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34 Cards in this Set
- Front
- Back
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precursor to gastric lymphoma
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MALToma - regresses with H. pylori treatment
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diagnostics for H. pylori
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blood antibody, stool antigen, carbon urea breath test, biopsy during endoscopy with CLO test (detects urease)
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gastric ulcer types
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I - lesser curve, II - 2 ulcers (lesser curve and duodenal), III - prepyloric, IV - high lesser curve, V - anywhere associated with NSAID use
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blood type associations with gastric ulcers
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type I with type A; other ulcers with type O blood
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risk factors for gastric adenocarcinoma (5)
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adenoma > 2 cm, type A blood, nitrosamines, chronic atrophic gastritis, pernicious anemia
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margin for resection of gastric adenocarcinoma
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6cm (intramural spread)
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treatment of gastric lymphoma
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chemo and RT rx of choice, surgery for complications
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effects of tryptophan deficiency (or diversion by carcinoid)
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pellagra (dermatitis, dementia, diarrhea)
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stomach transit time
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3-4h
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gastric blood supply
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celiac artery > left gastric, celiac > splenic > short gastrics and left gastroepiploic; celiac > common hepatic > right gastric & gastroduodenal
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cells, stimuli for HCl release
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parietal cells; acetylcholine, gastrin, histamine
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inhibitors of parietal cells
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somatostatin, PGE1, secretin, CCK
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cells, stimuli for gastrin release
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G cells in antrum; amino acids, acetylcholine
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syndromes causing increased acid and increased gastrin
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Z-E syndrome, antral cell hyperplasia, retained antrum, renal failure, gastric outlet obstruction, short bowel syndrome
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syndromes causing normal acid production and increased gastrin
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pernicious anemia, chronic gastritis, gastric cancer, postvagotomy, acid suppressive medication
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symptoms and treatment of gastric volvulus
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nausea without vomiting, severe pain, organoaxial volvulus; reduce and perform nissen
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difference in food tolerance between complete and highly selective vagotomies
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emptying of solids
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alterations caused by truncal vagotomy
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decreased acid output, increased gastrin secretion; decreased pancreas function, decreased postprandial bile flow, increased gallbladder volume; diarrhea in 30-50%
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location of ulcers more likely to perforate
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anterior
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location of ulcers more likely to bleed, and vessel they bleed from
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posterior; bleed from gastroduodenal artery
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types of chronic gastritis
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type A (fundus; pernicious anemia / autoimmune dz); type B (antrum; H. pylori)
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Krukenberg tumor
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mets of gastric cancer to ovary
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risk of cancer with adenomatous polyps
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10-20% (so resect endoscopically)
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factors determining survival in GISTs
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size, mitotic rate
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management of GISTs
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resect with >1cm margins, chemo if >5cm or >5-10 mitoses/hpf
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treatment of MALT
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antibiotics for H. pylori, surveillance and chemotherapy if it doesn't recede
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side effects of jejunoileal bypass
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increased risk of cirrhosis, kidney stones, osteoporosis
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symptoms and treatment of blind-loop syndrome
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bacterial overgrowth --> pain, diarrhea, malabsorption, B12 deficiency, steatorrhea. Rx: tetracycline, flagyl, metoclopramide, possibly reanastamose with shorter limb
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symptoms and treatment of afferent limb obstruction
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nonbilious vomiting, pain, steattorhea due to obstruction of afferent limb. Rx: dilate, shorten limb
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symptoms and treatment of efferent limb obstruction
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obstructive symptoms; dilate and find site of obstruction
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cause and treatment of postvagotomy diarrhea
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nonconjugated bile salts pushed into colon by persistent migratory complexes; cholestyramine and octreotide
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benefit of highly selective vagotomy
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don't get impaired empyting of solids you may get with complete vagotomy
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proportion of gastric cancers arising in the antrum
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40%
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proportion of gastric ulcers on the lesser curvature
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70-80%
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