The document discusses various topics related to gastrointestinal disorders and their treatment. It covers the causes of peptic ulcer disease, medications used to treat ulcers like proton pump inhibitors, treatments for constipation and diarrhea, antiemetics used for nausea and vomiting, and antidepressants. It also discusses the endocrine system, hormones produced and their functions, thyroid disorders and treatments, and basics of antimicrobial therapy.

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1 The two main causes of peptic ulcer disease are infection with_________ and the use
of Non-steroidal anti-inflammatory drugs (NSAIDs)
a) Gram-negative Helicobacter pylori
b) Staphylococcus
c) Streptococcus
d) None of these
2 Which of the following is correct about the Proton Pump Inhibitors (PPIs)?
a) They block the H+/K+-ATPase proton pump
b) They block the H2 receptors
c) They block the Na+/K+ -ATPase pump
d) None of the above
3 Prostaglandin E, produced by the gastric mucosa, inhibits secretion of acid and
stimulates secretion of mucus and bicarbonate (cytoprotective effect), the synthetic
analog of prostaglandin E1 is...........
a) Clopidogrel
b) Labetalol
c) Misoprostol
d) Esomeprazole
4 Antacids are weak bases that react with gastric acid to form water and a salt
to..................
a) Decrease the stomach pH
b) Increase acid production
c) Diminish gastric acidity
d) Both A & B
5 All are the H2 receptor blockers EXCEPT.......
a) Nizatidine
b) Cimetidine
c) Famotidine
d) Sucralfate
6 Laxatives are commonly used for constipation to accelerate the movement of food
through the GI tract, which of the following is a laxative
a) Aluminum hydroxide
b) Loperamide
c) Omeprazole
d) Docusate
7 One of the following laxative, works by activating chloride channels to increase fluid
secretion in the intestinal lumen
a) Lubiprostone

2. 2
b) Sodium Picosulfate
c) Senna
d) Aloe
8 Surface-active agents that become emulsified with stool produce softer feces and
ease passage are called..............
a) Bulk Forming laxatives
b) Osmotic Laxatives
c) Stool softeners Or Emollient Laxatives
d) None of the above
9 Which of the following is an osmotic laxative?
a) Polyethylene glycol (PEG)
b) Methylcellulose
c) Psyllium
d) All of above
10 Which of the following medications for gastrointestinal problems is contraindicated
in pregnancy?
a) Calcium carbonate
b) Famotidine
c) Lansoprazole
d) Misoprostol
11 Patients with peptic ulcer disease (duodenal or gastric ulcers) who are infected with
H. pylori require antimicrobial treatment e.g Triple therapy (is used) which include
the following Drugs EXCEPT.......
a) Proton Pump Inhibitor
b) Amoxicillin or Metronidazole
c) Bulk forming laxative
d) Clarithromycin
12 Increased motility of the GI tract and decreased absorption of fluid are major factors
in diarrhea, which of the following drugs activate presynaptic opioid receptors in the
enteric nervous system to inhibit acetylcholine release and decrease peristalsis
a) Diphenoxylate
b) Loperamide
c) Both A & B
d) None of the above
13 Adsorbent (such as aluminum hydroxide) is used to control.......
a) Diarrhea
b) Constipation
c) Emesis

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d) None of the above
14 Anti-emetic drugs are used to treat................
a) Constipation
b) Diarrhea
c) Abdominal Pain
d) Nausea and vomiting
15 Which of the following antiemetic is a 5HT3-receptor antagonist?
a) Ondansetron
b) Scopolamine
c) Dimenhydrinate
d) None of above
16 Substance P/neurokinin-1 receptor blocker ____________ targets the neurokinin
receptor in the brain and blocks the actions of the natural substance
a) Ondansetron
b) Proton pump Inhibitor
c) Aprepitant
d) None of above
17 One of the following anti-emetics is a dopamine (D2) receptor blocker
a) Ondansetron
b) Aprepitant
c) Domperidone
d) Scopolamine
18 The mechanism of Action of Dimenhydrinate is..............
a) Blocks H2 Receptors
b) Blocks H1 Receptors
c) Blocks NK1 receptors
d) Opioid agonist
19 All of the following drugs are anti-emetics EXCEPT....
a) Metoclopramide
b) Ondansetron
c) Prochlorperazine
d) Morphine
20 Chemotherapeutic agents are responsible for chemotherapy induced Nausea and
vomiting (CINV), the mechanism may be
a) They can directly activate the medullary CTZ or vomiting center
b) They activate dopamine receptor type 2 (D2) and serotonin type 3 (5-HT3)
c) Colour or smell of chemotherapeutic drugs activates higher brain center and
trigger vomiting

