Introduction: The anatomy and functions of stomach MCQs with answer provide B. Pharm students a focused review of gastric structure, cellular composition, secretion, motility and clinical correlations. This concise, exam-oriented guide covers stomach anatomy, histology (parietal, chief, G and D cells), gastric acid physiology, regulation by gastrin, vagal and histaminergic pathways, intrinsic factor and B12 absorption, mucosal defense, gastric emptying and common disorders like peptic ulcer disease and Zollinger–Ellison syndrome. It also links pharmacology of antacids, H2 blockers, proton pump inhibitors and prokinetics to normal physiology. Clear questions strengthen retention and prepare students for pharmacology and therapeutics. Now let’s test your knowledge with 50 MCQs on this topic.
Q1. Which of the following is the primary cell type responsible for hydrochloric acid secretion in the stomach?
- Chief cells
- Parietal cells
- Mucous neck cells
- G cells
Correct Answer: Parietal cells
Q2. Which hormone is mainly responsible for stimulating gastric acid secretion by acting on parietal cells and ECL cells?
- Somatostatin
- Secretin
- Gastrin
- Cholecystokinin (CCK)
Correct Answer: Gastrin
Q3. Which gastric cell secretes pepsinogen, the zymogen that is activated to pepsin in acidic pH?
- Parietal cells
- Chief cells
- Enterochromaffin-like (ECL) cells
- Mucous cells
Correct Answer: Chief cells
Q4. Intrinsic factor, essential for vitamin B12 absorption, is secreted by which cell type?
- Mucous neck cells
- Chief cells
- Parietal cells
- G cells
Correct Answer: Parietal cells
Q5. Which receptor on parietal cells is targeted by histamine to increase acid secretion?
- H1 receptor
- H2 receptor
- M3 receptor
- Beta-2 adrenergic receptor
Correct Answer: H2 receptor
Q6. Which drug class irreversibly inhibits the H+/K+ ATPase (proton pump) of parietal cells?
- H2 receptor antagonists
- Prostaglandin analogs
- Proton pump inhibitors (PPIs)
- Antacids
Correct Answer: Proton pump inhibitors (PPIs)
Q7. The cephalic phase of gastric secretion is primarily mediated by which cranial nerve?
- Glossopharyngeal nerve (IX)
- Facial nerve (VII)
- Vagus nerve (X)
- Hypoglossal nerve (XII)
Correct Answer: Vagus nerve (X)
Q8. Which cell type secretes histamine in the stomach to stimulate acid secretion indirectly?
- G cells
- D cells
- Enterochromaffin-like (ECL) cells
- Mucous neck cells
Correct Answer: Enterochromaffin-like (ECL) cells
Q9. Which peptide hormone inhibits gastrin release and reduces gastric acid secretion?
- Ghrelin
- Somatostatin
- Gastrin-releasing peptide (GRP)
- Motilin
Correct Answer: Somatostatin
Q10. Peptic ulcer disease is most commonly associated with infection by which organism?
- Escherichia coli
- Helicobacter pylori
- Staphylococcus aureus
- Clostridium difficile
Correct Answer: Helicobacter pylori
Q11. Which gastric layer contains the muscularis mucosae and is directly involved in mucosal defense and secretion?
- Serosa
- Submucosa
- Mucosa
- Muscularis externa
Correct Answer: Mucosa
Q12. Which neurotransmitter acting via M3 receptors enhances acid secretion from parietal cells?
- Norepinephrine
- Acetylcholine
- Dopamine
- Serotonin
Correct Answer: Acetylcholine
Q13. Zollinger–Ellison syndrome is characterized by gastrin-secreting tumors called:
- Leiomyomas
- Gastrinomas
- Adenomyomas
- Carcinoids
Correct Answer: Gastrinomas
Q14. Which of the following drugs is a cytoprotective prostaglandin analog used to prevent NSAID-induced gastric ulcers?
- Misoprostol
- Omeprazole
- Ranitidine
- Sucralfate
Correct Answer: Misoprostol
Q15. Gastric emptying is accelerated by which of the following?
- High-fat meals
- Hyperosmolar solutions
- Increased gastric motility via vagal stimulation
- Opioid administration
Correct Answer: Increased gastric motility via vagal stimulation
Q16. Which substance converts pepsinogen to active pepsin in the stomach?
- Intrinsic factor
- Hydrochloric acid (HCl)
- Bile salts
- Pancreatic lipase
Correct Answer: Hydrochloric acid (HCl)
Q17. The primary blood supply to the stomach’s lesser curvature is the:
- Right gastroepiploic artery
- Left gastroepiploic artery
- Right gastric artery
- Short gastric arteries
Correct Answer: Right gastric artery
Q18. Which cell type in the gastric antrum secretes gastrin?
