010715 stomach dis 5

Question 1

epidemiology of gastric adenocarcinoma in the world

Answer 1

higher incidence in developing countries
higher risk with higher geographic latitudes
risks: smoking, salt, nitrates

Question 2

epidemiology of gastric adenocarcinoma in US

Answer 2

more common w Asian, Hispanic, black ethnicity

men, older aged

Question 3

types of gastric adenocarcinoma

Answer 3

intestinal type (distal stomach, H pylori main risk factor, bakcground of intestinal metaplasia with precursors from bone marrow)

diffuse type (precursor lesion unknown, younger age, not H pylori related, signet ring cell histology, more aggressive)

hereditary diffuse type (E cadherin mutation)

diffuse type EBV-associated

adenocarcinoma of cardia

Question 4

clinical presentation of gastric adenocarcinoma

Answer 4

abd pain
early satiety and nausea
weight loss
dysphagia
vomiting
gastrointestinal bleeding/perforation

Question 5

gastric lymphoma is strongly associated with

Answer 5

H pylori

Question 6

gastric carcinoid tumors

Answer 6

derived from ECL cells
proliferate and transform in response to high circulating levels of GASTRIN (high gastrin due to atrophic gasritis or ectopic gastrin secretion)

Question 7

course of gastric carcinoid tumor

Answer 7

usually indolent and benign

Question 8

carcinoid

Answer 8

a neuroendocrine tumor

Question 9

atrophic metaplastic gastritis

Answer 9

inflam destruction of normal mucosa with replacement by metaplastic elements (commonly intestinal type with goblet cells)

type A-body and fundus (autoimmune)
type B-antrum (H pylori)

Question 10

atrophic metaplastic gastritis can have increased what?

Answer 10

gastrin

Question 11

tx for gastric carcinoid tumor?

Answer 11

antrectomy to remove gastrin