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d) All of the above
21 Anxiety is an unpleasant state of................
a) Tension
b) Apprehension
c) Uneasiness
d) All of above
22 The symptoms of depression include the following EXCEPT
a) Feelings of sadness and hopelessness
b) Chest pain with difficulty in breathing
c) Changes in sleep patterns and appetite, loss of energy, and suicidal thoughts
d) Inability to experience pleasure
23 All are the benzodiazepine EXCEPT
a) Diazepam
b) Midazolam
c) Alprazolam
d) Carbapenems
24 Benzodiazepines are widely used anxiolytic drugs, the targets for benzodiazepine
actions are........
a) The γ-aminobutyric acid (GABAA) receptors
b) Opioid receptors
c) Beta receptors
d) None of above
25 Activation of GABA receptor causes
a) Opening of Na+ channel
b) Opening of Cl- channel
c) Closure of Cl- channel
d) Opening of Ca2+ channel
26 GABA receptor antagonist that can rapidly reverse the effects of benzodiazepines is
a) Diazepam
b) Midazolam
c) Flumazenil
d) Phenobarbital
27 Very short-acting barbiturate which have been used to induce Anaesthesia but is
infrequently used today
a) Thiopental
b) Labetalol
c) Propranolol

5. 5
d) Propofol
28 The Adverse effects which are more associated with CNS drugs are
a) Tolerance & Dependence
b) Withdrawal effects
c) There are no significant adverse effects
d) Both A & B
29 Barbiturates potentiate GABA action on chloride entry into the neuron by prolonging
the duration of the_______________
a) Ca2+ Channels opening
b) Na+ Channels opening
c) Cl- Channels opening
d) None of above
30 Stimulation of (Melatonin) MT1 and MT2 receptors by __________is thought to
induce and promote sleep, is indicated for the treatment of insomnia characterized
by difficulty falling asleep (increased sleep latency)
a) Diazepam
b) Ramelteon
c) Midazolam
d) Propofol
31 Mono-amine theory proposes that depression is due to deficiency of monoamines
such as___________ at certain sites in brain
a) Noradrenaline
b) Serotonin
c) both a & b
d) None of above
32 The selective serotonin reuptake inhibitors (SSRIs) are a group of antidepressant
drugs that specifically inhibit serotonin reuptake, drug(s) include________
a) Citalopram
b) Escitalopram
c) Sertraline
d) All of above
33 Following are the Tricyclic anti-depressants EXCEPT
a) Amitriptyline
b) Protriptyline
c) Nortriptyline
d) Aminophylline
34 Mechanism of Action of Tricyclic anti-depressants is__________
a) Inhibits the neuronal reuptake of norepinephrine and serotonin

6. 6
b) They also block serotonergic, α-adrenergic, histaminic, and muscarinic
receptors
c) They acts on GABA receptors
d) Both A & B
35 Serotonin/norepinephrine reuptake Inhibitors (SNRIs) Include the following drug(s)
a) Duloxetine
b) Venlafaxine
c) Both A & B
d) None of above
36 MAOIs may irreversibly or reversibly inactivate the enzyme, permitting
neurotransmitters to escape degradation and, therefore, to accumulate within the
presynaptic neuron and leak into the synaptic space, which of the following drug is
MAO Inhibitor
a) Phenelzine
b) Citalopram
c) Amitriptyline
d) Nortriptyline
37 One of the following is not an antidepressant
a) Citalopram
b) Venlafaxine
c) Phenobarbital
d) Sertraline
38 Overdose of Tricyclic antidepressants can result in (3Cs)................
a) Convulsions, Comma, Cardiotoxicity
b) Cardiomegaly, Confusion, Comorbidities
c) Cardiomyopathy, Cholera, Constipation
d) CO2 retention, Coronary artery disease, Chronic Hepatitis
39 Mania is characterized by the opposite behavior:
a) Enthusiasm, anger, rapid thought and speech patterns
b) Extreme self-confidence
c) Impaired judgment
d) All of the above
40 Which of the following drug is not a MAO inhibitor?
a) Phenelzine
b) Selegiline
c) Sertraline
d) Both A & B

