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SURGERY BOARDS > stomach > Flashcards

stomach Flashcards

1
Q

Forrest Classification for endoscopic findings

active, non pulsating bleeding

A

IB

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2
Q

Forrest Classification for endoscopic findings

active, pulsating bleeding

A

IA

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3
Q

Forrest Classification for endoscopic findings

Adherent clot

A

Grade IIB

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4
Q

Forrest Classification for endoscopic findings

Non bleeding visible vessel

A

Grade IIA

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5
Q

Forrest Classification for endoscopic findings

Black dot

A

Grade IIC

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6
Q

Forrest Classification for endoscopic findings

No signs of recent bleeding

A

Grade IIIC

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7
Q

ULcer relieved by eating food

A

duodenal

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8
Q

marked abdominal guarding with rebound tenderness

board-like rigidity

A

perforation

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9
Q

what consists bismuth triple therapy

A

bismuth 2 tabs BID
Metronidazole 250mg TID
Tetracycline 500mg qid

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10
Q

gold standard for tx of ulcer

A

quadruple therapy

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11
Q

what consists quadruple therapy

A

PPI BID
Bismuth 2 tabs QID
Metronidazole 250mg TID
Tetracycline 500mg qid

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12
Q

PPI Triple therapy

A

PPI bid
Amox 1g BID
Clarithromycin 500mg bid

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13
Q

caused by the destruction of the pyloric sphincter causing abrupt delivery of hyperosmolar load to the small intestines

A

dumping syndrome

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14
Q

due to hyperinsulinemia with reactive hypoglycemia

A

late dumping

2-3 hrs after eating

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15
Q

peripheral and splanchnic vasodilatation leading to shock-like symptoms

A

early dumping

15-30 mins after eating

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16
Q

inflamed, beefy red, friable gastric mucosa by endoscopy

A

bile/ alkaline reflux gastritis

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17
Q

tx of bile reflux gastritis

A

frequent meals
antacids
cholestyramine

sx tx: long limb 45cm roux en y hastrojejunostomy

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18
Q

results from functional obstruction due to disruption of normal propagation of pacesetter potentials in the roux limb from the proximal duodenum
altered motility in the gastric remnant

A

roux stasis syndrome

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19
Q

chronic abdominal pain
nausea
vomiting aggravated by eating

A

roux stasis syndrome

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20
Q

dx roux stasis syndrome

A

upper GI series- delayed gastric emptying

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21
Q

tx roux stasis

A

pro motility drugs

near total or total gastrectomy

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22
Q

caused by acute bowel kink, volvulus or internal herniation

duodenal stump blowout from progressive afferent limb dilatation

A

afferent loop syndrome

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23
Q

results from intermittent obstruction of the efferent limb

obstructions are due to internal herniation of the distal intestines behind the efferent limb

A

efferent loop syndrome

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24
Q

uncontrolled secretion of gastrin by pancreatic/ duodenal neuroendocrine tumor

A

Zollinger-Ellison syndrome

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25
Q

most common pancreatic tumor in patients with MEN I

A

Gastrinoma

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26
Q

MC location of Ulcers in ZES

A

Proximal duodenum

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27
Q

mc causes of gastric adenoCA

A

H pylori

autoimmune gastritis

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28
Q

describes tumors based on microscopic configuration and growth pattern

A

Lauren classification

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29
Q

type of adenoCA

Well differentiated gland structure
slow growth

A

intestinal type

30
Q

type of adenoCA

no glands and poorly differentiated
small cells grow into the surrounding gastric wall

A

diffuse type

31
Q

mc location of diffuse type adenoCA

A

Cardia

32
Q

mc location of intestinal type adenoCA

A

Distal stomach

33
Q

characterized as the extensive or complete infiltartion of the entire stomach

SIGNET RING CELLS

A

linitis plastica

LEATHER BOTTLE STOMACH

34
Q

can detect aoccult metastasis

A

endoscopic utz

35
Q

sx tx for tumors in distal 75% of the stomach
pylorus +2cm of proximal duodenum
greater and lesser omentum

