Peptic Ulcer Disease
1 Gastric pits of stomach branch into ?
A. 1 or 2 gastric glands
B. 3 or 4 gastric glands
C. 4 or 5 gastric glands
D. 6 or 7 gastric glands
2 Which of the following cells is found deepest in the oxyntic gastric gland ?
A. Mucous neck cells
B. Parietal cells
C. Endocrine cells
D. Chief cells
3 Parietal cell is also known as ?
A. Mucous cell
B. Oxyntic cell
C. Endocrine cell
D. Enterochromaffin-like (ECL) cell
4 Peptic ulcer disease (PUD) occurs due to constant attack on gastroduodenal mucosa by all noxious agents except ?
A. Acid
B. Pepsin
C. Bile acids
D. Salivary amylase
5 PUD occurs due to constant attack on gastroduodenal mucosa by all noxious agents except ?
A. Pancreatic enzymes
B. Alcohol
C. Virus
D. Bacteria
6 Which of the following is an element of gastric mucosal defense system ?
A. Preepithelial
B. Epithelial
C. Subepithelial
D. All of the above
7 First line of defense of gastric epithelium is ?
A. Mucus layer
B. Bicarbonate-phospholipid layer
C. Phospholipid layer
D. Mucus-bicarbonate-phospholipid layer
8 Surface epithelial cells generate which of the following ?
A. Heat shock proteins
B. Trefoil factor family (TFF) peptides
C. Cathelicidins
D. All of the above
9 Trefoil factor family (TFF) peptides were formerly known as ?
A. C-domain peptides
B. D-domain peptides
C. G-domain peptides
D. P-domain peptides
10 Cathelicidin is best related to ?
A. P-domain peptides
B. Antimicrobial peptides (AMPs)
C. Angiogenesis
D. All of the above
11 Restitution of gastric mucosa means ?
A. Proliferation of damaged gastric mucosa
B. Regeneration of damaged gastric mucosa
C. Migration of normal gastric epithelium to damaged areas
D. All of the above
12 Which of the following statements about restitution is false ?
A. Occurs independent of cell division
B. Requires uninterrupted blood flow
C. Requires an alkaline pH in surroundings
D. None of the above
13 Restitution of gastric mucosa is modulated by ?
A. Epidermal growth factor (EGF)
B. Transforming growth factor alpha (TGF-a)
C. Fibroblast growth factor (FGF)
D. All of the above
14 Gastric epithelial cell regeneration is regulated by ?
A. Prostaglandins
B. Epidermal growth factor (EGF)
C. Transforming growth factor-alpha (TGF-a)
D. All of the above
15 Bicarbonate secretion in stomach is stimulated by all except ?
A. Calcium
B. Prostaglandins
C. VIP
D. Luminal acidification
16 Which of the following plays a central role in gastric epithelial defense / repair ?
A. Mucosal bicarbonate
B. Mucus
C. Prostaglandins
D. Growth factor
17 Prostaglandins are important in gastric epithelial defense / repair due to all except ?
A. Release of mucosal bicarbonate and mucus
B. Inhibition of parietal cell secretion
C. Maintaining mucosal lymphatic flow
D. Epithelial cell restitution
18 Key enzyme that controls the rate-limiting step in prostaglandin synthesis is ?
A. Thromboxane A2 (TXA2)
B. Phospholipase A2
C. Cyclooxygenase (COX)
D. Prostacyclin (PGI2)
19 COX-1 is expressed in all except ?
A. Stomach
B. Platelets
C. Kidneys
D. Liver
20 COX-2 is expressed in all except ?
A. Macrophages
B. Leukocytes
C. Platelets
D. Synovial cells
21 Which of the following about acid production in stomach is false ?
A. Basal acid production occurs in a circadian pattern
B. Cholinergic & histaminergic input are the principal contributors to basal acid secretion
C. Stimulated gastric acid secretion occurs in cephalic, gastric & intestinal phases
D. Cephalic phase stimulates gastric secretion via hormones
22 Which of the following about acid production in stomach is false ?
A. Cephalic phase stimulates gastric secretion via vagus
B. Gastric phase is activated when food enters stomach
C. Amino acids stimulate vagus to release gastrin
D. Intestinal phase is mediated by luminal distention
23 Somatostatin acts by ?
A. Direct inhibition of parietal cells
B. Decreased histamine release from ECL cells
C. Decreased gastrin release from G cells
D. All of the above
24 Which of the following about parietal cells is false ?
A. Located in oxyntic gland
B. Does not secrete intrinsic factor
C. Express receptors for histamine, gastrin & acetylcholine
D. Express receptors for ligands that inhibit acid production
25 Gastric acid production is inhibited by ?
A. Prostaglandins
B. Somatostatin
C. EGF
D. All of the above
26 Which of the following statements about enzyme H+, K+-ATPase is false ?
A. Transfers H+ ions from parietal cell cytoplasm to secretory canaliculi in exchange for K+
B. Located within secretory canaliculus & in nonsecretory cytoplasmic tubulovesicles
C. Tubulovesicles are impermeable to K+
D. At rest, 50% of pumps are within secretory canaliculus
27 Which of the following about chief cell is false ?
A. Found primarily in gastric fundus
B. Synthesize & secrete pepsinogen
C. Acid environment converts pepsinogen to pepsin
D. Pepsin activity is irreversibly inactivated & denatured at a pH of >=4
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