Pyloric Stenosis & Gastric Neoplasms

Question 1

acquired condition caused by hypertrophy and spasm of pyloric sphincter leading to gastric outlet obstruction

Answer 1

pyloric stenosis

Question 2

when does pyloric stenosis most commonly occur?

Answer 2

in first weeks of life

Question 3

exposure to what would make infants more at risk for pyloric stenosis?

Answer 3

macrolides

Question 4

what is the cause of primary adult pyloric stenosis?

Answer 4

idiopathic

Question 5

what is the cause of secondary adult pyloric stenosis?

Answer 5

local inflammation

Question 6

what are the main symptoms present in pyloric stenosis? (3)

Answer 6

forceful + projectile vomit
very hungry
visible peristaltic waves

Question 7

what is a physical finding in pyloric stenosis?

Answer 7

hypertrophied pylorus (olive)

Question 8

what can repetitive vomiting in a patient with pyloric stenosis lead to?

Answer 8

metabolic alkalosis

Question 9

what lab will be present in pyloric stenosis?

Answer 9

elevated BUN

Question 10

an abdominal xray shows dilated stomach with little to no gas in intestines. Dx?

Answer 10

pyloric stenosis

Question 11

what is the imaging of choice for pyloric stenosis? what will be seen?

Answer 11

ultrasound
elongated, thick pylorus

Question 12

what will be seen in a barium swallow if a patient has pyloric stenosis?

Answer 12

string sign

Question 13

what is the treatment for pyloric stenosis?

Answer 13

surgical pyloromyotomy

Question 14

what are the 2 types of gastric adenocarcinoma?

Answer 14

intestinal type
diffuse

Question 15

resembles intestinal cellular cancers with glandular structures

Answer 15

intestinal type gastric adenocarcinoma

Question 16

poorly differentiated, without glandular formations

Answer 16

diffuse gastric adenocarcinoma

Question 17

a patient presents with dyspepsia, vague MEG pain/tenderness, anorexia, early satiety, and weight loss. Dx?

Answer 17

gastric adenocarcinoma

Question 18

what is the diagnostic for gastric adenocarcinoma?

Answer 18

upper EGD + biopsy

Question 19

what diagnostic can be used after the initial diagnosis of gastric adenocarcinoma to determine depth of tumor?

Answer 19

endoscopic US

Question 20

what is the only curative option of gastric adenocarcinoma?

Answer 20

surgical resection

Question 21

what are treatment options for gastric adenocarcinoma in patients with non-curative disease? (2)

Answer 21

palliative surgery
chemotherapy

Question 22

what is the 2nd most common type of gastric cancer?

Answer 22

primary gastric lymphoma

Question 23

what is the largest risk factor for primary gastric lymphoma?

Answer 23

H pylori

Question 24

a patient presents with vague MEG pain and tenderness, weight loss, early satiety, and melena. Dx?

Answer 24

gastric lymphoma

Question 25

what is the diagnostic for gastric lymphoma? (2)

Answer 25

upper EGD + biopsy lymph node biopsy

Question 26

what are 2 diagnostics that can be done after the initial diagnosis of gastric lymphoma?

Answer 26

CT scan bone marrow bx

Question 27

what is the treatment for gastric lymphoma? (2)

Answer 27

treat H pylori +/- radiation and chemo

Question 28

most gastric carcinoid tumors occur with what?

Answer 28

pernicious anemia

Question 29

what do gastric carcinoid tumors cause?

Answer 29

carcinoid syndrome

Question 30

what is the diagnostic for gastric carcinoid tumors?

Answer 30

upper endoscopy + biopsy

Question 31

what is the treatment for small local single gastric carcinoid tumors?

Answer 31

resection

Question 32

what is the treatment for localized multiple gastric carcinoid tumors? (2)

Answer 32

radical gastrectomy + regional lymphadenectomy