Chapter 5: Stomach

Question 1

Most proximal portion of the stomach immediately distal to the GEJ

Answer 1

Cardia

Question 2

Most superior portion of the stomach

Answer 2

Fundus

Question 3

Largest portion of the stomach

Answer 3

Corpus/Body

Question 4

Extends from the fundus to the pylorus

Answer 4

Corpus/Body

Question 5

Begins at the angularis incisura as a wider area that leads into a narrower pyloric canal and sphincter

Answer 5

Antrum

Question 6

Part of the stomach that includes the pyloric sphincter

Answer 6

Pylorus

Question 7

Cells that produce pepsinogen in response to food and acethylcholine

Answer 7

Chief cells

Question 8

pH level wherein pepsinogen is activated to pepsin

Answer 8

<5 pH

Question 9

Cells that secretes HCl and Intrinsic Factor

Answer 9

Parietal/Oxyntic cells

Question 10

Secretes mucous and HCO3-

Answer 10

Mucous neck cells

Question 11

Secrete gastrin

Answer 11

G cells

Question 12

Secrete somatostatin

Answer 12

D cells

Question 13

Secrete serotonin

Answer 13

Enterochromaffin cells/Kulchitsky cells

Question 14

Secrete histamine

Answer 14

Enterochromaffin-like cells

Question 15

Supplies the proximal portion of the lesser curvature

Originates from the celiac trunk

Answer 15

Left gastric artery

Question 16

Supplies the distal portion of the lesser curvature

Originates from the common or proper hepatic artery

Answer 16

Right gastric artery

Question 17

Supplies the proximal portion of the greater curvature

Originates from the splenic artery

Answer 17

Left gastroepiploic artery

Question 18

Supplies the distal portion of the greater curvature and the pylorus
Originates from gastroduodenal artery

Answer 18

Right gastroepiploic artery

Question 19

Contribute to the supply of proximal stomach

Answer 19

Short gastric arteries

Question 20

Supplies the acetylcholine-mediated, parasympathetic innervation of the stomach

Answer 20

Vagus nerve

Question 21

Supplies sympathetic innervation of the stomach

Answer 21

Celiac plexus

Question 22

Enteric nervous system is composed of the following plexuses

Answer 22

Auerbach’s and Meissner’s plexuses

Question 23

Left vagus nerve runs ______ to the stomach

Answer 23

anterior

Question 24

Right vagus nerve runs ______ to the stomach

Answer 24

posterior

Question 25

Etiologies of stress-induced gastritis

Answer 25

Sepsis Shock Severe burn

Question 26

Most common type of peptic ulcer disease

Answer 26

Duodenal ulcers

Question 27

Food tends to exacerbate the epigastric pain in this type of ulcer

Answer 27

Gastric ulcer

Question 28

Food relieves the pain in this type of ulcer

Answer 28

Duodenal ulcer

Question 29

Most common type of gastric ulcer

Answer 29

Type 1

Question 30

Gastric ulcer found in the distal portion of the lesser curvature

Answer 30

Type 1

Question 31

Gastric ulcer found in the prepyloric or pyloric region

Answer 31

Type 3

Question 32

Gastric ulcer found in the proximal portion of the lesser curvature

Answer 32

Type 4

Question 33

Gastric ulcer found in the distal portion of lesser curvature and is associated with duodenal ulcer

Answer 33

Type 2

Question 34

Indications for surgical management of PUD

Answer 34

Refractory or recurrent disease | Complications (perforation, obstruction, uncontrolled bleeding)

Question 35

Rare disorder caused by gastrin-secreting tumor

Answer 35

Zollinger-Ellison Syndrome

Question 36

Gastrinoma triangle

Answer 36

Pancreatic neck Porta hepatis 3rd portion of the duodenum

Question 37

Gastrin levels confirming the diagnosis of ZES

Answer 37

>1000 pg/mL | Increase in gastrin level >200 pg/mL after a secretin challenge

Question 38

Clinical triad of ZES

Answer 38

Hypersecretion of HCl Severe PUD Gastrinoma

Question 39

Most commonly performed operation for GERD that involves a 360 degrees wrap

Answer 39

Nissen fundoplication

Question 40

Operation for GERD that includes 180 degrees wrap

Answer 40

Toupet

Question 41

Operation for GERD that includes 270 degrees wrap performed through the chest

Answer 41

Belsey Mark IV

Question 42

Most common complication from anti-reflux procedures

Answer 42

Pneumothorax

Question 43

Most common form of gastric cancer

Answer 43

Gastric adenocarcinoma

Question 44

Diffuse neoplasm involving the entire stomach to give a 'leather bottle' appearance

Answer 44

Linitis plastica

Question 45

Treatment for gastric adenocarcinoma

Answer 45

Surgical resection with a 6-cm resection margin

Question 46

Treatment for gastric adenocarcinoma in the proximal stomach

Answer 46

Total gastrectomy

Question 47

Treatment for gastric adenocarcinoma in the distal stomach

Answer 47

Subtotal gastrectomy with negative margins

Question 48

Submucosal, mesenchymal tumors arising from the interstitial cells of Cajal

Answer 48

Gastrointestinal Stromal Tumors (GIST)

Question 49

Mutation found in GIST

Answer 49

Gain of function tyrosine kinase mutation (KIT proto-oncogene)

Question 50

Non-Hodgkin's lymphoma associated with H. pylori infection

Answer 50

Gastric MALToma

Question 51

Indications for bariatric surgery

Answer 51

BMI > 40 kg/m2 or | BMI >35 kg/m2 with a comorbid condition

Question 52

What GI hormones are involved in the regulation of insulin release?

Answer 52

Gastric inhibitory peptide | CCK

Question 53

A 69-year old man is diagnosed with gastric adenocarcinoma. What are the most common symptoms?

Answer 53

Weight loss, early satiety, abdominal pain

Question 54

A 55-year old woman is found to have PUD without increase HCL secretion. What types of gastric ulcers may be present?

Answer 54

Types I or IV

Question 55

What type of gastric ulcer is often not responsive to highly selective vagotomy?

Answer 55

Type III

Question 56

What is the strongest layer of the GI tract wall?

Answer 56

Submucosa

Question 57

What technique is used for laparascopic band placement during which the gastrohepatic ligament is divided, a plane between the right diaphragmatic crus, and the overlying fat pad is dissected?

Answer 57

Pars flaccida technique