Professional Documents
Culture Documents
1. The primary role of stomach is to receive and store ingested food for onward release into the
duodenum, and to initiate digestion.
(a) True
o (b) False
o (a) Gastrin
(b) Histamine
o (c) Acetylcholine
4. Parietal cells contain a large number of smooth-walled vesicular or tubular membranes known as
tubulovesicles. The inactive proton pumps are present on the tubulovesicular membrane.
(a) True
o (b) False
(a) Canaliculus
o (b) Tubulovesicles
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Zantac SF Assessment - Team ABC and A - Q4 2016
7. The mucus provides lubrication and forms a physical barrier to acid damage, while the bicarbonate
neutralizes any acid that penetrates below the surface of the mucus.
(a) True
o (b) False
8. During the process of digestion, strong muscular mixing movements help to reduce food particles to
semi-liquid chyme, while the gastric acid, together with enzymes such as
___________________begins the process of chemical breakdown into essential nutrients.
(a) Pepsin
o (b) Amylases
o (c) Lysozymes
o (d) Phospholipase
9. The physiologic stimulation of acid secretion has classically been divided into three interrelated
phases: Cephalic, Gastric and Intestinal.
(a) True
o (b) False
10. ___________provides lubrication and forms a physical barrier to acid damage, while the
__________ neutralizes any acid that penetrates below the surface of the __________
(a) GERD
o (b) PEPTIC ULCER
o (c) DYSPEPSIA
12. In ____________________, Pain is more common at night, when it may prevent the patient from
getting to sleep.
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(d) GERD
(a) Gastric
o (b) Duodenal
14. ___________________ulcers are found at the beginning of the small intestine known as the
duodenum.
o (a) Gastric
(b) Duodenal
15. In Duodenal Ulcer, pain does not follow consistent pattern & Ingestion of food sometimes
exacerbates the symptoms rather relieves the pain that rarely occur at night.
o (a) True
(b) False
16. Two predominant causes of peptic ulcer disease are_______________ & ________________
17. Patients who relapse more than three times in any one year are likely to be considered candidates
for maintenance.
(a) True
o (b) False
o (a) True
(b) False
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19. Emotional stress, Smoking, Diet, Regularity and spacing of meals, NSAIDs are the contributing
factors in Dyspepsia.
(a) True
o (b) False
20. Idiopathic dyspepsia is a Category of dyspepsia, where Specific causes can be identified.
o (a) True
(b) False
21. _________________bind to the H2 receptor on the basolateral membrane of the gastric parietal cell,
thereby blocking the action of histamine on the parietal cells.
(a) H2RAs
o (b) PPI
o (c) Gastrin
o (d) Acetylcholine
22. Secretion of gastric juices occurs in three phases: A cephalic (reflex) phase, A local (gastric) phase,
_______________phase.
o (a) Duodenal
o (b) Positive Feedback
o (c) Negative Feedback
(d) Intestinal
24. HCL functions to break up cells, to denature proteins for easier digestion, to kill many ingested
bacteria and to convert pepsinogen to pepsin.
(a) True
o (b) False
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Zantac SF Assessment - Team ABC and A - Q4 2016
25. Pepsinogen is secreted by gastric chief cells into the lumen and is converted to its active form
Pepsin in the presence of HCL.
(a) True
o (b) False
o (a) True
(b) False
(a) Enterochromaffin
o (b) G Cells
o (c) Somatostatin
28. Mucus is secreted by mucous neck cells in the epithelium of the stomach. It is useful for lubrication
and protection of gastric epithelial cells from the effects of the strongly acidic environment in the
lumen.
(a) True
o (b) False
30. NSAIDs damage the gastro-duodenal mucosa by inhibiting the COX II enzyme, thereby inhibiting the
production of prostaglandins that are important protective factors.
(a) True
o (b) False
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Zantac SF Assessment - Team ABC and A - Q4 2016
31. Gastrin, Acetylcholine & Histamine are collectively known as Secretagogues responsible for Parietal
Cell stimulation.
