Gastrointestinal Drugs
>>>Part 2
44.1 Histamine H2 blockers attenuate the gastric secretory
response to acetylcholine and pentagastrin as well because:
A. H2 blockers block gastric mucosal cholinergic and gastrin receptors as well
B. H2 blockers inhibit the proton pump in gastric mucosa
C. Acetylcholine and gastrin act partly by releasing histamine in gastric mucosa
D. Histamine, acetylcholine and gastrin all act through the phospholipase C-IP3:DAG pathway
in gastric mucosa
44.2 For healing duodenal ulcer the usual duration of H2 blocker therapy is:
A. 4 weeks
B. 6 weeks
C. 8 weeks
D. 12 weeks
44.3 What is true of acid control therapy with H2 blockers:
A. It generally heals duodenal ulcers faster than gastric ulcers
B. It checks bleeding in case of bleeding peptic ulcer
C. It prevents gastroesophageal reflux
D. Both ‘A’ and ‘B’ are correct
44.4 In the intact animal H2 receptor antagonists potentiate the following action of histamine:
A. Cardiac stimulation
B. Fall in blood pressure
C. Uterine relaxation
D. Bronchospasm
44.5 Gynaecomastia can occur as a side effect of:
A. Bromocriptine
B. Cimetidine
C. Famotidine
D. Levodopa
44.6 Which histamine H2 blocker has most marked
inhibitory effect on microsomal cytochrome P-450 enzyme:
A. Cimetidine
B. Ranitidine
C. Roxatidine
D. Famotidine
44.7 Choose the correct statement about H2 receptor blockers:
A. They are the most efficacious drugs in inhibiting gastric acid secretion
B. They cause fastest healing of duodenal ulcers
C. They prevent stress ulcers in the stomach
D. They afford most prompt relief of ulcer pain
44.8 Ranitidine differs from cimetidine in the following respect:
A. It is less potent
B. It is shorter acting
C. It does not have antiandrogenic action
D. It produces more CNS side effects
44.9 Compared to H2 blockers, omeprazole affords the following:
A. Faster relief of ulcer pain
B. Faster healing of duodenal ulcer
C. Higher efficacy in healing reflux esophagitis
D. All of the above
44.10 Choose the drug which blocks basal as well as
stimulated gastric acid secretion without affecting
cholinergic, histaminergic or gastrin receptors:
A. Famotidine
B. Loxatidine
C. Omeprazole
D. Pirenzepine
44.11 Omeprazole exerts practically no other action except
inhibition of gastric acid secretion because:
A. It transforms into the active cationic forms only in the acidic pH of the gastric juice
B. Its active forms have selective affinity for the H+K+ATPase located in the apical canaliculi
of gastric parietal cells
C. Its cationic forms are unable to diffuse out from the gastric parietal cell canaliculi
D. All of the above
44.12 The most efficacious drug for inhibiting round the clock gastric acid output is:
A. Omeprazole
B. Cimetidine
C. Pirenzepine
D. Misoprostol
44.13 The following is true of proton pump inhibitors except:
A. They are the most effective drugs for Zolinger Ellison syndrome
B. Their prolonged use can cause atrophy of gastric mucosa
C. They inhibit growth of H. pylori in stomach
D. They have no effect on gastric motility
44.1 4 The first choice drug for nonsteroidal antiinflammatory drug associated gastric ulcer is:
A. Omeprazole
B. Misoprostol
C. Ranitidine
D. Sucralfate
44.15 Select the drug which is an inhibitor of gastric mucosal proton pump:
A. Carbenoxolone sodium
B. Sucralfate
C. Famotidine
D. Lansoprazole
44.16 The following class of gastric antisecretory drug also
reduce gastric motility and have primary effect on
juice volume, with less marked effect on acid and
pepsin content:
A. Histamine H2 blockers
B. Anticholinergics
C. Proton pump inhibitors
D. Prostaglandins
44.17 The primary mechanism by which prostaglandins promote ulcer healing is:
A. Inhibition of gastric acid secretion
B. Augmentation of bicarbonate buffered mucus layer covering gastroduodenal
mucosa
C. Increased bicarbonate secretion in gastric juice
D. Increased turnover of gastric mucosal cell
44.18 Choose the antiulcer drug that inhibits gastric acid
secretion, stimulates gastric mucus and bicarbonate
secretion and has cytoprotective action on gastric
mucosa:
A. Misoprostol
B. Sucralfate
