1.
Which of the following is a potassium losing diuretic?
Correct Answer
D. Hydrochlorothiazide
Explanation
Hydrochlorothiazide is a potassium losing diuretic because it works by increasing the excretion of water and sodium from the body, which in turn leads to the excretion of potassium. This diuretic is commonly used to treat conditions such as high blood pressure and edema.
2.
Which drug functions at the proximal convoluted tubule?
Correct Answer
D. Mannitol
Explanation
Mannitol functions at the proximal convoluted tubule. It is a diuretic that works by increasing the osmotic pressure in the tubule, preventing water reabsorption and promoting diuresis. This mechanism of action allows mannitol to be effective in reducing intracranial pressure and intraocular pressure, as well as in promoting diuresis in certain medical conditions.
3.
Which drug directly blocks the sodium channel through which sodium ca normally be reabsorbed from the tubular fluid in the cortical collecting duct?
Correct Answer
B. Amiloride
Explanation
triamterene as well
4.
Which of the following puts the drugs in the correct order from greatest to least ability to block sodium excretion?
Correct Answer
C. Furosemide < hydrochlorothiazide < spironolactone
Explanation
The correct order from greatest to least ability to block sodium excretion is furosemide, hydrochlorothiazide, and spironolactone. Furosemide is a loop diuretic that acts on the ascending limb of the loop of Henle, blocking sodium reabsorption. Hydrochlorothiazide is a thiazide diuretic that acts on the distal convoluted tubule, inhibiting sodium reabsorption. Spironolactone is a potassium-sparing diuretic that acts on the collecting duct, blocking the effects of aldosterone and reducing sodium reabsorption. Therefore, furosemide has the greatest ability to block sodium excretion, followed by hydrochlorothiazide, and then spironolactone.
5.
Which drug works more quickly Spironolactone or Triamterene?
Correct Answer
A. Triamterene
Explanation
Triamterene works more quickly than Spironolactone.
6.
Which of the following is paradoxically used to treat diabetes insipidus?
Correct Answer
A. Hydrochlorothiazide
Explanation
Hydrochlorothiazide is paradoxically used to treat diabetes insipidus because it is a diuretic that increases urine production, which seems counterintuitive for a condition characterized by excessive urination. However, hydrochlorothiazide works by increasing the reabsorption of water in the kidneys, reducing the amount of urine produced and helping to alleviate the symptoms of diabetes insipidus.
7.
Which drug increases the risk of kidney stones? Decreases?
Correct Answer
B. Furosemide, hydrochlorothiazide
Explanation
Furosemide and hydrochlorothiazide are both diuretic medications commonly used to treat conditions such as high blood pressure and edema. Furosemide works by increasing urine production, which can lead to an increased risk of kidney stone formation. Hydrochlorothiazide also increases urine production but has the opposite effect on kidney stones. It actually decreases the risk of kidney stone formation by increasing the excretion of calcium in the urine. Therefore, the correct answer is Furosemide, hydrochlorothiazide.
8.
Which drug causes an increase in plasma glucose,
increase in urate levels, and lipid levels?
Correct Answer
C. Hydrochlorothiazide
Explanation
Hydrochlorothiazide is a diuretic medication commonly used to treat high blood pressure and edema. It works by increasing urine production, which can lead to an increase in plasma glucose levels. Additionally, hydrochlorothiazide can cause an increase in urate levels, which is a byproduct of purine metabolism. This can be problematic for individuals with gout or kidney disease. Lastly, hydrochlorothiazide has been shown to increase lipid levels, including cholesterol and triglycerides, which can have implications for cardiovascular health.
9.
Which drug increases the risk of lithium and digoxin toxicity?
Correct Answer
B. Hydrochlorothiazide
Explanation
furosemide can too
10.
Which drugs MoA leads to dissipation of the medullary interstitial gradient?
Correct Answer
B. Furosemide
Explanation
Furosemide is a loop diuretic that inhibits the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle. By blocking this transporter, furosemide prevents reabsorption of sodium, potassium, and chloride ions, leading to increased excretion of these electrolytes in the urine. This diuretic effect disrupts the medullary interstitial gradient, which is essential for concentrating urine. Therefore, furosemide's mechanism of action results in the dissipation of the medullary interstitial gradient.
11.
Which drug is used for pulmonary edema and
edemas of the heart, kidney, and liver?
Correct Answer
B. Furosemide
Explanation
Furosemide is the correct answer because it is a loop diuretic that is commonly used to treat pulmonary edema and edemas of the heart, kidney, and liver. It works by increasing the excretion of water and electrolytes through the kidneys, which helps to reduce fluid buildup in the body. Hydrochlorothiazide, triamterene, and spironolactone are also diuretics but are not typically used for these specific conditions.
12.
Which drugs still works when renal blood flow and glomerular filtration are low?
