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SURGERY > Stomach > Flashcards

Stomach Flashcards

1
Q

Blood supply of the lesser curvature of stomach

A

Right gastric artery from common hepatic artery
Left gastric artery from celiac trunk

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2
Q

Blood supply of greater curvature

A

Right gastroepiploic artery from gastroduodenal artery
Left gastroepiploic artery from splenic artery

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3
Q

Blood supply of fundus

A

Short gastric artery from splenic artery

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4
Q

Protective mucus layer that contains bicarbonate and glyco protein

A

Surface mucous cells

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5
Q

Cells that contain pepsinogen

A

Mucus neck cell

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6
Q

Produces HCl and Intrinsic Factor

A

Parietal (oxyntic) cell

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7
Q

Stimuli of HCL secretion

A

Histamine
Gastrin
Acetylcholine

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8
Q

Chief cells produces?

A

Gastric lipase
Pepsinogen
Leptin

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9
Q

Release serotonin

A

Enterochromaffin cells

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10
Q

Release Histamine

A

Enterochromaffin LIKE cells

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11
Q

Release somatostatin

A

D cells

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12
Q

Release Gastrin

A

G cells

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13
Q

Alarm symptoms

A

Weight loss
Bleeding
Recurrent vomiting
Anemia
Dysphagia

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14
Q

Purpose of biopsy in ulcers

A

Rule out carcinoma
Document h pylori infection

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15
Q

Test of choice for h.pylori detection if endoscopy is not indicated

A

Serology

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16
Q

Most common complication of ulcers

A

Bleeding presented as melena or hematemesis

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17
Q

Indications for surgery

A

Persistent bleeding/rebleeding after endoscopic therapy
Significant bleeding (> 4 units/24hr)
Elderly px with co-morbidities
Ulcers located at posterior duodenal bulb or greater curvature
High risk of rebleeding based on endoscopic findings

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18
Q

A post gstrectomy problem caused by destruction of pyloric sphincter causing abrupt delivery of hyperosmolar load to the small intestines

A

Dumping syndrome

19
Q

2 types fo dumping syndrome

A

Early dumping (15-30 mins post prandial)
Late dumping (2-3 hours post prandial)

20
Q

Early dumpling is due to?

A

Peripheral and splanchnic vasodilation leadinh to shock like sx that is relieved by saline or recumbancy

21
Q

Non surgical tx for early dumping

A

Octreotide

22
Q

Late dumping syndrome is due to?

A

Hyperinsulinemia with reactive hypoglycemia

23
Q

Non surgical tx for late dumping secretion

A

Alpha glucosidase inhibitor

24
Q

Triad of bile or alkaline reflux gastritis

A

Constant epigastric pain
Nausea
Bilious emesis

25
Q

Endoscopy result of bile or alkaline reflux gastritis

A

Inflammation
Beefy red
Friable gastric mucosa

26
Q

Results from functional obstruction due to disruption of normal propagation of pacesetter potentials in roux limb as well as altered motility in gastric remnant

A

Roux stasis syndrome

27
Q

Clinical manifestations of roux stasis syndrome

A

Chronic abdominal pain
Nausea
Vomiting that is aggravated by eating

28
Q

Non operative tx for roux stasis syndrome

A

Pro-motility drugs

29
Q

Uncontrolled secretion of gastrin by a pancreatic or duodenal neuroendocrine tumor

A

Gastrinoma (zollinger ellison)

30
Q

Most common pancreatic tumor in patients with MEN1

A

Gastrinoma (zollinger-ellison)

31
Q

Most important risk factors for Gastric Adenocarcinoma

A

H.pylori infection
Atrophic gastritis
Family history

32
Q

Most common etiologic lesions that create an environment for gastric inflammation to develop

A

H. Pylori infection
Autoimmune gastritis

33
Q

2 types of hitological adenocarcinoma

A

Intestinal type
Diffused type

34
Q

Paraneoplastic syndrome seen in gastric adenocarcinoma

A

Trosseau syndrome (migratory thrombophlebitis)
Acanthosis nigrans

35
Q

Treatment for low grade gastric lymphoma

A

Nonsurgical
1st line is H. Pylori eradication

36
Q

GIST arise from

A

Interstitial cells of Cajal

37
Q

Prognostic factors for GIST

A

Tumore size and mitotic count

38
Q

Tumor marker for GIST

A

C-KIT (CD117)
CD34

39
Q

Treatment for GIST

A

Wedge resection with negative margins

40
Q

Tx for unresectable GIST

A

Imatinib

41
Q

Carcinoid triad

A

Diarrhea
Flushing
Right sided heart failure

42
Q

Associated with protein losing enteropathy and hypochlorhydia commonly presents in middle aged men with epigastric pain, weight loss, diarrhea and hypoproteinemia

A

Hypertrtophic gastropathy / menetrier’s disease

43
Q

Biopsy findings in menetrier’s disease

A

Diffuse hyperplasia of surface mucus secreting cells and decrease parietal cells

SURGERY (6 decks)

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