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Gastrointestinal System > Surgical Aspects Gastric/Duodenal Disorders > Flashcards

Surgical Aspects Gastric/Duodenal Disorders Flashcards

1
Q

Where are parietal + cheif cells found in the stomach?

A

Only Fundus

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2
Q

Phases of HCL Digestion

A

Cephalic: Vagus nerve ACh release
Gastric: Atral release of Gastrin
Intestinal: SI release of GI peptides + Histamine

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3
Q

What are the primary concerns/complications of Duodenal Ulcer Disease

A
  • Hemorrhage when ulcer erodes into gastroduodenal artery

- Erosion of anterior/superior side of duodenum leading to spilling contents into abdomen

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4
Q

What features require surgical intervention of PUD?

A

hemorrhage, perforation, and obstruction,as well as failure of nonoperative managemen

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5
Q

How does time of perforation determine surgical strategy?

A

> 6 H: only Plication

<6 H: Plication + Acid-reducing procedure

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6
Q

Tx of Upper GI hemorrhage

A
  • Gastric decompression
  • Gastric Lavage
  • Antacid Tx
  • Tx hemodynamics
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7
Q

T Acute PUD Obstruction

A
  • stomach should be decompressed with a nasogastric tube for 5 or 6 days
  • total parenteral nutrition
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8
Q

Gastric vs Duodenal Ulcer testing

A

Gastric: Biopsy every time

Duodenal: Only Biopsy if mass present

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9
Q

Surgical intention of duodenal Ulcer Disease

A

Vagotomy:

  • Trunkal
  • selective
  • proximal gastric
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10
Q

Test for ZES

A

Secretin infusion test -> Profound rise in serum Gastrin

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11
Q

Gastric Ulcer Presentation

A
  • Epigastric pain radiating to back
  • Produced by ingestion of food
  • weight loss
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12
Q

What are diagnostic signs of Gastric ulcers

A
  • Normal to low Gastrin acid secretion

- Possible Achlorhydria (sign of malignancy)

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13
Q

Surgical intervention Gastric Ulcer Disease

A

Distal Gastrectomy

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14
Q

Postgastrectomy syndrome

A
  • Early dumping
  • Late Dumping:
  • Afferent loop obstruction:
  • Blind Loop Syndrome
  • Alkaline Reflux Gastritis
  • Recurrent Ulcer Disease
  • Gastric Atony
  • Nutritional disturbance
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15
Q

Dumping syndromes

A
  • Early dumping: 15 min after ingesion; anxiety, weakness, tachycardia, diaphoresis, Diarrhea
  • Late Dumping: within 3 H after meals, desire of recumbent position, Anxiety, tachycardia, weakness, fatigue, and NO associated dumping
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16
Q

Afferent loop obstruction

A

Pancreatic + biliary secretions trapped in afferent limb; Severe crushing abdominal cramping; vomit dark brown bitter material

17
Q

Blind loop syndrome

A
  • Bacterial Overgrowth on limb of ingesting excluded f/ flow of chyme
  • S/S: weakness, anemia
18
Q

Alkaline Reflux Gastritis

A
  • Contents of duodenum, pancreas, + bile system reflux into Denver aged stomach
  • S/S: weakness, weight loss, persistent nausea, abdominal pain which radiates to back; often anemic
19
Q

Gastric atony

A

Substantial delay in emptying due to surgery

20
Q

Most common nutritional deficiencies Post gastrectomy

A

B12/Folate leading to megaloblastic or microcytic anemia

21
Q

Prophylactics Tx Stress Gastritis

A

H2-receptor antagonist

22
Q

Peutz-Jegher’s syndrome

A
  • Multiple benign polyps in SI

- Melanous spots on lips/Buccal mucosa

23
Q

Bezoars

A

Masses in the stomach that; usually need to be. Surgically removed:

  • Phytobezoar (vegtable fiber)
  • Trichobezoar (Hair)
24
Q

Molecular genetics in Gastric Carcinoma

A

MiR-183-5p is potential prognostic marker in gastric cancer + regulates EEF2

25
Q

Morphology Leiomyoma + Leiomyosarcoma

A
  • Raised smooth lesions with central ulceration in stomach
26
Q

Candidates for Bariatric surgery

A

100 Lbs over ideal body weight OR

Above BMI 40

27
Q

What is the Gold standard for weight loss surgery?

A

Roux-en-gastric bypass

28
Q

What minerals are a concern for gastric bypass surgery?

A

Calcium+Iron

29
Q

Rapid weight loss after gastric bypass is associated with increase risk for _______

A

Cholelithiasis

30
Q 
\_\_\_\_\_  is a 
weight-loss system that 
uses a removable 
gastric balloon that 
affects flow out of the 
stomach.
A

TPS Transpyloric Shuttle

Gastrointestinal System (32 decks)

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