Stomach

Question 1

What are the four regions of the stomach?

Answer 1

Fundus

Question 2

What are the two sphincters in the stomach?

Answer 2

Pyloric sphincter

Question 3

What are the four layers of the stomach wall?

Answer 3

Mucosa

Question 4

What is the definition of a peptic ulcer?

Answer 4

A break in the lining of the mucosa ≥5 mm with submucosal extension.

Question 5

What is the difference between an ulcer and an erosion?

Answer 5

Ulcer ≥5 mm

Question 6

What are the four types of gastric ulcers?

Answer 6

Type I (body)

Question 7

What is the most common cause of peptic ulcer disease (PUD)?

Answer 7

Helicobacter pylori (H. pylori) infection.

Question 8

What percentage of H. pylori-infected individuals develop peptic ulcers?

Answer 8

10-15%.

Question 9

What is the role of H. pylori in gastric cancer?

Answer 9

It increases the risk of gastric adenocarcinoma.

Question 10

What is the prevalence of H. pylori infection in the population?

Answer 10

~80%.

Question 11

What is the primary mechanism of NSAID-induced gastric damage?

Answer 11

Inhibition of prostaglandin synthesis (COX-1 inhibition).

Question 12

What are the two COX isoforms?

Answer 12

COX-1 (protective)

Question 13

What is the most common symptom of peptic ulcer disease?

Answer 13

Epigastric pain

Question 14

What is the gold standard for diagnosing peptic ulcers?

Answer 14

Esophagogastroduodenoscopy (EGD).

Question 15

What is the purpose of taking biopsies during EGD for gastric ulcers?

Answer 15

To rule out malignancy.

Question 16

What are the three main complications of peptic ulcer disease?

Answer 16

Bleeding

Question 17

What is the most common complication of PUD?

Answer 17

Gastrointestinal bleeding (15% of cases).

Question 18

What is the mortality rate of ulcer-related hemorrhage?

Answer 18

5-10%.

Question 19

What is the second most common complication of PUD?

Answer 19

Perforation (6-7% of cases).

Question 20

What is gastric outlet obstruction?

Answer 20

A complication of PUD causing nausea

Question 21

What is the treatment goal for H. pylori-related ulcers?

Answer 21

Eradication of H. pylori to prevent recurrence.

Question 22

What is the first-line treatment for H. pylori infection?

Answer 22

Triple therapy (PPI + two antibiotics).

Question 23

What is the role of proton pump inhibitors (PPIs) in PUD?

Answer 23

They inhibit gastric acid secretion by blocking H+

Question 24

When should PPIs be taken for maximum effectiveness?

Answer 24

Immediately before breakfast.

Question 25

What is the duration of PPI therapy for peptic ulcers?

Answer 25

8 weeks for healing.

Question 26

What is the recommended follow-up for H. pylori eradication?

Answer 26

Noninvasive tests (urea breath test or fecal antigen test).

Question 27

What is the treatment for NSAID-induced ulcers?

Answer 27

Discontinue NSAIDs and start PPI therapy.

Question 28

What is the most common cause of upper gastrointestinal bleeding (UGIB)?

Answer 28

Peptic ulcer disease.

Question 29

What is the management approach for acute UGIB?

Answer 29

Volume resuscitation followed by endoscopy.

Question 30

What is the role of endoscopic therapy in UGIB?

Answer 30

To control active bleeding (e.g.

Question 31

What is the mortality rate of perforated ulcers?

Answer 31

High

Question 32

What is the clinical presentation of a perforated ulcer?

Answer 32

Sudden onset of severe abdominal pain and peritonitis.

Question 33

What is the treatment for a perforated ulcer?

Answer 33

Surgical repair and PPI therapy.

Question 34

What is the most common site of duodenal ulcer penetration?

Answer 34

The pancreas.

Question 35

What is the most common site of gastric ulcer penetration?

Answer 35

The left hepatic lobe.

Question 36

What is the role of antacids in PUD treatment?

Answer 36

Symptomatic relief

Question 37

What is the role of mucosal protective agents in PUD?

Answer 37

They enhance mucosal defense (e.g.

Question 38

What is the most common symptom of gastric outlet obstruction?

Answer 38

Postprandial vomiting.

Question 39

What is the diagnostic approach to gastric outlet obstruction?

Answer 39

Endoscopy or imaging (e.g.

Question 40

What is the treatment for gastric outlet obstruction?

Answer 40

Endoscopic dilation or surgery.

Question 41

What is the most common cause of refractory ulcers?

Answer 41

Persistent H. pylori infection or NSAID use.

Question 42

What is the role of H2 receptor antagonists (H2RAs) in PUD?

Answer 42

They reduce gastric acid secretion but are less effective than PPIs.

Question 43

What is the most common endoscopic finding in peptic ulcers?

Answer 43

A well-defined mucosal defect with surrounding inflammation.

Question 44

What is the most common location for duodenal ulcers?

Answer 44

The duodenal bulb.

Question 45

What is the most common location for gastric ulcers?

Answer 45

The lesser curvature of the stomach.

Question 46

What is the role of COX-2 selective NSAIDs in PUD?

Answer 46

They reduce gastric damage compared to non-selective NSAIDs.

Question 47

What is the most common symptom of H. pylori gastritis?

Answer 47

Asymptomatic

Question 48

What is the most common complication of chronic H. pylori infection?

Answer 48

Peptic ulcer disease or gastric cancer.

Question 49

What is the most common cause of stress ulcers?

Answer 49

Critical illness or severe physiological stress.

Question 50

What is the treatment for stress ulcers?

Answer 50

PPIs or H2RAs for prophylaxis