Paper II
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min

Question

Patient: Mr. John Taylor, a 45-year-old man presents with the chief complaint: Severe heartburn and regurgitation of food after meals, especially at night. Medical History: Overweight (BMI: 29), Occasional alcohol use. No known drug allergies. Presenting Symptoms: Heartburn and acid regurgitation after meals for the past 3 months. Symptoms are worse when lying down, particularly at night. Difficulty swallowing at times. Has been self-medicating with over-the-counter antacids but reports no significant relief. Physical Examination: Normal vital signs, No signs of systemic illness, abdominal tenderness or masses and not anaemic. Diagnosis: Gastroesophageal reflux disease (GERD)

The primary mechanism of action of H2-receptor antagonists in the treatment of GERD is

  • a) Increase gastric acid secretion
  • c) Improve gastric motility
  • b) Decrease gastric acid secretion
  • d) Neutralize gastric acid
Qxiv1 marksMCQs (Case)

Answer

Correct answer: b) Decrease gastric acid secretion

H2-receptor antagonists competitively block histamine H2 receptors on gastric parietal cells, reducing histamine-stimulated acid secretion — decreasing gastric acid output, rather than neutralizing acid already present (antacids) or improving motility (prokinetics).

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