- D cells
- G cells
- Mucous neck cells
- Chief cells
Correct Answer: G cells
Q19. Proton pump inhibitors are prodrugs that require activation in which environment?
- Neutral pH of blood plasma
- Acidic canaliculi of parietal cells
- Basic environment of duodenum
- Inside lysosomes of chief cells
Correct Answer: Acidic canaliculi of parietal cells
Q20. Which of the following is a likely effect of vagotomy on gastric physiology?
- Increased acid secretion
- Decreased gastric motility and acid secretion
- Enhanced pepsinogen release
- Increased gastrin release from G cells
Correct Answer: Decreased gastric motility and acid secretion
Q21. Sucralfate protects the gastric mucosa by:
- Neutralizing acid through bicarbonate
- Forming a protective viscous barrier over ulcer sites
- Inhibiting H2 receptors
- Stimulating prostaglandin synthesis only
Correct Answer: Forming a protective viscous barrier over ulcer sites
Q22. Which gastric cell secretes somatostatin that inhibits gastrin release?
- Chief cells
- D cells
- Parietal cells
- Goblet cells
Correct Answer: D cells
Q23. Which of the following accurately describes the fundus region of the stomach?
- Primary site of gastrin secretion
- Contains oxyntic mucosa rich in parietal cells
- Lined predominantly by absorptive enterocytes
- Major site of digestion of carbohydrates
Correct Answer: Contains oxyntic mucosa rich in parietal cells
Q24. Which diagnostic test measures acidic gastric output and is sometimes used in research on acid secretion?
- Gastrin challenge test
- Heidelberg pH test
- Schilling test
- Basal acid output (BAO) and maximal acid output (MAO)
Correct Answer: Basal acid output (BAO) and maximal acid output (MAO)
Q25. Which drug class competitively inhibits histamine at H2 receptors, reducing acid secretion?
- PPIs
- H2 receptor antagonists
- Antacids
- Prostaglandin analogs
Correct Answer: H2 receptor antagonists
Q26. Pernicious anemia is caused by decreased intrinsic factor often due to:
- H. pylori infection only
- Autoimmune destruction of parietal cells
- Excessive antacid use
- Overproduction of pepsinogen
Correct Answer: Autoimmune destruction of parietal cells
Q27. The gastric mucosal barrier includes all EXCEPT which of the following?
- Mucous gel layer and bicarbonate
- Tight junctions between epithelial cells
- High mucosal blood flow for repair
- Direct coating by bile acids
Correct Answer: Direct coating by bile acids
Q28. Which of the following increases gastric mucosal blood flow and promotes mucosal protection?
- Prostaglandin E2
- H2 receptor antagonists
- Proton pump inhibitors
- Histamine
Correct Answer: Prostaglandin E2
Q29. Which enzyme in the stomach begins hydrolysis of dietary proteins once activated?
- Gastric lipase
- Pepsin
- Amylase
- Trypsin
Correct Answer: Pepsin
Q30. Which region of the stomach contains pyloric glands rich in G cells?
- Fundus
- Body (corpus)
- Antrum
- Cardia
Correct Answer: Antrum
Q31. Which of the following is TRUE about gastric motility?
- Peristaltic waves in the stomach are generated by the enteric pacemaker in the body and antrum
- Gastric peristalsis is inhibited by acetylcholine
- The pyloric sphincter is completely relaxed during strong antral contractions
- Gastric emptying is independent of meal composition
Correct Answer: Peristaltic waves in the stomach are generated by the enteric pacemaker in the body and antrum
Q32. Which pharmacologic agent increases gastric emptying and acts as a dopamine D2 antagonist / 5-HT4 agonist?
- Metoclopramide
- Lansoprazole
- Ranitidine
- Sucralfate
Correct Answer: Metoclopramide
Q33. Which factor does NOT directly stimulate acid secretion from parietal cells?
- Histamine from ECL cells
- Gastrin from G cells
- Somatostatin from D cells
- Acetylcholine from vagal efferents
Correct Answer: Somatostatin from D cells
Q34. Which diagnostic finding is most characteristic of Zollinger–Ellison syndrome?
- Low gastric acid secretion and low gastrin levels
- Multiple peptic ulcers and markedly elevated gastrin levels
- Autoimmune parietal cell destruction
- Gastric atrophy with low gastrin
Correct Answer: Multiple peptic ulcers and markedly elevated gastrin levels
Q35. Which of the following antacids works by neutralizing gastric acid and may contain aluminum or magnesium salts?
