Notes in Chapter_30:_Stomach

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Published	07/07/2024	Forrest Criteria class {{c1::Ia}} is active spurting bleeding
Published	07/07/2024	Forrest Criteria class {{c1::Ib}} is active oozing bleeding
Published	07/07/2024	Forrest Criteria class {{c1::IIa}} is non-bleeding but visible vessel
Published	07/07/2024	Forrest Criteria class {{c1::IIb}} is non-bleeding with adherent clot
Published	07/07/2024	Forrest Criteria class {{c1::IIc}} is non-bleeding with pigmented ulcer base
Published	07/07/2024	Forrest Criteria class {{c1::III}} is clean base with no sign of bleeding
Published	07/07/2024	An operation in which the pylorus is removed and the distal stomach is anastomosed directly to the duodenum is Billroth {{c1::I}}
Published	07/07/2024	An operation in which the greater curvature of the stomach is connected to the first part of the jejunum in end-to-side anastomosis Billroth {{c1…
Published	07/07/2024	Peristalsis only occurs in the {{c1::distal stomach (antrum)::part of stomach}}
Published	07/07/2024	The {{c3::right}} gastric artery branches off of the {{c2::proper hepatic}} artery {{c1::after::before/after}} the gastroduodenal arter…
Published	07/07/2024	{{c1::Brunner’s}} glands located in the {{c2::duodenum}} secrete {{c3::alkaline mucus}}
Published	07/07/2024	Rapid gastric emptying is most commonly caused by {{c1::previous surgery}} and {{c2::ulcers}}
Published	07/07/2024	Delayed gastric emptying is most commonly caused by {{c1::diabetes::endocrine}}, {{c1::hypothyroidism::endocrine}}, {{c2::opiates::drug}}, and {{c2::a…
Published	07/07/2024	A bulky mass trapped in the stomach that is composed of indigestible plant material such as fiber, skins, and seeds is called a {{c1::phytobezoar…
Published	07/07/2024	Mallory-Weiss tear usually occurs at the GE junction near the {{c1::less}}er curvature
Published	07/07/2024	{{c2::Truncal}} vagotomy involves severing the vagal nerves at the level of the {{c1::distal esophagus}}
Published	07/07/2024	{{c2::Proximal (aka highly selective)}} vagotomy involves severing the vagus nerve at the level of the {{c1::stomach (lesser curvature)…
Published	07/07/2024	{{c1::Proximal (highly selective)}} vagotomy spares the Crow's Foot branches
Published	07/07/2024	The advantage of a {{c1::proximal (highly selective)}} vagotomy is that the rate of solid emptying {{c2::doesn't change::↓↑}}
Published	07/07/2024	Vagotomy indications in peptic ulcer disease: - If peptic ulcer disease is {{c2::refractory to medical therapy}} - If patient has {{c2::alle…
Published	07/07/2024	The most common side effect of vagotomy is {{c1::diarrhea (40%)}}, which is caused by increased {{c2::migrating motor complexes}} forcing {{c2::b…
Published	07/07/2024	Following a vagotomy: - Acid output {{c3::↓::↑↓}}  - Gastrin cells {{c3::↑::↑↓}}  - Pancreas function {{c2::↓::↑↓}} &nbs…
Published	07/07/2024	Upper GI bleed management: Forrest classification {{c1::I - IIc}} require {{c2::endoscopic hemostasis::procedure}} and treatment for H. pylori
Published	07/07/2024	Upper GI bleed management: Forrest classification {{c1::III}} require {{c2::H. pylori biopsy::procedure}} and outpatient triple therapy treatment
Published	07/07/2024	Forrest class and bleeding recurrence: - Class {{c1::Ia}} ({{c2::spurting blood vessel}}) - highest 60% - Class {{c1::IIa}} ({{c2::visible n…
Published	07/07/2024	Vagotomy types (ulcer recurrence):{{c1::High}}est risk of recurrence is with {{c2::proximal vagotomy}} {{c1::Low}}est risk of recurrence&nbs…
Published	07/07/2024	Vagotomy types:{{c2::Low}}est mortality is with {{c1::proximal vagotomy}}{{c2::High}}est mortality is with {{c1::truncal vagotomy with antrectomy…
Published	07/07/2024	The preferred reconstruction method for failed vagotomy with antrectomy is {{c1::Roux-en-Y gastro-jejunostomy}}, because there is less …
Published	07/07/2024	Major bleeding from ulcer is defined as being hypotensive despite administration of >{{c1::6}} units of blood in 24 hours
Published	07/07/2024	Duodenal ulcer surgery is performed via {{c1::duodenotomy}}, followed by {{c1::gastroduodenal artery}} ligation, taking care to avoid injuri…
Published	07/07/2024	Gastric outlet obstruction treatment - Interventions: {{c1::PPI::drug}} and {{c1::serial dilation::procedure}} - Supportive: {{c2::IVFs}} an…
Published	07/07/2024	The surgical management of gastric outlet obstruction is {{c1::antrec}}tomy and {{c2::truncal vago}}tomywith ulcer resection if it is located {{c…
