Title GastroIntestinal diseases ✅

GI DISEASES A. PEPTIC ULCERS and HP 1. Which of the following is NOT a common cause of peptic ulcer disease (PUD)? A) Chronic alcohol ingestion B) Nonsteroidal anti-inflammatory drugs (NSAIDs) C) Smoking D) Helicobacter pylori infection 2. Which one of the following is a defensive mechanism in the gastric mucosa? A) Bicarbonate B) Pepsin C) Gastric acid D) cyclooxygenase-2 (COX-2) E) None of the above 3. Which of the following is/are true regarding the role of prostaglandins (PGs) in PUD? A) PGs play an important role in the maintenance of the mucosal layer B) PGs stimulate the production of bicarbonate in the mucosal layer C) PGs stimulate the production of acid in response to histamine activation D) A and B E) All of the above 4. NSAID-induced mucosal damage is caused in part by: A) Direct mucosal irritation B) Increased PG production C) Increased gastric mucosal blood flow D) Both A and B E) All of the above 5. Which of the following statements is true regarding bismuth-based four-drug regimens for H. pylori eradication? A) These regimens can be administered once daily
B) The resulting clinical cure rate is less than that seen with triple-drug regimens C) The resulting clinical cure rate is greater than that seen with triple-drug regimens D) These regimens usually consist of bismuth and three antimicrobials E) None of the above 6. Which one of the following should be considered when evaluating a patient who has failed H. pylori eradication therapy? A) Patient compliance B) Antimicrobial resistance C) Potential reinfection D) All of the above 7. Principles of Breath tests/Stool tests for Helicobacter Pylori (HP) A) Urea with isotopically labeled *C is hydrolysed by the enzyme urease of HP and *CO2 is expired in breath/Antigen of HP in stool B) Urea with isotopically labeled *H is hydrolysed by the enzyme urease of HP and *H2 is expired in breath/PCR or Antigen of HP in stool C) Urea with isotopically labeled *C is hydrolysed by the enzyme urease of HP and *CO2 is expired in breath/PCR or Antigen of HP in stool D) Urea with isotopically labeled *H is hydrolysed by the enzyme urease of H. pylori and *H2 is expired in breath/PCR of HP in stool 8. Clinical trials evaluating misoprostol prophylaxis for NSAID-associated PUD conclude that misoprostol prophylaxis: A) Will reduce PUD recurrence B) Will not lead to adverse drug reactions C) Will lead to the discontinuation of NSAID therapy D) Will reduce patients’ complaints of diarrhea 9. Use of a standard dose H2-receptor antagonist (H2RA) for prophylaxis against NSAID-associated PUD has been shown to be: A) Ineffective in trials incorporating endoscopic endpoints B) Superior to misoprostol C) Inferior to sucralfate D) Effective in reducing both gastric ulcer (GU) and duodenal ulcer (DU)
E) None of the above 10. Which one of the following statements is true regarding the role of PPI (Proton Pump Inhibitor) therapy for preventing NSAID associated PUD? A) PPI therapy is effective for prophylaxis against NSAID-associated DU only B) PPIs will not prevent PUD in patients taking low dose aspirin therapy C) PPIs are superior to either misoprostol or ranitidine prophylactic therapy D) PPI therapy is equivalent to sucralfate prophylactic therapy E) None of the above 11. Which one of the following is the most important methodological limitation of the trials that have evaluated COX-2 inhibitor therapy as a means to reduce the incidence of NSAID-associated PUD? A) Large trial sizes B) Use of standard doses of COX-2 inhibitors in both the CLASS and VIGOR trials C) Use of patients at high risk for ulcer recurrence D) Enrollment of patients who had H. pylori-positive infections E) None of the above 12. Refractory ulcers will most likely require which of the following interventions? A) An increase in the PPI (Proton Pump Inhibitor) dose B) An evaluation of serum Gastrin C) H. pylori testing if not done previously D) All of the above 13. What is the common cause for peptic ulcers? A) Smoking B) Helicobacter pylori infection C) Obesity D) Alcohol E) Aspirin 14. Helicobacter pylori infection is best diagnosed with: A) Stool test
B) Blood test C) Breath test D) Endoscopy with biopsy of the tissue (ulcer site) E) A and C 15. Blood test (for HP antibody detection) can only be used for Helicobacter Pylori screening, it is not used for treatment follow-up because: A) Antibody test is not accurate B) Antibody test has low sensitivity C) Antibody test has low specificity D) Antibody still exists in the blood more than 18-24 months after HP is eradicated 16. Helicobacter pylori is now accepted to be the main cause of A) gastric and duodenal ulcers (peptic ulcers) and chronic gastritis B) gastric cancers C) Zollinger–Ellison syndrome D) A and B are correct 17. The mode of transmission of H. pylori is A) Contaminated food and hands B) Saliva C) Faeco-oral route D) Still uncertain 18. Nine out of ten people infected by H. pylori do not develop ulcers. A) True B) False 19. If the microbe is predominantly in the antrum, the inflammation leads to dysfunction of the antral ________ that become hyperreactive and secrete disproportionate amounts of gastrin in response to food and gastric distension. Gastrin has a trophic effect on the gastric parietal cells to produce more acid, resulting in duodenal ulcers. A) G cells B) S cells