Correct Answer
A. Furosemide
Explanation
Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidneys. It is effective in increasing urine output even when renal blood flow and glomerular filtration are low. This is because furosemide acts on the loop of Henle, which is located after the glomerulus, bypassing the need for adequate renal blood flow and glomerular filtration for its action. Therefore, furosemide can still be effective in promoting diuresis in patients with compromised renal function.
13.
Which drug blocks the Na/K/Cl transporter?
Correct Answer
D. Furosemide
Explanation
Furosemide is the correct answer because it is a loop diuretic that specifically blocks the Na/K/Cl transporter in the ascending limb of the loop of Henle in the kidneys. By inhibiting this transporter, furosemide prevents the reabsorption of sodium, potassium, and chloride ions, leading to increased urine production and decreased fluid volume in the body. This mechanism of action makes furosemide an effective medication for treating conditions such as edema and hypertension.
14.
Which drug is proven to cross the placental barrier?
Correct Answer
A. Furosemide
Explanation
Furosemide is proven to cross the placental barrier. This means that when a pregnant woman takes furosemide, the drug can pass from the mother's bloodstream into the placenta and reach the developing fetus. This can have potential effects on the fetus, which is why furosemide is generally not recommended during pregnancy unless the benefits outweigh the risks. Mannitol, spironolactone, and hydrochlorothiazide are not known to cross the placental barrier to the same extent as furosemide.
15.
Which drug can cause ototoxicity, hyperglycemia, hyperuricemia, and also affects cholesterol in the body?
Correct Answer
B. Furosemide
Explanation
Furosemide is a loop diuretic commonly used to treat conditions such as edema and hypertension. It can cause ototoxicity, which is damage to the ear and hearing loss. Furosemide can also lead to hyperglycemia, an increase in blood sugar levels, and hyperuricemia, an elevated level of uric acid in the blood. Additionally, furosemide can affect cholesterol levels in the body, potentially causing an increase in cholesterol.
16.
Which drug should not be used with gentamycin? Why?
Correct Answer
A. Furosemide
Explanation
because they both can cause ototoxicity
17.
Which of the following is NOT a loop diuretic?
Correct Answer
D. All of the above are loop diuretics
Explanation
All of the options listed in the question are loop diuretics. Loop diuretics are a type of medication that work by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidney, leading to increased urine production. Torsemide, ethacrynic acid, and bumetanide are all examples of loop diuretics commonly used to treat conditions such as edema and high blood pressure. Therefore, the correct answer is that all of the options listed are loop diuretics.
18.
Which drug can be used in patients with a sulfa allergy?
Correct Answer
B. Ethacrynic acid
Explanation
Ethacrynic acid can be used in patients with a sulfa allergy because it is a loop diuretic that does not contain a sulfonamide group in its chemical structure. This makes it a suitable alternative for patients who are allergic to sulfa drugs, as it does not pose a risk of cross-reactivity or allergic reactions. Furosemide, bumetanide, and torsemide, on the other hand, are loop diuretics that contain a sulfonamide group and should be avoided in patients with a sulfa allergy.
19.
Which of the following drugs is a carbonic anhydrase inhibitor?
Correct Answer
D. Acetazolamide
Explanation
Acetazolamide is a carbonic anhydrase inhibitor. Carbonic anhydrase is an enzyme that catalyzes the conversion of carbon dioxide and water into carbonic acid, which then dissociates into bicarbonate ions and hydrogen ions. By inhibiting carbonic anhydrase, acetazolamide reduces the production of bicarbonate ions, which in turn reduces the secretion of hydrogen ions. This mechanism of action is useful in various medical conditions, such as glaucoma, edema, and certain types of epilepsy.
20.
Which of the following is NOT a therapeutic use of acetazolamide?
Correct Answer
B. Potassium sparing
Explanation
Acetazolamide is a carbonic anhydrase inhibitor commonly used in the treatment of glaucoma, acute mountain sickness, and metabolic alkalosis. It works by reducing the production of aqueous humor in the eye, decreasing fluid accumulation in the brain at high altitudes, and promoting renal excretion of bicarbonate to correct alkalosis. However, it is not used for potassium sparing. Potassium sparing refers to the ability of a medication to prevent the loss of potassium in the urine, and acetazolamide does not possess this property.
21.
Which of the following is NOT an adverse effect of carbonic anhydrase inhibitors?
Correct Answer
A. Respiratory acidosis
Explanation
Carbonic anhydrase inhibitors are commonly used to treat conditions such as glaucoma and epilepsy. They work by reducing the production of carbonic acid in the body, which can lead to a decrease in the levels of bicarbonate ions. This can result in metabolic acidosis, characterized by an increase in acidity in the blood. However, respiratory acidosis is not an adverse effect of carbonic anhydrase inhibitors. It is a condition that occurs when there is an excess of carbon dioxide in the blood due to impaired lung function.
