Session 5 - Stomach 2

Question 1

How do you diagnose and treat gastritis?

Answer 1

• FBC or a stool test can be used to diagnose
• Treated with antacids, or proton pump inhibitors or antibiotics

Question 2

What is a peptic ulcer?

Answer 2

Peptic ulcer is a break in superficial epithelial cells penetrating down into the muscularis mucosa of either the stomach or the duodenum

Question 3

How does a peptic ulcer present?

Answer 3

Presents with abdominal pain, nausea, loss of appetite, hematemesis (vomiting of blood). Pain worse at night and relieved when eating.

Question 4

How would you diagnose a peptic ulcer?

Answer 4

endoscopy

Question 5

How would you treat a peptic ulcer

Answer 5

PPIs, antibiotic to kill H. pylori

Question 6

How would a gastric cancer present?

Answer 6

heartburn, nausea, weight loss, yellow skin, dysphagia

Question 7

How would you diagnose a gastric cancer?

Answer 7

Endoscopy and biopsy

Question 8

How would you treat a gastric cancer?

Answer 8

surgery, chemo, radiotherapy

Question 9

How does GORD present?

Answer 9

Dyspepsia (heart burn) which is worse on lying down, bending over and drinking hot drinks.

Question 10

How would you diagnose and treat GORD?

Answer 10

• Diagnosis – Based on symptoms, endoscopy
• Treatment – Lose weight, reduce alcohol, antacids, PPIs.

Question 11

Describe the features of H pylori

Answer 11

H pylori is a gram negative, aerobic, helical, urease producing bacterium that resides in the stomach of infected individuals.

Question 12

How does H pylori survive in the stomach?

Answer 12

Production of urease produces ammonia, which neutralises acidic environment, which allows bacterium to survive.

Question 13

How would you treat an ulcer that formed due to H pylori infection?

Answer 13

• Proton Pump Inhibitor – Omeprazole
• Two Antibiotics – Clarithromycin / Amoxicillin
• H2 Antagonist (if severe) Stop treatment of NSAIDs

Question 14

Label the following

Answer 14

Question 15

Identify the spinal level of the inferior oesophageal sphincter

Answer 15

T 11

Question 16

Label the following

Answer 16

Question 17

Where is the greater omentum attached?

Answer 17

Greater curvature of the stomach

Question 18

Where is the lesser omentum attached?

Answer 18

Liver, duodenum, and Stomach via lesser curvature

Question 19

Label

Answer 19

Question 20

What spinal level does the coeliac trunk branch from?

Answer 20

T 12

Question 21

What spinal level does the SMA branch from?

Answer 21

L1

Question 22

What spinal level does the IMA branch from?

Answer 22

L3

Question 23

What arteries supply the stomach?

Answer 23

Gastric and gastroepiploic

Question 24

Where do the left and right gastric veins drain into?

Answer 24

Hepatic portal

Question 25

What is the name of the entrance to the lesser sac? Where is it located?

Answer 25

Epiploic foramen Just inferior to the lesser omentum