Pharm GERD and PUD Questions PDF

Here are 35 PANCE-style questions with answers: **GERD and PUD Questions** 1. **Which mechanism is primarily responsible for GERD?**\ a) Increased gastric acid production\ b) Decreased lower esophageal sphincter tone\ c) Excessive mucus production\ d) Impaired gastric emptying\...

Here are 35 PANCE-style questions with answers: **GERD and PUD Questions** 1. **Which mechanism is primarily responsible for GERD?**\ a) Increased gastric acid production\ b) Decreased lower esophageal sphincter tone\ c) Excessive mucus production\ d) Impaired gastric emptying\ **Answer**: b) Decreased lower esophageal sphincter tone 2. **Which of the following is the first-line pharmacologic treatment for mild GERD?**\ a) Proton pump inhibitors\ b) Antacids\ c) H2 receptor antagonists\ d) Prokinetic agents\ **Answer**: b) Antacids 3. **What is the mechanism of action of proton pump inhibitors?**\ a) Competitive inhibition of histamine at H2 receptors\ b) Neutralizing gastric acid\ c) Inhibiting H+/K+ ATPase on parietal cells\ d) Blocking dopamine receptors in the chemoreceptor trigger zone\ **Answer**: c) Inhibiting H+/K+ ATPase on parietal cells 4. **Which medication is associated with rebound acid hypersecretion if discontinued abruptly?**\ a) Famotidine\ b) Omeprazole\ c) Calcium carbonate\ d) Metoclopramide\ **Answer**: b) Omeprazole 5. **What is a major adverse effect of long-term PPI use?**\ a) Hypokalemia\ b) C. difficile infection\ c) Myopathy\ d) QT prolongation\ **Answer**: b) C. difficile infection 6. **Which lifestyle modification is recommended for GERD management?**\ a) Consuming high-fat meals before bedtime\ b) Remaining upright for 1-2 hours after meals\ c) Reducing protein intake\ d) Drinking carbonated beverages\ **Answer**: b) Remaining upright for 1-2 hours after meals 7. **Which medication may worsen GERD symptoms?**\ a) Metformin\ b) Amlodipine\ c) Omeprazole\ d) Sucralfate\ **Answer**: b) Amlodipine 8. **What is the primary goal of GERD therapy?**\ a) Eliminate all acid production\ b) Alleviate symptoms and prevent complications\ c) Increase gastric motility\ d) Achieve weight loss\ **Answer**: b) Alleviate symptoms and prevent complications 9. **What is a hallmark symptom of PUD?**\ a) Dysphagia\ b) Burning epigastric pain relieved by food\ c) Heartburn\ d) Chronic diarrhea\ **Answer**: b) Burning epigastric pain relieved by food 10. **Which bacteria is associated with the majority of PUD cases?**\ a) Streptococcus pyogenes\ b) Escherichia coli\ c) Helicobacter pylori\ d) Clostridium difficile\ **Answer**: c) Helicobacter pylori 11. **Which medications are included in triple therapy for H. pylori-associated ulcers?**\ a) PPI + clarithromycin + amoxicillin\ b) H2RA + metronidazole + bismuth\ c) PPI + bismuth + tetracycline\ d) Sucralfate + PPI + amoxicillin\ **Answer**: a) PPI + clarithromycin + amoxicillin 12. **What is the major risk factor for NSAID-induced ulcers?**\ a) Alcohol consumption\ b) H. pylori infection\ c) Use of COX-1 inhibitors\ d) Concomitant use of PPIs\ **Answer**: c) Use of COX-1 inhibitors 13. **Which therapy is recommended for the prevention of NSAID-induced ulcers?**\ a) H2 receptor antagonists\ b) Misoprostol\ c) Antacids\ d) Sucralfate\ **Answer**: b) Misoprostol 14. **What is the mechanism of action of sucralfate?**\ a) Neutralizes gastric acid\ b) Blocks histamine at H2 receptors\ c) Forms a protective coating over ulcers\ d) Inhibits H+/K+ ATPase\ **Answer**: c) Forms a protective coating over ulcers 15. **Which condition is associated with gastrin-producing tumors?**\ a) Zollinger-Ellison syndrome\ b) GERD\ c) Barrett's esophagus\ d) Gastroparesis\ **Answer**: a) Zollinger-Ellison syndrome 16. **Which PPI is commonly used in GERD therapy?