MCQ on diuretic and antidiuretic drugs

1. Which of the following statements about spironolactone is TRUE?

a) Spironolactone reverses many of the manifestations of aldosteronism

b) Spironilactone is also an androgen antagonist and as such is used in the treatment of hirsutism in wormen

c) Spironolactone is useful as a diuretic

d) All of the above

Ans: (d)

2. All of the following statements regarding diuretics are true, EXCEPT:

a) Carbonic anhydrase inhibition leads to increased reabsorption of NaHCO3

b) Loop diuretics decrease Na+ reabsorption at the loop of Henle by competing for the Cl- site on the Na+/K+/2Clcotransporter

c) In general, the potency of a diuretic is determined by where it acts in the renal tubule

d) Hydrochlorothiazide decreases urinary calcium excretion

Ans: (a)

3. The drug inhibits the ubiquitous enzyme carbonic anhydrase:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (HydroDiuril)

d) Spironolactone (Aldactone)

Ans: (a)

4. The drug acts by competitively blocking NaCl cotransporters in the distal tubule:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (HydroDiuril)

d) Spironolactone (Aldactone)

Ans: (c)

5. The drug acts at the proximal tubule:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (HydroDiuril)

d) Spironolactone (Aldactone)

Ans: (a)

6. The drug acts by competing with aldosterone for its cytosolic receptors:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (HydroDiuril)

d) Spironolactone (Aldactone)

Ans: (d)

7. The drug is a potassium-sparing diuretic that blocks Na+ channels in the collecting tubules:

a) Acetazolamide (Diamox)

b) Amiloride (Midamor)

c) Furosemide (Lasix)

d) Hydrochlorothiazide (HydroDiuril)

Ans: (b)

8. Chronic use of this drug can lead to distal tubular hypertrophy, which may reduce its diuretic effect:

a) Acetazolamide (Diamox)

b) Amiloride (Midamor)

c) Furosemide (Lasix)

d) Hydrochlorothiazide (HydroDiuril)

Ans: (c)

9. The drug has a steroid-like structure which is responsible for its anti-androgenic effect:

a) Amiloride (Midamor)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (HydroDiuril)

d) Spironolactone (Aldactone)

Ans: (d)

10. Sustained use of this drug results in increased plasma urate concentrations:

a) Furosemide (Lasix)

b) Acetazolamide (Diamox)

c) Both of the above

d) Neither of the above

Ans: (a)

11. The drug can be used to treat glaucoma:

a) Furosemide (Lasix)

b) Acetazolamide (Diamox)

c) Both of the above

d) Neither of the above

Ans: (b)

12. The drug can cause ototoxicity:

a) Furosemide (Lasix)

b) Acetazolamide (Diamox)

c) Both of the above

d) Neither of the above

Ans: (a)

13. The drug acts only on the lumenal side of renal tubules:

a) Furosemide (Lasix)

b) Acetazolamide (Diamox)

c) Both of the above

d) Neither of the above

Ans: (a)

14. The drug can promote sodium loss in patients with low (e.g., 40 ml/min) glomerular filtration rates:

a) Furosemide (Lasix)

b) Acetazolamide (Diamox)

c) Both of the above

d) Neither of the above

Ans: (a)

15. The drug needs aldosterone present in order to be effective:

a) Hydrochlorothiazide (HydroDiuril)

b) Amiloride (Midamor)

c) Both of the above

d) Neither of the above

Ans: (d)

16. The drug can be used to treat nephrogenic diabetes insipidus:

a) Hydrochlorothiazide (HydroDiuril)

b) Amiloride (Midamor)

c) Both of the above

d) Neither of the above

Ans: (a)

17. The drug is sometimes part of fixed-dose combinations used to treat essential hypertension:

a) Hydrochlorothiazide (HydroDiuril)

b) Amiloride (Midamor)

c) Both of the above

d) Neither of the above

Ans: (c)

18. The drug should never be administered to patients taking potassium supplements:

a) Hydrochlorothiazide (HydroDiuril)

b) Amiloride (Midamor)

c) Furosemide (Lasix)

d) Neither of the above

Ans: (b)

19. The drug decreases calcium excretion in urine:

a) Hydrochlorothiazide (HydroDiuril)

b) Amiloride (Midamor)

c) Furosemide (Lasix)

d) Acetazolamide (Diamox)

Ans: (a)

20. The drug acts by competitively blocking the Na+/K+/2Cl- cotransporter:

a) Loop diuretics

b) Thiazide diuretics

c) Potassium-sparing diuretics

d) Carbonic anhydrase inhibitors

Ans: (a)

