gastric cancer

Question 1

etiology for upper gi bleeding?

Answer 1

ruptured esophageal varices
mallory weiss
booerhave syndrome
peptic ulcer disease
gastric cancer

Question 2

risk factors for adenocarcinoma of stomach?

Answer 2

-chronic gastritis
-h pylori infection
-smoking
-gastric ulcer

Question 3

symptoms of gastric adenocarcinoma?

Answer 3

weight loss, upper gi bleeding, anemia, dysphagia, early satiety and vomiting (gastric outlet obstruction), epigastric pain worse with food intake

krukenberg tumor: spread to ovaries
virchow node: spread to left supraclavicular node
sister mary joseph: periumbilical spread nodule

Question 4

diagnosis and pathology of adenocarcinoma of stomach? treatment?

Answer 4

endoscopy with biopsy, CT for metastasis, cbc for anemia

pathology:
important type is linitis plastica: thickening of gastric wall with leather bottle appearance. composed of signet ring cells (filled with mucin)

gastrectomy

Question 5

which gastric cancer is highly associated with h pylori? and treatment?

Answer 5

gastric lymphoma (MALT: non hodgkin lymphoma)
low grade: treat h pylori
high grade: gastrectomy

Question 6

GIST define, arise in which organ, pathology, treatment?

Answer 6

gastrointestinal stromal tumor arise from intestinal cells of cajal commonly in stomach.

pathology: have c-kit (CD117) expression leading to high activity of tyrosine kinase receptor.

treated with gastrectomy and imatinib

Question 7

gastric volvulus define, symptoms, diagnosis, treatment?

Answer 7

twisting of the stomach often associated with paraesophageal hernia

severe epigastric pain, inability to vomit, difficult NGT insertion

surgical untwist, repair hernia, gastropexy/gastrectomy if necrotic