Diseases of Stomach & Duodenum

Question 1

what is gastritis?

Answer 1

inflammation causing mucosal injury of the stomach

Question 2

types of gastritis

Answer 2

acute or chronic

Question 3

aetiology of acute gastritis?

Answer 3

chemical injury, trauma, infection

Question 4

aetiology of chronic gastritis?

Answer 4

CHA CHA
chemical: NSAIDs, alcohol
H.Pylori
Autoimmune

Question 5

anaemic complications of gastritis

Answer 5

can lead to pernicious anaemia due to B12 def

Question 6

what are common complications of gastritis?

Answer 6

ulcers & cancer

Question 7

what is peptic ulceration?

Answer 7

breach in GI mucosa as a result of acid and pepsin attack

Question 8

what sites are peptic ulcers most common in?

Answer 8

duodenum, stomach, oesophogastric region

Question 9

aetiology of peptic ulcers?

Answer 9

excess acid production, H.pylori, NSAIDs, smoking

Question 10

symptoms of peptic ulcer?

Answer 10

burning epigastric pain, loss of appetite, feeling of fullness/nausea, dyspepsia (reflux)

Question 11

ix for peptic ulcer?

Answer 11

exclude H.Pylori- C13 urease breath test, stool antigen, serology of IgG
exclude cancer with endoscopy

Question 12

tx for peptic ulcer?

Answer 12

antacids, H2 antagonists, PPI or H.pylori eradication

• omeprazole & amoxicillin & clarithromycin or
• omeprazole & metronidazole & clarithromycin

Question 13

what are extreme Rx for H.pylori?

Answer 13

metoclopramide or bismuth chelate

Question 14

complications of peptic ulcer?

Answer 14

perforation, penetration, haemorrhage, stenosis

Question 15

what are 2 types of benign gastric tumours?

Answer 15

hyperplastic polyps, cystic fundic gland polyps

Question 16

3 types of malignant Gastric tumours?

Answer 16

carcinomas, lymphomas, GI stromal tumours (GISTs)

Question 17

what are GISTs linked to and typical pt?

Answer 17

55-60yo, linked to defective pacemaker cells (ICC)

Question 18

epidemiology of gastric adenocarcinoma?

Answer 18

high incidence in some countries (Japan, china, Colombia, Finland), males, 4th commonest cancer in the world

Question 19

aetiology of gastric adenocarcinoma?

Answer 19

H.pylori, pernicious anaemia, partial gastrectomy, menetrier’s disease

Question 20

pathogenesis of gastric adenocarcinoma

Answer 20

h.pylori > chronic gastritis > intestinal metaplasia> dysplasia > carcinoma

Question 21

where is adenocarcinoma most commonly found?

Answer 21

cardia/ GO junction

Question 22

what are the 2 classes of gastric adenocarcinoma?

Answer 22

T1: exophytic/ polypoid mass (intestinal)
T2: expands/ infiltrates stomach wall (diffuse)

Question 23

which of the 2 types of gastric adenocarcinoma is better?

Answer 23

T1- less diffused

Question 24

where is a common site for metastases of Adeno carcinoma?

Answer 24

liver

Question 25

symptoms of gastric adenocarcinoma?

Answer 25

epigastric pain, vomiting/ haematemesis, loss of appetite, dysphagia

Question 26

ix fo gastric Adenocarcinoma?

Answer 26

upper GI endoscopy & biopsy, CXR, CT

Question 27

tx for gastric adenocarcinoma?

Answer 27

resection, palliative care

Question 28

true/false…

if cancer is proximal then a surgeon should carry out a partial resection

Answer 28

false…

if proximal= total resection, if distal= partial resection

Question 29

what is the second type of malignant gastric cancer?

Answer 29

Gastric Lymphoma

Question 30

what is gastric lymphoma also known as…?

Answer 30

MALToma

Question 31

what is the aetiology for gastric lymphoma?

Answer 31

caused by H.pylori and derived from Mucosa Associated Lymphoid Tissue (MALT)

Question 32

what type of lymphoma is gastric lymphoma?

Answer 32

a b-cell lymphoma

Question 33

what part of the stomach is termed proximal?

Answer 33

the upper part ie. cardia, fundus and body

Question 34

what 2 structures are termed as the distal stomach?

Answer 34

Antrum & pylorus