Pharm Diuretics

20 Questions | By Chachelly | Last updated: Jul 20, 2018 | Total Attempts: 783

Questions

Settings

Questions and Answers

1.

Directions: questions 1-5 Match each diuretic with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug inhibits Na+ reabsorption in the proximal tubule
- A.
  
  Acetazolamide
- B.
  
  Amiloride
- C.
  
  Conivaptan
- D.
  
  Ethacrynic acid
- E.
  
  Indapamide
- F.
  
  Mannitol
- G.
  
  Spironolactone
- H.
  
  Triamterene
2.

Directions: questions 1-5 Match each diuretic with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug inhibits the synthesis of new Na+ channels in the collecting duct
- A.
  
  Acetazolamide
- B.
  
  Amiloride
- C.
  
  Conivaptan
- D.
  
  Ethacrynic acid
- E.
  
  Indapamide
- F.
  
  Mannitol
- G.
  
  Spironolactone
- H.
  
  Triamterene
3.

Directions: questions 1-5 Match each diuretic with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug causes an initial extracellular volume expansion in normal subjects
- A.
  
  Acetazolamide
- B.
  
  Amiloride
- C.
  
  Conivaptan
- D.
  
  Ethacrynic acid
- E.
  
  Indapamide
- F.
  
  Mannitol
- G.
  
  Spironolactone
- H.
  
  Triamterene
4.

Directions: questions 1-5 Match each diuretic with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug increases the renal reabsorption of Ca++
- A.
  
  Acetazolamide
- B.
  
  Amiloride
- C.
  
  Conivaptan
- D.
  
  Ethacrynic acid
- E.
  
  Indapamide
- F.
  
  Mannitol
- G.
  
  Spironolactone
- H.
  
  Triamterene
5.

Directions: questions 1-5 Match each diuretic with the appropriate description (each lettered option can be selected once, more than once, or not at all): This drug competitively blocks ADH receptors
- A.
  
  Acetazolamide
- B.
  
  Amiloride
- C.
  
  Conivaptan
- D.
  
  Ethacrynic acid
- E.
  
  Indapamide
- F.
  
  Mannitol
- G.
  
  Spironolactone
- H.
  
  Triamterene
6.

A 56-year old woman recently diagnosed with congestive heart failure, started a therapy which included furosemide. Acetazolamide was also added to counteract the potential metabolic alkalosis induced by furosemide. Which of the following molecular actions most likely mediated the therapeutic effect of acetazolamide in this patient?
- A.
  
  Inhibition of carbonic acid dehydration in the tubular lumen
- B.
  
  Stimulation of bicarbonate reabsorption in the proximal tubule
- C.
  
  Inhibition of Na+ reabsorption in the early distal tubule
- D.
  
  Stimulation of H+ reabsorption in the proximal tubule
- E.
  
  Stimulation of carbonic acid formation - inside the tubular cells
7.

A 27-year-old woman with a history of high altitude sickness was placed on prophylactic treatment with a diuretic drug prior to going on a hiking trip to the Rocky Mountains. Which of the following urine electrolyte profiles is most consistent with this drug treatment?(+ increased in urine; - decreased in urine; 0 no change in urine)
- A.
  
  A
- B.
  
  B
- C.
  
  C
- D.
  
  D
- E.
  
  E
8.

A 69-year-old depressed man, who has been suffering from glaucoma for ten years, was admitted to the emergency room after he took several tablets of one of his medications in a suicide attempt. The patient was drowsy an complained of nausea, paresthesias and tiredness. Physical examination disclosed an erythematous skin eruption and lab exams showed hyperchloremic metabolic acidosis. Which of the following medications might have caused the patient’s these symptoms?
- A.
  
  Mannitol
- B.
  
  Latanoprost
- C.
  
  Timolol
- D.
  
  Acetazolamide
- E.
  
  Pilocarpine
9.