C. Carbenoxolone sodium
D. Colloidal bismuth subcitrate
44.19 The following statement is true about misoprostol:
A. It relieves peptic ulcer pain, but does not promote ulcer healing
B. It heals nonsteroidal antiinflammatory drug induced gastric ulcer not responding to H2
blockers
C. It produces fewer side effects than H2 blockers
D. It is the most effective drug for preventing ulcer relapse
44.20 The ‘acid neutralizing capacity’ of an antacid is governed by:
A. The equivalent weight of the antacid
B. The pH of 1N solution of the antacid
C. The rate at which the antacid reacts with HCl
D. Both ‘A’ and ‘C’
44.21 As an antacid, sodium bicarbonate has the following disadvantages except:
A. It causes acid rebound
B. In ulcer patients, it increases risk of perforation
C. It has low acid neutralizing capacity
D. It is contraindicated in hypertensives
44.22 The following is true of aluminium hydroxide gel except:
A. It is a weak and slowly reacting antacid
B. Its acid neutralizing capacity decreases on storage
C. It interferes with absorption of phosphate in the intestine
D. It causes loose motions as a side effect
44.23 Choose the correct statement about magaldrate:
A. It is a mixture of magnesium and aluminium hydroxides
B. It has a rapid as well as sustained acid neutralizing action
C. Its acid neutralizing capacity is 2 m Eq/g
D. It causes systemic alkalosis
44.24 Antacid combinations of magnesium and aluminium
salts are superior to single component preparations because:
A. They have rapid as well as sustained acid neutralizing action
B. They are less likely to affect gastric emptying
C. They are less likely to alter bowel movement
D. All of the above
44.25 In peptic ulcer, antacids are now primarily used for:
A. Prompt pain relief
B. Ulcer healing
C. Preventing ulcer relapse
D. Control of bleeding from the ulcer
44.26 Sucralfate promotes healing of duodenal ulcer by:
A. Enhancing gastric mucus and bicarbonate secretion
B. Coating the ulcer and preventing the action of acid-pepsin on ulcer base
C. Promoting regeneration of mucosa
D. Both ‘A’ and ‘B’ are correct
44.27 Antacids administered concurrently reduce efficacy of the following antipeptic ulcer drug:
A. Cimetidine
B. Colloidal bismuth
C. Sucralfate
D. Pirenzepine
44.28 The following antiulcer drug does not act by reducing the secretion of or neutralizing gastric acid:
A. Magaldrate
B. Sucralfate
C. Misoprostol
D. Omeprazole
44.29 The most important drawback of sucralfate in the treatment of duodenal ulcer is:
A. Low ulcer healing efficacy
B. Poor relief of ulcer pain
C. High incidence of side effects
D. Need for taking a big tablet four times a day
44.30 Choose the correct statement about colloidal bismuth subcitrate:
A. It causes prolonged neutralization of gastric acid
B. It has anti-H.pylori activity
C. It relieves peptic ulcer pain promptly
D. All of the above are correct
44.31 Eradication of H.pylori along with gastric antisecretory drugs affords the following benefit(s):
A. Faster relief of ulcer pain
B. Faster ulcer healing
C. Reduced chance of ulcer relapse
D. Both ‘B’ and ‘C’ are correct
44.32 The drugs employed for anti-H.pylori therapy include the following except:
A. Ciprofloxacin
B. Clarithromycin
C. Tinidazole
D. Amoxicillin
44.33 The following is true of anti-H.pylori therapy except:
A. It is indicated in all patients of peptic ulcer
B. Resistance to any single antimicrobial drug develops rapidly
C. Concurrent suppression of gastric acid enhances efficacy of the regimen
D. Colloidal bismuth directly inhibits H.pylori
but has poor patient acceptability
44.34 The preferred regimen for preventing duodenal ulcer relapse is:
A. Maintenance antacid regimen
B. Maintenance H2 blocker regimen
C. On demand intermittent H2 blocker regimen
D. Maintenance sucralfate regimen
Ans:
44.1 C 44.2 C 44.3 A 44.4 D 44.5 B 44.6 A 44.7 C 44.8 C 44.9D 44.10 C 44 . 11D 44.12 A 44.13 B 44.14 A 44.15D 44.16 B 44.17 B 44.18 A 44.19 B 44.20D 44.21 C 44.22D 44.23 B 44.24D 44.25 A 44.26 B 44.27 C 44.28 B 44.29D 44.30 B 44.31D 44.32 A 44.33 A 44.34 B
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