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The correct option is (b) False

Explanation: CIMETIDINE is an H2 receptor antagonist thus used in the TREATMENT of peptic ULCER. It inhibits basal ACID secretion of the stomach including nocturnal secretion. It is readily absorbed after oral administration and has a brief duration of action from 4-8 hr.

The correct answer is (a) True

For explanation I would say: H^+, K^+-ATPase is located in the apical MEMBRANE of the oxyntic cell along the secretory canaliculi. The PUMP requires LARGE amounts of energy that is supplied by intracellular ATP that is why inhibition of H^+, K^+-ATPase blocks both basal and stimulated acid SECRETION.

The CORRECT answer is (c) HISTAMINE

Explanation: Cholinergic NEURON secretes ACETYLCHOLINE that bind to the muscarinic receptor in the parietal cell secrete acid into the gastric lumen. Enterochromaffine like cells secrete histamine which again bind to the H2 receptor and through the cAMP pathway helps the parietal cell to secrete acid. Gastrin secreted by ANTRAL G cell is the hormonal control of acid secretion by parietal cell.

Right OPTION is (c) Enterochromaffine like CELLS

Best explanation: Enterochromaffine like cells secrete histamine which through circulation again go and bind to the H2 receptor and through the cAMP pathway helps the parietal CELL to secrete ACID. Gastrin secreted by Antral G cell is the hormonal control of acid secretion by parietal cell.

Right option is (b) Gastrin

For explanation I would SAY: Gastrin secreted by Antral G cell is the hormonal control of acid secretion by parietal cell. Gastrin, Histamine and acetylcholine switch on the PROTON pump thus pumping H+ ions to produce acid in the GASTRIC lumen. Acid in our STOMACH is secreted by the parietal CELLS. Mucous is secreted by the goblet cells.

Right choice is (b) Parietal cells

Explanation: Cholinergic neuron SECRETES ACETYLCHOLINE that through circulation GOES and bind to the muscarinic receptor in the parietal cell secrete acid into the gastric lumen. ENTEROCHROMAFFINE like cells secrete histamine which again go and bind to the H2 receptor and through the cAMP pathway helps the parietal cell to secrete acid.

The correct ANSWER is (d) Acid

To explain I would say: ENTEROCHROMAFFINE like cells secrete histamine which again go and bind to the H2 receptor and through the cAMP pathway helps the parietal cell to secrete acid. Gastrin SECRETED by Antral G cell is the hormonal CONTROL of acid secretion by parietal cell. Acid in our stomach is secreted by the parietal cells. Mucous is secreted by the GOBLET cells.

The correct choice is (a) Acetylcholine

Explanation: Cholinergic neuron secretes acetylcholine that through circulation goes and bind to the muscarinic receptor in the parietal cell secrete ACID into the gastric lumen. Enterochromaffin-like CELLS secrete histamine which again goes and binds to the H2 receptor and through the cAMP pathway helps the parietal cell to secrete acid. GASTRIN secreted by Antral G cell is the hormonal control of acid secretion by the parietal cell. Gastrin, Histamine, and acetylcholine switch on the proton PUMP thus pumping H+ ions to produce acid in the gastric lumen.

The correct answer is (a) ACETYLCHOLINE

For explanation I would say: NEURONAL control is done by SECRETION of acetylcholine by the cholinergic neuron. HORMONAL control of gastric acid is done by gastrin. Paracrine control of gastric acid is done by histamine secreted by enterochromaffin-like CELLS.

Right answer is (c) PEPTIC cells

To EXPLAIN: Peptic cells in the stomach lining is ALSO known as a chief cell. The stomach lining has PARIETAL cells that secrete acid, Goblet cells, mucous neck cells, superficial epithelial cells. All these cells can be found in the body and fundus of the stomach.

The correct choice is (d) Antibody test, Urease CLO test, Histology and culture

The best explanation: The majority of cases of peptic ulcer disease are related to H. pylori. The DIAGNOSIS of H. pylori INFECTION MUST be confirmed prior to initiation of therapy. The methods can be histology and culture, antibody test, urease CLO test. H. pylori have a high activity of the ENZYME urease which enables it to colonize in the stomach. Infection can spread through fecal route. Infection thought to OCCUR between parents and young children.

Correct option is (a) Urease

For explanation I WOULD say: H. pylori primarily colonize in the antrum of the stomach it resides mainly within the gastric mucus. H. pylori have a high ACTIVITY of the enzyme urease which enables it to colonize in the stomach. Infection can spread through fecal route. Infection thought to OCCUR between PARENTS and young children.

