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GI, GERD, PUD

Total questions: 60

Worksheet time: 30mins

Name
Class
Date
1.

The gastrointestinal tract is best described as which of the following?

a)

A glandular system approximately 10 feet long

b)

A muscular tube approximately 30 feet long extending from mouth to anus

c)

A hollow organ limited to nutrient absorption

d)

A segmented tube controlled exclusively by the CNS

2.

Which of the following is NOT listed as a primary function of the GI tract?

a)

Ingestion

b)

Absorption

c)

Filtration

d)

Secretion

3.

Which GI tract layer contains blood vessels and glands responsible for secretion?

a)

Serosa

b)

Muscularis externa

c)

Submucosa

d)

Muscularis mucosa

4.

The myenteric (Auerbach) plexus primarily regulates which activity?

a)

Glandular secretion

b)

Contractions of muscularis mucosa

c)

Peristalsis and segmentation

d)

Pain reflexes

5.

Which reflex type transmits signals between different sections of the GI tract including the gastrocolic, enterogastric and colonoileal regions?

a)

Enteric nervous system reflexes

b)

Brainstem reflexes

c)

Prevertebral sympathetic ganglia reflexes

d)

Local mucosal reflexes

6.

Which GI movement is responsible for propulsion of contents via a contractile ring moving toward the anus?

a)

Segmentation

b)

Mixing

c)

Peristalsis

d)

Haustration

7.

Haustration occurs primarily in which region of the GI tract?

a)

Esophagus

b)

Stomach

c)

Small intestine

d)

Large intestine

8.

Which artery supplies the small intestine and proximal colon?

a)

Inferior mesenteric artery

b)

Celiac trunk

c)

Superior mesenteric artery

d)

Hepatic artery proper

9.

Venous blood from the GI tract ultimately enters the liver through which vessel?

a)

Inferior vena cava

b)

Hepatic vein

c)

Portal triad

d)

Hepatic portal vein

10.

Which muscle group elevates the teeth to crush food during mastication?

a)

Buccinator and orbicularis oris

b)

Medial and lateral pterygoids

c)

Masseter and temporalis

d)

Genioglossus

11.

Which salivary gland secretes all of the salivary amylase?

a)

Submandibular

b)

Sublingual

c)

Parotid

d)

Minor salivary glands

12.

Saliva is hypotonic primarily because of which ductal modification?

a)

Active sodium secretion

b)

Passive potassium reabsorption

c)

Active sodium reabsorption

d)

Passive bicarbonate secretion

13.

Which component of saliva plays a key role in killing bacteria?

a)

Mucin

b)

Lysozyme

c)

Amylase

d)

Bicarbonate

14.

Parasympathetic stimulation of salivary glands causes which effect?

a)

Decreased blood flow and thick saliva

b)

No effect on secretion

c)

Increased primary secretion and vasodilation

d)

Only protein-rich saliva production

15.

Which structure prevents food from entering the larynx during swallowing?

a)

Epiglottis

b)

Upper esophageal sphincter

c)

Soft palate

d)

Lower esophageal sphincter

16.

Which gastric cell secretes hydrochloric acid and intrinsic factor?

a)

Chief cell

b)

Mucous neck cell

c)

Parietal cell

d)

Enteroendocrine cell

17.

A deficiency in intrinsic factor results in which condition?

a)

Iron-deficiency anemia

b)

Megaloblastic anemia

c)

Pernicious anemia

d)

Hemolytic anemia

18.

Which enzyme is secreted inactive and gets activated by HCl?

a)

Gastric lipase

b)

Chymosin

c)

Amylase

d)

Pepsinogen

19.

Which statement best describes the primary secretion produced by salivary acinar cells?

a)

Hypotonic and low in electrolytes

b)

Isotonic with plasma and enzyme-rich

c)

Hypertonic with high potassium

d)

Protein-free and mucus-dominant

20.

Which condition would most likely result from chronic lack of saliva?

a)

Reduced protein digestion

b)

Increased gastric acid secretion

c)

Dental decay and oral infections

d)

Vitamin B12 deficiency

21.

Which scenario would most strongly stimulate salivary secretion via reflex pathways?

a)

Deep sleep

b)

Visual and olfactory food cues

c)

Sympathetic denervation

d)

Reduced blood flow to glands

22.

Which drug effect on salivation is correctly paired?

a)

Sleep – increases salivation

b)

Pilocarpine – decreases salivation

c)

Atropine – decreases salivation

d)

Nausea – decreases salivation

23.

Failure of which structure would most directly increase the risk of choking?

a)

Soft palate

b)

Epiglottis

c)

Upper esophageal sphincter

d)

Tongue

24.

The esophageal phase of swallowing is characterized primarily by:

a)

Voluntary skeletal muscle contractions

b)

Local segmentation contractions

c)

Peristaltic propulsion toward the stomach

d)

Haustral contractions

25.

Which gastric cell type protects the stomach lining from autodigestion?

a)

Chief cells

b)

Parietal cells

c)

Mucous neck cells

d)

Enteroendocrine cells

26.

Which secretion is essential for red blood cell maturation?

a)

Pepsin

b)

Gastric lipase

c)

Hydrochloric acid

d)

Intrinsic factor

27.

Which is NOT a function of gastric hydrochloric acid?

a)

Activating pepsin

b)

Killing ingested bacteria

c)

Emulsifying fats

d)

Converting ferric to ferrous iron

28.

Which GI tract layer is primarily responsible for protection and structural support?

a)

Mucosa

b)

Submucosa

c)

Muscularis externa

d)

Serosa

29.

Which structural feature allows the stomach to expand after a meal?

a)

Gastric pits

b)

Gastric glands

c)

Rugae

d)

Haustra

30.

