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  

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MCQ on Thyroid & Antithyroid Drugs

1. Hormones are:

a) Products of endocrine gland secretion

b) Mediators of inflammatory process

c) By-products of tissue metabolism

d) Product of exocrine gland secretion

Ans: (a)

2. Select an endocrine drug which is an amino acid derivative:

a) Insulin

b) Hydrocortisone

c) Calcitonin

d) Thyroxine

Ans: (d)

3. Select an endocrine drug which is a peptide derivative:

a) Oxitocin

b) Prednisolone

c) Nandrolone

d) Progesterone

Ans: (a)

4. Select an endocrine drug which is a steroidal derivative:

a) Gonadorelin

b) Insulin

c) Levothyroxine

d) Hydrocortisone

Ans: (d)

5. Hormone analogues are:

a) Naturally occurring substances but slightly different from hormones

b) Naturally occurring substances but less efficacious than hormones

c) Naturally occurring substances having the same structure but different pharmacological properties than hormones

d) Synthetic compounds, which resemble the naturally occurring hormones

Ans: (d)

6. Regarding the mechanism of action of hormones, indicate the FALSE statement:

a) Hormones interact with the specific receptors in the wall of the cells

b) Cyclic AMP acts as a second messenger system

c) They stimulate adenylcyclase enzyme

d) Many hormones owe their effect to primary actions on subcellular membrane.

Ans: (a)

7. Hypothalamic and pituitary hormones (and their synthetic analogs) have pharmacologic applications in three areas, EXCEPT the following:

a) As replacement therapy for hormone deficiency states

b) As drug therapy for a variety of disorders using pharmacologic doses to elicit a hormonal effect that is not present at physiologic a blood levels

c) As a diagnostic tool for performing stimulation tests to diagnose hypo- or hyperfunctional endocrine states

d) As food supplements

Ans: (d)

8. Which of the following hormones is produced by the hypothalamic gland?

a) Growth hormone-releasing hormone (GHRH)

b) Follicle-stimulating hormone (FSH)

c) Aldosterone

d) Estradiol

Ans: (a)

9. Which of the following hormones is produced by the anterior lobe of the pituitary?

a) Thyrotropin-releasing hormone (TRH)

b) Corticotropin-releasing hormone (CRH)

c) Growth hormone (somatotropin, GH)

d) Growth hormone-releasing hormone (GHRH)

Ans: (c)

10. The posterior pitutary does NOT secret:

a) Vasopressin

b) Oxytocin

c) Growth hormone

d) All of the above

Ans: (c)

11. Which of the following organs is a target for prolactin?

a) Liver

b) Adrenal cortex

c) Thyroid

d) Mammary gland

Ans: (d)

12. Which of the following organ hormones is a target for growth hormone (somatotropine, GH)?

a) Glucocorticoids

b) Insulin-like growth factors (IGF, somatomedins)

c) Triiodthyronine

d) Testosterone

Ans: (b)

13. All of the following statements about growth hormone are true, EXCEPT:

a) It may stimulate the synthesis or release of somatomedins

b) Low levels of insulin-like growth factor (IGF)-1 are associated with dwarfism

c) Hypersecretion can result in acromegaly

d) It is contraindicated in subjects with closed epiphyses

Ans: (c)

14. Correct statements about adrenocorticotropic hormone (ACTH) include all of the following, EXCEPT:

a) Endogenous ACTH is also called corticotropin

b) ACTH stimulates the synthesis of corticosteroids

c) ACTH is most useful clinically as a diagnostic tool in adrenal insufficiency

d) The oral route is the preferred rout of administration

Ans: (d)

15. The hypothalamic control exists for the thyroid gland. This consideration is:

a) True

b) False.

Ans: (a)

16. Indications of bromocriptine are following, EXCEPT:

a) Prolactin-secreting adenomas

b) Amenorrhea-Galactorrhea

c) Prolactin deficiency

d) Acromegaly

Ans: (c)

17. Currently used dopamine agonists decreasing pituitary prolactin secretion are following:

a) Bromocriptine

b) Cabergoline

c) Pergolide

d) All of the above

Ans: (d)

18. Indications of oxitocin are following:

a) Labor and augment dysfunctional labor for conditions requiring early vaginal delivery

b) Incompleted abortion

c) For control of pospartum uterine hemorrhage

d) All of the above

Ans: (d)

19. Indications of vasopressin are following:

a) Diabetes mellitus

b) Hypertension

c) Pituitary diabetes insipidus

d) Incompleted abortion

Ans: (c)

20. Vasopressin possesses the following:

a) Antidiuretic property

b) Vasodilatation property

c) Release of a thyroid hormone into the plasma

d) Diuretic property

Ans: (a)

