Q9: Gastroesophageal junction competence is increased by: a) Lying supine b) Paralysis of the diaphragm c) Use of Morphine d) Use of Metoclopromide e) Increased intra-abdominal pressure Correct Answer: d Explanation: Metoclopromide is D2 receptor antagonist that increased the resting tone of GIT, increases contractility & increases Lower esophageal junction tone. It is clinically used for Diabetic & post-surgery gastroparesis. Toxicity includes parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, diarrhea. Contraindicated in patients with small bowel obstruction. Other option under this question actually decrease the GE junction tone.