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SURGERY > Stomach > Flashcards

Stomach Flashcards

1
Q

Recognizable as an asymmetrical, pear shaped and most proximal abdominal organ

A

Stomach

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2
Q

BLOOD SUPPLY (ARTERY)
Less curvature

A

Right epigastric art. <– common hepatic artery

Left gastric artery <– celiac trunk

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3
Q

BLOOD SUPPLY (ARTERY)
Greater curvature

A

Right gastroepiploic artery <- gastroduodenal artery

Left gastroepiploic artery <- splenic artery

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4
Q

BLOOD SUPPLY (ARTERY)
Fundus

A

Short gastric artery <- splenic artery

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5
Q

Induces acid secretion: (3)

A

Acetylcholine
Histamine
Gastrin

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6
Q

Inhibits acid secretion

A

Somatostatin

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7
Q

Products produced by chief (zymogenic) cells (3)

A

Pepsinogen
Gastric lipase
Leptin

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8
Q

Products produced by parietal (oxyntic) cells

A

Hydrochloric acid
Intrinsic factor

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9
Q

Most serious complication of stomach related illness (?)

A

Perforation

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10
Q

Radiologic test that is helpful in the diagnosis of gastric perforation or delayed gastric emptying

A

Plain chest x-ray upright

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11
Q

Focal defects in the gastric or duodenal mucosa which extends into the submucosa or deeper

A

Peptic ulcer

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12
Q

All gastric ulcer and areas of gastritis should undergo this diagnostic test

A

Biopsy

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13
Q

Most common symptom for ulcer

A

Bleedjng

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14
Q

Diagnostic test for patients suspected to have gastrinoma

A

Serum gastrin levels

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15
Q

Screening for dysphagia but will not confirm diagnosis of ulcer

A

Barium meal examination

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16
Q

Indications for surgery of ulcers:

A

▪️Persistent bleeding / rebleeding after endoscopic therapy
▪️Significant hemorrhage (>4 units/24hr)
▪️Ulcers located at the posterior duodenal bulb and ulcers located at the gastric lesser curvature
▪️ High risk of rebleeding based on endoscopic findings

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17
Q

What do you find in your upright chest radiograph for patients with perforation?

A

Pneumoperitoneum

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18
Q

Common presentation of patients with gastric outlet obstruction

A

Nonbilous vomiting

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19
Q

Sloshing sound heard during sudden movement of patient on abdominal exam

A

Succussion splash

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20
Q

Alarm symptoms of your ulcer (5)

A

Weight loss
Bleeding
Recurrent vomiting
Anemia
Dysphagia

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21
Q

Medical treatment of PUD

A

Inhibition of acid secretion
Smoking cessation
Alcohol avoidance
NSAID withdrawal
Eradicate H.pylori
Repeat EGD and biopsy 6-8 weeks

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22
Q

Surgical Indication for peptic ulcer (4)

A

Intractable pain
Hemorrhage
Perforation
Obstruction

23
Q

Most common surgical procedure performed for gastric outlet obstruction related to PUD

A

Vagotomy and antrectomy
Vagotomy and pyloroplasty
Truncal vagotomy and gastrojejunostomy
Pyloroplasty

24
Q

Gastric ulcer Type:
Antral lesser curvature (most common)

A

Type I

25
Q

Gastric ulcer Type:
Type I ulcer + duodenal ulcer

A

Type II

26
Q

Gastric ulcer Type:
Prepyloric ulcer

A

Type III

27
Q

Gastric ulcer Type:
High in the lesser curvature

A

Type IV

28
Q

Gastric ulcer Type:
NSAID induced

A

Type V

29
Q

Most commonly associated with Bilroth II gastrojejunostomy

A

Bile or Alkaline Reflux Gastritis

30
Q

Triad of Alkaline Reflux Gastritis

A

Constant epigastric pain
Nausea
Bilious emesis

31
Q

Your diagnosis when endoscopy reveals inflamed, beefy red, friable gastric mucosa. Patient post bilroth II

A

Alkaline Reflux Gastritis

32
Q

Management for alkaline reflux gastritis

A

Roux-en-Y gastrojejunostomy

33
Q

Uncontrolled secretion of gastrin by a pancreatic or duodenal neuroendocrine tumor

A

Gastrinoma (Zollinger - Ellison Syndrome)

34
Q

Most common pancreatic tumor in patients with MEN1

A

Gastrinoma

35
Q

Presentation of gastrinoma (3)

A

Epigastric pain
GERD
Diarrhea

36
Q

Majority of gastrinomas are found in this triangle

A

Passaro triangle

37
Q

Pasarro triangle is formed by 3 points

A

▪️CBD and cystic duct
▪️2nd and 3rd portion of the duodenum junction
▪️junction of the neck and body the pancreas

Mnemonic: peptic-causing-disease

38
Q

Confirmatory test for gastrinoma

A

Secretin stimulation test
Gastrin >200 pg/mL after IV secretion administration

39
Q

Most common malignant tumor in the stomach

A

Adenocarcinoma

Note: in the esophagus its SCC

40
Q

Classification used for adenocarcinoma of the stomach

A

Lauren classification

41
Q

Most common presentation of stomach adenocarcinoma (3)

A

Weight loss
Anorexia
Early satiety

42
Q

Results from functional obstruction due to disruption of normal propagation of pacesetter potentials in the Roux limb from the proximal duodenum, as well as altered motility in gastric remnant

A

Roux stasis syndrome

43
Q

Diagnostic modalities useful for postoperative surveillance for gastric adenocarcinoma

A

CEA

44
Q

Diagnostic gold standard for gastric adenocarcinoma

A

Upper endoscopy (EGD) + biopsy

45
Q

Most frequently used modality for staging for gastric adenoCA

A

Abdominal or pelvic CT with IV and oral contrast

46
Q

detect occult metastases in up to 31% of cases in gastric adenoCA

A

Staging laparoscopy with peritoneal fluid cytology

47
Q

Low detection rate due to low tracer accumulation in diffuse and mucinous tumor (30%)

A

PET scan

48
Q

In Radical subtotal gastrectomy, you remove the following: (4)

A

Distal 75% of the stomach
Pylorus + 2cm of proximal duodenum
Greater and lesser omentum
Associated lymph nodes

49
Q

Associated with protein losing enteropathy & hypochlorhydria

A

HYPERTROPHIC GASTROPATHY (Ménétrier Disease)

50
Q

Presentation of HYPERTROPHIC GASTROPATHY (Ménétrier Disease) (4)

A

middle-aged men with epigastric pain
weight loss
diarrhea
hypoproteinemia

51
Q

Gastric carcinoid tumors arise from what cells

A

ECL cells

52
Q

Carcinoid triad:

A

Flushing, diarrhea, right sided heart failure

53
Q

blind loop syndrome (3)

A

steatorrhea, Vitamin B12, folate, & iron deficiency

SURGERY (11 decks)

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