Peptic Ulcer MCQ Questions and Answers
mcq on peptic ulcer pathophysiology
Peptic Ulcer Drugs MCQs

Note: Answers keys are given at the end of the MCQs.

1. Identify the mucosal protective agent from the given anti-peptic ulcer drugs?
a- sodium bicarbonate
b- aluminum hydroxide 
c- famotidine
d- bismuth subcitrate
e- all of the above

2. In antacids preparation, aluminum hydroxide and magnesium compounds are usually used in combination. The main reason behind this is;
a- to balance their constipative and purgative effects
b- to optimize activity in the stomach as well as the intestines
c- to reduce systemic absorption of each other
d- to prevent metabolic alkalosis
e- to correct electrolyte imbalance during PUD

3. Which of the following statements is WRONG about sodium bicarbonate?
a- it is a systemic antacid
b- clinically used as an antacid and urine alkalinizer
c- its adverse effects are gastric distention and fluid retention
d- can be given in renal insufficiency
e- it is contraindicated in cardiac failure

4. Which drug belongs to the antacids class of anti-peptic ulcer drugs?
a- omeprazole
b- cimetidine
c- pirenzepine
d- calcium carbonate
e- all of the above

5. The mechanism of ranitidine pharmacodynamics is;
a- neutralize gastric acidity by reacting with gastric HCl
b- competitively block histamine at H2 receptors on gastric parietal cells
c- irreversibly inhibit the gastric parietal cell proton pump
d- stimulate mucus and bicarbonate secretion
e- stimulates endogenous PG synthesis

6. Carbenoxolone is which type of GIT drug?
a- anti-peptic ulcer drug
b- emetic drug
c- anti-emetic drug
d- purgative agent
e- appetite stimulant

7. Gynecomastia in males and galactorrhea in females are the possible adverse effects of;
a- proton pump inhibitors
b- H2-receptors blockers
c- misoprostol
d- carbenoxolone 
e- aluminum hydroxide

8. The only agent among the following that selectively blocks gastric M1-muscarinic receptors, thereby inhibiting stomach secretions is;
a- pirenzepine
b- olanzapine
c- magnesium trisilicate 
d- clozapine
e- cyclosporine

9. Which statement is WRONG about propantheline bromide?
a- it is an anti-muscarinic drug 
b- its uses, action, and adverse effects are similar to those of atropine
c- used as anti-spasmodic for GI and urinary complaints
d- reduces gastric acid secretion
e- used as an adjunct in the cardiac arrhythmia treatment

10. The mechanism of action of carbenoxolone is;
a- increases production and viscosity of gastric, and intestinal mucus
b- decreases H+ diffusion from the lumen into the mucosa
c- decreases the rate of shedding of gastric mucosal cells
d- all of the above
e- both a and b

11. All of the following drugs are contraindicated in peptic ulcer disease except?
a- salicylates
b- antacids
c- reserpine
d- coffee
e- phenylbutazone

12. Misoprostol is;
a- a synthetic, oral PGE2 analog
b- used for treatment and prophylaxis of NSAID-induced peptic ulcer
c- safe during pregnancy
d- constipative in its side effects profile
e- an antacid

13. Darkening of tongue, teeth, and stool is the adverse effect of which anti-peptic ulcer drug?
a- iron polymaltose complex
b- rifampin
c- bismuth subsalicylate
d- cimetidine
e- aluminum hydroxide

14. Identify the INCORRECT statement(s) regarding GIT physiology, pathology and pharmacology?
1- milk is an example of dietary antacids
2- mental stress is a precipitating factor of PUD
3- chemically antacids are strong bases
4- spotting is the adverse effect of sucralfate
5- H. pylori is the only cause of peptic ulcer disease

a- 1 and 3
b- 2 and 4
c- 1, 3 and 4
d- 2, 4 and 5
e- 3, 4 and 5

15. Which H2-receptor antagonist inhibits cytochrome P450 mixed-function oxidase system and thus can slow down the metabolism of concomitantly administered drugs like warfarin, phenytoin, etc.?
a- famotidine
b- ranitidine
c- cimetidine 
d- nizatidine 
e- all H2 blockers inhibits CYP450

