MCQs: Gastrointestinal Drugs

Relapse rate for do although ulcer following monotherapy treatment with H2 receptor blockers:

A) 95 %

B) 75%

C) 50%

D) 15%

E) 5%

Physiological stimulation gastric acid secretion -- phases associated with food intake:

A) cephalic phase

B) gastric phase

C) intestinal phase

Physiological/pathophysiological effects of Helicobacter pylori:

A) proinflammatory

B) degradation of glycoprotein-lipid mucus layer complexes

C) production of damaging bacterial proteins

D) causes active, chronic gastritis

Acid secretion phase, following food intake, defined by stimulation of mechanical and chemical gastric
wall receptors by luminal contents:

A) cephalic phase

B) gastric phase

C) intestinal phase

Mechanism(s) by which somatostatin reduces gastrin release:

A) inhibits parietal cells accretion

B) inhibits histamine release by enterochromaffin-like cells

C) both

D) neither
Positive factor: Zollinger-Ellison syndrome --

A) Helicobacter pylori

B) gastrin-secreting islet cell tumor

C) both

D) neither

Pathogenic factor(s) in duodenal ulcer:

A) COPD (chronic obstructive pulmonary disease)

B) genetic factor

C) cigarette smoking

D) alcoholic cirrhosis

E) all of the above

Example(s) of "protective factor(s)" in peptic ulcer disease:

A) gastric mucus

B) prostaglandins

C) pepsins

D) bicarbonate

E) Helicobacter pylori

There exists a direct correlation between pepsinogen I serum concentrations and maximal gastric acid
secretion:

A) true

B) false

Peptic ulcer classification:

A) duodenal

B) gastric

C) both

D) neither
Characteristic(s) of gastric mucosal acid secretion:

A) oxidative dephosphorylation dependent

B) from parietal cells founded in mucosal glands of fundusof the stomach

C) stimulated by muscarinic cholinergic system (parietal cell innervation)

D) most potent stimulant -- histamine direct action

Activation of these/this receptor(s) on basolateral parietal cells inhibit(s) gastric acid secretion

A) histamine

B) gastrin

C) prostaglandins

D) acetylcholine

Relapse rate for duodenalulcer following H. pylori eradication:

A) 90%

B) 75%

C) 50%

D) 15%

E) 5%

Histamine and gastric acid secretion:

A) released from enterochromaffin-like cells

B) release enhanced by increased cholinergic activity

C) most important gastric acid secretion stimulant

Inhibition of basal acid secretion:

A) cimetidine (Tagamet)

B) histamine
C) nizatidine (Axid)

D) ranitidine (Zantac)

E) famotidine (Pepcid)

Location(s) of histamine in gastric mucosa:

A) enterochromaffin-like cells (ECL)

B) mast cell cytoplasmic granules

C) both

D) neither

Ranitidine (Zantac) and gastric acid secretion:

A) inhibits basal acid secretion

B) inhibits secretion in response to vagal stimulation or feeding

C) both

D) neither

Example(s) of "aggressive factors" in peptic ulcer disease:

A) gastric acid

B) pepsin

C) both

D) neither

Increased incidence of duodenal ulcer associated with:

A) chronic renal failure

B) alcoholic cirrhosis

C) renal transplantation
D) systemic mastocytosis

E) hyperparathyroidism

Basolateral parietal cell membranes contained these receptor types:

A) gastrin

B) acetylcholine

C) prostaglandins

D) histamine

Question # 1 rate for do although ulcer following monotherapy treatment with H2 receptor blockers:

Answer: (B) 75%

Question # 2 (Multiple Answer) Physiological stimulation gastric acid secretion -- phases associated with
food intake:

(A) cephalic phase

(B) gastric phase

(C) intestinal phase

Question # 3 (Multiple Answer) Physiological/pathophysiological effects of Helicobacter pylori:

(A) proinflammatory

(B) degradation of glycoprotein-lipid mucus layer complexes

(C) production of damaging bacterial protein

(D) causes active, chronic gastritis

Question # 4 (Multiple Choice) Acid secretion phase, following food intake, defined by stimulation of
mechanical and chemical gastric wall receptors by luminal contents:

Answer: (B) gastric phase

Question # 5 (Multiple Choice) Mechanism(s) by which somatostatin reduces gastrin release:

