5 - GASTROENTEROLOGY

Item Number: 5270 correct answer: 3 category: GI Disorder

1. Which of the following substances has its major activity as a saline

cathartic?

1. sodium bicarbonate

2. methylcellulose

3. sodium phosphate

4. castor oil

5. mineral oil

Item Number: 11804 correct answer: 4 category: GI Disorder

2. The correct statement regarding sucralfate:

1. pharmacologic action is to reduce gastric acid secretion by antagonizing

gastrin

2. enhances N+-K+ ATPase

3. antagonizes acetylcholine

4. most common side effects is constipation

5. increases gastric motility

Item Number: 10828 correct answer: 4 category: GI Disorder

3. Correct statement regarding metoclopramide:

1. central nervous system dopamine receptor agonist

2. peripheral blockage of acetylcholine at muscarinic synapse

3. decreases lower esophageal sphincter pressure

4. adverse effects include dystonic or extrapyramidal effects

5. increases motility of colon

Item Number: 10702 correct answer: 5 category: GI Disorder

4. In general, mechanisms of laxation include:

1. adding bulk to the stool

2. increasing peristaltic activity

3. emulsifying aqueous and fatty substances with stool

4. lubricating the passage of stool

5. All of the above

Item Number: 10804 correct answer: 1 category: GI Disorder

5. Appropriate indications for and/or uses of laxatives include:

A. prevent straining at the stool in patients with cardiovascular

disease

B. bulk forming agents for diverticular disease

C. treatment of drug overdose

D. to induce daily bowel movements in normal healthy individuals

1. A,B,C

2. A,C

3. B,D

4. D only

5. All of the above

Item Number: 5266 correct answer: 1 category: GI Disorder

6. Which of the following substances is most likely to cause systemic alkalosis?

1. sodium bicarbonate

2. methylcellulose

3. sodium phosphate

4. castor oil

5. mineral oil

Item Number: 8180 correct answer: 4 category: GI Disorder

7. Saline cathartics, such as sodium sulfate or magnesium sulfate:

1. are safe in patients with renal failure

2. are readily absorbed from the gastrointestinal tract

3. are slower acting than bulk-forming laxatives

4. act by increasing intestinal volume, hence stimulating peristaltic action

5. lower the surface tension of the feces to facilitate fecal hydration

Item Number: 10820 correct answer: 5 category: GI Disorder

8. Adverse effect(s) of laxatives:

1. electrolyte disturbances (hypernatremia, hypokalemia)

2. dehydration

3. spastic colitis with stimulant laxatives

4. gastrointestinal obstruction with bulk forming agents

5. All of the above

Item Number: 14538 correct answer: 5 category: GI Disorder

9. In esophagitis, elevation of the head of the bed, abstinence from ethanol and

tobacco, and small frequent meals are all useful adjunctive therapeutic

measures. Other useful therapy may include all of the following EXCEPT:

1. omeprazole

2. metoclopramide

3. bethanechol

4. cimetidine

5. amitriptyline

Item Number: 10826 correct answer: 2 category: GI Disorder

10. Drug which exerts anti-peptic ulcer effects through histamine-2 receptor

antagonism:

1. sucralfate

2. ranitidine

3. metoclopramide

4. omeprazole

5. misoprostol

Item Number: 5269 correct answer: 5 category: GI Disorder

11. The substance which is principally an emollient laxative is:

1. bran

2. methylcellulose

3. magnesium hydroxide

4. phenolphthalein

5. mineral oil

Item Number: 14576 correct answer: 3 category: GI Disorder

12. Laxatives may aid in the treatment of portal systemic encephalopathy by:

1. increasing stool pH

2. increasing coliform bacteria

3. decreasing protein contact time with GI mucosa

4. All of the above

5. 1,3

Item Number: 10827 correct answer: 5 category: GI Disorder

13. Agents of potential use in peptic ulcer disease include:

1. muscarinic antagonists

2. proton pump inhibitors

3. antacids

4. prostaglandins

5. All of the above

Item Number: 3808 correct answer: 5 category: GI Disorder

14. The physician must always be aware of possible drug interactions. Aluminum

hydroxide antacids tend to interfere with the gastrointestinal absorption of:

1. cephalexin

2. penicillin G

3. erythromycin

4. chloramphenicol

5. tetracycline

Item Number: 11811 correct answer: 4 category: GI Disorder

15. Prostaglandins E2 inhibit the secretion of gastric acid and stimulate the

secretion of mucus. One adverse effect limiting the wide use of

prostaglandins for gastric disease is:

1. headache

2. thrombocytopenia

3. gynecomastia

4. diarrhea

5. seizures

Item Number: 1851 correct answer: 3 category: GI Disorder

16. An agent which promotes defecation without increasing peristalsis is:

1. castor oil

2. phenolphthalein

3. docusate sodium

4. cascara

5. milk of magnesia

Item Number: 10825 correct answer: 4 category: GI Disorder

17. Cimetidine reduces the clearance of all of the following EXCEPT:

1. theophylline

2. phenytoin

3. warfarin

4. digoxin

5. quinidine

Item Number: 2888 correct answer: 5 category: GI Disorder

18. The basic approach to the patient with either acute or chronic hepatic

encephalopathy is aimed at reducing the ammonia load presented to the central

nervous system. Elimination of protein from the diet, cathartics, enemas,

neomycin and lactulose (a disaccharide) have been used to accomplish this

goal. Correct statements regarding the mechanism of action of lactulose

include:

1. reduced fecal Ph by the breakdown products of lactulose leads to reduced

ammonia absorption via non-ionic diffusion

2. the decreased fecal pH increases bacterial assimilation of ammonia

3. lactulose induces an osmotic diarrhea which diminishes fecal stasis and

reduces nitrogenous substrates

4. All of the above

5. 1,3

Item Number: 4693 correct answer: 5 category: GI Disorder

19. Antacids having a relatively non-systemic effect include:

1. aluminum hydroxide

2. sodium bicarbonate

3. calcium carbonate

4. All of the above

5. 1 and 3

Item Number: 5268 correct answer: 4 category: GI Disorder

20. Which of the following substances has its major activity as an stimulant

cathartic?

1. sodium bicarbonate

2. methylcellulose

3. sodium citrate

4. castor oil

5. mineral oil

Item Number: 11789 correct answer: 3 category: GI Disorder

21. One mechanism to reduce gastric acid secretion is by blocking the H+-Na+

ATPase pump in the parietal cell. One drug that has this pharmacologic action

is:

1. misoprostol

2. pirenzepine

3. omeprazole

4. serotonin

5. isoniazid

Item Number: 10792 correct answer: 1 category: GI Disorder

22. The amount of sodium, phosphate or magnesium contained in an antacid should be

assessed when selecting an antacid for patients with:

A. renal insufficiency

B. congestive heart failure

C. ascites

D. peptic ulcer disease

1. A,B,C

2. A,C

3. B,D

4. D only

5. All of the above

Item Number: 3700 correct answer: 3 category: GI Disorder

23. The concomitant administration of calcium and/or magnesium antacids to

patients receiving one of the tetracycline drugs may have which of the

following effects upon the action of the tetracycline:

1. enhances the action

2. causes no significant change

3. decreases the action

4. increases toxicity

5. suppresses hypersensitivity reactions

Item Number: 10822 correct answer: 2 category: GI Disorder

24. Pharmacologic effects of antacids include:

A. increase gastric pH

B. reversible inactivation of pepsin at pH > 6

C. increase or decrease gastric motor activity

D. decrease lower esophageal pressure

1. A,B,C

2. A,C

3. B,D

4. D only

5. All of the above.