1.
Directions: questions 1-5
Match each antihypertensive drug with its appropriate mechanism of action (each lettered option
can be selected once, more than once, or not at all):
Nitric oxide is the active metabolite
A. 
B. 
C. 
D. 
E. 
F. 
G. 
H. 
I. 
J. 
K. 
L. 
M. 
N. 
O. 
P. 
Q. 
2.
Directions: questions 1-5
Match each antihypertensive drug with its appropriate mechanism of action (each lettered option
can be selected once, more than once, or not at all):
Activation of D1 receptors
A. 
B. 
C. 
D. 
E. 
F. 
G. 
H. 
I. 
J. 
K. 
L. 
M. 
N. 
O. 
P. 
Q. 
3.
Directions: questions 1-5
Match each antihypertensive drug with its appropriate mechanism of action (each lettered option
can be selected once, more than once, or not at all):
Blockade of AT1 receptors
A. 
B. 
C. 
D. 
E. 
F. 
G. 
H. 
I. 
J. 
K. 
L. 
M. 
N. 
O. 
P. 
Q. 
4.
Directions: questions 1-5
Match each antihypertensive drug with its appropriate mechanism of action (each lettered option
can be selected once, more than once, or not at all):
Potassium channel opening in smooth muscle cells
A. 
B. 
C. 
D. 
E. 
F. 
G. 
H. 
I. 
J. 
K. 
L. 
M. 
N. 
O. 
P. 
Q. 
5.
Directions: questions 1-5
Match each antihypertensive drug with its appropriate mechanism of action (each lettered option
can be selected once, more than once, or not at all):
Competitive inhibition of renin
A. 
B. 
C. 
D. 
E. 
F. 
G. 
H. 
I. 
J. 
K. 
L. 
M. 
N. 
O. 
P. 
Q. 
6.
A 63-year-old man, recently diagnosed with stage 1 essential hypertension, started a
treatment with hydrochlorothiazide. After several weeks of treatment, the
antihypertensive action of the drug was most likely associated with which of the
following effects?
A. 
Remarkable postural hypotension
B. 
C. 
Decreased peripheral vascular resistance
D. 
Increased interstitial fluid volume
E. 
Decreased renal blood flow
7.
A 52-year-old man complained to his physician of acute pain at the base of his right
big toe. The man, who had been working as a painter for 15 years, was recently
diagnosed with essential hypertension and started an antihypertensive therapy one
month ago. A lab test showed a plasma uric acid level of 17 mg/dL. Which of the
following drugs might have caused the symptoms and signs of this patient?
A. 
B. 
C. 
D. 
E. 
F. 
8.
A 65 year-old woman was found to have a blood pressure of 165/90 during a routine
visit. Past history of the patient was significant for a second-degree heart block and for
osteoporosis. One year ago she had suffered from a severe episode of angioedema.
Which of the following antihypertensive drugs would be most appropriate for this
patient?
A. 
B. 
C. 
D. 
E. 
9.
A 52-y/o woman suffering from HTN still had a blood pressure of 156/92 mm Hg after three months of therapy with hydrochlorotiazide and losartan. Her physician decided to add a third drug which acts by decreasing central sympathetic outflow.
Which of the following adverse effects might most likely occur after few days of therapy with the new drug?
A. 
Severe postural hypotension
B. 
C. 
D. 
E. 
10.
A 65-year-old man with stage 2 essential hypertension, had been taking a thiazide
diuretic and losartan for three months but his blood pressure was still 160/95 mm Hg.
The physician decided to add a third drug and now his blood pressure was well
controlled. However, because the patient was experiencing daytime somnolence and dry
mouth, he decided to discontinue the prescribed medication. Twenty-four hour later he
exhibited restlessness, apprehension, tremor, sweating and tachycardia. Which of the
following drugs was most likely added to the patient regimen?
A. 
B. 
C. 
D. 
E. 
F. 
11.
A 35-year-old woman in her 29th week of gestation was found to have a positive direct
Coombs’ test during a routine prenatal visit. Two months after she became pregnant, she
was diagnosed with stage 1 hypertension and started an antihypertensive therapy. Which
of the following drugs was she most likely taking?
A. 
B. 
C. 
D. 
E. 
F. 
12.
A 47-year-old man with a history of hypertension had been taking hydrochlorothiazide
for one month, but his blood pressure was not controlled despite adherence to
medication and nonpharmacologic measures. The patient was also trying to quit
smoking without success. The physician decided to add to the therapeutic regimen a
second drug that also could help the patient as an adjunct to a smoking cessation
program. Which of the following drug was most likely prescribed?
A. 
B. 
C. 
D. 
E. 
13.
A 60-year-old man reported to his physician that he felt very dizzy and fainted upon standing up rapidly, after. The man, recently diagnosed with stage 1 essential hypertension and prostatic hyperplasia, started a drug treatment one week previously. Which of the following drugs most likely caused this adverse effect?
A. 
B. 
C. 
D. 
E. 
F. 
14.
A 61-year-old man suffering from hypertension had been taking hydrochlorothiazide and propranolol for two months but the therapy failed to completely control his blood pressure. The man was recently diagnosed with benign prostatic hyperplasia and experienced frequent nocturia. His physician decided to add a third drug which could also help the patient’s difficulty in urinating. A drug from which of the following drug classes was most likely prescribed?
