Stomach

Question 1

Diagnostic criteria for Zollinger-Ellison Syndrome (2)

Answer 1

fasting gastrin > 1000
pH < 2

Question 2

Gastrin increase w/ secretin stimulation for ZES

Answer 2

> 120

Question 3

Antibodies positive in celiac (2)

Answer 3

anti-tTG IgA
EMA

Question 4

Follow-up testing for celiac (2)

Answer 4

total IgA for IgA deficiency
repeat anti-tTG IgA after 6-12 months gluten free

Question 5

Biopsy findings for celiac

Answer 5

villous atrophy

Question 6

Route through the stomach

Answer 6

cardia - fungus - body - antrum

Question 7

Fundus function

Answer 7

gas storage

Question 8

Body of stomach function

Answer 8

food digestion

Question 9

Antrum function

Answer 9

churning

Question 10

Key regulators/stimulators of gastric acid (3)

Answer 10

1) gastrin
2) histamine - released from enterochromaffin-like cells
3) acetylcholine - released by vagal stimulation

Question 11

Tests for H. pylori diagnosis (3)

Answer 11

urea breath
stool antigen
biopsy via EGD

Question 12

Common supplementation needed post-gastrectomy (3)

Answer 12

vitamin B12
iron
calcium

Question 13

Testing for H. pylori eradication (2)

Answer 13

1) urea breath test
2) or stool antigen after 4 wks

Question 14

Gastric emptying study parameters (3)

Answer 14

<60% at 2 hrs
<10% at 4 hours
half-life > 90 minutes

Question 15

Treatment of severe cases of salmonella

Answer 15

ciprofloxacin 500 mg BID for 5-7 days

Question 16

Most common location of gastric ulcer

Answer 16

antrum

Question 17

Pain timing of gastric vs duodenal ulcer

Answer 17

gastric: soon after eating
duodenal: 2-5 hrs later, usually relieved by food

Question 18

Acid exposure time on ambulatory pH monitoring for GERD

Answer 18

> 4.2% of 24 hrs

Question 19

Diagnosis of carcinoid syndrome

Answer 19

elevated 24-hr urinary 5-HIAA

Question 20

Ulcer pain that improves w/ food

Answer 20

duodenal

Question 21

Ulcer pain that worsens w/ food

Answer 21

gastric

Question 22

Screening required following carcinoid diagnosis

Answer 22

cardiac valvulopathy

Question 23

Most common location of NSAID-induced ulcer

Answer 23

stomach

Question 24

Most common location of H. pylori-induced ulcer

Answer 24

duodenum

Question 25

Dor fundoplication wrap degree and position

Answer 25

180 degrees, anterior

Question 26

Toupet fundoplication wrap degree and position

Answer 26

270 degrees, posterior

Question 27

Nissen fundoplication wrap degree and position

Answer 27

360 degrees, complete wrap

Question 28

Best fundoplication if esophageal motility issues

Answer 28

Toupet

Question 29

Best fundoplication for dysphagia risk

Answer 29

Dor

Question 30

Most effective fundoplication for reflux control

Answer 30

Nissen