorvastatin

Answer 50

B) Niacin ## Footnote Niacin can increase insulin resistance.

Question 51

Which of the following correctly describes the role of the intrinsic pathway in coagulation? A) Activated by tissue factor B) Initiated by external trauma C) Monitored using PT/INR D) Triggered when blood contacts damaged endothelium

Answer 51

D) Triggered when blood contacts damaged endothelium ## Footnote The intrinsic pathway is part of the body's natural response to injury.

Question 52

Which factor directly converts fibrinogen (Factor I) to fibrin (Factor Ia)? A) Factor Xa B) Thrombin (Factor IIa) C) Tissue Factor D) Plasmin

Answer 52

B) Thrombin (Factor IIa) ## Footnote Thrombin is crucial in the coagulation cascade.

Question 53

What component of Virchow’s triad refers to abnormal blood flow? A) Endothelial injury B) Hypercoagulability C) Stasis or turbulence D) Platelet activation

Answer 53

C) Stasis or turbulence ## Footnote This can lead to thrombus formation.

Question 54

Which type of thrombus is most commonly associated with arterial plaque and is rich in platelets? A) Red thrombus B) White thrombus C) Mixed thrombus D) Embolus

Answer 54

B) White thrombus ## Footnote White thrombi are often found in arterial occlusions.

Question 55

Which receptor is responsible for platelet aggregation by binding fibrinogen? A) PAR-1 B) P2Y12 C) GP IIb/IIIa D) COX-1

Answer 55

C) GP IIb/IIIa ## Footnote This receptor is a target for antiplatelet therapies.

Question 56

Which is the key enzyme responsible for breaking down fibrin clots during fibrinolysis? A) Plasminogen B) Plasmin C) Thrombin D) TPA

Answer 56

B) Plasmin ## Footnote Plasminogen is converted to plasmin to dissolve clots.

Question 57

What is the function of tissue plasminogen activator (TPA)? A) Stimulates platelet aggregation B) Inhibits thrombin C) Converts plasminogen to plasmin D) Activates Factor X

Answer 57

C) Converts plasminogen to plasmin ## Footnote TPA is used therapeutically to dissolve clots.

Question 58

Warfarin primarily increases which coagulation test? A) aPTT B) Platelet count C) PT/INR D) Fibrinogen

Answer 58

C) PT/INR ## Footnote Monitoring INR is essential for patients on warfarin.

Question 59

Which anticoagulant acts by directly inhibiting thrombin? A) Apixaban B) Warfarin C) Dabigatran D) Enoxaparin

Answer 59

C) Dabigatran ## Footnote Dabigatran is a direct thrombin inhibitor.

Question 60

Which medication selectively inhibits Factor Xa? A) Heparin B) Apixaban C) Dabigatran D) Warfarin

Answer 60

B) Apixaban ## Footnote Apixaban is used in the prevention and treatment of thromboembolic disorders.

Question 61

Aspirin prevents platelet aggregation by inhibiting the production of which mediator? A) ADP B) GP IIb/IIIa C) TXA2 D) Plasmin

Answer 61

C) TXA2 ## Footnote TXA2 promotes platelet aggregation and vasoconstriction.

Question 62

Which P2Y12 inhibitor is known for reversible binding and is not a prodrug? A) Clopidogrel B) Prasugrel C) Ticagrelor D) Cangrelor

Answer 62

C) Ticagrelor ## Footnote Ticagrelor provides a more rapid onset of action compared to prodrugs.

Question 63

Which antiplatelet drug class is associated with the highest bleeding risk and is given IV? A) COX inhibitors B) P2Y12 inhibitors C) Glycoprotein IIb/IIIa inhibitors D) PAR-1 antagonists

Answer 63

C) Glycoprotein IIb/IIIa inhibitors ## Footnote These are used in acute coronary syndromes.

Question 64

Which lab value is used to monitor the extrinsic pathway of coagulation? A) Activated Partial Thromboplastin Time (aPTT) B) Platelet count C) Prothrombin Time (PT)/INR D) Bleeding time

Answer 64

C) Prothrombin Time (PT)/INR ## Footnote PT/INR is essential for managing patients on anticoagulants.

Question 65

Which vitamin is essential for synthesis of clotting factors II, VII, IX, and X? A) Vitamin C B) Vitamin D C) Vitamin K D) Vitamin B12

Answer 65

C) Vitamin K ## Footnote Vitamin K deficiency can lead to bleeding disorders.

