Saturday, January 12, 2008

4 - gastroesophageal reflux diseases ( G E R D bits )

Question 1
Which of these is not true with regard to heartburn?
A. It is a burning pain under the sternum
B. Increased on bending
C. Relieved by fatty food-------------
D. More frequent or worse at night

Question 2
Heartburn can be a symptom of which of these conditions?
A. Gastro-oesophageal reflux disease
B. Hiatus hernia
C. Dyspepsia
D. Any of the above-----------

Question 3
Which of the following is not a potential symptom of GERD?
A. Chronic hoarseness
B. Belching
C. Breathlessness
D. Chest pain--------------

Question 4
Long term complications of Gastro-oesophageal reflux disease could be following, except
A. Barret's oesophagus----------(check)
B. Hiatus hernia
C. Diabetes
D. None of the above

Question 5
Long-term surveillance is required after diagnosis of Barret's oesophagus because there is a marked correlation between this condition and
A. Oesophageal adenocarcinoma-----------
B. Adenocarcinoma of gastric cardia
C. Squamous cell carcinoma of oesophagus
D. Squamous cell carcinoma of gastric cardia

Question 6
Apart from antacids other medications that can relieve the symptoms of heartburn are
A. Histamine receptor blockers
B. Promotolity agents
C. Proton pump inhibitors
D. All of the above-----------

Question 7
Should everyone suffering from heartburn undergo endoscopic evaluation?
A. Not required at all
B. Should always be done to find the cause of heartburn
C. Should be done if mild to moderate symptoms are present for many years---------
D. None of the above

Question 8
Heartburn is quite harmless if relieved with antacids. It should be investigated if accompanied with
A. Loss of weight
B. Dysphagia
C. Haematemesis
D. Any of the above--------------

Question 9
Heartburn can be controlled by
A. Elevating footend of the bed by 6 inches
B. Lying down for few minutes soon after eating
C. Including fried and fatty food in diet
D. Loosing weight if overweight-------------

Question 10
What is the optimal time to take an antacid?
A. Just before bedtime
B. After a meal----------(check)
C. When symptoms appear
D. 20 minutes before the first meal of the day

Question 11
Which medications do not exacerbate the symptoms of heartburn?
A. Calcium channel blocker
B. Progesterone
C. Diazepam
D. None of the above------------

Question 12
Which of the following statement is not true?
A. Histamine receptor blockers require frequent dosing
B. Proton pump inhibitor are generally administered once daily
C. Side effects are more with proton pump inhibitor than histamine receptor blockers--------------
D. Gastric acid suppression is more with proton pump inhibitors than histamine receptor blockers

Question 13
What is likely to happen if antacid and iron preparations are administered together?
A. Effect of antacid is nullified by iron preparation
B. Decreased bioavailibility of iron preparation due to binding with antacid-------------
C. No interaction between the two drugs
D. None of the above statements is true

Question 14
Omeprazole is a
A. Histamine receptor blocker
B. Promotolity agent
C. Proton pump inhibitor---------
D. Antacid

Question 15
Which of these is highly predictive of healing when using PPI for treatment of GERD?
A. Increase in weight
B. Relief from heartburn-------------
C. Increased appetite
D. Reduced hoarseness of voice

Question 16
Which of the following statements is true and may influence the choice of proton pump inhibitors (PPIs) over H2-receptor antagonists for treatment of GERD?
A. H2-receptor antagonists have less frequent dosing.
B. H2 receptor antagonists have to be taken in higher doses at more frequent intervals----------
C. PPIs are associated with higher costs and increased incidence of adverse effects
D. PPIs have decreased treatment adherence and lower costs.

Question 17
What is the mechanism of action for PPIs?
A. Bind to and permanently inactivate the gastric proton pump-----------.
B. Increase gastric acid production at the final common step in the gastric acid secretion pathway.
C. Competitively and reversibly inhibit stimulation of gastric parietal cell receptors.
D. Facilitates esophageal acid clearance by increasing LES pressure.

Question 18
Which of the following is a goal of treatment for patients with GERD?
A. Healing of erosive lesions, if present
B. Symptom control
C. Avoidance of complications, e.g. strictures
D. All of the above-------------

Question 19
Drug therapy for GERD involves increasing gastrointestinal motility and
A. Reducing gastric acidity-----------
B. Increasing parietal acid production
C. Enhancing gastrin activity
D. All of the above

Question 20
Erosive esophagitis is an important subset of GERD, since it appears to be chronic in up to 80% of cases. The percentage of erosive esophagitis in patients with frequent symptoms of GERD is
A. Less than 10%
B. 10% to 20%------------
C. 20% to 30%
D. 30% to 50%

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