Question 1

Which of the following is the main problem causing gastroesophageal reflux disease (GERD)?

Accepted Answer

The main problem is the lack of adequate function of the cardiac sphincter,allowing backflow to occur.The symptoms are exacerbated by eating large meals and by assuming a supine position.In this condition,the stomach contents flow up into the esophagus.Because the esophagus is not designed to endure the stomach's acid irritation,inflammation and erosion can occur.

Question 2

Use of which laxative is able to interfere with the absorption of the fat-soluble vitamins (A,D,E,and K)?

Accepted Answer

Because mineral oil is a hydrophobic oil,fat-soluble vitamins can dissolve in it,and their absorption into the body will be impeded.The other choices are all laxatives,but they do not interfere with the absorption of fat-soluble vitamins.

Question 3

Which of the following gastrointestinal drugs is a phenothiazine used to treat nausea?

Accepted Answer

Prochlorperazine (Compazine)is used to treat severe nausea.Mineral oil is a lubricant that is used to treat constipation.Loperamide is used to treat diarrhea.Lansoprazole is used to treat ulcers and GERD.Ranitidine is used to treat ulcers and GERD.

Question 4

Which agent inhibits the hydrogen/potassium adenosine triphosphate (H⁺/K⁺ ATPase)enzyme system found at the surface of the gastric parietal cell?

Accepted Answer

Proton-pump inhibitors,such as lansoprazole,inhibit gastric H⁺/K⁺ ATPase as their mechanism of action.Ketoconazole is an antifungal agent.Misoprostol is prostaglandin E₂-alpha PGE₂ₐ.Famotidine is a histamine-2 receptor antagonist.Metronidazole is an antibacterial agent.

Question 5

Newer types of combination therapy for treating ulcers often combine an antibiotic with a(n)

Accepted Answer

Newer combinations often use one antibiotic and a PPI such as clarithromycin and esomeprazole (Nexium).These agents are used for 2 weeks and often result in a cure.There are several types of regimens for treating ulcers caused by Helicobacter pylori.A combination of two antiinfective agents,an H₂-blocker or a PPI,and bismuth subsalicylate (Pepto-Bismol)may be used.

Question 6

If a dentist notices a great amount of enamel erosion during a clinical examination,the patient should be referred to his or her primary care physician for evaluation of which of the following?

Accepted Answer

A patient who presents with symptoms of enamel erosion should be referred to his or her primary care physician for further evaluation.It could be due to GERD.Ulcers and Crohn disease will not cause enamel erosion.

Question 7

Which of the following adverse reactions is common to all of the currently marketed H₂-blocking agents?

Accepted Answer

Reversible hepatitis and abnormal liver function tests have been reported with all H₂-blockers.Cimetidine's hematologic effects include granulocytopenia,thrombocytopenia,and neutropenia.Slurred speech,delusions,confusion,and headache are associated with cimetidine.Because cimetidine binds with the androgen receptors,it produces antiandrogenic effects such as gynecomastia,reduction in sperm count,and sexual dysfunction.Neither ranitidine nor famotidine has been found to possess antiandrogenic activity.

Question 8

Sucralfate can be thought of as a "bandage" for ulcers because it inhibits the action of pepsin and absorbs the bile salts.

Accepted Answer

Sucralfate can be thought of as a "bandage" for ulcers because it combines with proteins,forming a complex that binds preferentially with the ulcer site.Sucralfate also inhibits the action of pepsin and absorbs the bile salts.However,the physical form sucralfate takes and the physical protection it provides the ulcer site make it akin to a bandage.All other choices are incorrect.

Question 9

Which histamine-2 (H₂)-blocking agent has been associated with dry mouth and taste alterations?

Accepted Answer

Famotidine has been associated with dry mouth and taste alterations.Cimetidine and ranitidine are H₂-blockers that do not cause xerostomia or taste alterations.Meclizine does cause xerostomia,but is an anticholinergic rather than H₂-blocker.It is used to prevent vomiting,vertigo,and motion sickness.

