Stomach

Question 1

Most all non-NSAID induced gastritis caused by

Answer 1

H. pylori

Question 2

Type A gastritis

Answer 2

Autoimmune - pernicious anemia

Involves the BODY of the stomach

Question 3

Type B gastritis

Answer 3

H. pylori, involves the ANTRUM and BODY of stomach

Question 4

H. pylori also associated w

Answer 4

PUD
Gastric Adenocarcinoma
Gastric Lymphoma

Question 5

Diminishes local prostaglandin production in the stomach or duodenum

Answer 5

NSAIDs

Question 6

Non NSAID, non H. Pyori gastriti

Answer 6

ALCOHOL

Question 7

Diagnostic studies for gastritis

Answer 7

Endoscopy - biopsy, location/extent of gastritis, presence of H. pylori

Question 8

Non invasive diagnostic study for H. pylori

Answer 8

Urea breath test

Fecal antigen testing

Question 9

Any ulcer of the upper GI system (gastric, duodenal)

Answer 9

PUD

Question 10

Most common cause of PUD

Answer 10

H. pylori

Question 11

Lifetime risk of ulcer disease

Answer 11

5-10%

Equal for men and women

Question 12

DDX for PUD

Answer 12

Dyspepsia Abdominal pain Nausea can also be associated with

Gastritis
Malignancy
Ischemic Heart Disease

Question 13

How does bleeding w PUD typically manifest

Answer 13

Melena

Question 14

Most common cause of nonhemorrhagic GI bleeds

Answer 14

PUD

Question 15

Combo therapy for H. pylori

Answer 15

2-4 weeks

1) PPI with clarithromycin and amoxacillin OR clarithromycin with metronidazole
2) Bismuth salicylate with tetracycline, metranidazole, and PPI

Question 16

Tx for patients with history of ulcer who require daily NSAID use, or a need for chronic steroids

Answer 16

Prophylactic treatment with

Misoprostol or PPI

Question 17

Gastrin-secreting tumor, results in refractory PUD

Answer 17

Zollinger Ellison Syndrome

Question 18

Percentage of PUD caused by ZES

Answer 18

1%

Question 19

About 1/3 of gastrinomas are part of an autosomal dominant condition syndrome

Answer 19

Multiple Endocrine Neoplasm type I

Question 20

Clinical feature of ZES that is different from PUD

Answer 20

More refractory

May present with secretory diarrhea that improves w H2 blockers or PPIs

Question 21

Diagnosis of hypergastrinemia

Answer 21

Fasting gastrin level > 150ph/mL

Question 22

Test needed to confirm presences of ZES

Answer 22

Secretin test
differentiates patients with Gastrinomas and peptic ulcer disease, even in the presence of acid blockers

ZES positive patients, gastrin levels will subsequently increase by > 200pg/mL

Question 23

Signs of metastatic spread of gastric adenocarcinoma

Answer 23

Virchow’s node - Left Supraclavivular Lymphadenopathy

Sister Mary Joseph Nodule (umbilical nodule)

Question 24

The presence of an umbilical nodule (Sister Mary Joseph nodule) and/or Virchow’s node (Left supraclavicular lymphadenopathy) indicates what

Answer 24

Metastasized gastric adenocarcinoma

Question 25

Most common lab finding in gastric adenocarcinoma

Answer 25

Iron deficiency anemia

Question 26

Patients older than 40 yrs with dyspepsia who are unresponsive to therapy

Answer 26

Do an endoscopy with cytology to rule in/out gastric adenocarcinoma

Question 27

After gastric adenocarcinoma diagnosed, further diagnostic studies?

Answer 27

CT to determine extend of disease

Question 28

Tumors of the stomach which are general benign and self limited, rarely caused by hypergastrinemia

Answer 28

Carcinoid tumors of the stomach

Question 29

Most common extra-nodal site for Non-Hodgkin lymphoma

Answer 29

STOMACH

Question 30

Dyspepsia and weight loss associated w anemia and occult GI bleeding in a patient older than 40 years

Answer 30

Gastric Adenocarcinoma

OR

Gastric lymphoma

DDX by biopsy

Question 31

Gastric lymphoma risk

Answer 31

Greater risk by sixfold if H. pylori present