Right choice is (a) True

To EXPLAIN I would say: Peptic ulcer disease affects all age GROUPS can occur in children, although rare, duodenal ulcers tend to occur first at around the age 25 and continue until the age of 75. Gastric ulcers PEAK in people between the ages of 55 and 65. Men have twice the risk as women do. High levels of acid production, weakness in the mucosal layer, abnormal non-productive mucus production. Increase Acid Production and/or Decrease in Bicarbonate and PG Production.

Right choice is (b) A benign lesion of gastric MUCOSA

Explanation: A benign lesion of gastric or duodenal mucosa occurring at a site where the MUCOSAL epithelium is exposed to acid and PEPSIN. It can be caused by excess acid PRODUCTION or an intrinsic defect in the mucosal defence barrier. High levels of acid production, weakness in the mucosal layer, abnormal NON protective mucus production.

The correct option is (b) OVERPRODUCTION of acid and over relaxation of lower esophageal sphincter

The BEST explanation: GERD or Gastro Oesophageal Reflux Disease is when acid and PEPSIN from the stomach flows backward up into the ESOPHAGUS OFTEN called heartburn. Gastric juice contains both acid and pepsin. It can happen due to overproduction of acid/pepsin or over the relaxation of Lower Esophageal Sphincter.

The correct answer is (C) Amoxicillin

For explanation: Anti H. pyloric drugs are amoxicillin, tinidazole, and TETRACYCLINE. These are range of antibiotics which are used to kill the microbes residing in our STOMACH. Neutralization of gastric acid by antacids are by sodium carbonate, magnesium hydroxide, ETC. Ulcer protectives are such as sucralfate, Colloidal Bismuth Subricate. H2 antihistamines are cimetidine. Proton pump inhibitor will be OMEPRAZOLE. Prostaglandin analogues are misoprostol.

Right OPTION is (c) Sucralfate

The best explanation: Ulcer protectives are such as sucralfate, Colloidal Bismuth Subricate. These drugs have the TENDENCY to bind to damaged proteins. Thus they binds to the corroded area of the stomach forms a layer and HELPS preventing further damage. Neutralization of gastric ACID by antacids are by sodium carbonate, MAGNESIUM hydroxide, etc.

Correct choice is (c) Mg hydroxide

For explanation: Neutralization of gastric acid by antacids are by sodium carbonate, magnesium hydroxide, etc. ULCER protectives are such as sucralfate, Colloidal Bismuth Subricate. Anti H. pyloric drugs are AMOXICILLIN, tinidazole, and tetracycline.H2 antihistamines are cimetidine. Proton PUMP inhibitor will be OMEPRAZOL. Prostaglandin analogues are misoprostol.

Correct choice is (c) Pirenzepine

Explanation: Anticholinergics are Pirenzepine and PROSTAGLANDIN analogues are misoprostol. H2 antihistamines are cimetidine. PROTON pump inhibitor will be omeprazole. Neutralization of gastric acid by ANTACIDS are by sodium carbonate, magnesium hydroxide, etc. ULCER protectives are such as sucralfate, Colloidal Bismuth Subricate.

The correct option is (b) Omeprazole

The BEST I can explain: H2 RECEPTOR blockage antihistamine function by reducing gastric ACID secretion. H2 antihistamines are cimetidine. Proton pump inhibitor will be omeprazole, lansoprazole, pantoprazole. These drugs GOES and binds to the proton PUMPS thus inhibiting further release of any protons to produce acids.

Right option is (a) Inhibits histamine and gastrin-RELEASING cells

Explanation: Somatostatin releasing cells inhibits the histamine and gastrin releasing cells and THUS regulates the secretion. Vagus nerve provides a SIGNAL which stimulates histamine releasing cells i.e. enterochromaffin cells. Acetylcholine works on acetylcholine receptors and leads to H+ ions release. Gastrin releasing cells release gastrin which further AID the process.

The CORRECT answer is (a) Captopril

Best explanation: Diuretics example is furosemide, Hydrochlorothiazide. A beta-blockers example is Atenolol, PROPRANOLOL. ACE inhibitors are captopril, enalapril. Calcium channel blocker examples are amlodipine, DILTIAZEM.

The correct choice is (b) ANGIOTENSIN CONVERTING enzyme

For explanation: Renin is a very IMPORTANT enzyme which is used to convert the Angiotensinogen to Angiotensin I. The renin is releases by juxtaglomerular cells of kidney. Angiotensin I is CONVERTED to angiotensin II in the presence of angiotensin converting enzyme. Angiotensin converting enzyme gets attached to the angiotensin II receptor sites PRESENT in blood vessels and capillaries of lungs.