Question 10

Which of the following is the best non-narcotic analgesic for the management of a dental patient with peptic ulcer disease or gastroesophageal reflux disease?

Accepted Answer

Acetaminophen is the best choice.Avoid the use of aspirin or NSAIDs because they can exacerbate an existing ulcer and further aggravate GERD.Tylenol #3 contains codeine,a centrally acting opioid rather than a peripheral drug.

Question 11

Which of the following agents is a synthetic prostaglandin indicated for NSAID-induced ulcers?

Accepted Answer

NSAIDs inhibit PG synthesis,and PGs have a protective effect on the stomach lining.Misoprostol is a PGE₂ₐ and can replenish the PG in the stomach.It increases gastric mucus and inhibits gastric acid secretion.Ranitidine (Zantac)is an H₂-receptor blocker.Omeprazole/sodium bicarbonate (Zegerid)is a proton-pump inhibitor.Both H₂-blockers and PPIs reduce the symptoms of NSAID-induced ulcers but do not prevent the ulcers.Metoclopramide (Reglan)is a dopamine antagonist.It is indicated for relief of symptoms associated with diabetic gastroparesis and improves delayed gastric emptying time.

Question 12

Which of the following is the most common gastrointestinal disease in the United States population?

Accepted Answer

GERD is the prevalent gastrointestinal disease in the United States.In this condition,the stomach contents,including the acid,reflux,or flow backward through the cardiac sphincter,up into the esophagus.Ulcers may occur in the stomach or the small intestine.Diarrhea is treated with antidiarrheals and laxatives are used for constipation.An autoimmune response is thought to be associated with ulcerative colitis.

Question 13

The following are actions of metoclopramide except one.Which is the exception?

Accepted Answer

Metoclopramide stimulates motility of the upper gastrointestinal tract and increases peristalsis in the duodenum.Metoclopramide is a dopamine antagonist that facilitates cholinergic effects in the gastrointestinal tract.Metoclopramide stimulates the motility of the upper gastrointestinal tract.It increases the tone of the lower esophageal sphincter.

Question 14

A patient with gastroesophageal reflux disease (GERD)may not be able to sit in a supine position in the dental chair due to

Accepted Answer

Acid reflux may prevent the patient from sitting in a supine position.Some patients may not be able to sleep while lying down and may be to raise the head of the bed with bricks or use several pillows.Ulcerative colitis,Crohn disease,and irritable bowel syndrome all involve the lower gastrointestinal tract.

Question 15

Which is the primary concern for a patient diagnosed with Barrett esophagus?

Accepted Answer

Barrett esophagus is normally diagnosed with endoscopy.Barrett esophagus is of concern because a small number of patients can progress to esophageal cancer.Repeated exposure to stomach acid causes a change in the color and composition of esophageal cells.This can lead to a hiatal hernia;however,this is not the most serious potential consequence of having Barrett esophagus.

Question 16

Certain gastrointestinal drugs such as _____ have been abused by patients with _____.

Accepted Answer

Some patients with bulimia misuse laxatives to induce bowel movements.Short-term,occasional use for constipation and prior to diagnostic procedures such as colonoscopy or barium enema are legitimate indications.For other patients,no connection has been established among the drug,the disease,and abuse.

Question 17

Which of the following is a serious possible consequence of gastroesophageal reflux disease (GERD)?

Accepted Answer

Barrett esophagus occurs when the cells of the lower esophagus become damaged as a result of repeated exposure to stomach acid.Barrett esophagus is most often diagnosed in patients with long-term GERD;however,only a small percentage of patients with GERD will go on to develop Barrett esophagus.Ulcerative colitis and Crohn disease are subcategories of chronic inflammatory bowel disease.Barrett esophagus is not associated with intestinal stasis.

Question 18

Which of the following types of drugs is considered first-line therapy for treatment of irritable bowel syndrome (IBD)?

