Show:
The __ __basics
Whats in a name
By the numbers
next (very) step
Room 237
100
G cells from ___ release ___ to increase gastric secretion
What is Antrum and gastrin
100
This nerve is preserved during a HSV and accidently retained in incomplete truncal vagotomies and can contribute to recurrent stomach and duodenal ulcers
What is criminal nerve of grassi
100
This vitamin needs lifelong replacement after a Csendes procedure for a type IV gastric ulcer
What is B12
100
Young and stable, history of gastric ulcers, Hb 6, rises to 8 after transfusion
What is EGD
100
Young, Hemodynamically stable, peritonitis, free air, duodenal thickening on CT
What is graham patch
200
___, ____ and ____ are hormones released from Antral and duodenal acidification
What is CCK secretin and somatostatin
200
This procedure is the definitive surgical therapy for a severe Type I gastric ulcer
Bilroth I
200
These gastric ulcers are not associated with acid hyper secretion.
What is 1,4 and 5
200
Resection of Antrum and first portion of duodenum for large anterior gastric ulcer and now the two segments don't approximate
What is kocher maneuver
200
Bleeding duodenal ulcer in stable patient not controlled by Epi injection
What is duodenotomy with oversewing of gastroduodenal and pancreaticoduodenal artery
300
While somatostatin and PGE decrease gastric acid secretion, ___, ____ and ____ increase it with receptors on parietal cells
What is gastrin ACh and histamine
300
This ulcer in stress gastritis is seen in critically injured CNS injury
What is crushings ulcer
300
Symptoms associated with afferent limb greater than 20cm
What is abdominal pain, nausea, and bilious vomiting
300
22.5 years after BI for severe and frequent ulcers, a 65yo man has bloating nausea and vomiting. EGD shows GOO with very small lumen at the anastomoses
What is biopsy
300
32 yo male with known bleeding gastric ulcer on max dose PPI. You perform truncal vagotomies. Biopsy of nerve sent to pathology shows complete segment of neural tissue. Success! You are ready to close when your instincts says "I mean guys... dyawanna do anything else"
What is vagotomies
400
___ and ____arteries supply to the proximal duodenum and are supplied by the common hepatic
What is the gastroduodenal and the superior pancreaticoduodenal
400
In a Heineke Mikulicz pyloroplasty the incision is made in this direction and closed in this direction
What is logitudinal opened and transversely closed
400
When an ulcer is this size it has a 30% chance of malignancy
3cm
400
1 year after BII reconstruction, patient has frequent symptoms of bile reflux that have become beyond tolerable. He begs you to help him. You agree to operate. All pre-op testing was normal and he in on the table. On inspection there are significant adhesions around the afferent limb
What is RNY revision
400
A 65yo with chronic back pain come in with h/o 5 BM that have been only BRB. You tell the ED to call IR but they are on the back 9 and both scanners are down. He is coagulopathic but stable enough for surgery. In the OR you find diffuse ulcerations that seem to bleed more when oversewn.
What is total gastrictomy?
500
____ works via cyclic AMP to increase acid secretion
What is histamine
500
During a Bilroth II what is the maximum tolerable length of the afferent limb and where is the jejunum in relation to the colon
What is 20cm and retrocolic
500
Length of the roux limb (efferent limb) in a RNY reconstruction after antrectomy and doudenectomy
What is 40cm
500
Intractable ulcer despite max dose PPI therapy
What is order serum gastrin level
500
After saving a patients life by performing a gastroduodenostomy and oversewing the bleeding posterior vessels, you attempt to close your hole but the distal duodenum is under tension. To the horror of everyone in the room you extend your gastroduodenotomy to perform this procedure
What is finny pyloroplasty