A

radical subtotal gastrectomy

billroth II
ROUX EN Y gastroduodenostomy

36
Q

sx tx for all lesions in the mid body or fundus
linitis plastica
Menetrier disease; gastric remnant carcinoma, multiple diffuse gastric polyps

A

radical total gastrectomy

37
Q

gastrectomy plus resection of n1 and n2 nodes

A

D2

38
Q

gastrectomy plus resection of n1 and n3 nodes

A

d3

39
Q

gastrectomy plus complete dissection of n1 nodes

A

D1

40
Q

gastrectomy plus INcomplete dissection of n1 nodes

A

D0

41
Q

Paraaortic nodes

A

N4

42
Q

Nodes in the hepatoduodenal ligament, retropancreatic region, celiac plexus, SMA

A

N2

43
Q

Perigastric nodes along greater and lesser curvature

A

N1

44
Q

MC type of gastric lymphoma

A

non hodgkin

b cell type- arise from MALT

45
Q

Non MALT type of Primary gastric lymphoma

A

high grade lymphoma

46
Q

tx of high grade type lymphoma

A

inactivation of p53 tumor supressor gene; expression of the replication error phenotype, c-myc proto oncogene mutation

47
Q

arise from the interstitial cells of cajal

doughnut sign

A

GIST

48
Q

Prognostic factors of GIST

A

Tumor size; mitotic count

49
Q

GIST mode of metastasis

A

hematogenously

50
Q

tumor markers of GIST

A

c KIT (CD 117) and CD 34

51
Q

sx treatment GIST

A

Wedge resection with negative margins

52
Q

tx for unresectable, metastatic GIST

A

Imatinib (Gleevec)

53
Q

MC type of GIST

A

Epithelial cell stroma

2nd- spindle type

54
Q

arise from gastric ECL cells

usually assoc with hepatic metastasis

A

gastric carcinoids

55
Q

type of gastric carcinoid
autoimmune
type a chronic atrophic gastritis, w/ or w/o pernicious anemia

A

TYPE 1

56
Q

type of gastric carcinoid

Assoc with ZES and patients with MEN 1

A

Type 2

57
Q

type of gastric carcinoid

sporadic form/ neuroendocrine carcinoma
mc in men
usually SOLITARY

A

Type 3

58
Q

localizing test for gastric carcinoid

A

somatostatin analogue- indium octreotide

59
Q

tx for gastric carcinoid

A

debulking sx plus somatostatin

60
Q

associated with protein losing enteropathy and hypochlorydia

large rugal folds that spare the antrum

A

hypertrophic gastropathy (menetrier disease)

61
Q

diffuse hyperplasia of surface mucus-secreting cells and decrease parietal cells

A

hypertrophic gastropathy (menetrier disease)

62
Q

dilated mucosal blood vessels in the DISTAL stomach

A

Watermelon stomach ( gastric antral vascular ectasia)

63
Q

dilated mucosal blood vessels in the PROXIMAL stomach

A

portal gastropathy

64
Q

Elderly women with chronic GI loss

assoc autoimmune Connective tissue d/o

A

Watermelon stomach ( gastric antral vascular ectasia)

65
Q

TX Watermelon stomach ( gastric antral vascular ectasia)

A

Endoscopic antrectomy

66
Q

unusually large submucosal artery

congenital AV malformation

A

dieulafoy lesion

67
Q

endoscopic finding of pulsating blood from a normal appearing gastric mucosa

A

dieulafoy lesion

68
Q

TX dieulafoy lesion

A

Endoscopic hemostasis; angiographic embolization oversew or resection

69
Q

regurgitation of feedings
projectile non bilous emesis
PERISTALTIC GASTRIC WAVES
OLIVE SHAPED mass in RU epigastrium

A

pyloric stenosis

70
Q

tx pyloric stenosis

A

Fredet Ramstedt pyloromyotomy

SURGERY BOARDS (7 decks)

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