(a) True
o (b) False
32. Which of the following step is not true in the Mechanism of Acid Secretion (HCl) by Parietal Cells?
o (a) Combination of H+ ions with Cl- ions in the secretory cannaliculus to form HCL
o (b) Activation of parietal cells
o (c) Translocation of proton pumps from tubulovesicles to the membrane of secretory cannaliculus
(d) Stimulation of parietal cells by histamine, dopamine, and/or gastrin
o (a) Low pH in the stomach, reduced vagus nerve activity, Presence of stimulating factors
o (b) High pH in the stomach, Increased vagus nerve activity, Absence of stimulating factors
(c) Low pH in the stomach, reduced vagus nerve activity, Absence of stimulating factors
34. Gastrin, a hormone released in response to the presence of certain types of food, such as Green
Vegetables.
o (a) True
(b) False
35. Nerve stimuli received from the brain via the vagus nerve, triggered by the sight or smell of food.
(a) True
o (b) False
36. The control of stomach pH is mediated by interplay between factors that excite gastric section, and
those that inhibit gastric secretion.
(a) True
o (b) False
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Zantac SF Assessment - Team ABC and A - Q4 2016
37. There are several possible ways to either reduce the acidity of the gastrointestinal contents or to
protect against the damaging effects of excess acid using pharmacological agents (drugs) and
interventions. The principal methods are:
38. Choose the main factors that have been found to contribute to Gastroesophageal reflux.
39. Which factor is NOT responsible for Incompetence of the lower functional oesophageal sphincter?
40. Resting & Activated Phases are TWO key factors involved in Control of Acid Secretion?
o (a) True
(b) False
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(a) Hyper
o (b) Hypo
46. In __________ ulcer, Normal secretion of HCL & corrosive effect of HCL surpasses the diminished
resistance of the gastric mucosa.
o (a) Duodenal
(b) Gastric
o (c) Peptic
o (a) Duodenal
o (b) Gastric
(c) Peptic
48. Study of changes of normal mechanical, physiological and biochemical functions either caused by a
disease or resulting from an abnormal syndrome is called __________________.
(a) Pathophysiology
o (b) Algology
o (c) Gerontology
49. ___________________ phase is activated by the thought, taste, smell and site of food, and
swallowing. It is mediated mostly by the vagus nerve which secretes acetylcholine.
o (a) Intestinal
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Zantac SF Assessment - Team ABC and A - Q4 2016
o (b) Gastric
(c) Cephalic
50. The______________phase is due to the chemical effects of food and distension of the stomach.
o (a) Intestinal
(b) Gastric
o (c) Cephalic
(a) Fruits
o (b) Decreased peristalsis
o (c) Impaired mucosal defence
o (d) Incompetence of the lower functional oesophageal sphincter
(a) Colposcopy
o (b) Endoscopy
o (c) X-ray using a barium (contrast)
54. Ulcer patients who relapse more than three times in any one year are likely to be considered
candidates for ___________________________
(a) Maintenance
o (b) X-Ray
o (c) Surgery
o (d) Endoscopy
55. Which of the following is not the characteristic feature of Gastric Carcinoma.
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56. Stopping _____________is probably the single most important lifestyle change a patient can make
in order to help treat an acid-related disorder.
o (a) Alcohol
(b) Smoking
o (c) Spices
o (d) weight control
57. Drop in pH<4 for at least 1 continuous hour is a pharmacological phenomenon termed nocturnal
gastric acid breakthrough (NAB).
(a) True
o (b) False
o (a) 88%
o (b) 96%
o (c) 100%
(d) 98%
59. Acid related disorders such as GERD & Peptic Ulcers are _____________ , _____________
conditions.
60. Mortality rates in patients who bleed as a result of Stress Related Mucosal disease area as high as
________%
o (a) 65%
o (b) 77%
(c) 57%
o (d) 80%
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61. According to literature, Reported prevalence of GERD in Pakistan ranges from _____% to _____%
62. According to literature, PEPTIC Ulcer may lead to potentially life threatening complications like
heamorrhage and perforation.
(a) True
o (b) False
63. According to literature, Profound acid suppression leads to rebound acid HYPOSECRETION from
the second week after treatment, and lasts till ECL cell mass is normalized, i.e., 2-3 months after
stopping treatment.
o (a) True
(b) False
66. According to literature, PPIs appear to be associated with an elevated risk of MI in the general
population; and H2 blockers show no such association.