A 55-year-old alcoholic man was admitted to the hospital because of disorientation, amnesia, confusion and bizarre behavior of 24 hour duration. His wife reported that the man was under therapy for hypertension and for a recently diagnosed glaucoma. Physical examination revealed a cachectic male in a confused mental state. Abdomen appeared tense with prominent veins and ascites and a musty ,pungent odor was noted in his breath. Neurological sings included nystagmus, ataxia and asterixis. Which of the following drugs most likely triggered the patient’s syndrome?
- A.
  
  Acetazolamide
- B.
  
  Nifedipine
- C.
  
  Losartan
- D.
  
  Timolol
- E.
  
  Lovastatin
10.

A 54-year-old woman recently diagnosed with open angle glaucoma was prescribed topical timolol. Two weeks later the intraocular pressure was decreased but was still above the normal value. The ophthalmologist decided to add another topical drug that act by decreasing aqueous humor production. Which of the following drugs was most likely prescribed?
- A.
  
  Pilocarpine
- B.
  
  Carbachol
- C.
  
  Latanoprost
- D.
  
  Dorzolamide
- E.
  
  Mannitol
11.

A 15-year-old boy awoke with weakness and an hour later realized he could not move his legs. The attack lasted about 2 hours, then it disappeared without residual symptoms. The boy was referred to a neurologic clinic where the diagnosis of familial hypokalemic periodic paralysis was made. He was prescribed potassium chloride and a diuretic that is able to prevent the attacks in many cases. Which of the following drugs was most likely prescribed?
- A.
  
  Mannitol
- B.
  
  Hydrochlorothiazide
- C.
  
  Ethacrynic acid
- D.
  
  Triamterene
- E.
  
  Acetazolamide
12.

A 67-year-old man was found to have a plasma level of calcium of 12.2 mg/dL. during a followup visit. The man, who had been suffering from Hodgkin’s lymphoma for three years, was recently diagnosed with nephrolithiasis and started a therapy with hydrochlorothiazide three weeks previously. Which of the following statements best explains the most likely mechanism of thiazide induced hypercalcemia?
- A.
  
  Enhancement of Na+/Ca++ exchanger in the distal tubule
- B.
  
  Increased Ca++ reabsorption in the proximal tubule
- C.
  
  Decreased secretion of parathyroid hormone
- D.
  
  Decreased renal excretion of Vit D
- E.
  
  Enhancement of Na+/K+/ 2Cl symport
- F.
  
  Increased glomerular filtration of Ca++
13.

A 67-year old woman was found to have a plasma level of potassium 3.8 mEq/L during a followup visit. The woman, recently diagnosed with essential hypertension, started a therapy with hydrochlorothiazide one month previously. Which of the following actions most likely contributed to the thiazide-induced increase of renal excretion of potassium?
- A.
  
  Increased Na+ load in the lumen of the collecting tubule
- B.
  
  Blockade of Na+/K+/2Cl- cotransporter
- C.
  
  Thiazide-induced decrease in renal secretion of uric acid
- D.
  
  Stimulation of Na+/K+ pump
- E.
  
  Decreased delivery of bicarbonate to the collecting duct
14.

A 65-year-old man was found to have a plasma level of calcium of 12.2 mg/dL. during a followup visit. The man, who had been suffering from Hodgkin’s lymphoma for three years, was recently diagnosed with nephrolithiasis and started a therapy with hydrochlorothiazide three weeks previously. Which of the following statements best explains the most likely mechanism of thiazide induced hypercalcemia?
- A.
  
  Enhancement of Na+/Ca++ exchanger in the distal tubule
- B.
  
  Increased Ca++ reabsorption in the proximal tubule
- C.
  
  Decreased secretion of parathyroid hormone
- D.
  
  Decreased renal excretion of Vit D
- E.
  
  Enhancement of Na+/K+/ 2Cl symport
- F.
  
  Increased glomerular filtration of Ca++
15.

A 76-year-old woman from a nursing home presented to the emergency room with a change in her mental state over the past few hours. She had a medical history of coronary artery disease and hypertension. Her medications included aspirin, captopril , lovastatin and a diuretic. On physical examination she showed a decreased skin turgor, orthostatic hypotension, disorientation to time, place and person, without focal neurologic deficits. Pertinent blood test results on admission were Na 125 mEq/L, creatinine 2.7 mg/dL. Which of the following drugs most likely caused the patient syndrome?
- A.
  