Published	07/07/2024	After gastric outlet obstruction surgery, the resected area should be sent to pathology to rule out {{c1::cancer}}
Published	07/07/2024	Gastric perforation can have radiating pain to the {{c1::paracolic}} gutter(s)
Published	07/07/2024	Perforated gastric ulcers that have perforated are surgically repaired using the {{c1::Graham patch}} procedure
Published	07/07/2024	Perforated gastric ulcer surgical management if the patient has had an omentectomy is to use the {{c1::ligamentum teres hepatis}} instead of omen…
Published	07/07/2024	An intractable peptic ulcer is defined as {{c1::3}} months without relief while on increasing doses of PPI
Published	07/07/2024	Is alcohol a risk factor for gastric ulcers?{{c1::Yes}}
Published	07/07/2024	Renal problems can cause gastric ulcers due to {{c1::uremia}}
Published	07/07/2024	Hemorrhaging ulcers are more deadly when they are in the {{c1::stomach::stomach or duodenum}}
Published	07/07/2024	The best test for H. pylori is {{c1::biopsy}}; the second best is {{c1::CLO test}}
Published	07/07/2024	Type {{c1::I}} gastric ulcer
Published	07/07/2024	Type {{c1::II}} gastric ulcer
Published	07/07/2024	Type {{c1::III}} gastric ulcer
Published	07/07/2024	Type {{c1::IV}} gastric ulcer
Published	07/07/2024	Type {{c1::IV}} gastric ulcers are usually located along the {{c2::cardia}} of the stomach due to the decreased mucosal protection
Published	07/07/2024	Type 5 gastric ulcers are associated with {{c1::NSAIDs}}
Published	07/07/2024	The confirmatory test for H. pylori eradication is {{c1::urea breath test}}
Published	07/07/2024	Which gastric ulcer surgical indication is not included in the IHOP mnemonic?{{c1::Not being able to exclude malignancy}}
Published	07/07/2024	{{c2::Cushing's}} ulcers are usually {{c1::gastric}} ulcers(Cushing's or Curling's)
Published	07/07/2024	{{c2::Curling's}} ulcers are usually {{c1::duodenal}} ulcers(Cushing's or Curling's)
Published	07/07/2024	Type {{c1::A}} ulcers are associated with autoimmune causes and are treated with {{c2::PPI}}
Published	07/07/2024	Type B ulcers are treated with {{c2::PPI (triple therapy)}}
Published	07/07/2024	Which blood type is associated with gastric cancer?Type {{c1::A}}
Published	07/07/2024	{{c3::Diffuse gastric}} cancer (aka {{c2::linitis plastica}}) is treated with {{c1::total gastrectomy}}
Published	07/07/2024	A contraindication to gastric cancer resection is if there is {{c1::metastasis}}; only do surgery if it is {{c2::palliative}}
Published	07/07/2024	Indications for paliative gastric cancer surgery are {{c1::obstruction}}, bleeding, or pain
Published	07/07/2024	Palliative gastric cancer surgery in obstruction: - Proximal stomach: {{c1::stent}} - Distal stomach: {{c1::gastrojejunostomy}}
Published	07/07/2024	Palliative gastric cancer surgery in obstruction:{{c2::Dist}}al stomach - gastrojejunostomy{{c2::Proxim}}al stomach - stent
Published	07/07/2024	The most common malignancy in stomach is {{c1::GIST}}
Published	07/07/2024	GIST tumors are hyp{{c1::o}}echoic on ultrasound
Published	07/07/2024	The malignancy criteria for a GIST tumor are >{{c1::5}} {{c2::cm}} and >{{c1::5}} {{c2::mitoses/50 high-powered field}}
Published	07/07/2024	Which lymph nodes do you dissect for GIST tumors located in the stomach{{c1::None}}
Published	07/07/2024	The margins required for a GIST tumor is {{c1::1}} cm
Published	07/07/2024	If MALToma does not regress after triple therapy treat with {{c1::radiation}}
Published	07/07/2024	The most common location for extra-nodal lymphoma is {{c1::stomach}}
Published	07/07/2024	Gastric lymphomas are usually {{c1::non-H}}odgkin
Published	07/07/2024	Which comorbidity does NOT improve after bariatric surgery?{{c1::Peripheral artery disease}}
Published	07/07/2024	B12 deficiency can occur in Roux-en-Y bypass patients due to low {{c1::acid levels}} so B12 cannot bind to {{c2::haptocorrin (R-binder)…
Published	07/07/2024	Complications of Roux-en-Y gastric byass:{{c2::Leak}} - caused by {{c3::ischemia::mechanism}} - presents with symptoms of infection but often do NOT h…
Published	07/07/2024	Testing for gastric bypass leak is with {{c2::upper GI::test}} on post-op day {{c1::2}}
Published	07/07/2024	Most common cause of bypass surgery weight loss failure is {{c1::high carb snacking}}
Published	07/07/2024	Marginal ulcers are treated with {{c1::PPI}}
Published	07/07/2024	{{c2::Marginal}} ulcers are usually located on the {{c1::jejunum}}
Published	07/07/2024	Small bowel obstruction in a patient with prior gastric bypass is treated with {{c1::surgery}}
