Stomach Flashcards Preview

Surgery PLE > Stomach > Flashcards

Flashcards in Stomach Deck (62):
1

where are the parietal cells located

Body of the stomach

2

largest artery to the stomach

left gastric artery

3

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

criminal nerve of grassi

4

What nerve innervates gastric contraction

vagus nerve from parasympathetic fibers

5

Location of gastric ulcers associated with increase gastric acid production

pylorus
type II and III

6

Most serious complication of EGD

esophageal perforation

7

Advantage of double contrast upper GI series compared to EGD

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

8

Gold standard for H. pylori diagnostic

Histologic examination of antral biopsy with special stains

9

Test for eradication of H. pylori

urease breath test

10

Blood type more common duodenal ulcer

type O

11

Blood type more common gastric ulcer

Type A

12

Peptic ulcer formed after severe burn injury

curling ulcer

13

Peptic ulcer formed after severe brain injury

cushing ulcer

14

Types of ulcer associated with increased gastric acid secretion

Type II and III

15

Types of ulcer associated with normal or decreased gastric acid secretion

Type I and IV

16

Ulcer located in the Angularis Incisura

Type I - most common

17

Ulcer located in the angularis incisura but with accompanying duodenal ulcer

Type II

18

Ulcer located in the Prepyloric area

Type III

19

Ulcer located in the GE junction

Type IV

20

Ulcer caused by NSAID and can occur anywhere

Type V

21

Indications of endoscopy in PUD

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

22

Location of High risk ulcer for massive bleeding

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

23

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

highly selective vagotomy
parietal cell vagotomy
proximal gastric vagotomy

24

This is a posterior truncal vagotomy and anterior seromyotomy

Taylor procedure

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