- Omeprazole
- Ranitidine
- Aluminum hydroxide / magnesium hydroxide
- Sucralfate
Correct Answer: Aluminum hydroxide / magnesium hydroxide
Q36. Gastric acid secretion is lowest during which physiological phase?
- Cephalic phase
- Gastric phase
- Intestinal phase
- Postprandial phase
Correct Answer: Intestinal phase
Q37. Which of the following best describes the role of bicarbonate in the stomach?
- Secreted into the lumen to neutralize acid throughout the stomach
- Part of the mucous layer that neutralizes acid at the epithelial surface
- Main enzyme for protein digestion
- Stimulates gastrin release
Correct Answer: Part of the mucous layer that neutralizes acid at the epithelial surface
Q38. Which imaging or test is gold standard to detect H. pylori infection in gastric biopsies?
- Urea breath test only
- Stool antigen test only
- Histology of gastric biopsy with special stains
- Serology for H. pylori IgG only
Correct Answer: Histology of gastric biopsy with special stains
Q39. Which of the following is a common adverse effect of long-term proton pump inhibitor therapy?
- Increased gastric acid secretion (rebound) permanently
- Risk of decreased vitamin B12 absorption and potential deficiency
- Immediate mucosal ulceration
- Excess intrinsic factor production
Correct Answer: Risk of decreased vitamin B12 absorption and potential deficiency
Q40. The gastric barrier to autodigestion includes which secreted protein that traps pepsin?
- Mucin
- Pepsinogen
- Intrinsic factor
- Enterokinase
Correct Answer: Mucin
Q41. Which statement about gastric acid physiology is TRUE?
- Gastric acid secretion is independent of neural inputs
- Gastrin directly stimulates parietal cells and indirectly via ECL cells
- H2 receptor activation inhibits acid secretion
- Prostaglandins increase acid secretion
Correct Answer: Gastrin directly stimulates parietal cells and indirectly via ECL cells
Q42. Which of the following drugs can be used in triple therapy to eradicate H. pylori?
- Amoxicillin, clarithromycin, and a PPI
- Ranitidine, misoprostol, and antacid
- Sucralfate, metoclopramide, and bismuth
- Omeprazole, aluminum hydroxide, and simethicone
Correct Answer: Amoxicillin, clarithromycin, and a PPI
Q43. Which of the following best describes the pH in the stomach lumen under normal fasting conditions?
- Highly alkaline (pH > 8)
- Neutral (pH ≈ 7)
- Highly acidic (pH ~1–3)
- Variable but always > 6
Correct Answer: Highly acidic (pH ~1–3)
Q44. Which enzyme secreted by chief cells aids in digestion of triglycerides in neonates?
- Gastric lipase
- Pepsin
- Pancreatic lipase
- Enteropeptidase
Correct Answer: Gastric lipase
Q45. What is the primary mechanism by which NSAIDs increase risk of gastric ulceration?
- Directly increase gastrin secretion
- Inhibit prostaglandin synthesis, reducing mucosal defense
- Stimulate parietal cell proliferation
- Enhance bicarbonate secretion
Correct Answer: Inhibit prostaglandin synthesis, reducing mucosal defense
Q46. Which neural plexus in the stomach wall primarily controls local secretion and motility?
- Hypogastric plexus
- Myenteric (Auerbach) and submucosal (Meissner) plexuses
- Cardiac plexus
- Renal plexus
Correct Answer: Myenteric (Auerbach) and submucosal (Meissner) plexuses
Q47. Which ion exchange is directly mediated by the parietal cell proton pump?
- Na+/K+ ATPase exchanging Na+ and K+
- H+/K+ ATPase exchanging intracellular H+ for luminal K+
- Cl−/HCO3− exchanger only
- Ca2+/H+ antiporter
Correct Answer: H+/K+ ATPase exchanging intracellular H+ for luminal K+
Q48. Which clinical condition results from loss of parietal cells leading to achlorhydria and B12 deficiency?
- Peptic ulcer disease
- Pernicious anemia
- Zollinger–Ellison syndrome
- Gastric outlet obstruction
Correct Answer: Pernicious anemia
Q49. Which of the following is most likely to slow gastric emptying?
- Low-fat liquid meal
- Sympathetic activation and opioids
- Vagal stimulation and prokinetics
- Hypoglycemia
Correct Answer: Sympathetic activation and opioids
Q50. Which agent is a selective antagonist of the gastrin/CCK-B receptor and would directly block gastrin action (primarily a research tool)?
- Proglumide
- Ranitidine
- Omeprazole
- Metoclopramide
Correct Answer: Proglumide
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