Gastric Disease

Question 1

Gives causes of acute gastritis

Answer 1

Chemical irritation
Trauma
Burns

Question 2

What are the 3 main causes of chronic gastritis?

Answer 2

Chemical insult
Bacterial (H. pylori)
Autoimmune disease

Question 3

In terms of aetiology of chronic gastritis, chemical insult rarer than bacterial infection which is rarer than autoimmune disease. True/False?

Answer 3

False

Other way around! Chemical insult is most common, followed by bacterial, then autoimmunity

Question 4

What happens in autoimmune gastritis?

Answer 4

Antibodies destroy parietal cells + intrinsic factor

Can lead to pernicious anaemia

Question 5

What is the most common bacteria that causes bacterial gastritis?

Answer 5

H. pylori

Question 6

Where does H. pylori like to reside?

Answer 6

Between the epithelial cell surface + mucosal barrier, where it can cause inflammation

Question 7

Which chemicals are the most common causes of chemical gastritis?

Answer 7

NSAIDs
Alcohol
Bile reflux

Question 8

How does chemical insult affect the stomach?

Answer 8

Dissolves + destroys lipid bilayer, causing inflammation, hyperplasia and ulcers

Question 9

Define “peptic ulceration”

Answer 9

Breach of the GI mucosa by acid/pepsin attack

Question 10

Where are common sites for peptic ulcers?

Answer 10

Duodenum (1st part)
Stomach
Gastro-oesophageal junction

Question 11

Name some benign gastric tumours

Answer 11

Mainly polyps - hyperplastic polyps or fundic gland polyps

Question 12

Name some malignant gastric tumours

Answer 12

Adenocarcinoma
Lymphomas
Gastrointestinal stromal tumours (GISTs)

Question 13

Where do adenocarcinomas of the stomach tend to develop?

Answer 13

Proximally (GO junction, cardia)

Question 14

Pernicious anaemia is a premalignant condition. True/False?

Answer 14

True

Question 15

Intestinal type gastric adenocarcinoma has better prognosis than diffuse type. True/False?

Answer 15

True

Question 16

From which tissue is gastric lymphoma derived?

Answer 16

MALT (mucosal-associated lymphoid tissue)

Question 17

What is gastroparesis?

Answer 17

Delayed gastric emptying that is NOT due to obstruction

Question 18

Give examples of symptoms of gastroparesis

Answer 18

Feeling of fullness, bloating
Nausea, vomiting
Weight loss
Upper abdominal pain

Question 19

What investigations are done for gastric cancer?

Answer 19

Endoscopy
Barium meal
CT scan

Question 20

In surgery for gastric cancer, when is a partial and total gastrectomy done?

Answer 20

Total gastrectomy for proximal lesions

Partial gastrectomy for distal lesions

Question 21

What is the classical sign for gastric cancer? List other symptoms

Answer 21

Troisier’s sign - the finding of a palpable left supraclavicular lymph node
Dyspepsia, weight loss, vomiting, dysphagia, anaemia, fatigue, abdo pain, bloating, anorexia early satiety

Question 22

What staging techniques are used in gastric cancer?

Answer 22

CT
PET scan
Endoscopic US

Question 23

What are the main causes of gastroparesis?

Answer 23

DM
Cannabis
Meds - opiates, anticholinergics
Systemic disease e.g. sclerosis

Question 24

What investigation is done in gastroparesis? How is it treated?

Answer 24

Gastric emptying studies

Liquid/ sloppy diet, remove cause, eat small meals often, promotility agents