(a) True
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Zantac SF Assessment - Team ABC and A - Q4 2016
o (b) False
67. According to literature, H2RAs modestly increased the risk of hip, spine and any-site fractures.
o (a) True
(b) False
68. According to literature, PPIs use is associated with significantly higher risk of incident of Chronic
Kidney Disease whereas H2RAs are not associated with CKD.
(a) True
o (b) False
69. According to literature, The 2013 American College of Gastroenterology Guidelines recommends
that H2RAs can be added to daytime PPI therapy for effective relief of night time reflux.
(a) True
o (b) False
70. According to literature, NAB was shown to occur in more than ____% of patients on PPI therapy, but
can be _________by adding a ______at bedtime.
71. Following are the most common symptoms of GERD, EXCEPT one
o (a) Heartburn
o (b) Regurgitation
(c) Cough
72. Which of the following step is not true in the Mechanism of Acid Secretion (HCl) by Parietal Cells?
o (a) Combination of H+ ions with Cl- ions in the secretory cannaliculus to form HCL
o (b) Secretion of H+ ions into the secretory cannaliculus by the proton pump in exchange for K+
o (c) Activation of parietal cells
(d) Stimulation of parietal cells by histamine, dopamine, and/or gastrin
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Zantac SF Assessment - Team ABC and A - Q4 2016
73. Following are the secretagogues for the production of HCl, Except one:
o (a) Histamine
o (b) Gastrin
o (c) Acetylcholine
(d) Dopamine
74. The __________ is the part of the GI tract where 90% of the digestion and absorption of food
occurs, the other 10% taking place in the stomach and large intestine. The main function of this
portion is absorption of nutrients and minerals from food.
o (a) Duodenum
(b) Small Intestine
o (c) Stomach
o (d) Jejunum
75. The control of stomach pH is mediated by interplay between factors that excite gastric section, and
those that inhibit gastric secretion.
(a) True
o (b) False
76. The gastrointestinal __________is brought into repeated contact with potentially corrosive gastric
acid throughout the day, every day.
o (a) walls
(b) Mucosa
o (c) sphincter
o (d) tract
77. Factors such as delaying gastric emptying may also contribute to damage the lining of the stomach,
because the highly acidic chyme is retained in the stomach for longer than usual.
(a) True
o (b) False
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Zantac SF Assessment - Team ABC and A - Q4 2016
78. The muscular walls of the lower part of the oesophagus form a __________that normally provides a
physical barrier to reflux.
79. Drugs that affect parasympathetic nerve activity e.g. anticholinergics may NOT affect the
Incompetence of the lower functional oesophageal sphincter.
o (a) True
(b) False
80. The GERD Pain may be provoked by stooping or bending, and is sometimes relieved by sitting up or
standing.
(a) True
o (b) False
o (a) Esomeprazole
o (b) Omeprazole
o (c) Lansoprazole
(d) Misoprostol
82. PPI are unable to control acid secretion over the complete 24-hrs period with a single dose.
(a) True
o (b) False
83. Antacids are class of medications that act by directly ________________gastric acid.
o (a) Reducing
(b) Neutralizing
o (c) Inhibiting
o (d) Increasing
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84. ______________provide temporary relief of heartburn (lasting 30 to 60 minutes) and thus may
require frequent dosing; acid suppression is not maintained throughout the night even if they are
given at bedtime and diarrhea or constipation.
(a) Antacids
o (b) PPIs
o (c) H2RAs
85. aglandins & Alginates enhance the natural mucosal defences against acid.
(a) True
o (b) False
86. _______________ is the transection of part of the vagus nerve to reduce nervous system
stimulation of acid secretion.
(a) Vagotomy
o (b) Gastric Resection
(a) Sucralfate
o (b) Colloidal Bismuth
o (c) Prostaglandins
o (d) H2RAs
88. Acid suppression has been shown to lead to elevated Serum gastrin in many individuals may even
lead to enterochromaffin-like cell hyperplasia, is the key disadvantage of using _____________
o (a) Antacids
(b) PPI
o (c) H2RAs
89. Bedtime Histamine-2 receptor antagonists can control NAB in patients who are on PPI twice daily
therapy better compared with an additional bedtime dose of PPI.