Accepted Answer

Antiinflammatory drugs are usually the first line of therapy in the treatment of IBD.These drugs include sulfasalazine (Azulfidine),mesalamine (Apriso),balsalazide (Colazal),and olsalazine (Dipentum)and work by reducing the symptoms of IBD by decreasing inflammation.Immunosuppressant drugs,such as 6-mercaptopurine (Purinethol)and azathioprine (Imuran),work by blocking the immune reaction that contributes to inflammation.Non-aspirin salicylates,adrenocorticosteroids,immune modifiers,and antibiotics are used to treat IBD;however,they are not first-line therapy.Acute gastritis and symptoms of ulcers are sometimes managed with antacids.

Question 19

Magnesium sulfate should be used with caution in patients with renal impairment because hypermagnesemia has been reported in patients with renal disease.

Accepted Answer

Magnesium salts produce osmotic diarrhea.Magnesium from magnesium sulfate may be absorbed into the body.This magnesium will not be properly excreted through the kidney from patients with renal impairment,and the level of magnesium in the body may become abnormally high.

Question 20

Which type of drugs work by blocking 5-HT₃ receptors in the central nervous system and the chemoreceptor trigger zone?

Accepted Answer

Ondansetron (Zofran),dolasetron (Anzemet),granisetron (Kytril),and palonosetron (Aloxil)control the nausea and vomiting of postoperative and cancer chemotherapeutic agents.The most common adverse effects include constipation or diarrhea,headache,and dizziness.Laxatives include: bulk laxatives,lubricants,stimulants,stool softeners,and osmotics.Antidiarrheals include: opioid-like agents and adsorbents.Antacids are drugs that partially neutralize hydrochloric acid in the stomach.Proton-pump inhibitors affect the hydrogen/potassium adenosine triphosphate enzyme system at the surface of the gastric parietal cell.

Quiz 13: Drugs for the Treatment of Gastrointestinal Diseases

Which of the following is the main problem causing gastroesophageal reflux disease (GERD) ?

Use of which laxative is able to interfere with the absorption of the fat-soluble vitamins (A,D,E,and K) ?

Which of the following gastrointestinal drugs is a phenothiazine used to treat nausea?

Which agent inhibits the hydrogen/potassium adenosine triphosphate (H⁺/K⁺ ATPase) enzyme system found at the surface of the gastric parietal cell?

Newer types of combination therapy for treating ulcers often combine an antibiotic with a(n)

If a dentist notices a great amount of enamel erosion during a clinical examination,the patient should be referred to his or her primary care physician for evaluation of which of the following?

Which of the following adverse reactions is common to all of the currently marketed H₂-blocking agents?

Sucralfate can be thought of as a "bandage" for ulcers because it inhibits the action of pepsin and absorbs the bile salts.

Which histamine-2 (H₂) -blocking agent has been associated with dry mouth and taste alterations?

Which of the following is the best non-narcotic analgesic for the management of a dental patient with peptic ulcer disease or gastroesophageal reflux disease?

Which of the following agents is a synthetic prostaglandin indicated for NSAID-induced ulcers?

Which of the following is the most common gastrointestinal disease in the United States population?

The following are actions of metoclopramide except one.Which is the exception?

A patient with gastroesophageal reflux disease (GERD) may not be able to sit in a supine position in the dental chair due to

Which is the primary concern for a patient diagnosed with Barrett esophagus?

Certain gastrointestinal drugs such as _ have been abused by patients with _.

Which of the following is a serious possible consequence of gastroesophageal reflux disease (GERD) ?

Which of the following types of drugs is considered first-line therapy for treatment of irritable bowel syndrome (IBD) ?

Magnesium sulfate should be used with caution in patients with renal impairment because hypermagnesemia has been reported in patients with renal disease.

Which type of drugs work by blocking 5-HT₃ receptors in the central nervous system and the chemoreceptor trigger zone?