**\ a) Ranitidine\ b) Omeprazole\ c) Sucralfate\ d) Misoprostol\ **Answer**: b) Omeprazole 17. **What is a contraindication for misoprostol use?**\ a) Chronic kidney disease\ b) Pregnancy\ c) Active ulcer disease\ d) Diabetes mellitus\ **Answer**: b) Pregnancy 18. **Which test is used to confirm H. pylori eradication after therapy?**\ a) Fecal occult blood test\ b) Urea breath test\ c) Gastrin level test\ d) Endoscopy\ **Answer**: b) Urea breath test 19. **Which medication is indicated for stress ulcer prophylaxis in ICU patients?**\ a) Antacids\ b) Sucralfate\ c) Proton pump inhibitors\ d) H2 receptor antagonists\ **Answer**: c) Proton pump inhibitors 20. **Which electrolyte disturbance can occur with long-term PPI use?**\ a) Hypermagnesemia\ b) Hypomagnesemia\ c) Hypernatremia\ d) Hypokalemia\ **Answer**: b) Hypomagnesemia 21. **What is the first-line treatment for Zollinger-Ellison syndrome?**\ a) H2 receptor antagonists\ b) PPIs\ c) Antacids\ d) Surgery\ **Answer**: b) PPIs 22. **Which class of drugs works by neutralizing gastric acid?**\ a) PPIs\ b) Antacids\ c) H2 receptor antagonists\ d) Antibiotics\ **Answer**: b) Antacids 23. **What is a common adverse effect of bismuth subsalicylate?**\ a) Black stools\ b) Hypercalcemia\ c) Bradycardia\ d) Constipation\ **Answer**: a) Black stools 24. **Which medication combination is used in quadruple therapy for H. pylori?**\ a) PPI + bismuth + tetracycline + metronidazole\ b) PPI + amoxicillin + clarithromycin\ c) H2RA + bismuth + tetracycline\ d) Sucralfate + PPI + amoxicillin\ **Answer**: a) PPI + bismuth + tetracycline + metronidazole 25. **Which PUD form is most commonly associated with critical illness?**\ a) H. pylori-related\ b) NSAID-induced\ c) Stress ulcers\ d) Zollinger-Ellison syndrome\ **Answer**: c) Stress ulcers 26. **Which dietary modification is recommended for GERD?**\ a) High-carbohydrate meals\ b) Frequent small meals\ c) High-fat diet\ d) Avoid protein-rich foods\ **Answer**: b) Frequent small meals 27. **What is a major adverse effect of cimetidine use?**\ a) Constipation\ b) Gynecomastia\ c) Tachycardia\ d) Renal failure\ **Answer**: b) Gynecomastia 28. **Which test is preferred to diagnose GERD-related complications?**\ a) Endoscopy\ b) Abdominal ultrasound\ c) CT scan\ d) Serum gastrin levels\ **Answer**: a) Endoscopy 29. **Which medication is most effective for healing esophageal mucosa in GERD?**\ a) Antacids\ b) H2 receptor antagonists\ c) PPIs\ d) Prokinetic agents\ **Answer**: c) PPIs 30. **Which symptom is more common in duodenal ulcers than gastric ulcers?**\ a) Pain worsens after eating\ b) Pain improves with eating\ c) Dysphagia\ d) Vomiting\ **Answer**: b) Pain improves with eating 31. **Which factor increases the risk of Barrett's esophagus in GERD?**\ a) Female gender\ b) Long-standing symptoms\ c) Vegetarian diet\ d) Use of H2RAs\ **Answer**: b) Long-standing symptoms 32. **What is a key adverse effect of metronidazole?**\ a) Disulfiram-like reaction with alcohol\ b) Hypercalcemia\ c) QT prolongation\ d) Dysphagia\ **Answer**: a) Disulfiram-like reaction with alcohol 33. **What is the role of sucralfate in GERD during pregnancy?**\ a) Neutralizes gastric acid\ b) Forms a protective barrier\ c) Stimulates gastric motility\ d) Reduces LES pressure\ **Answer**: b) Forms a protective barrier 34. **Which medication should be avoided in children with viral infections?**\ a) Bismuth subsalicylate\ b) Sucralfate\ c) Omeprazole\ d) Metoclopramide\ **Answer**: a) Bismuth subsalicylate 35. **What is the first step in managing GERD symptoms in pregnancy?**\ a) Start a PPI\ b) Lifestyle and dietary modifications\ c) H2 receptor antagonist\ d) Metoclopramide\ **Answer**: b) Lifestyle and dietary modifications