Answer: (C) both

Question # 6 (Multiple Choice) Positive factor: Zollinger-Ellison syndrome --

Answer: (C) both

Question # 7 (Multiple Choice) Pathogenic factor(s) in duodenal ulcer:

Answer: (E) all of the above

Question # 8 (Multiple Answer) Example(s) of "protective factor(s)" in peptic ulcer disease:

(A) gastric mucus

(B) prostaglandins

(D) bicarbonate

Question # 9 (True/False) There exists a direct correlation between pepsinogen I serum concentrations
and maximal gastric acid secretion:

Answer: True

Question # 10 (Multiple Choice) Peptic ulcer classification:

Answer: (C) both

Question # 11 (Multiple Answer) Characteristic(s) of gastric mucosal acid secretion:

(A) oxidative dephosphorylation dependent

(B) from parietal cells founded in mucosal glands of fundusof the stomach

(C) stimulated by muscarinic cholinergic system (parietal cell innervation)

most potent: gastrin

Question # 12 (Multiple Answer) Activation of these/this receptor(s) on basolateral parietal cells
inhibit(s) gastric acid secretion

(C) prostaglandins

Question # 13 (Multiple Choice) Relapse rate for duodenalulcer following H. pylori eradication:

Answer: (D) 15%

Question # 14 (Multiple Answer) Histamine and gastric acid secretion:

(A) released from enterochromaffin-like cells

(B) release enhanced by increased cholinergic activity

(C) most important gastric acid secretion stimulant

Question # 15 (Multiple Answer) Inhibition of basal acid secretion:

(A) cimetidine (Tagamet)

(C) nizatidine (Axid)

(D) ranitidine (Zantac)

(E) famotidine (Pepcid)

Question # 16 (Multiple Choice) Location(s) of histamine in gastric mucosa:

Answer: (C) both

Question # 17 (Multiple Choice) Ranitidine (Zantac) and gastric acid secretion:

Answer: (C) both

Question # 18 (Multiple Choice) Example(s) of "aggressive factors" in peptic ulcer disease:

Answer: (C) both

Question # 19 (Multiple Answer) Increased incidence of duodenal ulcer associated with:

(A) chronic renal failure

(B) alcoholic cirrhosis

(C) renal transplantation

(D) systemic mastocytosis

(E) hyperparathyroidism

Question # 20 (Multiple Answer) Basolateral parietal cell membranes contained these receptor types:

(A) gastrin

(B) acetylcholine

(C) prostaglandins

(D) histamine

Question # 1 (Multiple Choice) More likely to affect the cytochrome P450 drug metabolizing system:

A) ranitidine (Zantac)

B) cimetidine (Tagamet)

Question # 2 (Multiple Choice) Only class of antiulcer drugs that can eradicate Helicobacter pylori and
cure associated gastritis:

A) sucralfate (Carafate)

B) colloidal bismuth

C) H2 blockers

D) Anticholinergic agents

Question # 3 (Multiple Choice) Antacid: melt-alkali syndrome:

A) aluminum hydroxide

B) magnesium hydroxide

C) calcium carbonate

D) sodium bicarbonate

Question # 4 (True/False) Reduces basal unstimulated gastric acid secretion; enhanced mucosal
resistance to injury-- prostaglandins (PGE1/PGE2)

A) true

B) false

Question # 5 (Multiple Choice) Antacid: effective, but associated with systemic alkalosis

A) calcium carbonate

B) sodium bicarbonate

C) magnesium hydroxide

D) aluminum hydroxide

Question # 6 (Multiple Choice) Antacid: most likely to cause systemic phosphate depletion:

A) sodium bicarbonate

B) calcium carbonate

C) magnesium hydroxide

D) aluminum hydroxide

Question # 7 (Multiple Choice) Monotherapy effectiveness in eradication of H. pylori-- bismuth

compounds
A) 5%

B) 20%

C) 50%

D) 90%

Question # 8 (Multiple Answer) Omeprazole (Prilosec) and lansoprazole approved for clinical treatment
of:

A) duodenal ulcer

B) erosive gastritis

C) Zollinger-Ellison syndrome and other gastric acid hypersecretory states

Question # 9 (Multiple Choice) Side effect profile-- antiulcer medication: urinary retention, blurred
vision, xerostromia,:

