5 - diuretic resistance mcqs

Question 1
What is diuretic resistance?
Short-term decrease in response to a diuretic
Occurrence of braking phenomenon before edema is relieved--------------
Occurrence of braking phenomenon after edema is relieved
Any of the above

Question 2
Diuretic resistance can be due to
Reduced renal function
Reduced peak concentration of loop diuretic in the tubular fluid
Delayed peak concentration of loop diuretic in the tubular fluid
Any of the above------------


Question 3
In renal failure diuretic resistance can be due to
Reduced renal blood flow
Reduced sodium filtration
Accumulation of organic acids that inhibit tubular secretion of the diuretic
Any of the above------------

Question 4
Which of these drugs could lead to apparent diuretic resistance?
Non steroidal anti-inflammatory drugs----------
Prostaglandin E2
None of the above
Both of the above


Question 5
Loop diuretics reach the tubular lumen by
Glomerular filtration
Passive diffusion
Active secretion----------
All the above

Question 6
Chronic administration of loop diuretics results in hypertrophy and hyperplasia in the epithelial cells of the
Proximal convoluted tubule of nephron
Loop of Henle
Distal convoluted tubule of Nephron-------------
None of the above

Question 7
Which of these can overcome diuretic resistance in congestive heart failure?
Increasing the dose of diuretic
More frequent administration of the diuretic
Intravenous administration of the diuretic
All of the above--------------

Question 8
Which of these can be given in combination with a loop diuretic to achieve sequential nephron blockade?
Thiazide diuretic
Thiazide type diuretic
Potassium sparing diuretic
Any of the above--------------

Question 9
In a person requiring diuretic medication, the amount of sodium intake should be
<100mmol/day-----------
<150mmol/day
<200mmol/day
<250mmol/day

Question 10
In which of these conditions loop diuretic may be rendered ineffective after reaching the lumen due to high intraluminal albumin concentration?
Congestive heart failure
Nephrotic syndrome--------------
Hepatic cirrhosis
None of the above

Question 11
Metolazone is a
Thiazide diuretic
Thiazide type diuretic---------
Potassium sparing diuretic
Osmotic diuretic

Question 12
Metolazone is indicated in edema associated with
Congestive heart failure
Chronic kidney disease
Nephrotic syndrome
All the above-----------

Question 13
Which of the following statement is not true with regard to Metolazone?
It is ineffective when glomerular filtration rate is <30ml/min---------
It causes reabsorption of calcium
It inhibits the reabsorption of sodium and chlorine in the distal convoluted tubule of nephron
None of the above

Question 14
Which of the following diuretic can be used in any stage of kidney failure?
Metolazone-------------
Indapamide
Furosemide
None of the above

Question 15
Which of the following statements is true with regard to Metolazone?
Dosage adjustment is not required at any stage of chronic kidney disease
Diuretic effect is observed at doses ranging from 1mg to 25 mg
It exerts its action in the distal and proximal convoluted tubule of the nephron
All are true------------

4 - statins mcqs

Question 1
Apart from reducing cholesterol levels, statins also:
Reduce inflammation
Improve endothelial function
Stabilise atherosclerotic plaque
All the above------------

Question 2
Of the following patients, which group is more likely to have adverse effects of statins?
Elderly
Those receiving immunosuppressive drugs
Those receiving high doses of statins
All the above------------

Question 3
In people taking statins, transaminase values should be estimated:
Before starting therapy
12 weeks after initiation of therapy
At any elevation in dose
At all the above-----------------

Question 4
Which of the following statements is true? Coadministration of ezetimibe with 10mg atorvastatin:
Provides the same reduction in LDL-C as obtained with 80mg of atorvastatin----------------
Provides the same reduction in LDL-C as obtained with 60mg of atorvastatin
Provides the same reduction in LDL-C as obtained with 40mg of atorvastatin
Provides greater reduction in LDL-C as obtained with 80mg of atorvastatin

Question 5
Which of the following statements is true?
There is an increased risk of side effects with combination of statin and gemfibrozil as compared to statin and fenofibrate--------------
There is increased risk of side effects with combination of statin and fenofibrate as compared to statin and gemfibrozil
Increase in risk of side effects is similar when statin is given with fenofibrate or gemfibrozil
Risk of side effects is not increased when statin is given with fenofibrate or gemfibrozil

Question 6
For which statin, a lower dosage is recommended in Asians as compared to people from western countries?
Atorvastatin
Simvastatin
Rosuvastatin----------
Fluvastatin

Question 7
Which of the following statins should be given in the evening?
Atorvastatin
Simvastatin-------------
Rosuvastatin
All the above

Question 8
The therapeutic potential of statins might extend beyond cholesterol lowering and coronary artery disease to other inflammatory disorders such as:
Multiple sclerosis
Rheumatoid arthritis
Chronic kidney disease
All the above-----------------

Question 9
In patients with renal disease, statins benefit by:
Reducing hyperlipidaemia
Improving glomerular filtration rate(GFR)
Reducing proteinuria
All the above-------------

Question 10
When LDL-C drug is used to treat high risk persons or moderately high risk patients, the serum LDL-C should be reduced by at least:
5-10%
10-20%
20-30%
30-40%------------

Question 11
Which of the following statements is not true?
The beneficial effects of statin in ischemic stroke or transient ischemic attack (TIA) are independent of cholesterol levels
Statin treatment should be initiated soon after an ischemic stroke or TIA
There is no potential risk of recurrent haemorrhage with statins in patients with haemorrhagic stroke-----------------
From the standpoint of statin treatment, stroke or TIA should be considered a coronary heart disease risk equivalent

Question 12
In patients with acute coronary syndrome, statin should be given:
As early as possible-----------
After 24 hours
After stabilisation of patient’s condition
On discharge

Question 13
The principle benefit with statins in acute coronary syndrome are due to their:
Anti-inflammatory effects----------
Lipid lowering effects
Anti-hypertensive effect
Both a and b

Question 14
Which of the following statement is not true?
Statins are the first choice pharmacological therapy for diabetic dyslipidemia
Patients with type 2 diabetes may be canditate for statin therapy regardless of LDL cholesterol
Statin can be combined with fibrate or niacin for more comprehensive lipid control in diabetic patients.
As per latest NCEP guidelines, target LDL-C level in diabetic patients in the absence of cardiovascular disease should be 70 mg/dl-------------------

Question 15
Which of the following statement is not true?
Statins should be given to all patients with a prior atheromatous disease
Statins should be given to all patients at increased risk of cardiovascular disease irrespective of lipid profile
Statins should be given only to patients with cardiovascular disease with coexisting hyperlipidemia--------------
Statins should be given to all patients with a history of ischemic stroke.