Published	07/07/2024	Jejunoileal bypass is associated with {{c1::cirrhosis::hepatic}}, {{c2::kidney stones::renal}}, and {{c3::osteoporosis::musculoskeletal}}
Published	07/07/2024	{{c1::Jejunoileal}} bypass should be corrected with Roux-en-Y, due to the risks of other organ systems
Published	07/07/2024	The two phases of dumping syndrome include a hyp{{c1::erosmotic}} load and a hyp{{c1::oglycemia}} phase
Published	07/07/2024	Dumping syndrome symptoms include hypotension, dizziness, and diarrhea caused by {{c1::fluid}} shift in phase {{c2::1}}
Published	07/07/2024	Dumping syndrome is diagnosed with {{c1::gastric emptying study}}
Published	07/07/2024	Dumping syndrome is treated with:  - Meals with {{c1::high}} {{c2::protein-carb}} ratio - No {{c3::liquids}} with meals - No {{c4:…
Published	07/07/2024	Although rarely needed, surgical treatment of dumping syndrome can be accomplished by increasing the {{c1::gastric reservoir}}
Published	07/07/2024	Bypass complications:{{c3::Alkaline reflux gastritis}} presents with post-prandial epigastric pain that doe{{c1::s not}} resolve with {{c2::…
Published	07/07/2024	Alkaline reflux gastritis is diagnosed with {{c1::EGD}}
Published	07/07/2024	Alkaline reflux gastritis testing (EGD) will show {{c2::bile reflux}} into {{c1::stomach}}
Published	07/07/2024	What adjunct procedure might be performed during a Roux-en-Y?{{c1::cholecyst}}ectomy, but only if you notice {{c1::stones}} are present in t…
Published	07/07/2024	Patients with Billroth II and Roux-en-Y can develop {{c2::blind loop}} syndrome, which is diagnosed with {{c1::EGD culture}}, and …
Published	07/07/2024	Post-vagotomy diarrhea is treated with {{c1::cholestyramine}} and {{c2::loperamide}}
Published	07/07/2024	The surgical treatment for presistent post-vagotomy diarrhea is {{c1::reversed jejunal interposition}} graft
Published	07/07/2024	{{c3::Duodenal stump blow-out}} is diagnosed with {{c2::CT scan}} and treated with {{c1::duodenostomy tube}}
Published	07/07/2024	PEG tube complications can include insertion through the {{c2::liver}} or {{c1::colon}}
Published	07/07/2024	Surgical indications for gastric ulcers can be remembered with IHOPI{{c1::ntractability}}H{{c2::emorrhage (uncontrolled bleeding)}}O{{c3::bstruction}}…
Published	07/07/2024	In Roux-en-Y, the {{c1::alimentary/Roux}} limb should be {{c2::130}}-{{c2::150}} cm
Published	07/07/2024	The most common complication of {{c2::gastric sleve::bariatric}} surgery is {{c1::new or worsening GERD}}
Published	07/07/2024	Treatment refractory {{c2::GERD}} after sleeve gastrectomy is treated with {{c1::Roux-en-Y}}
Published	07/07/2024	Linear erythematous lesions of gastric mucosa above diaphragmatic hiatus are called {{c1::Cameron ulcer}}
Published	07/07/2024	The management of accidental PEG tube removal includes {{c1::insertion of Foley catheter}}
Published	07/07/2024	If a PEG tube is accidentally removed and it has been > {{c2::24}} hours, it is usually necessary to use a {{c1::Hegar dilator}} before r…
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Published	07/07/2024	The GI bleed risk-stratification score to determine patient discharge status is the {{c1::Glasgow-Blatchford}} bleeding score
Published	07/07/2024	The GI bleed risk stratification score to determine if a patient should be treated inpatient or outpatient is the {{c1::Rockall}} score
Published	07/07/2024	Closing a gastrotomy is done in {{c1::two}} layer(s)
Published	07/07/2024	Is pneumatosis an indication for surgery?{{c1::No, it can have benign causes (lupus, feeding tube, HIV, etc)}}
Published	07/07/2024	The medical management for impacted food bolus includes {{c2::glucagon}} and {{c1::sublingual nitroglycerin}}
Published	07/07/2024	Bleeding ulcer epinephrine injections are done {{c3::2}}-{{c3::3}} mL (1:{{c2::10,000}} ratio) in {{c1::four quadrants::distribution}}
Published	07/07/2024	Epinephrine injection for bleeding ulcer is started {{c1::posteriorly}}, then {{c1::anteriorly}}, followed by the {{c1::lateral}} quadrants
Published	07/07/2024	Stomach and small intestinal causes of pancreatitis include {{c1::ruptured ulcer (usually posterior)}}
Published	07/07/2024	Presistently high levels of gastric acid after vagotomy is most likely due to {{c1::an intact Criminal Nerve of Grassi}}
Published	07/07/2024	{{c1::Buried Bumper}} syndrome is a late complication where the G-tube bulb is too tight and errodes through the gastric wall into the area under…
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