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GIT > Esophagus, Stomach > Flashcards

Esophagus, Stomach Flashcards

1
Q

First diagnostic test in patients with suspected esophageal disease

A

Barium swallow.

Determines ANATOMIC problems. if you want to do functional, you can use marshmallow impregnated with barium swallow

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2
Q

Most direct mehod of measuring increased esophageal exposure to gastric juice (not reflux)

A

24 hour ambulatory pH monitoring

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3
Q

Gold standard for the diagnosis of Gerd

A

24 hour ambulatory pH monitoring

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4
Q

Most common esophageal pathology

A

GERD

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5
Q

Most common esophageal pathology

A

GERD

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6
Q

MC defect of GERD

A

Intrabdominal esophageal length is less than 1 cm (normal: 2-4cm)

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7
Q

MC antireflux surgical prodecure and is the surgical standard of care

A

Nissen fundoplication
- full 360 degrees

Partial: Toupet fundoplication and Dor Fundoplication

Increase length: Collis gastroplasty

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8
Q

MC antireflux surgical prodecure and is the surgical standard of care

A

Nissen fundoplication
- full 360 degrees

Partial: Toupet fundoplication and Dor Fundoplication

Increase length: Collis gastroplasty

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9
Q

MC type of esophageal hernia

A 
Type 1 (slidding hernia)
- upward dislocation fo GE junction and cardia into the thorax throgh the esopageal hiatus of the diaphragm.
CM: GERD

vs
Type 2 rolling or paraesophageal hernia: fundus
CM obstructive. tx sx
Type 3: combin

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10
Q

chest pain
Retching with inability to vomit
Inability to pass NGT

What do you call this triad

A

Borchardt triad

- Indicative of incarcerated intra thoracic stomach

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11
Q

MC esophageal diverticula

A

Zenker diverticulum

- d/t high pressure generated in the hypopharynx

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12
Q

potential weakness behind the cricopharyngeus muscle. A RF for zenker diverticulum

A

Killian triangle: potential weakness behind the cricopharyngeus muscle

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13
Q

Hypertensive LES
Aperistalsis of esophageal body
Failure of LES to relax

A

Achalasia

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14
Q

Treatment of choice for achalasia

A

Heller myotomy + partial fundoplication

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15
Q

MC primary esophageal motility disorder

A

Nutcracker esophagus / Hypertensive peristalsis

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16
Q

In caustic injury, this is the phase where px is most symptomatic.

A

Acute necrotic phase (first phase)

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17
Q

In caustic injury, this is the phase where you should do surgery

A

First phase acute necrotic phase (1 to 4 days)

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18
Q

In caustic injury, this is the phase where the esophagus is at its weakest

A

2nd phase Ulceration and granulation phase (3-5 days)

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19
Q

MC site of perforation in caustic injuries

A

Mid esophagus

20
Q

MC type if esophageal CA

A

SCC

21
Q

Cervical sympathetic nerve involved in Horner syndrome (ptosis myosis and anhydrosis)

A

C4

22
Q

Cervical sympathetic nerve involved in Horner syndrome (ptosis myosis and anhydrosis)

A

C4

23
Q

CURATIVE surgery for esophageal carcinoma

A

Transthoracic (Ivor Lewis)

Vs transhiatal (Orringer and Sloan)

24
Q

MCC of drug induced esophageal web

A

FeSO4

25
Q 
Dysphagia
Atrophic oral mucosa
Spoon shaped fingers
Brittle nails 
chronic anemia
A

Plummer vinson syndrome

26
Q

Most impt management for tracheoesophageal atresia /fistula

A

Ventilatory support

27
Q

Criminal nerve of Grassi supplies what organ?

A

Posterior fundus of the stomach

28
Q

Secretes HCl and intrinsic factor (for B12)

A

Parietal or Oxyntic cells

29
Q

Most numerous cells in the stomach

A

Chief / Zymogenic cells
Secretes pepsinogen
Gastric lipase
Leptin

30
Q

Cells left after vagotomy

A

Enterochromaffin LIKE cells : secretes Histamine

31
Q 
Gastric cells which secretes serotonin
A. Enterochromoffin cells
B. Enterochromoffin like cells
C. S cells
D. Zymogenic cell
A

A

32
Q

Gold standard for h pylori diagnosis

A

Histologic examination of antral mucosal biopsy

33
Q

Standard for test to CONFIRM eradication of H pyrloru post treatment

A

Urease breath test1

34
Q

MC type of gastric ulcer

A

Type 1 antral lesser curvature

Type V NSAID induced

35
Q

MC pancreatic tumor in patinets with MEN I

A

Gastrinoma (Zollinger Ellison syndrome)

36
Q

MC neoplasm of the stomach

A

Adenocarcinoma 95%

37
Q

Type of stomach CA with worse prognosis

A

Diffuse type

- leather bottle

38
Q

LN metastasis at the pelvix cul de sac secondary to gastric CA

A

Blumer shelf

39
Q

Gold standard for dx of gastric CA

most sensitive and most specific

A

Upper endoscopy with biopsy

40
Q

MC location of gastric CA

A

Antrum / distal 75%
Vs ulcers: lesser curvature

Tx of choice: radical subtotal gastrectomy

41
Q

Characteristic of Diffused type of gastric cancer

A

Signet ring cells
Lanitis plastica
Leather bottle appearance
Non distendable stomach

42
Q

First line treatment for low grade gastric lymphoma

A

H. pylori eradication

If highgrade: chemoradiation

43
Q

Rapidly increasing gastric tumor, (+) donut sign on barium study

A

GIST: thickening of the submucosa

44
Q

Case: 30 yo man with intermittent bleeding. On endoscopy, there is normal appearing mucosa but with pulsating blood. Dx?

A

Dieulafoy lesion

Bleeding from a submucosal vessel

45
Q

Surgical management for Pyloric stenosis

A

Fredet Ramsted pyloromyotomy

  • spreading he muscle mucosa until it bulges to level of serosa
  • serosa and muscle layer only

GIT (2 decks)

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