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ABSITE > Stomach > Flashcards

Stomach Flashcards

1
Q

Type 1 Hiatal Hernia

A

Sliding >90%

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2
Q

Type 2 Hiatal hernia

A

Purely paraesophageal - GE junction is in the NORMAL location

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3
Q

Type 3 hiatal hernia

A

Combined sliding and paraesophageal

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4
Q

Type IV hiatal hernia

A

Entire stomach in chest + another organ (usually colon) - needs repair

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5
Q

Type I gastric ulcer - location and cause

A

Lesser curve - decreased mucosal protection

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6
Q

Type II gastric ulcer - location and cause

A

Lesser curve and duodenum - increased acid production

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7
Q

Type III gastric ulcer - location and cause

A

Type THREE = PRE pyloric - increased acid production

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8
Q

Type IV gastric ulcer - location and cause

A

Proximal lesser curve - decreased mucosal protection

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9
Q

Type V gastric ulcer - location and cause

A

Diffuse - NSAIDS

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10
Q

Siewart Classification - Class I

A

1-5 cm above GE junction

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11
Q

Siewart Classification - Type II

A

Within 1cm above and 2cm below the GE junction

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12
Q

Siewart Classification Type 3

A

2-5cm below the GE junction

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13
Q

Type of volvulus that cases rotation along axis of stomach from GE junction to pylorus

A

Organoaxial

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14
Q

Type of volvulus that causes rotation along short axis of stomach bisecting the lesser and greater curvature

A

Mesoaxial

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15
Q

Deemester score of greater than _____ indicates reflux

A

14.72

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16
Q

Bochdalek Hernia

A

Diaphragmatic posterior lateral

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17
Q

Morgagni Hernia

A

Congenital Anterior Diaphragmatic Hernia

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18
Q

H. pylori triple therapy

A
  1. Amoxicillin (or Flagyl), 2. Clarithromycin, 3. PPI
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19
Q

Treatment for bleeding that cannot be controlled endoscopically?

A

Midline laparotomy, anterior gastrotomy, oversew the bleeding area, biopsy, close

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20
Q

Treatment for duodenal bleeding that cannot be controlled endoscopically?

A

Longitudinal anterior duodenotomy, control bleeding with sutures placed superior and inferior to ulcer (taking care to avoid CBD), approximate ulcer crater, close duodenotomy transversely - 0 Vicryl UR 6

21
Q

Hereditary diffuse gastric cancer is caused by a germline mutation in?

22
Q

Women with CDH1 are at increased risk of?

23
Q

FAP is caused by a mutation on which gene?

24
Q

T1b gastric cancer invades into?

A

The submucosa

25
Q

T1a gastric cancer invades into?

A

Lamina propria or muscularis mucosa

26
Q

Who gets neoadjuvant chemo in gastric cancer?

A

T2 (invades muscularis propria) or higher or any N

27
Q

How many lymph nodes are needed in gastric cancer resection?

28
Q

D1 dissection

A

Stations 1-6

29
Q

D2 dissection

A

Stations 7-11

30
Q

Adjuvant therapy in gastric cancer

A

5FU based therapy - T3 (invades into subserosa), T4 (invades through serosa or adjacent structures) or node + disease after R0 (negative microscopic margin) resection

31
Q

Gastric mass with expansion of marginal zone compartment with sheets of lymphoid cells

A

Maltoma- Treatment of H. pylori

32
Q

Which hormone is inhibited by acidification of the duodenum?

33
Q

What is the treatment of GIST?

A

All should be resected with wedge, R0 resection if greater than or equal to 2cm

34
Q

Stomach mesenchymal neoplasm expressing CD117 and KIT

35
Q

What is a D2 dissection?

A

Removal of perigastric lymph nodes + nodes around the left gastric, common hepatic, celiac and splenic arteries

36
Q

What surgery is performed for mid-distal gastric cancers?

A

Partial gastrectomy with 5cm proximal margin and 2cm distal margin on the duodenum

37
Q

Surgical option for refractory gastroparesis?

A

Pyloroplasty

38
Q

Gastric emptying study is abnormal if?

A

> 60% of tracer present after 2 hrs, or >10% remains after 4 hrs

39
Q

Which type of polyps have no malignant potential?

A

Fundic polyps

40
Q

Spiral shaped, gram negative, motile bacteria that reside in the mucosa of the stomach

41
Q

Treatment of bile reflux after partial gastrectomy?

A
  1. Lifestyle management, weight loss, cholestyramine
  2. Conversion to Roux-en-Y
42
Q

What is the most common type of Sarcoma found in the GI tract?

A

GIST - originating from the interstitial cells of Cajal

43
Q

Absolute contraindications to PD catheter placement

44
Q

Which type of vagotomy patients have higher incidence of dumping syndrome?

A

Truncal vagotomy

45
Q

Highly selective vagotomy

A

Removes innervation only to the lesser curvature (pylorus preserving)

46
Q

Truncal vagotomy

A

Removes innervation to both vagus nerves (pylorus loses function) - requires drainage

47
Q

Placement of vagus nerve at GE junction

A

Left anterior, right posterior (LARP)

48
Q

Stage IV gastric lymphoma (bleeding or obstruction management)

A

Chemotherapy, palliative gastrectomy

49
Q

Which technique can help to reduce gastric band slippage?

A

Pars-flaccida technique

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