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SOTE 2020 > Esophagus and Gastric Diseases > Flashcards

Esophagus and Gastric Diseases Flashcards

1
Q

What are the “Alarm” signs of gastroesophageal reflux disease, except?

A) dysphagia
B) nausea
C) weight loss
D) anemia

A

B) nausea

cancer rel symptoms give cause for alarm like weight loss, anemia, and dysphagia

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2
Q

Oesophageal motility disorder in gastroesophageal reflux disease may be characterized as, except:

A) decreased basal tone of the lower oesophageal sphincter
B) transient relaxation of the lower oesophageal sphincter
C) increased clearance of the oesophagus
D) damage to the primary peristalsis function of the oesophagus
E) regular upper oesophageal sphincter relaxation

A

C) inc clearance of the esophagus

motility disorder results in overall dec clearance

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3
Q

May decrease oesophageal sphincter tone, except:

A)  	atropine
B)  	domperidone
C)  	glucagon
D)  	cholecystokinin
E)  	nifedipine
A

B) domperidone

all others dec LES

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4
Q

There is no correlation between gastritis Helicobacter pylori gastritis and:

A) adenocarcinoma of the stomach
B) elevated gastrin levels
C) neutrophilic infiltration
D) perniciosis of anemia

A

D) pernicious anemia

can be seen with atrophic gastritis but its mech isn’t related to H pylori

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5
Q

The main proteolytic enzyme from gastric enzymes is:

A) gastric lipase
B) motilin
C) secretin
D) pepsin

A

D) pepsin

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6
Q

When are the most of gastric fluids produced from the daily 1,5 L?

A) between meals
B) in the cephalic phase
C) in the gastric phase
D) in the intestinal phase

A

C) gastric phase

gastric phase = postprandial

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7
Q

They increase the risk of developing gastric cancer, except:

A) anemia perniciosa
B) adenomatous polyp in the stomach
C) previous gastric surgery for ulcer
D) blood type B

A

D) B blood type

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8
Q

Determines the prognosis of gastric cancer, except:

A) stage of tumor growth
B) localization of the tumor
C) presence of stromafibrosis in the tumor tissue
D) degree of tumor differentiation

A

C) presence of stromafibrosis in the tumour tissue

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9
Q

True for gastric lymphoma, except:

A) most of them are diffuse histiocytic lymphoma
B) lymphoma in the stomach is less frequent than in the colon
C) stage is the most important prognostic factor
D) may be associated with chronic gastritis, intestinal metaplasia

A

B) lymphoma in the stomach is less freq than in the colon

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10
Q

The following statements are true for gastric carcinoid tumors, except:

A) The stomach is the most common site for carcinoid tumors.
B) Carcinoid tumors of the stomach are randomly detected.
C) Gastric carcinoid tumors produce 5HT (serotonin).
D) Carcinoid tumor develops more frequent in the stomach in case of atrophic gastritis or in association with pernicious anemia.

A

A) stomach is the most common site for carcinoid tumours

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11
Q

Which condition is not typical for the clinical appearance of Zollinger-Ellison syndrome?

A) Over 60% of patients experience heartburn.
B) Diarrhoea does not occur in the syndrome.
C) Hyperparathyroidism and hypercalcaemia may be associated with increased acid secretion in multiple endocrine neoplasia.
D) Ulcers appear at unusual location in the syndrome.

A

B) diarrhea doesn’t occur in the syndrome

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12
Q

Medications for gastro-oesophageal reflux disease, except:

A) proton pump inhibitors
B) prokinetic agents in monotherapy
C) proton pump inhibitors in combination with prokinetic agents
D) H2 receptor antagonists

A

B) prokinetics in monotherapy

PPIs are preferred bc they’re cheap but can be combo’d with prokinetics in some cases

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13
Q

A 53-year-old man was hospitalized with the following symptoms: epigastric pain, lower extremity oedema, diarrhea. Laboratory findings confirmed iron deficiency anemia. The gastroscopy shows giant folds in the stomach. The trial breakfast shows reduced acid secretion. Biopsy taken from the deeper layer of the mucosa also shows no malignancy. Which disease is it?