A) ranitidine (Zantac)

B) atropine

C) nifedipine (Procardia, Adalat)

D) sucralfate (Carafate)

Question # 10 (Multiple Answer) Examplesof H2 (histamine receptor Type II) antagonists:

A) cimetidine (Tagamet)

B) ranitidine (Zantac)

C) nizatidine (Axid)
D) famotidine (Pepcid)

E) terfenadine

Question # 11 (Multiple Choice) Mechanism of action: cytoprotection, binds to the ulcer base,
antibacterial effect:

A) metronidazole (Flagyl)

B) tetracycline (Achromycin)

C) bismuth compounds

D) ranitidine (Zantac)

E) omeprazole (Prilosec)

Question # 12 (Multiple Answer) Drug(s) used iin eradication of Helicobacter pylori infection:

A) bismuth compounds

B) metronidazole (Flagyl)

C) clarithromycin (Biaxin)

D) omeprazole (Prilosec)

E) amoxicillin (Amoxil Polymox)

Question # 13 (Multiple Choice) Most widely used antacid in treating ulcer disease:

A) sodium bicarbonate

B) calcium carbonate

C) magnesium hydroxide

D) aluminum hydroxide
E) combination of aluminum hydroxide and magnesium hydroxide

Question # 14 (Multiple Choice) Treatment of gastric a disease: atropine vs.H2-receptor blockers --

atropine is:

A) more effective than H2 receptor blockers

B) less effective than H2 receptor blockers

C) equally effective

Question # 15 (Multiple Choice) Drawbacks of "triple therapy" {bismuth compounds + metronidazole

(Flagyl) + tetracycline (Achromycin)}in treating peptic ulcer disease:

A) patient compliance (2 week treatment = 200 tablets)

B) side effects

C) both

D) neither

Question # 16 (Multiple Choice) Antacid: constipation

A) aluminum hydroxide

B) magnesium hydroxide

Question # 17 (Multiple Choice) Most successful protocol for eradication of H. pylori/treatment of peptic
ulcer disease:

A) bismuth monotherapy
B) therapy using bismuth compounds, metronidazole (Flagyl), and amoxicillin (Amoxil Polymox) in
combination -triple therapy

C) bismuth compounds and amoxicillin (Amoxil Polymox)

D) all of the above equally effective

Question # 18 (Multiple Choice) Antacid: loose stools

A) aluminum hydroxide

B) magnesium hydroxide

C) both

D) neither

Question # 19 (Multiple Choice) Eradication of H. pylori effectiveness for bismuth compounds when
using combination with antibiotics:

A) 5%

B) 20%

C) 50%

D) 80%

E) 95%

--------------------------------------------------------------------------

Correct Answers
[HIDE]

Question # 1 (Multiple Choice) More likely to affect the cytochrome P450 drug metabolizing system:

Answer: (B) cimetidine (Tagamet)

Question # 2 (Multiple Choice) Only class of antiulcer drugs that can eradicate Helicobacter pylori and
cure associated gastritis:

Answer: (B) colloidal bismuth

Question # 3 (Multiple Choice) Antacid: melt-alkali syndrome:

Answer: (C) calcium carbonate

Question # 4 (True/False) Reduces basal unstimulated gastric acid secretion; enhanced mucosal
resistance to injury-- prostaglandins (PGE1/PGE2)

Answer: True

Question # 5 (Multiple Choice) Antacid: effective, but associated with systemic alkalosis
Answer: (B) sodium bicarbonate

Question # 6 (Multiple Choice) Antacid: most likely to cause systemic phosphate depletion:

Answer: (D) aluminum hydroxide

Question # 7 (Multiple Choice) Monotherapy effectiveness in eradication of H. pylori-- bismuth

compounds

Answer: (B) 20%

Question # 8 (Multiple Answer) Omeprazole (Prilosec) and lansoprazole approved for clinical treatment
of:

(A) duodenal ulcer

(B) erosive gastritis

(C) Zollinger-Ellison syndrome and other gastric acid hypersecretory states

Question # 9 (Multiple Choice) Side effect profile-- antiulcer medication: urinary retention, blurred
vision, xerostromia,:

Answer: (B) atropine

Question # 10 (Multiple Answer) Examplesof H2 (histamine receptor Type II) antagonists:

(A) cimetidine (Tagamet)

