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Surgery PLE > Stomach > Flashcards

Stomach Flashcards

(62 cards)

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1
Q

where are the parietal cells located

A

Body of the stomach

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2
Q

largest artery to the stomach

A

left gastric artery

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3
Q

What is the nerve in the posterior fundus that is easily missed during truncal or highly selective vagotomy

A

criminal nerve of grassi

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4
Q

What nerve innervates gastric contraction

A

vagus nerve from parasympathetic fibers

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5
Q

Location of gastric ulcers associated with increase gastric acid production

A

pylorus

type II and III

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6
Q

Most serious complication of EGD

A

esophageal perforation

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7
Q

Advantage of double contrast upper GI series compared to EGD

A
  1. diverticula
  2. fistula
  3. tortuosity or stricture location
  4. size of hiatal hernia
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8
Q

Gold standard for H. pylori diagnostic

A

Histologic examination of antral biopsy with special stains

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9
Q

Test for eradication of H. pylori

A

urease breath test

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10
Q

Blood type more common duodenal ulcer

A

type O

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11
Q

Blood type more common gastric ulcer

A

Type A

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12
Q

Peptic ulcer formed after severe burn injury

A

curling ulcer

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13
Q

Peptic ulcer formed after severe brain injury

A

cushing ulcer

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14
Q

Types of ulcer associated with increased gastric acid secretion

A

Type II and III

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15
Q

Types of ulcer associated with normal or decreased gastric acid secretion

A

Type I and IV

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16
Q

Ulcer located in the Angularis Incisura

A

Type I - most common

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17
Q

Ulcer located in the angularis incisura but with accompanying duodenal ulcer

A

Type II

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18
Q

Ulcer located in the Prepyloric area

A

Type III

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19
Q

Ulcer located in the GE junction

A

Type IV

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20
Q

Ulcer caused by NSAID and can occur anywhere

A

Type V

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21
Q

Indications of endoscopy in PUD

A
  1. patient > 45 y.o
  2. patient regardless of age with alarm symptoms
    a. weight loss
    b. dysphagia
    c. anemia
    d. bleeding
    e. recurrent vomiting
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22
Q

Location of High risk ulcer for massive bleeding

A
  1. lesser curvature of stomach with erosion to left gastric artery
  2. posterior duodenal ulcer with erosion to gastroduodenal artery
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23
Q

This surgery is done by severing the proxial 2/3 of vagal supply to the stomach, preserves the antrum and pylorus and remaining abdominal viscera

A

highly selective vagotomy
parietal cell vagotomy
proximal gastric vagotomy

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24
Q

This is a posterior truncal vagotomy and anterior seromyotomy

A

Taylor procedure

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25
This procedure is useful for patients who require pyloroduodenotomy to deal with the ulcer complication
truncal vagotomy + pyloroplasty
26
This is a good choice in patients with gastric outlet obstruction
truncal vagotomy + gastrojejunostomy
27
Where is gastrin produced
antral G cells
28
What is the most potent inhibitor of gastrin
luminal acid
29
what is the most potent stimulatn of gastrin
luminal peptide and amino acid
30
Where does 90% of Zollinger Ellison Syndrome occur
Pasaro's Triangle | Gastrinoma triangle
31
What are the boundaries of Pasaro's Triangle
1. junction of cystic and common bile duct 2. 2nd and 3rd segment of duodenum 3. junction of body and neck of pancreas
32
Confirmatory Test for ZES
Posivie secretin stimulation test
33
What other laboratory test are needed to check for ZES
serum calcium and PTH to rule out MEN1 - parathyroid - pituitary - pancreatic or duodenal tumors
34
What is the preoperative imaging of choice for gastrinoma
Somatostatin receptor scintigraphy
35
Where is somatostatin produced
D cells located through out the gastric mucosa
36
Major stimulus for somatostatin release
antral acidification
37
What inhibits somatostatin release
acetylcholine
38
A type of ulcer that is due to inadequate gastric mucosal blood flow
Stress ulcer
39
Which risk factor has no role in gastric adenocarcinoma
ALCOHOL!
40
Type of polyps associated with gastric carcinoma
1. hyperplastic | 2. adenomas
41
Protective factors of gastric carcinoma
1. vitamin c 2. aspirin 3. high in fruits and vegetables
42
What is the most common precancerous lesion in gastric carcinoma
atrophic gastritis
43
What is the most important prognosticating factor or gastric cancer
lymph node involvemet | depth of tumor invasion
44
Another name for linitis plastica
Scirrhous Tumor
45
A name for palpable umbilical nodule in gastric CA
sister mary and joseph nodule
46
A name for palpable nodule in the pouch of douglas
blumer nodes | sign of drop metastases
47
Only curative treatment of gastic cancer
radical subtotal gastrectomy
48
goal of resecting gastric cancer
R0 resection | grossly negative margin of at least 5 cm
49
What is the most common site for primary GI lymphoma
stomach
50
Treatment of gastric lymphoma
chemotherapy | It is equivalent to surgery
51
It is a submucosal solitary slow growing tumor arising from the interstitial cells of cajal
GIST
52
Most common cell type of GIST
epithelial cell stromal GIST
53
Marker for GIST
(+) c - kit
54
Treatment of GIST
wedge resection with clear margins
55
Treatmet of unresectable or metastatic GIST
Imatinib - tyrosine kinase inhibitor
56
Mode of metastasis of GIST
hematogenous: liver and lungs
57
Most common type of polyp
hyperplastic (regenerative) polyp - 75%
58
What is the cause of afferent limb obstruction (blind loop syndrome)
billroth II - distal gastric resection followed by gastrojejunal anastomosis
59
What is the treatment of afferent limb obstruction?
conversion of billroth II to rouy en y gastric bypass
60
What is roux syndrome
delayed gastric emptying | Endoscopy: Bezoar formation
61
This presents with hypochloremic, hypokalemic, metabolic alkalosis
Gastric outlet obstruction
62
This disease occurs when there is delivery of a hyperosmolar load into the small bowel
Dumping Syndrome

Surgery PLE (16 decks)

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