Q6. Which of the following does not appear to cause early dumping
a) Serotonin
b) Bradykinin
c) Neurotensin
d) Secretin
Q7. Which is not a genetic alteration associated with Carcinoma Stomach?
a) Over expression of k-sam
b) Over expression of c-erbB2
c) Inactivation of c-met
d) Inactivation of p53
Q8. Which does not predispose to Carcinoma stomach?
a) Low fat and protein diet
b) Salted meat and fish
c) Low Nitrate consumption
d) HIgh Complex carbohydrate consumption
Q9.Which of the following is not true about gastric lymphoma?
a) Stomach is the most common organ in the gi system which is involved in Lymphoma
b)Peak incidence of lymphomas is seen in 6th-7th decade
c)Endoscopy usually reveals gastritis like picture or gastric ulcer.
d)MALT lymphoma is the commonest variety.
Q10. Which is false for GIST (Gastro intestinal stromal tumor) of stomach
a) It is the same as leiomyoma and leomyosarcoma as described previously.
b) origin is from mucosa from the interstitial cells of Cajal
c) Associated with C-Kit Mutation
d) Imatinab is a new effective drug for adjuvant therapy.
Answers
6.d
Serotonin, Bradykinin, Neurotensin and Enteroglucagon are associated with symptoms of early dumping.
Secretin has no association with Dumping
Sabiston 17 th page 1296
7. c
The over expression of met, sam and erbB2 associated with inactivation of p53 and p16 are associated with carcinoma stomach.
Sabiston 17th page 1304
8. c
Factors associated with increased risk of developing stomach cancer are
Nutritional Environmental Social Medical
Low Fat and Protein Poor food preparation Low Social class Prior gastric surgery
Salted meat and fish No refrigeration H.Pylori
HIgh NItrate Consumption Poor drinking water Gastric atrophy
High Complex Carbohydrates Smoking Adenomatous polyp and male gender
Sabiston 17th page 1303
9. d
Diffuse B cell lymphoma is the commonest variety (55%) followed by MALT
The stomach is the most common site for lymphomas in the gastrointestinal system. However, primary gastric lymphoma is still relatively uncommon, accounting for less than 15% of gastric malignancies and 2% of lymphomas.
Endoscopy rarely reveals a mass lesion and stomach is the most commonly involved organ
10.b
Gastric sarcomas arise from mesenchymal components of the gastric wall and constitute about 3% of all gastric malignancies.
GISTs were previously classified as leiomyomas or leiomyosarcomas. Histologically, they appear to arise from the muscularis propria & not mucosa; most likely originate from the cells of Cajal.
Kit is a transmembrane tyrosine kinase receptor,The Kit protein is detected by immunohistochemistry and can reliably distinguish GISTs from true smooth muscle neoplasms.
Imatinib mesylate (formerly ST1517, now Glivic/Gleevec) is a competitive inhibitor of certain tyrosine kinases, including the kinases associated with the transmembrane receptor Kit and platelet-derived growth factor receptors. Initial studies showed encouraging results, with 54% of patients exhibiting at least a partial response