(B) ranitidine (Zantac)

(C) nizatidine (Axid)

(D) famotidine (Pepcid)

Question # 11 (Multiple Choice) Mechanism of action: cytoprotection, binds to the ulcer base,
antibacterial effect:

Answer: (C) bismuth compounds

Question # 12 (Multiple Answer) Drug(s) used iin eradication of Helicobacter pylori infection:

(A) bismuth compounds

(B) metronidazole (Flagyl)

(C) clarithromycin (Biaxin)

(D) omeprazole (Prilosec)

(E) amoxicillin (Amoxil Polymox)

Question # 13 (Multiple Choice) Most widely used antacid in treating ulcer disease:

Answer: (E) combination of aluminum hydroxide and magnesium hydroxide

Question # 14 (Multiple Choice) Treatment of gastric a disease: atropine vs.H2-receptor blockers --

atropine is:
Answer: (B) less effective than H2 receptor blockers

Question # 15 (Multiple Choice) Drawbacks of "triple therapy" {bismuth compounds + metronidazole

(Flagyl) + tetracycline (Achromycin)}in treating peptic ulcer disease:

Answer: (C) both

Question # 16 (Multiple Choice) Antacid: constipation

Answer: (A) aluminum hydroxide

Question # 17 (Multiple Choice) Most successful protocol for eradication of H. pylori/treatment of peptic
ulcer disease:

Answer: (B) therapy using bismuth compounds, metronidazole (Flagyl), and amoxicillin (Amoxil Polymox)
in combination -triple therapy

Question # 18 (Multiple Choice) Antacid: loose stools

Answer: (B) magnesium hydroxide

Question # 19 (Multiple Choice) Eradication of H. pylori effectiveness for bismuth compounds when
using combination with antibiotics:

Answer: (E) 95%

[/HIDE]

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03-22-2009, 07:01 AM#3trimurtulu trimurtulu is offline

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Question # 1 (Multiple Answer) In anesthesiology: high-risk patients for aspiration pneumonitis:

A) patients with hiatus hernia

B) patients with esophageal reflux

C) patients with acute pain, "full stomach" -- emergency surgery

Question # 2 (Multiple Choice) Aspiration pneumonia less likely when:

A) metoclopramide (Reglan) is used alone

B) metoclopramide (Reglan) is combined with ranitidine (Zantac)

Question # 3 (Multiple Answer) Properties of metoclopramide (Reglan):

A) decreases upper gastrointestinal motility

B) decreases gastroesophageal sphincter tone

C) relaxes the pylorus

D) relaxes the duodenum

Question # 4 (True/False) Pre-treatment with metoclopramide (Reglan) guarantees complete gastric

emptying:

A) true

B) false

Question # 5 (Multiple Choice) Greatest increase in gastric fluid volume which may be associated with
antacid administration:

A) single dose antacid

B) multiple antacid dosing

C) repeated dosing with concurrent opioid administration (e.g. during labor)

Question # 6 (Multiple Choice) Aspiration of gastric fluid containing particulate antacids may have
this/these consequences:

A) pulmonary edema

B) arterial hypoxemia

C) both
D) neither

Question # 7 (True/False) Use of gastrokinetic drugs diminishes the need for correct, diligent anesthetic
techniques to protect the airway during anesthesia:

A) true

B) false

Question # 8 (True/False) Metoclopramide (Reglan): may not be effective of increasing gastric emptying
following sodium citrate administration:

A) true

B) false

Question # 9 (Multiple Choice) Omeprazole (Prilosec) and gastric acid suppression

A) effective if given by IV 30 minutes prior to induction

B) duration of action: about one day

C) both

D) neither

Question # 10 (Multiple Choice) Effect on antacids on gastric fluid volume:

A) increases

B) decreases

C) no effect
Question # 11 (True/False) Pulmonary aspiration gastric content -- rare in elective surgery:

A) true

B) false

Question # 12 (Multiple Choice) Concerning nonparticulate antacids and their use in preoperative
medication:

A) may themselves produce pulmonary damage if aspiration gastric fluid containing this type of an acid
occurs

B) more effective than colloidal antacids suspensionsin increasing gastric acid pH

C) both

D) neither

Question # 13 (Multiple Choice) Ondansetron (Zofran) probably mediates its antiemetic effects by
interacting with this receptor system:

