30 Stomach ANATOMY AND PHYSIOLOGY
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Questions and Answers

Which enzyme is primarily secreted by chief cells in the stomach?

  • Trypsin
  • Amylase
  • Lipase
  • Pepsinogen (correct)
  • What is the final pathway for H+ release in parietal cells?

  • Adenylate cyclase activation
  • H+/K+ ATPase inhibition (correct)
  • Phosphorylase kinase activation
  • Protein kinase A activation
  • Which artery supplies the greater curvature of the stomach?

  • Left gastric artery
  • Right gastroepiploic artery (correct)
  • Left gastroepiploic artery
  • Right gastric artery
  • What causes the release of H+ from parietal cells in the stomach?

    <p>Acetylcholine and gastrin activation</p> Signup and view all the answers

    Where does peristalsis primarily occur in the stomach?

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

    Which part of the stomach receives blood from the gastroduodenal artery?

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

    Which surgical procedure has the lowest rate of ulcer recurrence?

    <p>Truncal vagotomy and antrectomy</p> Signup and view all the answers

    What is the most frequent complication of duodenal ulcers?

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

    What is the initial treatment of choice for obstruction due to duodenal ulcers?

    <p>Serial dilation and PPI</p> Signup and view all the answers

    What is the best test for H. pylori eradication?

    <p>Urea breath test</p> Signup and view all the answers

    Which type of gastric ulcer is associated with diffuse ulcers and NSAIDs?

    <p>Type V</p> Signup and view all the answers

    What is the primary risk factor associated with gastric ulcers?

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

    Which surgical procedure is the initial treatment for refractory obstruction due to gastric ulcers?

    <p>Truncal vagotomy and antrectomy</p> Signup and view all the answers

    What is the primary risk factor associated with gastric adenocarcinoma?

    <p>Intestinal metaplasia</p> Signup and view all the answers

    Which type of gastritis occurs 3–10 days after events such as multiple trauma or burns?

    <p>Stress gastritis type A (fundus)</p> Signup and view all the answers

    What are Virchow's nodes associated with in gastric cancer?

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

    What is the most common area for gastric adenocarcinoma?

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

    What is the primary symptom associated with gastric adenocarcinoma?

    <p>Pain unrelieved by eating and weight loss</p> Signup and view all the answers

    What is the most effective diagnostic test for alkaline reflux gastritis?

    <p>EGD with biopsy</p> Signup and view all the answers

    Which surgical option is indicated for post-vagotomy diarrhea that is unresponsive to medical treatment?

    <p>Reversed interposition jejunal graft</p> Signup and view all the answers

    What is the main cause of blind-loop syndrome in patients with Billroth II or Roux-en-Y procedures?

    <p>Bacterial overgrowth</p> Signup and view all the answers

    What is the most appropriate initial diagnostic test for retained antrum after gastrectomy?

    <p>CT scan of the abdomen</p> Signup and view all the answers

    Which surgical option is recommended for afferent-loop obstruction causing symptoms of obstructive jaundice and pancreatitis?

    <p>Reanastomosis with shorter (40-cm) afferent limb</p> Signup and view all the answers

    What is the primary treatment for chronic gastric atony presenting with delayed gastric emptying and nausea?

    <p>Gastric electric stimulator</p> Signup and view all the answers

    Which surgical procedure can be considered for small gastric remnant leading to early satiety in gastric bypass patients?

    <p>Jejunal pouch construction</p> Signup and view all the answers

    What is the most likely diagnosis for a patient presenting with pain, steatorrhea, and B12 deficiency after Billroth II surgery?

    <p>Blind-loop syndrome</p> Signup and view all the answers

    What imaging study would be most appropriate for diagnosing afferent-loop obstruction in a patient with long afferent limb after Roux-en-Y surgery?

    <p>CT scan</p> Signup and view all the answers

    What is the main treatment option for efferent-loop obstruction following Billroth II or Roux-en-Y surgery?

    <p>Balloon dilation</p> Signup and view all the answers

    Which of the following inhibits the release of gastrin and acid?

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

    What is the function of D cells in the stomach?

    <p>Secrete somatostatin</p> Signup and view all the answers

    Which condition is associated with mucous cell hyperplasia and increased rugal folds in the stomach?

    <p>Ménétrier’s disease</p> Signup and view all the answers

    What is the most common risk factor for duodenal ulcers?

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

    Which surgical indication for ulcers requires resection of the ulcer?

    <p>Inability to rule out cancer</p> Signup and view all the answers

    What is the most common symptom of upper gastrointestinal bleeding (UGI bleeding)?

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

    Which factor is associated with the highest risk of mortality in non-variceal UGI bleeding?

    <p>Continued or rebleeding</p> Signup and view all the answers

    What is the primary treatment for bleeding varices in a patient with liver failure?

    <p>EGD with variceal bands or sclerotherapy</p> Signup and view all the answers

    Which surgical procedure results in an increase in solid emptying?

    <p>&quot;Pyloroplasty formation&quot;</p> Signup and view all the answers

    What is the treatment for diarrhea, the most common problem following vagotomy?

    <p>&quot;Cholestyramine and loperamide&quot;</p> Signup and view all the answers

    Which mutation is associated with a 70% lifetime risk of gastric cancer and a 40% lifetime risk of breast cancer in women?

    <p>CDH1 mutation</p> Signup and view all the answers

    What is the primary treatment for MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMA (MALT LYMPHOMA) if it does not regress after treatment for H. pylori?

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

    What surgery is recommended for stage I gastric lymphomas (tumor confined to stomach mucosa)?

    <p>Partial resection</p> Signup and view all the answers

    What is the most common benign gastric neoplasm, which can also be malignant if certain criteria are met?

    <p>Gastrointestinal stromal tumor (GIST)</p> Signup and view all the answers

    What is the primary treatment modality for gastric lymphomas?

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

    In morbid obesity, what is the approximate operative mortality associated with bariatric surgery?

    <p>~1%</p> Signup and view all the answers

    Which of the following complications can occur after gastrectomy or after vagotomy and pyloroplasty?

    <p>Dumping syndrome</p> Signup and view all the answers

    What is the primary cause of leak in the context of Roux-en-Y gastric bypass surgery?

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

    'Dumping syndrome' is primarily caused by rapid entering of which substance into the small bowel?

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

    What is the most common location for MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMA (MALT LYMPHOMA)?

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

    Which of the following symptoms are usually associated with Gastrointestinal Stromal Tumors (GISTS)?

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

    What is the primary symptom associated with diffuse-type gastric cancer (linitis plastica)?

    <p>Weight loss and anorexia</p> Signup and view all the answers

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