GI Disorders: GERD, Ulcers & Gastritis Quiz

1. Which medication class is first-line treatment for both GERD and peptic ulcers?

Antacids

Proton pump inhibitors

Anticholinergics

Sucralfate

2. Which symptom pattern best distinguishes a gastric ulcer from a duodenal ulcer?

Gastric: pain with food; duodenal: pain relieved by food

Gastric: severe bleeding; duodenal: mild symptoms

Gastric: nausea only; duodenal: heartburn only

Both present identically

3. A patient taking clopidogrel develops gastric bleeding. Why is PPI use cautious in this setting?

PPIs are ineffective for bleeding

PPIs may reduce clopidogrel effectiveness

PPIs cause ulcers

PPIs increase bleeding risk

4. Which finding on upper endoscopy is diagnostic of a gastric ulcer?

Erythema of the gastric mucosa

A discrete mucosal defect with surrounding erythema

Mild inflammation only

Increased vascularity

5. A patient presents with dysphagia and chest pain. Which condition should be ruled out?

Simple GERD

Severe GERD with esophageal stricture

Gastritis only

Duodenal ulcer

6. How does sucralfate differ from PPIs in treating ulcers?

It reduces acid; sucralfate coats the ulcer

It kills bacteria; PPIs reduce acid

It is more effective for GERD

It has no acid-reducing properties

7. A patient on long-term PPI therapy requires monitoring for which complication?

Vitamin B12 and calcium malabsorption

Hyperacidity

Increased ulcer formation

Esophageal strictures

8. Which diagnostic test is most specific for confirming H. pylori infection?

Endoscopy with biopsy

Chest X-ray

Abdominal ultrasound

Complete blood count

9. What is the most common cause of acute gastritis?

Alcohol or NSAID use

Spicy food exclusively

Lack of exercise

Excessive salt intake

10. A patient reports pain that improves with food intake. Which condition is most likely?

GERD

Duodenal ulcer

Acute gastritis

Esophageal spasm

11. A 45-year-old patient reports heartburn and regurgitation after eating spicy foods. Which condition is most likely?

GERD

Peptic ulcer disease

Acute gastritis

Barrett's esophagus

12. A patient with Barrett's esophagus has a history of untreated GERD. What is the clinical significance?

Increased risk of esophageal cancer

Guaranteed progression to ulcer disease

Automatic need for surgery

No clinical significance

13. How does H. pylori contribute to ulcer formation?

It increases stomach acid production

It damages the protective mucous layer and causes inflammation

It blocks nutrient absorption

It increases lower esophageal sphincter pressure

14. Which clinical finding would most suggest a perforated peptic ulcer?

Gradual onset epigastric pain

Sudden severe abdominal pain and rigid abdomen

Mild nausea and vomiting

Chronic heartburn

15. A patient taking NSAIDs develops a gastric ulcer. What is the primary mechanism of injury?

Increased acid secretion

Inhibition of prostaglandin synthesis

Bacterial overgrowth

Decreased mucus production only

16. Which lifestyle modification is most effective for reducing GERD symptoms?

Eating smaller meals and elevating head of bed

Increasing fluid intake with meals

Consuming more citrus fruits

Lying down immediately after eating

17. GERD differs from peptic ulcer disease in that GERD primarily involves damage to which structure?

The gastric mucosa

The esophageal mucosa

The pyloric sphincter

The duodenal wall

18. A patient with acute gastritis presents with epigastric pain and nausea. Which medication is contraindicated?

Proton pump inhibitor

Ibuprofen

Antacid

H2 receptor blocker

19. Which risk factor is most strongly associated with peptic ulcer disease?

Stress and spicy food

H. pylori infection or NSAID use

Excessive caffeine intake

Sedentary lifestyle

20. What is the primary pathophysiologic mechanism in GERD?

Increased gastric acid production

Incompetence of the lower esophageal sphincter

Helicobacter pylori infection

Decreased gastric motility

GI Quiz: GERD, Gastritis or Ulcer?