16. A 34-year-old male patient is suffering from sexual dysfunction. Which anti-peptic ulcer drug has the potential to worsen this condition and therefore should be avoided in this patient for the management of PUD?
a- dihydroxy aluminum aminoacetate
b- bismuth dinitrate
c- cimetidine
d- lansoprazole
e- misoprostol

17. An ideal antacid should;
a- neutralize gastric acidity and increase pH up to 7
b- neutralize stomach acidity without increasing pH above 4
c- increase gastric pH up to 9
d- not reduce pepsin activity
e- both B and D

18. The most common dose-related adverse effect of misoprostol which limits the use of this agent for the prevention of NSAID-induced gastric ulceration is;
a- abdominal pain
b- abortion
c- diarrhea
d- nausea and vomiting
e- worsening of ulcer

19. Which one of the following is not an ideal antacid because of its systemic absorption?
a- calcium carbonate
b- sodium bicarbonate
c- magnesium oxide
d- aluminum hydroxide gel
e- sucralfate

20. For maximum effectiveness, the best time to administer antacids is;
a- 1 hour before meals
b- between meals
c- after meals
d- just after waking up
e- just before sleep

21. Which one of the following drugs is NOT used in the treatment of PUD?
a- misoprostol
b- dicyclomine
c- bismuth subsalicylate
d- nizatidine
e- all are used in PUD ttt

22. Prolonged acid suppression with proton pump inhibitors may result in low levels of which vitamin in our bodies?
a- vitamin C
b- vitamin A
c- vitamin B12
d- vitamin B6
e- vitamin E

23. Proton pump secretes hydrogen ions into the gastric lumen in exchange of;
a- Na+
b- K+ 
c- OH-
d- HCO3-
e- Cl-

24. Use of magnesium-containing antacids can most likely cause;
a- cluster headache
b- diarrhea
c- nausea
d- hypertension
e- constipation

25. All of the following anti-peptic ulcer drugs are correctly matched to their pharmacological actions except;
a- misoprostol : activates adenylyl cyclase
b- esomeprazole : blocks proton pump
c- famotidine : blocks H2-histamine receptors
d- dicyclomine : blocks the actions of acetylcholine
e- bismuth subsalicylate :protects ulcerated mucosa

26. Concomitant use of which of the following PPIs with clopidogrel is not recommended?
a- esomeprazole
b- pantoprazole
c- rabeprazole
d- lansoprazole
e- all of the above

27. Which statement is factually WRONG about calcium carbonate?
a- used as a supplement for the prevention of osteoporosis
b- elevated gastric pH impairs its absorption
c- can be given in nephrolithiasis
d- can be given for the management of hyperphosphatemia
e- it occurs naturally in bones

28. Omeprazole can interfere with the effectiveness of Clopidogrel by inhibiting which cytochrome P450 isoform?
a- CYP3A4
b- CYP2D6
c- CYP2C19
d- CYP1A2
e- CYP2E1

29. The following agents are indicated in gastrointestinal problems. Which one is contraindicated in pregnancy?
a- magnesium hydroxide
b- esomeprazole
c- misoprostol
d- cimetidine
e- all of the above

30. In what way, Esomeprazole will affect the activity of Clopidogrel in the body?
a- inhibits the conversion of Clopidogrel to its active form
b- increases the serum concentration of Clopidogrel
c- decreases the serum concentration of Clopidogrel
d- converts Clopidogrel into less-active metabolites
e- no effect on Clopidogrel activity


See Also:

1000 Pharmacy MCQs along with solutions

Answer Keys

MCQ # - Correct option

1 - d
2 - a
3 - d
4 - d
5 - b
6 - a
7 - b
8 - a
9 - e
10 - d

11 - b
12 - b
13 - c 
14 - e
15 - c
16 - c
17 - e
18 - c
19 - b
20 - c

21 - e
22 - c
23 - b
24 - b
25 - a
26 - a
27 - c
28 - c
29 - c
30 - a