(a) True
o (b) False
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Zantac SF Assessment - Team ABC and A - Q4 2016
90. __________________is an appropriate choice either for acute treatment or for maintenance
therapy.
(a) Zantac
o (b) Omeprazole
o (c) Esomperazole
o (d) Lansoperazole
91. Which of the following is the dose of Zantac in Long-term management of reflux oesophagitis
(GERD)?
(a) FALSE
o (b) TRUE
93. What is the dose of Zantac for the prophylaxis of NSAID induced ulcer?
94. Ranitidine has a relatively long duration of action and so a single 150 mg oral dose effectively
suppresses gastric acid secretion for _______ hours.
o (a) 24
o (b) 18
o (c) 6
(d) 12
95. Which of the following is the recommendation for the administration of ZANTAC intravenous
Injection?
o (a) A slow (over 1minutes) intravenous (i.v.) injection of 50 mg, diluted to a volume of 20 ml
o (b) A slow (over 2 minutes) intravenous (i.v.) injection of 50 mg, diluted to a volume of 2 ml
o (c) A slow (over 2 minutes) intravenous (i.v.) injection of 50 mg, diluted to a volume of 5 ml
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(d) A slow (over 2 minutes) intravenous (i.v.) injection of 50 mg, diluted to a volume of 20 ml
97. Usual dose of ZANTAC in children is 2mg/kg to 4mg/kg twice daily to a maximum of 300 mg per day.
(a) TRUE
o (b) FALSE
o (a) TRUE
(b) FALSE
o (a) Hepatomegaly
(b) Leucopenia
o (c) Asthma
o (d) Pneumonia
101. The dosage regimen of Zantac for Nocturnal Acid Breakthrough is__________________
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Zantac SF Assessment - Team ABC and A - Q4 2016
102. The standard dosage regimen of Zantac for duodenal or benign gastric ulcer
is__________________
103. For the long-term management of duodenal or benign gastric ulcer the usual dosage regimen of
Zantac is__________
104. What is the treatment regimen of Zantac for NSAID associated peptic ulceration?
105. What is the treatment of Zantac for Moderate to Severe Oesophagitis (GERD) patients?
106. What is the dosage regimen of Zantac for symptomatic relief in GERD patients?
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107. What is the standard dosage regimen of Zantac Injection for the prophylaxis of mendelson's
syndrome?
o (a) 25 mg by I.M. or slow I.V. injection 45 to 60 mins before induction of general anaesthesia
(b) 50 mg by I.M. or slow I.V. injection 45 to 60 mins before induction of general anaesthesia
o (c) 75 mg by I.M. or slow I.V. injection 45 to 60 mins before induction of general anaesthesia
o (d) 100 mg by I.M. or slow I.V. injection 45 to 60 mins before induction of general anaesthesia
108. Each 2ml of Aqueous solution of Zantac Injection contains 50 mg of Ranitidine as Ranitidine
hydrochloride B.P (25mg/ml)
o (a) FALSE
(b) TRUE
o (a) Saliva
(b) Kidneys
o (c) Liver
o (d) Sweat
o (a) FALSE
(b) TRUE
111. Ranitidine at usual therapeutic doses potentiate the actions of drugs which are inactivated by
cytochrome P450 enzyme system.
o (a) TRUE
(b) FALSE
112. Ranitidine does not cross Placenta and is not excreted via breast milk.
(a) FALSE
o (b) TRUE
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113. Ranitidine has long duration of action so a single 150mg oral dose effectively suppresses gastric
acid secretion for _________ hours.
o (a) 16
(b) 12
o (c) 24
o (d) 18
114. Following oral administration of 150mg Ranitidine maximum plasma concentration occurred
after_______ hours.
(a) 1 to 3
o (b) 4 to 6
o (c) 2 to 4
115. Absorption of Ranitidine after IM injection is rapid & peak plasma concentrations are usually
achieved within 30 minutes of administration.
(a) FALSE
o (b) TRUE
o (a) 20
o (b) 2 to 8
o (c) 18
(d) 30
117. Zantac injection is compatible with the following I.V Infusion fluids.
(a) TRUE
o (b) FALSE
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119. There is No evidence of an interaction between oral Ranitidine with amoxicillin and
metronidazole.
(a) TRUE
o (b) FALSE
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