Stomach

Question 1

In what region do we seen generalized pain from the stomach?

Answer 1

Epigastric

Question 2

What is the most common pathogen responsible for gastrointestinal infection?

Answer 2

Helicobacter pylori

Question 3

What is the unique appearance seen with the vomit associated with a stomach infection?

Answer 3

Hematemesis, “coffee ground” appearance

Question 4

What is the appearance of feces associated with a stomach infection?

Answer 4

Melena (black, tarry feces)

Question 5

What are risk factors for gastritis?

Answer 5

Alcohol, NSAIDs, age, chemotherapy, radiation therapy

Question 6

What leukocyte is present for the initial onset of acute gastritis?

Answer 6

Neutrophils

Question 7

What is the clinical term for acute gastritis that progresses into mucosal erosion, ulceration, and hemorrhage?

Answer 7

Acute erosive hemorrhagic gastritis

Question 8

What are risks for acute gastritis?

Answer 8

NSAIDs: ASA, ibuprofen, naproxen

Alcohol, smoking, irradiation, chemo, sepsis, physical trauma

Question 9

Why are NSAIDs a risk factor for acute gastritis?

Answer 9

Inhibition of bicarbonate production

Question 10

What are the medications used to treat acute gastritis?

Answer 10

PPIs, hydrogen receptor antagonists

Question 11

How do the medications for acute gastritis work?

Answer 11

Decrease gastric activity

Question 12

What is the condition of aspirin toxicity?

Answer 12

Salicylism

Question 13

Is an acute peptic ulceration the same as a peptic ulcer?

Answer 13

NO

Question 14

What are the two causes of acute peptic ulcerations?

Answer 14

Severe physiologic stress

NSAIDs

Question 15

What is the recovery timeline for acute gastritis?

Answer 15

Heals within a few days to weeks

Question 16

Acute peptic ulceration can occur in patients with what neural condition and why?

Answer 16

Intracranial disease due to increased ICP (via vagal nerve hypothesis)

Question 17

Which is more severe: acute or chronic gastritis?

Answer 17

Acute gastritis

Question 18

Hematemesis is rare in which kind of gastritis: acute or chronic?

Answer 18

Chronic

Question 19

Which form of gastritis has upper abdominal “discomfort” and which has epigastric pain?

Answer 19

Acute - epigastric pain

Chronic - upper abdominal discomfort

Question 20

Chronic gastritis is associated with what other GI condition?

Answer 20

Peptic ulcers

Question 21

What are the two major complications associated with chronic gastritis?

Answer 21

Peptic ulcer disease

Gastric adenocarcinoma

Question 22

70-90% of chronic gastritis cases involve which pathogen?

Answer 22

Helicobacter pylori

Question 23

What are risk factors for chronic gastritis?

Answer 23

Poor childhood sanitation/hygiene

Question 24

What is unique about the symptoms of chronic gastritis?

Answer 24

Most commonly asymptomatic (although chronic)

Question 25

What are the effects of chronic gastritis on the body?

Answer 25

1 increased acid production | 2 epithelial metaplasia leading to risk for gastric cancer

Question 26

Autoimmune gastritis most commonly affects what population?

Answer 26

Elderly females over 60 years of age

Question 27

What is autoimmune gastritis?

Answer 27

Gastric atrophy + chronic gastritis

Question 28

Autoimmune gastritis attacks what specific GI cells and can lead to what overlying condition?

Answer 28

Attack parietal cells; pernicious anemia

Question 29

What is pernicious anemia?

Answer 29

Difficulty producing RBC due to the inability to absorb vitamin B12 because of the loss of intrinsic factor

Question 30

What are the locations for peptic ulcer disease?

Answer 30

1 proximal duodenum | 2 gastric antrum (distal stomach)

Question 31

What is the appearance associated with peptic ulcer disease?

Answer 31

Red granulation tissue as a solitary "punched-out" lesion and possible hemorrhage

Question 32

What is the gender bias associated with peptic ulcer disease?

Answer 32

Males

Question 33

Peptic ulcer disease is usually a result from what?

Answer 33

Chronic gastritis or hyperacidity

Question 34

What is the most common pathogen involved with peptic ulcer disease?

Answer 34

Helicobacter pylori

Question 35

Helicobacter pylori is present in what percent of PUD cases?

Answer 35

70-90%

Question 36

Will all cases of a Helicobacter pylori infection result in PUD?

Answer 36

NO (only 5-10%) but remember that the majority of PUD cases DO involve H. pylori

Question 37

How is smoking a risk factor for PUD?

Answer 37

Decreased GI blood flow | Decreased healing ability

Question 38

When is the epigastric pain associated with PUD most present?

Answer 38

At night and 1-3 hours postprandial (after eating)

Question 39

What can relieve epigastric pain due to PUD?

Answer 39

Alkaline substances

Question 40

Is peptic ulcer disease a medical emergency?

Answer 40

YES (perforation/hemorrhage is possible)

Question 41

Which type of ulcer is relieved after eating?

Answer 41

Duodenal

Question 42

Which type of ulcer is worsened by eating?

Answer 42

Gastric

Question 43

What characteristics are shared by both types of peptic ulcers?

Answer 43

Relieved by alkaline substances Worse at night Inconsistent pain patterns

Question 44

What is the serious form of a gastric polyp?

Answer 44

Gastric adenoma

Question 45

What forms of gastric polyps are common but not worrisome?

Answer 45

Inflammatory and hyperplastic polyp (75%) | Fundic gland polyp (15%)

Question 46

Why are gastric adenomas worrisome?

Answer 46

30% transition into adenocarcinomas

Question 47

What is the frequency of gastric adenomas?

Answer 47

10% (least common gastric polyp)

Question 48

What is the only way to determine if a gastric polyp is worrisome?

Answer 48

Biopsy

Question 49

What is the clinical term for an upper endoscopy?

Answer 49

Esophagogastroduodenoscopy

Question 50

What type of cancer makes up 90% of all cases?

Answer 50

Gastric adenocarcinomas

Question 51

What country is at a higher risk for gastric adenocarcinomas?

Answer 51

Japan (20X)

Question 52

What are the risks for gastric adenocarcinomas?

Answer 52

``` Chronic inflammation (EBV or H. pylori) Dysplastic adenomas ```

Question 53

What is unique about the type of cancer that is a gastric adenocarcinoma?

Answer 53

5% are ex-nodal lymphomas

Question 54

The symptoms of gastric adenocarcinomas resemble what GI condition?

Answer 54

PUD

Question 55

When an isolated form of gastric adenocarcinoma, what is the prognosis?

Answer 55

90% 5-year survivablitiy