Right option is (d) Intake of LOTS of protein rich food

Easiest explanation: The steps of treating HTN are lifestyle modification, first-line treatment, second-line treatment, third line treatment. Usually, by routine doctor’s visit, one high BP reading does not mean you have HTN thus it is always recommended to TAKE repeated BP reading will be done at different positions, complete physical, MEDICAL and FAMILY history will be performed, risk FACTORS are identified.

Right CHOICE is (b) Increasing contractility

Easy EXPLANATION: Stress leads to DECREASED filtration surface for the nephrons, over activity of the sympathetic nervous system and excess secretion of renin-angiotensin. Over activity of the sympathetic nervous system leads to an increase of the contractility of the blood vessel. Thus narrowing of the blood vessel means more FLUID flowing through a narrow route and an increase of the pressure per sq. centimetre. This increases the blood pressure.

The CORRECT OPTION is (b) Angiotensin-converting enzyme INHIBITOR

The explanation: Second-line treatment which includes adding drugs such as Angiotensin Converting Enzyme (ACE) Inhibitor, Calcium Channel Blocker, Angiotensin II Receptor Blocker (ARB), α- blocker, α- and β-blocker. And line should be given when 1^st line treatment with lifestyle modification, initial drug selection should be diuretic, beta-blocker is in adequate. If 2^nd line treatment is INADEQUATE, continue to third line treatment increase drug dose or SUBSTITUTE another drug or add a second drug from another class. If inadequate may need to do further studies serious organ damage may be present.

The correct option is (c) Fluid volume

To explain I would say: Blood pressure depends upon cardiac output, CONTRACTILITY, fluid volume, PERIPHERAL vascular resistance. Blood pressure is affected by the nervous system, kidney functions, hormonal changes, capillary fluid shift. A person is told to have a higher blood pressure when the systolic blood pressure is higher than 140 MMHG and diastolic blood pressure is higher than 90 mmHg.

The correct option is (a) More than 140 mm Hg

Explanation: A person is told to have a higher blood pressure when the systolic blood pressure is higher than 140 mmHg and diastolic blood pressure is higher than 90 mmHg. Blood pressure is the force of blood exerted on arteries as it FLOWS through them. A NORMAL healthier person has BP systolic LESS than 120 mmHg and diastolic less than 80 mmHg.

Right ANSWER is (d) When lower oesophagus gets lined by red coloured tissue

To explain: GERD or Gastro Oesophageal Reflux Disease has many severe complications such as severe chest pains, bleeding or a pre-malignant change in the lining of the ESOPHAGUS called Barrett’s esophagus – can result in adenocarcinoma. Barret’s esophagus causes histological changes in the cells lining esophagus ASSOCIATED with adenocarcinoma of the esophagus.

The correct option is (C) Increase drug dose

Explanation: Third line treatment is INCREASING drug dose or substitute ANOTHER drug or add a second drug from another class. 1^st line treatment should CONTINUE with lifestyle modification, initial drug selection should be diuretic, beta-blocker. If inadequate, continue to second-line treatment which includes adding drugs such as Angiotensin Converting Enzyme (ACE) Inhibitor, Calcium CHANNEL Blocker, Angiotensin II Receptor Blocker (ARB), α- blocker, α- and β-blocker.

Correct answer is (b) More than 90 mm Hg

Easiest explanation: A person is told to have a higher blood pressure when the diastolic blood pressure is higher than 90 mmHg and the SYSTOLIC blood pressure is higher than 140 mmHg. Diastolic is the MEASURE of the force of the blood on the artery walls when the ventricles SQUEEZE the blood so that it can go to our different BODY parts.

Right answer is (c) Sucralfate

Explanation: Ulcer protectives also KNOWN as mucoprotective drugs have a natural TENDENCY to get bind with damaged proteins. Such drugs binds with the corroded part of our STOMACH DUE to ulcer and form a PROTECTIVE layer around it. Drugs such as sucralfate, Colloidal Bismuth Subricate are mucoprotective drugs. Anti H. pyloric drugs are amoxicillin, tinidazole, and tetracycline.

The correct OPTION is (a) Diuretic

Easiest explanation: 1^st line treatment should continue with lifestyle MODIFICATION, initial drug selection should be diuretic, beta-blocker. If inadequate, continue to second-line treatment which includes adding drugs such as Angiotensin Converting Enzyme (ACE) Inhibitor, Calcium Channel Blocker. If inadequate, continue to third line treatment increase drug dose or Substitute another drug or add a second drug from another class. If inadequate may need to do further STUDIES serious organ damage may be PRESENT.