  Captopril
- B.
  
  Spironolactone
- C.
  
  Lovastatin
- D.
  
  Triamterene
- E.
  
  Acetazolamide
- F.
  
  Indapamide
16.

A 47-year-old woman suffering from metastatic breast cancer was admitted to the hospital because of a persistent thirst and polyuria. Admission lab data were: serum K 2.8 mEq/L, Ca 16.2 mg/dL, Na 155 mEq/L. Urinalysis: specific gravity 1.001, osmolality 80 mOsm/L (range 50-1440), protein and microscope negative. The patient was given a water deprivation test: all fluids were withheld until serum osmolality increased into the hyperosmolar range (> 310), then 5 units of vasopressin were given SC. Results are tabulated below: Which of the following drugs would be most appropriate to treat the patient’s condition?
- A.
  
  Desmopressin
- B.
  
  Hydrochlorothiazide
- C.
  
  Demeclocycline
- D.
  
  Amiloride
- E.
  
  Furosemide
17.

A 63-year-old man with a long history of heart failure was admitted to the hospital because of severe dyspnea and edema on legs, thighs and lower abdominal wall. Pertinent lab results on admission included a GFR of 25 mL/min. A diuretic with which of the following mechanism of action would be appropriate to relieve the edema of this patient?
- A.
  
  Blockade of Na+ reabsorption in the proximal tubule
- B.
  
  Blockade of Na+ channels in the collecting tubule
- C.
  
  Blockade of Na+/K+/2Cl- symport in the Henle’s loop
- D.
  
  Inhibition of aldosterone actions in the collecting tubule
- E.
  
  Blockade of Na+/Cl- symport in the early distal tubule
18.

A 42-year-old obese female was hospitalized because of hypokalemia despite a daily administration of potassium supplement. Laboratory tests upon admission revealed metabolic alkalosis. The patient admitted taking furosemide tablets in an effort to loose weight. Which of the following actions might contribute to furosemide-induced metabolic alkalosis in this patient?
- A.
  
  The increased reabsorption of uric acid
- B.
  
  The increase delivery of Na+ to the distal tubule
- C.
  
  The mild inhibition of carbonic anhydrase
- D.
  
  The decreased reabsorption of Ca++ in Henle’s loop
- E.
  
  The inhibition of renin secretion
19.

A 78-year-old man from a nursing home presented to the emergency room with a change in his mental state over the past few hours. He had a medical history of angina and hypertension presently treated with isosorbide mononitrate, losartan and hydrochlorothiazide. Physical examination showed a person with decreased skin turgor, disorientation to time and place, without focal neurologic deficits. Blood pressure was 110/65 mm Hg on standing and 140/88 mm Hg on laying. Pertinent blood tests on admission were: Na 116 q/L, K 3.1 mEq/L, uric acid 10.2 mg/dL, creatinine 3.7 mg/dL. The physician thought that the syndrome was due to diuretic therapy. Which of the following drug-induced adverse effects most likely caused the patient’s symptoms and signs ?
- A.
  
  Kidney insufficiency
- B.
  
  Hypokalemia
- C.
  
  Hypovolemic hyponatremia
- D.
  
  Hyperuricemia
- E.
  
  Hypervolemic hyponatremia
20.

A 66-year-old woman suffering from systolic cardiac failure was brought to the emergency room because of a sudden onset of extreme dyspnea. She presented with cyanosis, tachypnea, hyperpnea, restlessness, anxiety and a sense of suffocation. Cough was prominent and produced pink-tinged, frothy sputum. Pulse was thready and fast (120 bpm), blood pressure 80/45 mm Hg and rales were audible at the lung bases. Which of the following drugs was most likely included in the immediate medical treatment of this patient?
- A.
  
  Hydrochlorothiazide
- B.
  
  Amiloride
- C.
  
  Mannitol
- D.
  
  Epinephrine
- E.
  
  Furosemide
- F.
  
  Metoprolol