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 drug preferred as an adjunctive therapy in GERD by accelerating gastric emptying is

  • a) Metoclopramide
  • b) Lansoprazole
  • c) Ranitidine
  • d) Sucralfate
Qxv1 marksMCQs (Case)

Answer

Correct answer: a) Metoclopramide

Metoclopramide is a D2 antagonist with additional 5-HT4 agonist prokinetic action, increasing gastric emptying and lower esophageal sphincter tone — useful as adjunctive therapy in GERD, particularly where delayed gastric emptying contributes to reflux, unlike the acid-suppressing (lansoprazole, ranitidine) or mucosal-protective (sucralfate) options listed.

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