Medicine Marrow Pg 51-60 (GIT)
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Questions and Answers

Which substance is NOT an inhibitor of acid production?

  • Prostaglandin (PG)
  • Cholecystokinin (CCK)
  • Gastrin (correct)
  • Somatostatin

    • Acute phlegmonous gastritis is commonly found in immunocompetent individuals.

    False

    What is the primary causative organism of acute phlegmonous gastritis?

    Streptococci

    The histological inflammation of gastric mucosa is known as __________.

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

    Match the following components with their role in acid production:

    <p>ECL = Releases histamine G-cells = Secretes gastrin Acetylcholine = Acts on m3 receptors GRP = Stimulates gastrin release</p> Signup and view all the answers

    What is the sensitivity of the stool antigen test used to confirm eradication of H. pylori?

    <p>94%</p> Signup and view all the answers

    The rapid urease test is conducted on a blood sample.

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

    What are the two main drugs in the first-line regimen for treating H. pylori?

    <p>Omeprazole and Clarithromycin</p> Signup and view all the answers

    The first-line regimen for H. pylori treatment includes a 14-day course of ______ and ______.

    <p>Omeprazole; Clarithromycin</p> Signup and view all the answers

    Match the drug to its dosage in the first-line regimen for H. pylori treatment:

    <p>Omeprazole = 20 mg BD Clarithromycin = 500 mg BD Amoxicillin = 1 g BD Metronidazole = 500 mg BD</p> Signup and view all the answers

    What should be done at least one month after completing the first-line treatment for H. pylori?

    <p>Conduct a urea breath test or stool antigen test</p> Signup and view all the answers

    An H. pylori positive test result after the second-line treatment indicates that the symptoms are likely due to H. pylori.

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

    What is the recommended action if there is a positive H. pylori test after third-line treatment?

    <p>Refer to a specialist</p> Signup and view all the answers

    If the initial H. pylori test is negative, then H. pylori is ______ the cause of symptoms.

    <p>not</p> Signup and view all the answers

    Match the following treatment steps with their appropriate follow-up actions:

    <p>First-line treatment = Wait one month before testing Second-line treatment = Perform a urea breath test or stool antigen test Third-line treatment = Endoscopy with culture and sensitivity testing Negative test result after treatment = Consider alternative causes of symptoms</p> Signup and view all the answers

    Which of the following is NOT considered a damaging factor to gastroduodenal mucosal defense?

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

    The interstitial cells of Cajal are responsible for producing the basal electric rhythm (BER) in the gastrointestinal tract.

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

    What is the main function of Auerbach's plexus in the enteric nervous system?

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

    The ______ layer of the gastroduodenal mucosa is responsible for restitution.

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

    Match the following layers of the gastrointestinal tract with their descriptions:

    <p>Mucosa = Innermost layer containing epithelial and connective tissues Serosa = Outer layer providing structural support Muscularis mucosa = Muscle layer that aids in local movements Lamina propria = Connective tissue layer supporting the epithelium</p> Signup and view all the answers

    What percentage of duodenal ulcers are attributed to Helicobacter Pylori?

    <p>70-80%</p> Signup and view all the answers

    The Type IV Secretion system of Helicobacter Pylori is primarily used to neutralize gastric acid.

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

    Name one symptom of dyspepsia.

    <p>Post prandial fullness</p> Signup and view all the answers

    Helicobacter Pylori produces _______ which can cause gastric mucosal injury by generating ammonia.

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

    Match the following forms of gastritis to their associated conditions:

    <p>Antral predominant gastritis = Duodenal ulcer Corpus predominant atrophic gastritis = Gastric ulcer Non atrophic pan-gastritis = Maltoma Atrophic gastritis = Intestinal metaplasia</p> Signup and view all the answers

    Which part of the stomach is responsible for secreting gastrin?

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

    The fundus of the stomach contains oxyntic glands.

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

    What is the secretion produced by the parietal cells in the body/corpus of the stomach?

    <p>Acid and intrinsic factor</p> Signup and view all the answers

    The ______ is located below the incisura and contains pyloric glands.

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

    Match the parts of the stomach with their respective glands:

    <p>Fundus = Fundic glands Body/Corpus = Oxyntic glands Antrum = Pyloric glands</p> Signup and view all the answers

    Which of the following features is associated with hypoalbuminemia?

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

    Helicobacter pylori is a Gram positive bacilli that produces urease.

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

    What is the main cytokine involved in the pathogenesis of gastroenterological conditions?

    <p>TGF-α</p> Signup and view all the answers

    Helicobacter pylori predominantly resides in the __________ of the stomach.

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

    Match the following conditions or characteristics with their description:

    <p>Foveolar hyperplasia = Increase in mucous cell proliferation Chronic superficial gastritis = Most common outcome of H. pylori colonization EGFR antagonist = A treatment option for certain gastrointestinal conditions Urease = Enzyme that creates an alkaline environment in the stomach</p> Signup and view all the answers

    Which of the following is a common clinical feature of infectious diarrhoea?