7. 7
41 The neuroendocrine system, which is controlled by the pituitary and hypothalamus,
coordinates body functions by transmitting messages between
a) Individual cells and tissues
b) Between two neurones
c) Hormones
d) None of these
42 The hormones secreted by the hypothalamus and the pituitary are
all________________ that act by binding to specific receptor sites on their target
tissues
a) Peptides or low molecular weight proteins
b) High molecular weight proteins
c) Peptides with high molecular weight proteins
d) Steroids
43 The hormones of the anterior pituitary are regulated by neuropeptides that are
called
a) Releasing or Inhibitory factors
b) Releasing or Inhibitory Hormones
c) Both a & b
d) None of above
44 Hormones of the anterior and posterior pituitary are administered by following
route(s)
a) Intramuscularly (IM), subcutaneously, or intranasally
b) Rectal route
c) Sub lingual route
d) None of the above
45 Secretion of GH is inhibited by another hypothalamic hormone called
a) Somatotropin
b) Corticotrophin releasing hormone
c) Thyroid releasing Hormones
d) Somatostatin
46 In the pituitary, somatostatin binds to receptors that suppress GH and thyroid-
stimulating hormone release, Somatostatin analog is called
a) Leuprolide
b) Octreotide
c) Selegiline
d) None of above
47 The synthetic analog of GnRH is
a) Leuprolide

8. 8
b) Octreotide
c) Somatropin
d) None of above
48 Following are the uses of Growth hormone EXCEPT
a) Growth Hormone deficiency in children
b) Growth failure due to Prader-Willi syndrome
c) Management of AIDS wasting syndrome
d) Used for the treatment of Acromegaly
49 Vasopressin and Oxytocin are the hormones of _____________, they are not
regulated by releasing hormones
a) Anterior lobe of Pituitary
b) Posterior lobe of pituitary
c) Intermediate lobe of pituitary
d) Both A & B
50 Vasopressin is also called antdiuretic hormone which has antdiuretic and vasopressor
effects, its synthetic analog is_________
a) Oxytocin
b) Desmopressin
c) Streptomycin
d) None of above
51 Inadequate secretion of thyroid hormone results in bradycardia, poor resistance to
cold, and mental and physical slowing this condition is called_________
a) Hypothyroidism
b) Hyperthyroidism
c) Both a & b
d) None of above
52 Excess secretion of thyroid hormones can cause tachycardia and cardiac arrhythmias,
body wasting, nervousness, tremor, and heat intolerance this condition is known
as__________
a) Hypothyroidism
b) Hyperthyroidism
c) Both a & b
d) None of these
53 Which of the following statement is incorrect about the thyroid hormones?
a) T3 and T4 are secreted by thyroid gland
b) T3 and T4 are absorbed after oral administration
c) Food, calcium preparation, and aluminum-containing antacid do not affect
the absorption of T4

9. 9
d) Deiodination is the major route of metabolism of T4
54 Which of the following is the treatment of choice for hypothyroidism?
a) Iodide
b) Levothyroxine
c) Both a & b
d) None of above
55 Surgical removal of thyroid gland is done to treat_________
a) Hypothyroidism
b) Hyperthyroidism
c) Dwarfism
d) Acromegaly
56 Adrenocorticotropic hormone (ACTH), causes the release of Cortisol from the adrenal
cortex, Cortisol is responsible for the following actions______
a) Anti-inflammatory actions
b) Increased Gluconeogenesis
c) Increased protein breakdown
d) All of above
57 Oxytocin is used in obstetrics to
a) Stimulate uterine contraction
b) Induce labor
c) Both A & B
d) None of these
58 Physiologic effects of GH are exerted directly at its targets, others are mediated
through the
___________insulin-like growth factors 1 and 2
a) Somatostatin
b) Somatomedins
c) TNF
d) Cytokines
59 Hormones of Anterior and posterior pituitary are administered via IM, SC or
Intranasally because
a) They cannot absorbed from GIT
b) Susceptible to destruction by proteolytic enzymes of GIT
c) They are water soluble
d) Both a & c
60 Gonadotropins Releasing Hormone (GnRH) cause the release of following hormones
from anterior pituitary
a) ACTH, Growth hormone