A) Ménétrier disease
B) Stomach lymphoma
C) Zollinger-Ellison syndrome
D) Scleroderma

A

A) Menetrier disease

MD = exudative gastropathy of UO with thik walls due to excessive mucous membrane prolif

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14
Q

Which is the most common anemia after total gastrectomy

A) iron deficiency
B) vitamin B12 deficiency
C) folate deficiency
D) hemolytic

A

B) vit B12

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15
Q

All but one of the factors listed increases pepsinogen secretion:

A) somatostatin
B) gastrin
C) histamine
D) vagal stimulation

A

A) stomatostatin

vagal stim is the strongest stimulant then histamine and gastrin. somatostatin stops gastrin relsease and doesn’t inc pepsinogen at all

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16
Q

The key enzyme of hydrochloric acid secretion in the apical part of the capillary cells:

A) Na + -K + -ATPase
B) H + -K + -ATPase
C) tyrosine kinase
D) carbonic anhydrase

A

B) H/K ATPase

parietal cells have a lot of mitochondria in order to make ATP which powers the H/K ATPase into releasing H and Cl out of the cytosol

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17
Q

The most common type of polyp in the stomach:

A) hyperplasiogen
B) adenomatosus
C) juvenile
D) carcinoid

A

A) hyperplastic

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18
Q

Peptic ulcer diseases, except:

A) NSAID ulcer
B) KCI ulcer
C) Helicobacter-positive ulcer
D) Zollinger-Ellison syndrome

A

B) KCl ulcer

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19
Q

Factors that are known to play a role in the pathogenesis of classical peptic ulcer disease, except:

A) stress
B) smoking
C) Helicobacter pylori
D) viral infection

A

D) viral infection

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20
Q

Typical site for Helicobacter pylori colonization:

A) antrum
B) antrum-corpus border
C) fundus
D) duodenum

A

A) antrum

21
Q

Characteristics of NSAID ulcers, except:

A) mild dyspepsic complaints
B) relatively poor symptoms
C) typical hunger pain
D) tendency to bleed, perforate

A

C) typical hunger pain

22
Q

The most common localization of NSAID ulcers is:

A) esophagus
B) stomach
C) duodenum
D) jejunum

A

B) stomach

23
Q

Mechanisms involved in the formation of NSAID ulcers, except:

A) inhibition of the synthesis of protective prostaglandins
B) an increase in the blood supply to the gastric mucosa
C) activation of the lipoxygenase pathway
D) an increase in hydrochloric acid secretion

A

B) inc in blood supply to gastric mucosa

24
Q

The most common localization of gastrinoma is:

A) pancreas
B) duodenum
C) jejunum
D) appendix

A

A) pancreas

25
Q

The most specific diagnostics in Zollinger-Ellison syndrome is:

A) determination of hydrochloric acid secretion
B) X-ray of the stomach
C) secretin-provocation test with serum-gastrin assay
D) endoscopy

A

C) secretin provocation test with serum gastrin assay

26
Q

Methods used nowadays to treat Zollinger-Ellison ulcer, except:

A) total gastrectomy
B) H2 receptor blocking agents
C) proton pump inhibitors (PPIs)
D) removal of the gastrinoma

A

A) total gastrectomy

27
Q

In gastroesophageal reflux disease, the endoscopic view of the esophagus may be:

1) diffuse mucosal hyperaemia
2) mucosal ulcers in the lower third of the esophagus
3) isolated linear erosion over cardia
4) intact esophageal epithelium

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

E) all

28
Q

Used for the diagnosis of gastroesophageal reflux disease:

1) proton pump inhibitor test
2) esophageal impedance test
3) 24-hour oesophageal pH monitoring
4) pentagastric test

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3

29
Q

It may favorably affect the symptoms of diffuse oesophageal spasm, except:

1) diltiazem
2) glyceryl trinitrate
3) nifedipine
4) ranitidine

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

D) only 4

ranitidine is incorrect bc it’s a H2 recptor antagonist

30
Q

Increases the incidence of oesophageal epithelial cell carcinomas:

1) Barrett’s metaplasia
2) achalasia cardiae
3) nutcracker esophagus
4) smoking

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

2 4 are correct

achalasia and smoking inc risk of epithelial cc (barretts leads to adeno cc)

31
Q

Important in staging esophageal carcinomas:

1) chest CT scan
2) oesophageal endosonography
3) endoscopy by histological examination
4) barium swallow test

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3

32
Q

Gastrointestinal side effects of NSAIDs include:

1) Non-steroidal anti-inflammatory drugs (NSAIDs) cause gastric mucosal damage by inhibition of protective prostaglandins.
2) Mortality due to gastrointestinal complications is 3-4 times higher in chronic NSAID users.
3) NSAIDs can cause erosions and ulcers.
4) NSAID ulcers always cause intense pain.

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3

33
Q

Characteristics of the duodenal ulcer:

1) hunger pain
2) is more common with NSAIDs than with gastric ulcer
3) can cause pylorusstenosis
4) never penetrates the surrounding organs

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 3 are correct

hunger pain means pain after eating or when stomach is empty

34
Q

The effects of proton pump inhibitors are true:

1) Proton pump inhibitors act on the H + / K + -ATPase pump.
2) PPIs significantly increase serum gastrin levels.
3) They are among the basic drugs for Helicobacter pylori eradication schemes.
4) It should not be administered with NSAIDs due to drug interactions.

