Acid Peptic Disorders and Inflammatory Bowel Disease MCQs

Some of the side effects of PPIs Gastrointestinal Nausea, diarrhoea, abdominal pain, flatulence ↑ Risk of C. difficile infection Reactive hypergastrinemia ↓ Absorption of iron and vitamin B12 ↓ Absorption of calcium and magnesium → ↑ risk of osteoporosis in long-term use→ ↑ risk of fractures in elderly individuals Neurological Light headedness, headaches Possibly increased risk of developing cognitive impairment/dementia Others Exanthema Visual disturbances (rare) ↑ Risk of pneumonia In rare cases, acute interstitial nephritis Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 1095

This young Caucasian patient has a history of recurrent respiratory infections caused by Pseudomonas aeruginosa, chronic diarrhea, and failure to thrive. These findings, along with a family history of early sibling death from pulmonary infection, suggest a diagnosis of cystic fibrosis. Steatorrhea and failure to thrive occur as a result of malabsorption due to obstructive fibrosis and progressive insufficiency of the exocrine pancreas . Pancreatic lipase supplementation is likely to improve this patient's condition by enhancing macronutrient and vitamin absorption. Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 1092

Sucralfate is a small molecule that polymerizes in stomach acid and forms a protective coat over the ulcer bed. Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 1110

This woman has symptoms of dyspepsia likely due to gastroesophageal reflux (GERD), a common disorder that occurs with reflux of gastric acid into the oesophagus. Management of patients with frequent symptoms includes lifestyle and dietary modifications (eg, weight loss, avoidance of tobacco) and medications to suppress gastric acid secretion, such as H2 receptor antagonists (eg, ranitidine) and proton pump inhibitors ([PPIs] eg, pantoprazole, omeprazole). PPl are the most effective inhibitors of gastric acid secretion; they bind to and irreversibly inhibit the hydrogen-potassium ATPase on parietal cells . Potential side effects are related to the increased gastric pH and include increased risk of Clostridium difficile infections and nutritional deficiencies (eg, calcium, magnesium, iron). Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 1099

Explanation: The main treatments for GERD involve proton pump inhibitors and prokinetic agents. Domperidone is a prokinetic drug used to manage GERD. It works by tightening the lower esophageal sphincter (LES), which helps prevent stomach contents from refluxing back into the esophagus. Explanation for other options: Ondansetron (Option A): is a 5-HT3 receptor antagonist mainly used to prevent nausea and vomiting, particularly in chemotherapy or post-surgery patients. It is not used to treat GERD. Loperamide (Option C): is an antidiarrheal medication used to manage diarrhea, but it has no role in treating GERD. Diphenoxylate (Option D): is another antidiarrheal drug and does not have any direct application in the treatment of GERD.