Stomach, SI

Question 1

what separates UGIB and LGIB

Answer 1

ligament of trietz (4th portion of duodenum)

Question 2

MCC peptic ulcer disease?

Answer 2

H. Pylori

Question 3

PUD treatment

Answer 3

• triple therapy (clarithromycin, PPI, amox)
• sx when medical mgmt fails
• perforation/gastric outlet obstruction

Question 4

Billroth I vs II

Answer 4

Bilroth 1-making stomach smaller, stomach to duodenum

Bilroth II-stomach to jejunum (side to side anastomosis)

Question 5

Rou en Y

Answer 5

Attach jejunum, mobilize duodenum and place it downstream, less pressure
restrictive (making stomach smaller)
absorptive (quicker transit time down the SI)

Question 6

Classes of ulcers

Answer 6

I-over 50%, along body of stomach
II-ulcer in body w/combo of duodenal ulcer
III-pyloric channel within 3 cm of pylorus
IV-proximal GE
V-anywhere in the stomach, associated w/NSAIDs/ASA

Question 7

how does duodenal perforates occur?

Answer 7

anteriorly

Question 8

how to treat duodenal perforation?

Answer 8

Graham patch or omentum plug

Question 9

Zollinger-Ellison syndrome

Answer 9

Oversecretion of Gastrin leading to peptic ulceration from gastric acid
gastrinoma

Question 10

Cushing’s ulcers:

Curling’s ulcers:

Answer 10

associated with head injuries

associated with burn patients

Question 11

MC gastric cancer?

Answer 11

adenocarcinoma

Question 12

MCC SBO?

Answer 12

adhesions

Question 13

acute mesenteric ischemia

Answer 13

pain out of proportion to exam

Question 14

perforated diverticulitis would require a….

Answer 14

Hartmans