A) muscarinic, cholinergic

B) nicotinic, cholinergic

C) dopaminergic

D) serotonergic

E) GABA

Question # 14 (True/False) In adults: relatively high risk of pulmonary complications if aspiration volume
is greater than 25 ml and pH < 2.5:
A) true

B) false

Question # 15 (Multiple Answer) Physiological effects of metoclopramide (Reglan):

A) stimulates upper gastrointestinal motility

B) increases gastroesophageal sphincter tone

C) increases gastric fluid pH

D) increases gastric acid secretion

Question # 16 (Multiple Choice) Drugs that may offset metoclopramide (Reglan) effect on the upper GI
tract:

A) opioids

B) concurrent atropine administration

C) both

D) neither

Question # 17 (Multiple Choice) Greater "lag time" in increasing gastrointestinal pH:

A) antacids

B) H2 blockers

C) both about the same lifetime

Question # 18 (Multiple Choice) Appropriate for preoperative antiemetic use:

A) droperidol (Inapsine)

B) metoclopramide (Reglan)

C) both

D) neither

Question # 19 (Multiple Answer) Antiemetic drugs particularly useful for patients undergoing:

A) opthalmological surgery

B) laproscopic surgery

C) gynecologic procedures

--------------------------------------------------------------------------

Correct Answers

[HIDE]

Question # 1 (Multiple Answer) In anesthesiology: high-risk patients for aspiration pneumonitis:

(A) patients with hiatus hernia

(B) patients with esophageal reflux

(C) patients with acute pain, "full stomach" -- emergency surgery

Question # 2 (Multiple Choice) Aspiration pneumonia less likely when:

Answer: (B) metoclopramide (Reglan) is combined with ranitidine (Zantac)

Question # 3 (Multiple Answer) Properties of metoclopramide (Reglan):

(C) relaxes the pylorus

(D) relaxes the duodenum

Question # 4 (True/False) Pre-treatment with metoclopramide (Reglan) guarantees complete gastric

emptying:

Answer: False

Question # 5 (Multiple Choice) Greatest increase in gastric fluid volume which may be associated with
antacid administration:

Answer: (C) repeated dosing with concurrent opioid administration (e.g. during labor)
Question # 6 (Multiple Choice) Aspiration of gastric fluid containing particulate antacids may have
this/these consequences:

Answer: (C) both

Question # 7 (True/False) Use of gastrokinetic drugs diminishes the need for correct, diligent anesthetic
techniques to protect the airway during anesthesia:

Answer: False

Question # 8 (True/False) Metoclopramide (Reglan): may not be effective of increasing gastric emptying
following sodium citrate administration:

Answer: True

Question # 9 (Multiple Choice) Omeprazole (Prilosec) and gastric acid suppression

Answer: (C) both

Question # 10 (Multiple Choice) Effect on antacids on gastric fluid volume:

Answer: (A) increases

Question # 11 (True/False) Pulmonary aspiration gastric content -- rare in elective surgery:

Answer: True

Question # 12 (Multiple Choice) Concerning nonparticulate antacids and their use in preoperative
medication:

Answer: (D) neither

Question # 13 (Multiple Choice) Ondansetron (Zofran) probably mediates its antiemetic effects by
interacting with this receptor system:

Answer: (D) serotonergic

Question # 14 (True/False) In adults: relatively high risk of pulmonary complications if aspiration volume
is greater than 25 ml and pH < 2.5:

Answer: True

Question # 15 (Multiple Answer) Physiological effects of metoclopramide (Reglan):

(A) stimulates upper gastrointestinal motility

(B) increases gastroesophageal sphincter tone

no effect on pH or secretion

Question # 16 (Multiple Choice) Drugs that may offset metoclopramide (Reglan) effect on the upper GI
tract:

Answer: (C) both

Question # 17 (Multiple Choice) Greater "lag time" in increasing gastrointestinal pH:

Answer: (B) H2 blockers

Question # 18 (Multiple Choice) Appropriate for preoperative antiemetic use:

Answer: (A) droperidol (Inapsine)

Question # 19 (Multiple Answer) Antiemetic drugs particularly useful for patients undergoing:
(A) opthalmological surgery

(B) laproscopic surgery

(C) gynecologic procedures

[/HIDE]