10. 10
b) Oxytocin, vasopressin
c) FSH, LH
d) Prolactin
61 Selection of the most appropriate antimicrobial agent requires knowing EXCEPT
a) The organism’s identity
b) The organism’s susceptibility to a particular agent
c) The site of the infection
d) Patient gender
62 Immediate administration of drug(s) prior to bacterial identification and susceptibility
testing is called
a) Empiric therapy
b) Enteric therapy
c) Non-specific therapy
d) Specific therapy
63 The drug which arrest the growth and replication of bacteria at serum (or urine)
levels achievable in the patient is known as
a) Bacteriostatic drug
b) Bactericidal drug
c) Both a & b
d) None of above
64 ____________ is the lowest antimicrobial concentration that prevents visible growth
of an organism after 24 hours of incubation
a) Minimum bactericidal concentration
b) Minimum excitatory concentration
c) Minimum inhibitory concentration
d) None of these
65 The Chemotherapeutic agents acting only on a single or a limited group of
microorganisms are said to have a____________
a) Extended-spectrum antibiotics
b) Broad-spectrum antibiotics
c) Narrow spectrum antibiotics
d) All of the above
66 66. Bacteria are considered resistant to an antibiotic if the maximal level of that
antibiotic _________, (that can be tolerated by the host)
a) Halt their growth
b) Does not halt their growth
c) Completely eliminate bacteria
d) Kill all the bacteria

11. 11
67 Drug resistance is mediated by a variety of mechanisms such as
a) Modification of target sites
b) Decreased accumulation
c) Enzymatic inactivation
d) All of the above
68 One of the following is a 3rd Generation Cephalosporin
a) Cefadroxil
b) Cefaclor
c) Ceftriaxone
d) Cefepime
69 Penicillins are the antimicrobial drugs that interfere with
a) Synthesis of the bacterial cell wall
b) Synthesis of the bacterial proteins
c) Synthesis of bacterial DNA
d) None of these
70 One of the following drugs is not a macrolide
a) Azithromycin
b) Streptomycin
c) Clarithromycin
d) Erythromycin
71 The Mechanism of Action of Tetracyclines is
a) Cell wall synthesis inhibition
b) Protein synthesis inhibition
c) DNA synthesis inhibition
d) None of these
72 Carbapenems are the Cell wall synthesis inhibitors; one of the following drugs
belongs to Carbapenems
a) Penicillin G
b) Cefepime
c) Imipenem
d) Cefixime
73 Aminoglycoside drugs include all of the following EXCEPT_______
a) Gentamicin
b) Neomycin
c) Streptomycin
d) Doxycycline
74 DNA synthesis inhibitors include the following group of drugs
a) Aminoglycoside

12. 12
b) Cephalosporins
c) Carbapenems
d) Fluoroquinolones
75 Following drug(s) belongs to Fluoroquinolones
a) Ciprofloxacin
b) Levofloxacin
c) Pefloxacin
d) all of above
76 Inhalation Anaesthetic agents include the following EXCEPT
a) Halothane
b) Propofol
c) Isoflurane
d) Sevoflurane
77 All the inhaled anaesthetics are volatile halogenated hydrocarbons EXCEPT
a) Nitrous Oxide
b) Oxygen
c) Both a & b
d) None of these
78 Lidocaine is a_____________
a) General Anaesthetic
b) Local Anaesthetic
c) Barbiturate
d) Benzodiazepine
79 Propofol is used for__________
a) Induction and maintenance of anesthesia
b) Local anesthesia
c) Inhalation anaesthesia
d) None of above
80 Local anaesthetic agents include the following drugs EXCEPT
a) Procaine
b) Lidocaine
c) Succinylcholine
d) Bupivacaine

13. 13
Answers
1. A 11. C 21. D 31. C 41. A 51. A 61. D 71. B
2. A 12. C 22. B 32. D 42. A 52. B 62. A 72. C
3. C 13. A 23. D 33. D 43. C 53. C 63. A 73. D
4. C 14. D 24. A 34. D 44. A 54. B 64. C 74. D
5. D 15. A 25. B 35. C 45. D 55. B 65. C 75. D
6. D 16. C 26. C 36. A 46. B 56. D 66. B 76. B
7. A 17. C 27. A 37. C 47. A 57. C 67. D 77. A
8. C 18. B 28. D 38. A 48. D 58. B 68. C 78. B
9. A 19. D 29. C 39. D 49. B 59. B 69. A 79. A
10. D 20. D 30. B 40. C 50. B 60. C 70. B 80. C