Gastric Disorders
The biggest risk factor for Gastric MALT lymphoma is ____
chronic infection of H. pylori
Adenocarcinoma affects which portion of the esophagus?
The lower third
What is the fastest method of administrating a drug?
A 45-year-old patient with immunodeficiency needs vaccination against influenza and hepatitis A. Which type of vaccines is most appropriate, since they cannot replicate in the body and are safe for immunocompromised individuals?
inactivated killed vaccines
Which types of polyps are the most common type in gastric polyps and are they malignant?
Hyperplastic and Fundic gland polyps
No
A 45 year old patient presents with heartburn and regurgitation 3-4x a week. Lifestyle modifications and antacids have provided only partial relief. Which classes of drugs could the physician assign to reduce gastric acid production to promote healing of the esophagus & control symptoms?
H2 receptor antagonists and proton pump inhibitors
A patient consumes a large amount of alcohol over a short period. Despite very high blood alcohol levels, the liver metabolizes roughly the same fixed amount of ethanol per hour. Which type of drug elimination kinetics does ethanol follow in this situation?
Zero-order elimination
A patient is immunocompromised and has a severe T-cell deficiency and requires vaccinations. Which vaccine type should be avoided, and why?
live attenuated vaccine
Autoimmune gastritis leads to the destruction of __1__ and loss of secretion of __2__ which can lead to __3__ anemia
1. gastric parietal cells
2. intrinsic factor
3. pernicious anemia
A patient presents again to office for dysphagia. Initially, the physician thought it was GERD but patient had a poor response to treatment. A biopsy revealed eosinophil predominant infection. What disorder does this patient most likely have?
Eosinophilic esophagitis
Two drugs produce the same maximum effect in reducing high cholesterol. Drug A achieves 50% of it's maximum effect at 4 mg. Drug B achieves 50% of it's maximum effect at 10 mg. Which drug is more potent?
Drug A
A patient receives a continuous IV infusion of 120 mg/hr. Clearance is 4 L/hr. What is the steady-state plasma concentration (Css)?
Css= rate of infusion/clearance
120/4= 30mg/L
A patient presents with acanthosis nigricans, and weight loss. The physical exam was unremarkable. An endoscopy revealed a thickened gastric wall with poorly defined margins. The biopsy revealed signet-ring cells infiltrating the gastric wall. What does the patient most likely have?
Diffuse type Adenocarcinoma
A 47 year old female presents to office with dysphagia, iron-deficiency anemia and a beefy red tongue. An endoscopy shows esophageal webs in the upper esophagus. What does this patient most likely have?
Plummer-Vinson Syndrome
A 60-year-old patient with chronic liver failure is prescribed a drug that is primarily metabolized by the liver. After a few days, the patient develops signs of drug accumulation and toxicity despite standard dosing. Which pharmacokinetic parameter is most likely impaired, and why?
Hepatic clearance --> liver dysfunction reduces metabolism which leads to decreased clearance and eventually drug accumulation
would also accept metabolism parameter
A patient with H. pylori infection is started on a therapy that includes a drug that coats ulcers, has antimicrobial activity, and can cause black stools. Which drug is this?
Bismuth subsalicylate (mucosal protective and antimicrobial activity)
Which type of gastric disorder develops through the Correa cascade?
correa cascade: chronic gastritis --> atrophy --> intestinal metaplasia --> dysplasia --> adenocarcinoma
specifically the intestinal type adenocarcinoma
A 50 year old male presents to clinic with a history of alcohol use disorder and chest pain. A chest x-ray shows pneumomediastinum and subcutaneous emphysema. An endoscopy was not performed due to risks of worsening the transmural rupture. The patient most likely has___
BoerHaave Syndrome
A patient is prescribed digoxin for heart failure. Small changes in dose or blood levels can easily lead to toxicity. What is the key clinical consideration when using this drug?
i.e. what steps to avoid toxicity?
Careful dosing and frequent monitoring
A patient is taking a weakly acidic drug. The drug is mostly non-ionized in the stomach (pH 1-2) but it largely ionized in the intestine (pH 7-8). Where is the drug more likely to be absorbed?
The stomach
non-ionized= lipid soluble and able to cross cell membranes via passive diffusion