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3 are correct

35
Q

In the treatment of peptic ulcer disease:

1) All H2 blocker is effective in treating peptic ulcer.
2) H2 blockers are usually given 3 times a day before main meals.
3) PPIs reduce ulcer pain faster than H2 blockers.
4) PPIs and H2 blockers are usually cured within 2-4 weeks.

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 3

36
Q

Think of malignant stomach cancer:

1) if patient has a history of epigastric pain and significant weight loss.
2) if the patient has meat aversion.
3) if epigastric resistance is palpable.
4) if the patient is anacid and the Virchow gland is palpable.

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

E) all

virchow’s gland = node -> L supraclavicular

37
Q

In case of suspected recurrent gastric ulcer:

1) it is sufficient to perform an x-ray of the stomach.
2) gastroscopic examination is preformed to confirm Helicobacter pylori infection.
3) anti-ulcer therapy can be started without examination.
4) because of the tendency of ventricular ulcer to malignancy, gastroscopic examination should be performed for histological sampling.

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

2 4 are correct

38
Q

The following diseases and conditions may be associated with gastroparesis:

1) multiple sclerosis
2) diabetes mellitus
3) hypokalaemia
4) Parkinson’s disease

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

E) all

39
Q

Most important things to do in case of upper gastrointestinal bleeding:

1) stabilizing the circulation with fluid and, if necessary, blood supplementation
2) gastric tube insertion, gastric lavage
3) gastroscopy to localize the source of bleeding, if possible
4) immediate administration of PPI or H2 blocker orally to reduce acid secretion

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3 are correct

40
Q

If gastric ulcer is suspected:

1) gastroscopic examination should be performed immediately
2) physical examine the absence of liver dullness
3) barium gastric x-ray should be performed immediately
4) native abdominal imaging should be performed immediately

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

2 and 4

41
Q

In case of haematemesis oesophageal varices should be considered in the following diseases:

1) cirrhosis hepatis
2) v. portae thrombosis
3) an advanced stage of Budd-Chiari syndrome
4) oesophageal cancer

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3 are correct

42
Q

The disturbance of gastric emptying may be caused by:

1) pylorusstenosis caused by duodenal ulcer
2) antrumtumor spreading to pylorus
3) large pancreaspseudocyst
4) liver cirrhosis

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3

43
Q

The following substances enhance gastric secretion:

1) gastrin
2) caffeine
3) histamine
4) somatostatin

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 2 3

somatostatin inhibits gastric acid secretion and the release of many GI hormones

44
Q

It is true that:

1) CEA and AFP play a prominent role in the early diagnosis of gastric cancer.
2) Ectopic gastric mucosa can occur in almost any area of the gastrointestinal tract without clinical significance.
3) Gastric cancer has characteristic early symptoms.
4) Gastric cancer may be classified into two main groups according to its histological division: intestinal and diffuse gastric cancer.

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

D) only 4 is correct

45
Q

Which of the following is the most likely diagnosis?

A 48-year-old non-smoking, abstinent woman turns to you for having increased swallowing difficulties for half a year, weight loss, unpleasant mouth odor and frequent regurgitation of undigested food.

A)  	corrosive stricture
B)  	bulbar palsy
C)  	gastroesophageal reflux disease
D)  	achalasia cardiae
E)  	nutcracker esophagus
A

D) achalasia cardiae

46
Q

What did your barium swallow test result show based on the above diagnosis?

A 48-year-old non-smoking, abstinent woman turns to you for having increased swallowing difficulties for half a year, weight loss, unpleasant mouth odor and frequent regurgitation of undigested food.

1) dilated esophagus
2) spastic esophageal contractions
3) cardia for drinking cold, cold water
4) uneven constriction over cardia

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 3 are correct

47
Q

What further examinations may confirm the above diagnosis?

A 48-year-old non-smoking, abstinent woman turns to you for having increased swallowing difficulties for half a year, weight loss, unpleasant mouth odor and frequent regurgitation of undigested food.

1) endoscopy
2) standard acid reflux test
3) esophageal manometry
4) 24-hour oesophageal pH monitoring

A)  	only answers 1, 2 and 3 are correct
B)  	only answers 1 and 3 are correct
C)  	only answers 2 and 4 are correct
D)  	only answer 4 is correct
E)  	all of the answers are correct
A

1 3 are correct

48
Q

Possible means of treatment, except:

A 48-year-old non-smoking, abstinent woman turns to you for having increased swallowing difficulties for half a year, weight loss, unpleasant mouth odor and frequent regurgitation of undigested food.

A)  	diltiazem
B)  	pneumatic dilatation
C)  	metoprolol
D)  	nitroglycerin
E)  	cardiomyotomy
A

C) metoprolol

cardio selective beta blocker has no effect

SOTE 2020 (7 decks)

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