Which motility pattern primarily functions to chop and mix intestinal contents rather than propel them forward?

a)

Peristalsis

b)

Mass movement

c)

Segmentation

d)

Esophageal contraction

31.

Which imbalance is primarily responsible for the development of peptic ulcer disease?

a)

Increased mucus and bicarbonate secretion

b)

Increased prostaglandin synthesis

c)

Increased aggressive factors over defensive factors

d)

Decreased acid secretion

32.

Which of the following is classified as an aggressive factor contributing to peptic ulcer disease?

a)

Prostaglandins

b)

Mucus

c)

Bicarbonate

d)

Pepsin

33.

Which enzyme produced by H. pylori allows it to survive in the acidic gastric environment?

a)

Carbonic anhydrase

b)

Urease

c)

Pepsin

d)

Cyclooxygenase

34.

Which mediator inhibits the acid release from p?

a)

Acetylcholine

b)

Gastrin

c)

Histamine

d)

Prostaglandin E₂

35.

GERD primarily results from:

a)

Increased gastric emptying

b)

Reduced gastric acid production

c)

Reflux of gastric contents into the esophagus

d)

Increased mucus secretion

36.

What is the most common mechanism responsible for GERD?

a)

Hiatal hernia

b)

Obesity

c)

Reduced esophageal peristalsis

d)

Transient lower esophageal sphincter relaxation

37.

Which drug is most associated with anti-androgenic effects?

a)

Famotidine

b)

Ranitidine

c)

Nizatidine

d)

Cimetidine

38.

Which drug’s absorption is reduced when taken with H₂-receptor antagonists?

a)

Warfarin

b)

Phenytoin

c)

Ketoconazole

d)

Digoxin

39.

PPIs reduce gastric acid secretion by:

a)

Competitive inhibition of H₂ receptors

b)

Neutralizing gastric acid

c)

Irreversible inhibition of the proton pump

d)

Inhibiting gastrin release

40.

PPIs require which condition for activation?

a)

Neutral pH

b)

Alkaline environment

c)

Hepatic metabolism only

d)

Acidic secretory canaliculi

41.

Chronic PPI therapy is associated with which adverse effect?

a)

Hypercalcemia

b)

Hypomagnesemia

c)

Hyperkalemia

d)

Hyperphosphatemia

42.

Which PPI interferes with clopidogrel activation?

a)

Pantoprazole

b)

Rabeprazole

c)

Omeprazole

d)

Dexlansoprazole

43.

Sucralfate protects ulcers primarily by:

a)

Neutralizing acid

b)

Blocking proton pumps

c)

Forming a viscous protective barrier

d)

Increasing LES tone

44.

Sucralfate should be avoided in patients with:

a)

Liver failure

b)

Heart failure

c)

Renal failure

d)

Asthma

45.

Which adverse effect is associated with bismuth subsalicylate?

a)

White stools

b)

Blackened tongue

c)

Hyperkalemia

d)

Severe constipation

46.

Misoprostol is contraindicated in:

a)

Elderly patients

b)

Patients with GERD

c)

Pregnant patients

d)

Patients with renal disease

47.

Which antacid is considered systemic?

a)

Magnesium hydroxide

b)

Aluminum hydroxide

c)

Calcium carbonate

d)

Sodium bicarbonate

48.

A common adverse effect of magnesium-based antacids is:

a)

Constipation

b)

Diarrhea

c)

Hypokalemia

d)

Osteomalacia

49.

Vonoprazan reduces acid secretion by:

a)

Blocking histamine release

b)

Inhibiting carbonic anhydrase

c)

Competing at the K⁺ binding site of the proton pump

d)

Neutralizing gastric acid

50.

Which antibiotic is listed as part of anti-H. pylori therapy?

a)

Ciprofloxacin

b)

Amoxicillin

c)

Vancomycin

d)

Ceftriaxone

51.

Metoclopramide improves GI motility primarily by:

a)

Activating dopamine receptors

b)

Blocking acetylcholine

c)

Antagonizing dopamine D₂ receptors

d)

Inhibiting serotonin

52.

Long-term use of metoclopramide carries a risk of:

a)

QT prolongation

b)

Tardive dyskinesia

c)

Renal failure

d)

GI bleeding

53.

A peptic ulcer is best defined as erosion of the mucosal layer extending to:

a)

Submucosa

b)

Muscularis mucosa

c)

Serosa

d)

Lamina propria only

54.

NSAIDs primarily contribute to ulcer formation by:

a)

Increasing gastrin secretion

b)

Increasing histamine release

c)

Inhibiting prostaglandin synthesis

d)

Increasing bicarbonate secretion

55.

H. pylori infection is associated with which of the following malignancies?

a)

Esophageal squamous cell carcinoma

b)

Pancreatic adenocarcinoma

c)

Gastric MALT lymphoma

d)

Colorectal carcinoma

56.

Abrupt discontinuation of PPIs may cause:

a)

Reduced acid secretion

b)

Acid rebound hypersecretion

c)

Hypochlorhydria

d)

Immediate ulcer healing

57.

Long-term PPI therapy increases susceptibility to:

a)

Tuberculosis

b)

Viral hepatitis

c)

Clostridium difficile infection

d)

Fungal esophagitis only

58.

Bismuth subsalicylate contributes to ulcer healing by:

a)

Blocking proton pumps

b)

Providing mucosal coating and antimicrobial activity

c)

Increasing LES tone

d)

Inhibiting histamine release

59.

Chronic aluminum hydroxide use may lead to:

a)

Hyperphosphatemia

b)

Hypophosphatemia

c)

Hypercalcemia

d)

Metabolic alkalosis

60.

Vonoprazan is contraindicated with which medication?

a)

Warfarin

b)

Rilpivirine

c)

Diazepam

d)

Phenytoin

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