21. The drug acts at the proximal tubule:

a) Loop diuretics

b) Thiazide diuretics

c) Potassium-sparing diuretics

d) Carbonic anhydrase inhibitors

Ans: (d)

22. The drug acts in the distal convoluted tubule:

a) Loop diuretics

b) Thiazide diuretics

c) Potassium-sparing diuretics

d) Carbonic anhydrase inhibitors

Ans: (b)

23. The drug acts in the collecting tubules:

a) Loop diuretics

b) Thiazide diuretics

c) Potassium-sparing diuretics

d) Carbonic anhydrase inhibitors

Ans: (c)

24. The drug is the most potent diuretic:

a) Loop diuretics

b) Thiazide diuretics

c) Potassium-sparing diuretics

d) Carbonic anhydrase inhibitors

Ans: (a)

25. The drug acts by competitively blocking the NaCl cotransporter:

a) Loop diuretics

b) Thiazide diuretics

c) Potassium-sparing diuretics

d) Carbonic anhydrase inhibitors

Ans: (b)

26. The drug inhibits sodium and chloride transport in the cortical thick ascending limb and the early distal tubule:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (Hydrodiuril)

d) Amiloride (Midamor)

Ans: (c)

27. The drug can cause ototoxicity:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (Hydrodiuril)

d) Amiloride (Midamor)

Ans: (b)

28. The drug blocks the sodium/potassium/chloride cotransporter in the thick ascending loop of Henle:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (Hydrodiuril)

d) Amiloride (Midamor)

Ans: (b)

29. The drug is one of the most potent diuretics:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (Hydrodiuril)

d) Amiloride (Midamor)

Ans: (b)

30. The drug is usually given in combination with a thiazide diuretic:

a) Acetazolamide (Diamox)

b) Furosemide (Lasix)

c) Hydrochlorothiazide (Hydrodiuril)

d) Amiloride (Midamor)

Ans: (d)

31. All of the following statements regarding diuretics are true EXCEPT:

a) Furosemide (Lasix) can increase the likelihood of digitalis toxicity

b) Chlorthalidone (Hygroton) can decrease the excretion of lithium

c) Ibuprofen can increase the antihypertensive effect of chlorthalidone

d) Chlorthalidone has a longer duration of action than furosemide

Ans: (c)

32. The drug is the least potent diuretic:

a) Osmotic diuretics

b) Loop diuretics

c) Thiazide diuretics

d) Potassium-sparing diuretics

Ans: (d)

33. These agents must be given parenterally because they are not absorbed when given orally:

a) Osmotic diuretics

b) Loop diuretics

c) Thiazide diuretics

d) Potassium-sparing diuretics

Ans: (a)

34. These drugs may be used in the treatment of recurrent calcium nephrolithiasis:

a) Osmotic diuretics

b) Loop diuretics

c) Thiazide diuretics

d) Potassium-sparing diuretics

Ans: (b)

35. Furosemide (Lasix) acts at this nephron site:

a) Proximal convoluted tubule

b) Ascending thick limb of the loop of Henle

c) Distal convoluted tubule

d) Collecting duct

Ans: (b)

36. Metolazone (Mykrox) acts at this nephron site:

a) Proximal convoluted tubule

b) Ascending thick limb of the loop of Henle

c) Distal convoluted tubule

d) Collecting duct

Ans: (c)

37. Acetazolamide (Diamox) acts at this nephron site:

a) Proximal convoluted tubule

b) Ascending thick limb of the loop of Henle

c) Distal convoluted tubule

d) Collecting duct

Ans: (a)

38. Spironolactone (Aldactone) acts at this nephron site:

a) Proximal convoluted tubule

b) Ascending thick limb of the loop of Henle

c) Distal convoluted tubule

d) Collecting duct

Ans: (d)

39. Amiloride (Midamone) acts at this nephron site:

a) Proximal convoluted tubule

b) Ascending thick limb of the loop of Henle

c) Distal convoluted tubule

d) Collecting duct

Ans: (d)

40. The drug competitively blocks chloride channels and prevents movement of sodium, potassium, and chloride into the renal tubular cells:

a) Furosemide (Lasix)

b) Acetazolamide (Diamox)

c) Triamterene (Dyrenium)

d) Mannitol (Osmitrol)

Ans: (a)

41. The drug acts by affecting the tubular fluid composition in a non-receptor mediated fashion:

a) Furosemide (Lasix)

b) Acetazolamide (Diamox)

c) Triamterene (Dyrenium)

d) Mannitol (Osmitrol)

Ans: (d)

 MCQ on diuretic and antidiuretic drugs