Question 66

Which of the following factors is not part of Virchow’s triad? A) Hypercoagulability B) Endothelial injury C) Low platelet count D) Abnormal blood flow

Answer 66

C) Low platelet count ## Footnote Virchow’s triad includes stasis, hypercoagulability, and endothelial injury.

Question 67

Which clotting factor has the shortest half-life and is most sensitive to warfarin inhibition? A) Factor X B) Factor II C) Factor VII D) Protein C

Answer 67

C) Factor VII ## Footnote Factor VII's rapid turnover makes it a key target for warfarin.

Question 68

Which mediator is stored in platelets and promotes platelet aggregation via the P2Y12 receptor? A) TXA2 B) ADP C) Thrombin D) Collagen

Answer 68

B) ADP ## Footnote ADP plays a crucial role in the activation of platelets.

Question 69

Which of the following medications directly inhibits plasmin to prevent clot breakdown? A) Tenecteplase B) Tranexamic acid C) Warfarin D) Heparin

Answer 69

B) Tranexamic acid ## Footnote Tranexamic acid is used to manage excessive bleeding.

Question 70

What is the mechanism of action of Tenecteplase? A) Directly inhibits Factor Xa B) Enhances platelet aggregation C) Activates plasminogen to plasmin D) Inhibits thromboxane A2

Answer 70

C) Activates plasminogen to plasmin ## Footnote Tenecteplase is a thrombolytic agent used in acute myocardial infarction.

Question 71

Which anticoagulant requires regular INR monitoring and has a narrow therapeutic index? A) Apixaban B) Enoxaparin C) Warfarin D) Dabigatran

Answer 71

C) Warfarin ## Footnote Regular monitoring is essential to avoid complications.

Question 72

Which medication directly inhibits plasmin to prevent clot breakdown? A) Tenecteplase B) Tranexamic acid C) Warfarin D) Heparin

Answer 72

Tranexamic acid ## Footnote Tranexamic acid is specifically used to control bleeding by inhibiting the breakdown of fibrin clots.

Question 73

What is the mechanism of action of Tenecteplase? A) Directly inhibits Factor Xa B) Enhances platelet aggregation C) Activates plasminogen to plasmin D) Inhibits thromboxane A2

Answer 73

Activates plasminogen to plasmin ## Footnote Tenecteplase is a thrombolytic agent that converts plasminogen into plasmin, leading to clot dissolution.

Question 74

Which anticoagulant requires regular INR monitoring and has a narrow therapeutic index? A) Apixaban B) Enoxaparin C) Warfarin D) Dabigatran

Answer 74

Warfarin ## Footnote Warfarin is often monitored due to its potential for bleeding and interactions with food and other medications.

Question 75

Which agent inhibits only Factor Xa but not thrombin? A) Unfractionated heparin B) LMWH (e.g., enoxaparin) C) Dabigatran D) Argatroban

Answer 75

LMWH (e.g., enoxaparin) ## Footnote Low Molecular Weight Heparin (LMWH) selectively inhibits Factor Xa, providing anticoagulation without direct thrombin inhibition.

Question 76

Which anticoagulant has a reversal agent called idarucizumab? A) Apixaban B) Warfarin C) Dabigatran D) Heparin

Answer 76

Dabigatran ## Footnote Idarucizumab is used to reverse the anticoagulant effects of dabigatran in cases of bleeding or urgent surgery.

Question 77

Which antiplatelet agent is an irreversible COX-1 inhibitor with a 7–10 day effect on platelets? A) Ticagrelor B) Aspirin C) Clopidogrel D) Vorapaxar

Answer 77

Aspirin ## Footnote Aspirin's effects last for the lifespan of the platelet, about 7-10 days, making it effective for long-term antiplatelet therapy.

Question 78

Which P2Y12 inhibitor is not a prodrug and has reversible platelet binding? A) Clopidogrel B) Prasugrel C) Ticagrelor D) None of the above

Answer 78

Ticagrelor ## Footnote Ticagrelor provides rapid onset and offset of action due to its reversible binding to the P2Y12 receptor.

Question 79

Vorapaxar acts by inhibiting which receptor? A) GP IIb/IIIa B) COX-1 C) P2Y12 D) PAR-1

Answer 79

PAR-1 ## Footnote Vorapaxar is a protease-activated receptor-1 antagonist that reduces thrombin-induced platelet aggregation.