Continuing with questions on stomach

Questions 1-5            Questions 11-15              Questions 16-20              Questions 21- 25                     Bariatric

Q6. Which of the following hormone does not appear to  be associated with early dumping
a) Serotonin
b) Bradykinin
c) Neurotensin

d) Secretin

Q7. Which is not a genetic alteration implicated 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 of the following is not a risk factor for Carcinoma stomach?
a) Low fat and protein diet
b) Salted meat and fish
c) Low Nitrate consumption

d) HIgh Complex carbohydrate consumption

Q9. False statement  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.

 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 and  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
Low Fat and Protein                                               
Salted meat and fish                                                                         
HIgh Nitrate Consumption                                                              
High Complex Carbohydrates                                                                       
Poor food preparation
No refrigeration
Poor drinking water
Low Social class
Prior gastric surgery
H Pylori infection
Gastric Atrophy
Adenomatous polyp
Male gender

Sabiston 18 th edition

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

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


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