22.
Which of the following is NOT an osmotic diuretic?
Correct Answer
D. Dorzolamide
Explanation
Dorzolamide is not an osmotic diuretic because it does not work by increasing the osmotic pressure in the renal tubules to promote water excretion. Dorzolamide is actually a carbonic anhydrase inhibitor used to reduce intraocular pressure in glaucoma patients. Osmotic diuretics like urea, glycerin, mannitol, and isosorbide work by increasing the osmotic pressure in the renal tubules, causing water to be drawn out of the body and increasing urine production.
23.
Which type of drug can pull water out of cells all over the body?
Correct Answer
A. Mannitol
Explanation
Mannitol is a type of drug known as an osmotic diuretic. Osmotic diuretics work by increasing the osmolarity (concentration) of the filtrate in the kidney, which prevents water reabsorption and leads to increased urine production. Mannitol is able to pull water out of cells all over the body because it is not metabolized by the body and remains in the extracellular space. It creates an osmotic gradient that draws water out of the cells and into the extracellular space, resulting in increased urine output and decreased fluid accumulation in the body.
24.
The net effect of what type of drug is to pull water out of the body in excess of electrolytes?
Correct Answer
D. Osmotic diuretics
Explanation
Osmotic diuretics are drugs that pull water out of the body in excess of electrolytes. These drugs work by increasing the osmotic pressure in the kidneys, which prevents the reabsorption of water and electrolytes back into the bloodstream. As a result, more water is excreted in the urine, leading to increased urine production and removal of excess fluid from the body.
25.
Which drug can specifically exacerbate heart failure?
Correct Answer
C. Mannitol
Explanation
Mannitol is a drug that can specifically exacerbate heart failure. Mannitol is an osmotic diuretic that works by increasing the osmolarity of the filtrate in the renal tubules, leading to increased water excretion. However, in patients with heart failure, the increased fluid loss caused by mannitol can further strain the heart and worsen the symptoms of heart failure. This is why mannitol is contraindicated in patients with heart failure.
26.
Which of the following is NOT a therapeutic use of osmotic diuretics?
Correct Answer
D. PropHylaxis of heart failure
Explanation
Osmotic diuretics are used to reduce intracranial pressure, prophylaxis of renal failure, and reduction of intraocular pressure. However, they are not used for the prophylaxis of heart failure. Heart failure is a condition where the heart is unable to pump enough blood to meet the body's needs, and osmotic diuretics are not typically indicated for this condition. Other medications and interventions, such as ACE inhibitors, beta blockers, and lifestyle modifications, are commonly used for the prophylaxis and treatment of heart failure.
27.
Which drug is approved for treatment of hyponatremia due to Syndrome of Inappropriate ADH Secretion?
Correct Answer
D. Conivaptan
Explanation
Conivaptan is the correct answer because it is approved for the treatment of hyponatremia due to Syndrome of Inappropriate ADH Secretion. Conivaptan is a vasopressin receptor antagonist that helps to increase the excretion of water without affecting electrolyte balance. This drug is specifically indicated for the treatment of euvolemic hyponatremia, which is often caused by the excessive secretion of antidiuretic hormone (ADH). By blocking the action of ADH, conivaptan helps to restore normal sodium levels in the body.
28.
Which drug prevents ADH insertion of the aquaporin water channels mediating water reabsorption in the collecting duct?
Correct Answer
A. Conivaptan
Explanation
Conivaptan prevents ADH insertion of the aquaporin water channels in the collecting duct. ADH (antidiuretic hormone) is responsible for increasing water reabsorption in the kidneys. By inhibiting the action of ADH, conivaptan reduces water reabsorption and promotes diuresis. Furosemide, triamterene, and mannitol do not directly affect ADH or aquaporin channels. Furosemide is a loop diuretic that inhibits sodium and water reabsorption in the loop of Henle. Triamterene is a potassium-sparing diuretic that acts on the distal tubule. Mannitol is an osmotic diuretic that increases osmolarity in the renal tubules, promoting water excretion.
29.
Which of the following should NOT be coadministered with diuretics?
Correct Answer
E. All of the above
Explanation
Diuretics are medications that increase urine production and help in removing excess fluid from the body. Coadministration of diuretics with NSAIDs can reduce the diuretic effect and increase the risk of kidney damage. Morphine can also reduce the effectiveness of diuretics and cause fluid retention. Sedative hypnotics may cause excessive sedation when taken with diuretics. Licorice can increase blood pressure and counteract the effects of diuretics. Therefore, all of the above options should not be coadministered with diuretics.
30.
Which drug can be used to treat a child who has overdosed on aspirin?
Correct Answer
B. Carbonic anhydrase
Explanation
Promotes HCO3 and Na excretion and alkalinizes urine which traps secreted aspirin for excretion