21. Oxytocin produces the following effects:

a) It causes contraction of the uterus

b) It assists the progress of spermatozoa into the uterine cavity

c) It brings about milk ejection from the lactating mammary gland

d) All of the above

Ans: (d)

22. Vasopressin causes a pressor effect by:

a) Releasing noradrenaline from the nerve terminals

b) Releasing and activating renin-angiotensin system

c) A direct action on smooth muscles of the blood vessels

d) All of the above mechanisms

Ans: (c)

23. Which of the following statements is true

a) Hypothyroidism is a syndrome resulting from deficiency of thyroid hormones and is manifested largely by a reversible slowing down of all body functions

b) Hypothyroidism is the clinical syndrome that results when tissues are exposed to high levels of thyroid hormone

Ans: (a)

24. Which of the following hormones is produced by the thyroid gland?

a) Thyroxine

b) Thyroid-stimulating hormone

c) Thyrotropin-releasing hormone

d) Thyroglobulin.

Ans: (a)

25. Which of the following hormones is produced by the thyroid gland?

a) Thyroid-stimulating hormone

b) Thyrotropin-releasing hormone

c) Triiodothyronine

d) Thyroglobulin.

Ans: (c)

26. Thyroid stimulating hormone regulates the following:

a) Iodine uptake

b) Biosynthesis of iodothyroglobulin

c) Release of thyroid hormone into the plasma

d) All of the above.

Ans: (d)

27. Thyroid hormones produce various pharmacological effects. Indicate the wrong statement(s).

a) Decline of the basal metabolic rate in the body

b) Increase in the rate and force of contraction of the heart

c) Increase in the blood cholestrol level

d) Increase in the heat production

Ans: (a)

28. Synthesis and release of thyroid hormones are controlled by:

a) Anterior pituitary alone

b) Hypothalamus alone

c) Blood levels of thyroid hormones alone

d) All of the above

Ans: (d)

29. Thyrotrophin stimulates the following processes:

a) Concentration of iodine by thyroid follicles

b) Iodination of thyroglobulin

c) Release of thyroxine and triidothyronine

d) De-iodination of thyroid hormones.

Ans: (c)

30. The rate of secretion of thyrotropin is controlled by:

a) The amount of iodine in the thyroid gland

b) The amount of thyroid hormones in the thyroid gland

c) The concentration of thyroid hormones in blood

d) The concentration of catecholamines in blood

Ans: (c)

31. Indications of thyroid hormones are following, EXCEPT:

a) Cretinism

b) Myxoedema

c) Hashimoto's disease

d) For treatment of simple obesity

Ans: (d)

32. The common side effect of thyroid hormones is following:

a) Increases in basal metabolic rate

b) Angina pectoris

c) Tremors

d) Exopthalmos

Ans: (d)

33. Currently used antithyroid drugs include the following, EXCEPT:

a) Propylthiouracil (PTU)

b) Diatrizoate sodium (Hypaque)

c) Methimazole (Tapazole)

d) Potassium perchlorate

Ans: (d)

34. In an area where goitre is endemic, which of the following drugs is used?

a) Iodide 1 part in 100000

b) Propylthiouracil 200 mg daily

c) Methimazole 40 mg daily

d) Any of the above can be used.

Ans: (a)

35. Iodide preparations can be used in following situations, EXCEPT:

a) In thyroid disorders

b) In granulomatous lesions e.g. Syphilis

c) As an antiseptic

d) In iodism

Ans: (d)

36. Daily administration of large doses (several milligrammes) of iodides to a thyrotoxic patient causes:

a) Involution of the thyroid which reaches a maximum in two weeks

b) Increased vascularity of the thyroid gland

c) Decreased storage of the colloid in the thyroid gland

d) Thyroid gland growing firm and less vascular

Ans: (d)

37. Radioiodines (I131 and I132) is suitable for:

a) Elderly patients (over 45 years)

b) Pregnant women

c) Nursing mothers

d) Younger patients

Ans: (a)

38. Radioiodines in the body emit:

a) Mainly β radiations

b) Mainly γ radiations

c) β and γ radiations equally.

d) Do not emit any radiation, therefore, are safe

Ans: (a)

MCQ on Thyroid & Antithyroid Drugs

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What is Adulterated drugs

A drug shall be deemed to be adulterated,—

(a) if it consists in whole or in part, of any filthy, putrid or decomposed substance; or

(b) if it has been prepared, packed or stored under insanitary conditions whereby it may have been contaminated with filth or whereby it may have been rendered injurious to health; or

(c) if its container is composed, in whole or in part, of any poisonous or deleterious substance which may render the contents injurious to health; or

(d) if it bears or contains, for the purposes of colouring only, a colour other than one which is prescribed; or

(e) if it contains any harmful or toxic substance which may render it injurious to health; or

(f) if any substance has been mixed therewith so as to reduce its quality or strength.

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