A. 
B. 
C. 
D. 
E. 
F. 
15.
A 50-year-old woman complained to o her physician complaining of dizziness and
vertigo of three days duration. The woman, recently diagnosed with hypertension and
diastolic dysfunction, started a hypertensive therapy one week previously. Physical
examination showed blood pressure of 166/94 mm Hg while laying and of 140/83 mm Hg
while standing. Which of the following antihypertensive drugs was the patient most likely
taking?
A. 
B. 
C. 
D. 
E. 
16.
A 38-year-old man was diagnosed with hypertension (156/95 mm Hg) during a routine
visit. Subsequent exams indicated he was affected by hypertrophic cardiomyopathy.
Which of the following antihypertensive drugs would be most appropriate for this
patient?
A. 
B. 
C. 
D. 
E. 
F. 
17.
A 64-year-old man with a long history of hypertension presented to the hospital
complaining of the sudden onset of severe, sharp, diffuse chest pain which radiated to
his back. Physical examination revealed a pulse of 110 bpm and a blood pressure of
200/120 mm Hg. A CT scan showed a dissection of the arch of the aorta. An emergency
treatment was started IV. Which of the following pairs of drugs were most likely
administered?
A. 
B. 
Diazoxide and hydralazine
C. 
D. 
Nitroprusside and esmolol
E. 
18.
A 56-year-old woman recently diagnosed with hypertension and atrial fibrillation
started a treatment with atenolol, two tablets daily. Which of the following sets of
physiologic changes was most likely after the administration of the drug?
A. 
B. 
C. 
D. 
E. 
19.
A 56-year-old man complained to his physician of palpitations, sweating and flushing
of two day duration. The man, who had been suffering from hypertension for 3 months,
had started a therapy with hydrochlorothiazide and captopril but one month later his
blood pressure was still 170/100 mm Hg. One week ago the physician decided to add a
third antihypertensive agent to the treatment. Which of the following drugs was most
likely added to the patient’s therapy?
A. 
B. 
C. 
D. 
E. 
20.
A 61-year-old man, suffering from stage 2 hypertension for many years, had minoxidil
added recently to his antihypertensive therapy. Which of the following actions best
explains the antihypertensive effect of this drug?
A. 
B. 
Decreased central adrenergic tone
C. 
Decreased extracellular fluid volume
D. 
Decreased synthesis of angiotensin II
E. 
Decreased total peripheral resistance
21.
A 34-year-old woman complained of itching and burning around her vagina and a foulsmelling vaginal discharge. A wet mount examination of the discharge showed pear-shaped trophozoites that exhibited jerky motility. Which of the following drugs would be appropriate for this patient?
A. 
B. 
C. 
D. 
E. 
F. 
22.
A 35-year-old woman, back from a tourist trip in the Amazona forest, developed a red papule in her right arm, which enlarged slowly and began to ulcerate but caused no pain. A few days later multiple lesions developed. A smear taken from the skin lesions demonstrated the presence of amastigotes. Which of the following drugs would be appropriate for this patient?
A. 
B. 
C. 
D. 
E. 
F. 
23.
A 24-year-old woman, who was 22-week pregnant, presented with a 5-day history of loose stools containing bloody mucus. Her past medical history was significant for an optic neuritis one month ago, apparently due to a viral infection. Upon physical examination, her abdomen was soft but nontender. The exam of fresh stools showedE. histolytica trophozoites. A CT scan was negative for gut wall or liver amebiasis.Which of the following drugs would be appropriate for this patient?
A. 
B. 
C. 
D. 
E. 
F. 
24.
A 31-year-old homosexual man presented to the hospital with a 10-day history of abdominal pain and multiple, brown, watery stools. Physical examination revealed a tall man with abdominal distress. Vital signs were: blood pressure 125/75 mm Hg, pulse 78 bpm, temperature 103.5° F. His abdomen was slightly distended with a tender mass palpable in the lower right quadrant, which proved to be an abdominal abscess on ultrasound examination. A serologic test was positive for E . histolytica .Which of the following pairs of drugs would be appropriate for this patient?
A. 
Metronidazole and iodoquinol
B. 
Chloroquine and clindamycin
C. 
Metronidazole and pyrimethamine
D. 
Doxycycline and iodoquinol
E. 
Chloroquine and ciprofloxacin
F. 
Pyrimethamine and ciprofloxacin
25.
A 45-year-old black man referred to his physician that few days ago he noticed a persistent yellow color in his eyes . One week before, coming back from a trip to central America, the man had started a treatment which included primaquine. A blood test disclosed the following:RBC count: 3.8 x 106/ mm3 (normal: 4-5.5)Hb: 9 g/dL (normal: > 12)Reticulocytes: 3.7% of red cells (normal 0.5-1.5%)WBC count 12000/mm3 (normal: 3200-9800)The physician told the patient that he probably had a genetically induced enzyme defect. Which of the following enzymes was most likely abnormal?
A. 
B. 
Uroporphyrinogen decarboxylase
C. 
D. 
E. 
Glucose-6-phosphate-dehydrogenase