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ABSITE > Foregut > Flashcards

Foregut Flashcards

1
Q

Bleeding duodenal ulcer refractory to endoscopy and unstable; next step

A

Duodenotomy and oversewing GDA and transverse pancreatic

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2
Q

Initial management of phytobezoar

A

Chemical dissolution (Coca-Cola)

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3
Q

Released from parietal cells and aids in B12 absorption in the TI

A

Intrinsic factor

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4
Q

Gastroparesis refractory to medical therapy; tx

A

Pyloroplasty and gastric pacemaker

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5
Q

Tx marginal ulcers in RYGB

A

PPI

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6
Q

Unique about gastric fundic polyps

A

No malignant potential

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7
Q

Options for ERCP with RYGB

A

Lap assisted, balloon enteroscopy

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8
Q

T1 gastric cancer distal 2/3rds of stomach; tx

A

Partial gastrectomy with 5cm prox and 2cm distal margin + D2 LND

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9
Q

Indication for neoadjuvant chemo in gastric cancer

A

Potentially resectable T2N0 (muscularis propria) or higher non-cardia gastric cancer

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10
Q

Dx test for gastro-gastric fistula s/p gastric division procedures

A

Oral contrasted CT or upper GI

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11
Q

Most common sarcoma in the GI tract and where

A

GIST, stomach then SB

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12
Q

Staging laparoscopy for gastric cancer

A

Peritoneal washings from left/right parabolic gutters and pelvis as well as suspicious nodules

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13
Q

Sign of highest risk of rebleed, peptic ulcer

A

Pulsatile bleed

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14
Q

Classification for Endoscopic findings and rebleeding risk in PUD

A

Forrest classification
Ia - active pulsatile bleeding
Ib - active oozing
IIa - nonbleeding vessel
IIb - adherent clot
Iic - black spot
III - clean base

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15
Q

Absolute contraindication for peritoneal dialysis catheter placement

A

Impaired mental ability to care for it
Severe protein malnutrition
Active intraabdominal infection
Frequent diverticulitis

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16
Q

Secreted by D cells and inhibits insulin, glucagon and PP

A

Somatostatin

17
Q

Initial tx of bile reflux and alkaline reflux gastritis after partial gastrectomy

A

Weight loss, smoking cessation, small frequent meals, cholestyramine

18
Q

Absolute contraindications to PEG placement

A

Active infection
Complete oropharyngeal/esophageal obstruction
Hemodynamic instability
Peritoneal carcinomatosis
Severe malnutrition
Uncontrolled ascites
Uncorrected coagulopathy

19
Q

Spiral shaped, gram-neg, motile bacteria, increase risk for PUD and gastric cancer

A

H. Pylori

20
Q

Lifestyle modification that can treat marginal ulcers s/p RYGB

A

Snoking cessation

21
Q

Hx lap band with free intraperitoneal air; dx and tx

A

Band erosion, band removal and defect repair

22
Q

Proximal gastric adenocarcinoma; tx

A

Total gastrectomy

23
Q

Gastric emptying; study, dx result, tx

A

Gastric emptying study, >60% tracers at 2hrs or >10% at 4hrs, Dopamine receptor antagonists (Metoclopramide and domperidone)

24
Q

Initial Gastric Outlet Obstruction management

A

H Pylori eradication and endoscopic balloon dilation

25
Q

Types of vagotomy, describe, which need drainage procedure

A

Truncal - main trunk, need drainage
Selective - Ant/Post nerves of Latarjet, need drainage
Proximal - highly selective fibers innervating parietal cells

26
Q

First line therapy for suspected GI bleed

A

EGD

27
Q

Acute pancreatitis with duodenal diverticula identified on ERCP; management

A

Treat pancreatitis, subsequent diverticulectomy

28
Q

S/p Billroth II with severe pain and non bilious emesis, dilated limb proximal to anastomosis; dx and tx

A

Afferent loop syndrome, immediate operation to prevent bowel necrosis or duodenal blowout

29
Q

Prevention of afferent loop syndrome during Billroth reconstruction

A

Keep afferent limb <12-15cm from LT

30
Q

Early dumping timing and etiology

A

15-60min, hyperosmolality leading to rapid fluid shift

31
Q

Late dumping syndrome timing and etiology

A

2-3hrs, Hyperinsulinemia after carb ingestion

32
Q

GIST antigen and gene

A

CD117 and KIT

33
Q

Released by K cells, decreases acid secretion and stimulates insulin

A

GIP

34
Q

Released by G cells, stimulated by alkaline environment

A

Gastrin

35
Q

Released by S cells, inhibits gastrin and stimulates bicarb

A

Secretin

36
Q

Acidification of duodenum stimulates what

A

Somatostatin, Secretin, GIP, Motilin

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