Right OPTION is (d) Antral G cell

The explanation is: Cholinergic neuron secretes acetylcholine that through circulation GOES and bind to the muscarinic receptor in the parietal cell secrete acid into the gastric lumen. Enterochromaffine like cells secrete HISTAMINE which again go and bind to the H2 receptor and through the cAMP pathway helps the parietal cell to secrete acid. Gastrin secreted by Antral G cell is the hormonal control of acid secretion by parietal cell. Gastrin, Histamine and acetylcholine SWITCH on the proton pump thus pumping H+ ions to produce acid in the gastric lumen.

The correct option is (b) Gastrin

The explanation: Neuronal control is done by SECRETION of ACETYLCHOLINE by the cholinergic NEURON. HORMONAL control of gastric acid is done by gastrin. Paracrine control of gastric acid is done by histamine secreted by enterochromaffin-like cells.

The correct OPTION is (a) True

The best explanation: The side effects of Beta blockers are fatigue, orthostatic hypotension, weakness, BLURRED vision, stuffy nose, impotence, rash, bradycardia, pulmonary edema. Treatment of side effects is changing position slowly, SIT at the edge of bed or chair for a few minutes before standing up, drink an adequate AMOUNT of fluids, contact physician in more serious CASE to adjust the dose or change the medication.

Right answer is (c) Heart

Explanation: Beta blockers are Beta-adrenergic receptor blockers – they block the ACTION of ADRENALIN and Noradrenaline (SNS stimulants), which are involved in “Fight-or-flight’ response. There are two types of Beta receptors β1 – FOUND mostly in the heart and β2 – found mostly in the lungs.

Correct answer is (d) Need further studies

The EXPLANATION is: 1st line treatment should continue with lifestyle modification, initial drug selection should be diuretic, beta-blocker. If INADEQUATE, continue to SECOND-line treatment which includes adding drugs such as Angiotensin Converting Enzyme (ACE) Inhibitor, Calcium Channel Blocker, Angiotensin II Receptor Blocker (ARB), α- blocker, α- and β-blocker. If inadequate, continue to third line treatment increase drug dose or Substitute another drug or add a second drug from another class. If inadequate may need to do further studies SERIOUS organ DAMAGE may be present.

Correct choice is (a) Renin

To EXPLAIN I would say: The juxtaglomerular cells of kidney release renin, this renin HELPS to convert angiotensinogen to angiotensin I. Angiotensin converting enzyme helps to convert angiotensin I to angiotensin II which gets attached to the angiotensin II receptor SITES present in blood vessels and CAPILLARIES of lungs. CALCIUM channel blockers work in the vascular smooth muscle and decrease muscle contraction.

Right option is (d) More than 160 mm Hg SYSTOLIC and more than 100 mm Hg DIASTOLIC

To explain: A person has STAGE 1 hypertension when he/ she has BLOOD pressure 140-159 mm Hg Systolic and 90-99 mm Hg diastolic and stage 2 hypertension when more than 160 mm Hg Systolic and more than 100 mm Hg diastolic. A normal HEALTHIER person has BP systolic less than 120 mmHg and diastolic less than 80 mmHg.

The correct answer is (a) Cimetidine

Explanation: H2 receptor blockage ANTIHISTAMINE function by reducing gastric acid SECRETION. H2 antihistamines are cimetidine, RANITIDINE, famotidine. Proton PUMP inhibitor will be omeprazole. Anticholinergics are Pirenzepine and prostaglandin analogues are misoprostol. Neutralization of gastric acid by antacids are by sodium carbonate.

The correct choice is (a) Nervous SYSTEM

The explanation is: Nervous system doesn’t directly AFFECT the BLOOD pressure of our body. Cardiac output, contractility, peripheral vascular resistance plays a huge role in determining the blood pressure of a person. Blood pressure depends upon cardiac output, contractility, fluid volume, peripheral vascular resistance. Blood pressure is AFFECTED by the nervous system, kidney FUNCTIONS, hormonal changes, capillary fluid shift.

The correct answer is (c) 140-159 MM Hg Systolic and 90-99 mm Hg DIASTOLIC

Explanation: A person is told to have a higher blood PRESSURE when the systolic blood pressure is higher than 140 MMHG and diastolic blood pressure is higher than 90 mmHg. Blood pressure is the force of blood exerted on arteries as it flows through them. A normal HEALTHIER person has BP systolic less than 120 mmHg and diastolic less than 80 mmHg. A person has stage 1 hypertension when he/ she has Blood pressure 140-159 mm Hg Systolic and 90-99 mm Hg diastolic and stage 2 hypertension when more than 160 mm Hg Systolic and more than 100 mm Hg diastolic.