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

    Toxic megacolon is a complication that can arise from infectious diarrhoea.

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

    What is the first-line treatment for non-severe Clostridium difficile infection?

    <p>Oral Fidaxomicin or Oral Vancomycin</p> Signup and view all the answers

    The test used for diagnosing Clostridium difficile infection includes glutamate dehydrogenase and __________ against toxin A/B.

    <p>enzyme immunosorbent assay (EIA)</p> Signup and view all the answers

    Match the management strategies with the severity of Clostridium difficile infection:

    <p>Non-Severe = Oral Fidaxomicin or Oral Vancomycin Severe = Oral Vancomycin and IV metronidazole Fulminant = Surgical consultation and IV metronidazole</p> Signup and view all the answers

    What is the common cause of Type B chronic gastritis?

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

    Type A chronic gastritis is more common than Type B chronic gastritis.

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

    What complication is associated with Type A chronic gastritis?

    <p>Megaloblastic anemia</p> Signup and view all the answers

    Hypertrophic gastritis is also known as __________ disease.

    <p>Menetrier's</p> Signup and view all the answers

    Match the types of chronic gastritis with their characteristics:

    <p>Type A = Autoimmune metaplastic Atrophic Gastritis Type B = Environmental metaplastic Atrophic Gastritis Hypertrophic gastritis = Menetrier's disease Eosinophilic gastritis = Intestinal obstruction</p> Signup and view all the answers

    What is the most common functional pancreatic neuroendocrine tumor?

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

    Gastrinomas are associated with a high risk of metastasis to the liver.

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

    What syndrome is commonly manifested due to gastrinomas?

    <p>Zollinger-Ellison syndrome</p> Signup and view all the answers

    Gastrinomas are typically located at the junction of the cystic duct and the ______.

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

    Match the type of gastrinoma with its features:

    <p>Sporadic = 2nd most common functional pancreatic neuroendocrine tumor, single, large tumor Associated with MEN-1 = Most common neuroendocrine tumor in MEN-1, multiple, small tumors</p> Signup and view all the answers

    What is the recommended treatment for sporadic gastrinomas larger than 2.5 cm?

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

    Gastrinomas associated with MEN-1 are usually benign.

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

    What substance secretion is increased due to gastrinomas leading to gastric ulcers?

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

    Study Notes

    Gastrinoma

    • A neuroendocrine tumor that secretes gastrin.
    • 80% are sporadic (single, large tumor)
    • Sporadic gastrinomas typically occur in people aged 30-50
    • Sporadic gastrinomas have a high malignancy risk with 60% metastasizing to the liver.
    • 20% are associated with MEN-1 (multiple, small tumors)
    • Gastrinomas associated with MEN-1 are most common in the duodenum
    • Gastrinomas associated with MEN-1 have a lower malignancy risk (mostly benign)
    • Individuals with MEN-1 typically develop gastrinomas at an earlier age, usually before 50.
    • Gastrinomas commonly affect the ‘Gastrinoma Triangle’, a region where the cystic duct joins the common bile duct, the second and third part of the duodenum meet, and the body and neck of the pancreas are situated.
    • Majority of cases are treated surgically
    • Prognosis is good for cases associated with MEN-1
    • High dose PPIs are often used to control acid levels in cases associated with MEN-1
    • Gastrinomas have a poor prognosis if > 2.5 cm

    Effects of Increased Gastrin

    • Increased gastrin stimulates parietal cells
    • Increased HCl secretion
    • Damage to the mucosal lining of the GI tract
    • Gastric and duodenal ulcers
    • Acid inactivates pancreatic enzymes
    • Diarrhea, steatorrhea and malabsorption may occur

    Note

    • Insulinoma is the most common functional pancreatic neuroendocrine tumor
    • Entero pancreatic neuroendocrine tumor (Gastrinoma) is the most common cause of death in MEN-1.
    • Neuroendocrine markers for identifying gastrinoma are chromogranin and NSE
    • Clinical manifestation for gastrinoma includes Zollinger-Ellison syndrome

    Gastrinoma Triangle

    • This is the area where most cases are located and can be identified by:
      • The junction of the cystic duct and CBD
      • The junction of the second and third portion of the duodenum
      • The junction of the body and neck of the pancreas
    • The triangle is formed by the junction of cystic duct and CBD, junction of second and third portion of duodenum, junction of body and neck of pancreas.

    Additional information

    • Gastrinoma is a neuroendocrine tumor that secretes gastrin.
    • The clinical manifestation of gastrinoma is Zollinger-Ellison syndrome.
    • Neuroendocrine markers such as chromogranin and NSE can be utilized to identify gastrinoma.

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    Description

    This quiz covers key details about gastrinomas, a type of neuroendocrine tumor that secretes gastrin. Learn about their characteristics, treatment options, and differences between sporadic gastrinomas and those associated with MEN-1. Understand the implications of tumor size and location on prognosis.

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