4. Path of the GIT-Stomach

Question 1

A 40 year old man complains of abdominal pain and frequent vomiting. A ureases test is done and is positive. Which portion of the stomach is mostly likely affected?

A.Body
B. Fundus
C. Cardia 
D. Pylorus
E. Antrum

RFA

Answer 1

Ans . Antrum E- since it is ureases positive can conclude that the patient has H. Pylori which usually infects the Antrum

A. Body and B. Fundus- is where autoimmune type gastritis usually occurs

Question 2

A 48 year old Japanese man who loves goes to his doctor due to abdominal pain and blood in his vomit and stool. . Upon history taken you find out that his family has a family history of mutation of E-cadherin. What is associated with the mans condition?

A. Smoked Food 
B. Neoplastic cells from glands 
C. Signet ring cells 
D. H pylori
E. Metastasis to the Periumbilical region 

RFA

Answer 2

Ans. C Signet rings cells- E-cadherin mutation is associated with Diffuse Gastric Carcinoma.

All the other answer choices are associated with Intestinal Type Gastric carcinoma

Question 3

A 1 month old infant is brought to the physician by her mother who has noticed regurgitation and projectile vomiting after meals. Physical exam finds a palpable mass in the epigastric region. The doctor has the baby fed in the office and see visible peristalsis. Which of the following congenital conditions is NOT associated with this child’s ailment? (MG)

A. Turner syndrome
B. Trisomy 18
C. Esophageal atresia
D. Down’s syndrome

Answer 3

D. Down’s syndrome

All other options are associated with congenital hypertrophic pyloric stenosis.

Question 4

A 68 year old man is involved in a motor vehicle accident in which he hit his head on the steering wheel. Cranial CT shows a lesion on the frontal lobe. Aside from treating his head trauma, the medical team also needs to monitor him for acute gastric ulcers. Why would his head trauma cause gastric ulcers? (MG)

A. Systemic acidosis
B. Vagal stimulation
C. Hypoxia
D. Systemic alkalosis
E. Peripheral demyelination

Answer 4

B. Vagal stimulation

Head injuries and intracranial lesions can cause Cushing ulcers

Curling ulcers are caused by extensive burns via systemic acidosis and hypoxia. (A and C)

D and E are just distractors and not relevant to this disease.

Question 5

A 65 y/o male smoker presents to his oncologist. His last tumor biopsy showed bundles of spindle shaped cells and whorls. His current treatment includes chemo and Gleevac. Which of the following is associated with his type of cancer?

A. E-cadherin mutation 
B. H. pylori
C. Destruction of oxyntic glands
D. Necrotic fibronoid debris
E. Derived from cells of cajal

SZ

Answer 5

Ans. E. Derived from cells of cajal- Gastrointestinal stromal tumor

A. E-cadherin mutation = Diffuse type of gastric adenocarcinoma
B. H. Pylori = intestinal type of gastric adenocarcinoma
C. Destruction of oxyntic glands = autoimmune gastritis
D. Necrotic fibronoid debris = peptic ulcer disease

Question 6

Which of the following are associated with H. pylori?

A. Peptic ulcer disease
B. Gastric carcinoma
C. Gastric lymphoma
D. GIST
E. Acute gastritis 

SZ

Answer 6

Ans. A, B, C

PUD, Gastric carcinoma and lymphoma are associated with H. pylori