Gastric Cancer Types
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Questions and Answers

What percentage of duodenal ulcers are due to H. pylori?

  • 80-90%
  • 95% (correct)
  • 60-70%
  • 75%
  • What is the typical location of a gastric ulcer?

  • Fundus of the stomach
  • Pyloric antrum
  • Greater curvature of the antrum
  • Lesser curvature of the antrum (correct)
  • What is a common cause of gastric ulcers besides H. pylori infection?

  • NSAIDs
  • Bile reflux
  • Gastroesophageal reflux disease
  • All of the above (correct)
  • What is a characteristic feature of benign peptic ulcers?

    <p>Small, sharply demarcated, and surrounded by radiating folds of mucosa</p> Signup and view all the answers

    What is the main difference between duodenal and gastric ulcers?

    <p>Pain pattern</p> Signup and view all the answers

    What is the risk of bleeding from a ruptured gastric ulcer?

    <p>Bleeding from the left gastric artery</p> Signup and view all the answers

    What is the role of biopsy in peptic ulcer diagnosis?

    <p>To exclude gastric carcinoma</p> Signup and view all the answers

    What is the typical location of a duodenal ulcer?

    <p>Proximal duodenum</p> Signup and view all the answers

    What is a risk factor for the intestinal type of gastric carcinoma?

    <p>H pylori infection</p> Signup and view all the answers

    Which of the following is NOT associated with diffuse type of gastric carcinoma?

    <p>Signet ring cells</p> Signup and view all the answers

    What is a common site of distant metastasis in gastric carcinoma?

    <p>Liver</p> Signup and view all the answers

    What is a risk factor for acute gastritis?

    <p>Severe burn</p> Signup and view all the answers

    Which of the following is a rare presentation of gastric carcinoma?

    <p>Acanthosis nigricans</p> Signup and view all the answers

    What is the term for the thickening of the stomach wall seen in diffuse type of gastric carcinoma?

    <p>Linitis plastica</p> Signup and view all the answers

    What is a defense mechanism of the gastric mucosa?

    <p>Bicarbonate secretion by surface epithelium</p> Signup and view all the answers

    What is a clinical feature of chronic gastritis?

    <p>Chronic inflammation of the stomach mucosa</p> Signup and view all the answers

    Which of the following nodes can be involved in lymph node spread of gastric carcinoma?

    <p>Left supraclavicular node</p> Signup and view all the answers

    What is a consequence of acid damage to the gastric mucosa?

    <p>Superficial inflammation and ulceration</p> Signup and view all the answers

    What is a risk factor for gastric mucosal damage?

    <p>Long-term use of NSAIDs</p> Signup and view all the answers

    What is a complication of chronic gastritis?

    <p>All of the above</p> Signup and view all the answers

    What is a defense mechanism of the gastric mucosa against H. pylori infection?

    <p>Increased mucus production by foveolar cells</p> Signup and view all the answers

    What is a characteristic of chronic autoimmune gastritis?

    <p>Autoimmune response against parietal cells</p> Signup and view all the answers

    Study Notes

    Gastric Carcinoma

    • Intestinal type: large, irregular ulcer with heaped up margins, commonly involves the lesser curvature of the antrum
    • Risk factors: intestinal metaplasia (e.g., due to H pylori and autoimmune gastritis), nitrosamines in smoked foods (Japan), and blood type A
    • Diffuse type: characterized by signet ring cells that diffusely infiltrate the gastric wall, resulting in thickening of the stomach wall (linitis plastica)
    • Not associated with H pylori, intestinal metaplasia, or nitrosamines
    • Presents late with weight loss, abdominal pain, anemia, and early satiety; rarely presents as acanthosis nigricans or Leser-Trelat sign
    • Spread to lymph nodes can involve the left supraclavicular node (Virchow node)
    • Distant metastasis most commonly involves the liver; other sites include the periumbilical region (Sister Mary Joseph nodule)

    Peptic Ulcer Disease

    • Solitary mucosal ulcer involving the proximal duodenum (90%) or distal stomach (10%)
    • Duodenal ulcer: almost always due to H pylori (> 95%); rarely due to ZE syndrome
    • Presents with epigastric pain that improves with meals
    • Diagnostic endoscopic biopsy shows ulcer with hypertrophy of Brunner glands
    • Usually arises in the anterior duodenum; when present in the posterior duodenum, rupture may lead to bleeding from the gastroduodenal artery or acute pancreatitis
    • Gastric ulcer: usually due to H pylori (75%); other causes include NSAIDs and bile reflux
    • Presents with epigastric pain that worsens with meals
    • Ulcer is usually located on the lesser curvature of the antrum
    • Rupture carries risk of bleeding from the left gastric artery
    • Differential diagnosis of ulcers includes carcinoma
    • Benign peptic ulcers are usually small (< 3 cm), sharply demarcated ("punched-out"), and surrounded by radiating folds of mucosa
    • Malignant ulcers are large and irregular with heaped up margins
    • Biopsy is required for definitive diagnosis

    Acute Gastritis

    • Acidic damage to the stomach mucosa
    • Due to imbalance between mucosal defenses and acidic environment
    • Defenses include mucin layer produced by foveolar cells, bicarbonate secretion by surface epithelium, and normal blood supply
    • Risk factors: severe burn (Curling ulcer), NSAIDs, heavy alcohol consumption, chemotherapy, increased intracranial pressure (Cushing ulcer), and shock
    • Acid damage results in superficial inflammation, erosion (loss of superficial epithelium), or ulcer (loss of mucosal layer)

    Chronic Gastritis

    • Chronic inflammation of the stomach mucosa

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    Description

    This quiz covers the two main types of gastric cancer, intestinal and diffuse, including their characteristics and risk factors.

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