Chronic Gastric Ulcer

Chronic gastric ulcer

Q. 1

Commonest complication of chronic gastric ulcer is which of the following?

 A

Adenocarcinoma

 B

Perforation

 C

Lymphoma

 D

Haematenesis

Q. 1

Commonest complication of chronic gastric ulcer is which of the following?

 A

Adenocarcinoma

 B

Perforation

 C

Lymphoma

 D

Haematenesis

Ans. D

Explanation:

GI bleed is the commonest complication of acute or chronic gastric ulcer.

Outlet obstruction is the least commonest complication.


Q. 2

Gastric ulcer which is 3 cm away from pylorus and associated with duodenal ulcers is classified as:

 A

Type 1

 B

Type 2

 C

Type 3

 D

Type 4

Q. 2

Gastric ulcer which is 3 cm away from pylorus and associated with duodenal ulcers is classified as:

 A

Type 1

 B

Type 2

 C

Type 3

 D

Type 4

Ans. C

Explanation:

Majority of gastric ulcers (GUs) can be attributed to either H. pylori or NSAID-induced mucosal damage.

Gastric ulcers have been classified based on their location: 

  • Type I occur in the gastric body and tend to be associated with low gastric acid production
  • Type II occur in the antrum and gastric acid can vary from low to normal
  • Type III occur within 3 cm of the pylorus and are commonly accompanied by duodenal ulcers and normal or high gastric acid production
  • Type IV are found in the cardia and are associated with low gastric acid production.
Ref: Valle J.D. (2012). Chapter 293. Peptic Ulcer Disease and Related Disorders. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison’s Principles of Internal Medicine, 18e.

Q. 3

Most common complication of chronic gastric ulcer is –

 A

Tea pot stomach

 B

Scirrhous carcinoma (adenocarcinoma)

 C

Perforation

 D

Massive haematemesis

Q. 3

Most common complication of chronic gastric ulcer is –

 A

Tea pot stomach

 B

Scirrhous carcinoma (adenocarcinoma)

 C

Perforation

 D

Massive haematemesis

Ans. D

Explanation:

Ans. is ‘d’ i.e., Massive haematemesis 

  • Most common complication of peptic ulcer is gastro intestinal bleeding.
  • It is seen with both chronic and acute type of ulcers. Infact, chronic peptic ulcers are the most common cause of haematemesis and malaena.

Complications of peptic ulcer 

1)    Gastrointestinal bleeding Most common complication of peptic ulcer

Bleeding is more common in duodenal ulcers

It is commonly seen in posterior duodenal ulcers because of erosion of gastroduodenal artery.

2)    Perforation

It is the second most common complication of peptic ulcer disease.

Perforation occurs commonly in the ulcers located in the anterior part of duodenum.

Duodenal ulcers tend to penetrate into pancreas causing pancreatitis.

Gastric ulcers tend to penetrate into left hepatic lobe.

3)   Gastric outlet obstruction It is the least common ulcer related complication.

It is commonly associated with duodenal ulcers.

Tea pot stomach is caused due to longitudinal shortening of the gastric ulcer at the lesser curvature of the stomach (It causes the stomach to look like tea pot).

Hour glass stomach is caused due to cicatricial contraction of a saddle shaped ulcer at the lesser curvature.

Quiz In Between


Q. 4

All of the following are associated with Gastric Ulcer’s Except:

 A

H. Pylori infection

 B

High Acid output

 C

Smoking

 D

Bile Reflux

Q. 4

All of the following are associated with Gastric Ulcer’s Except:

 A

H. Pylori infection

 B

High Acid output

 C

Smoking

 D

Bile Reflux

Ans. B

Explanation:

Answer is B (High Acid Output)

Gastric ulcers are associated with normal or decreased gastric acid output. High Acid output is a feature of Duodenal Ulcers.

`Gastric acid output (basal and stimulated) tend to be normal or decreased in Gastric Ulcer Patient’s’- Harrison

Aetiological factors in peptic ulceration:

Causal factor

Gastric ulcer

Duodenal ulcer

Hellicobacter pylori

Important

Very important

NSAIDs and aspirin

Important

Important

Acid

Normal or low acid output

High or normal acid output

Bile reflux

Important

Unimportant

Smoking

Important

Important

Stress

Evidence for head injuries and burns only

Family history

Uncommon

Common


Q. 5

The most common site of a benign (peptic) gastric ulcer is:

 A

Upper third of lesser curvature

 B

Greater curvature

 C

Pyloric antrum

 D

Lesser curvature near incisura angularis

Q. 5

The most common site of a benign (peptic) gastric ulcer is:

 A

Upper third of lesser curvature

 B

Greater curvature

 C

Pyloric antrum

 D

Lesser curvature near incisura angularis

Ans. D

Explanation:

Answer is D (Lesser Curvature near incisura angularis)

The most common site of gastric ulcers (benign) is on the lesser curvature straddling the incisura angularis.


Q. 6

Most common complication of chronic gastric ulcer is:

 A

Tea pot stomach

 B

Scirrhous carcinoma (adenocarcinoma)

 C

Perforation

 D

Haemorrhage

Q. 6

Most common complication of chronic gastric ulcer is:

 A

Tea pot stomach

 B

Scirrhous carcinoma (adenocarcinoma)

 C

Perforation

 D

Haemorrhage

Ans. D

Explanation:

Answer is D (Haemorrhage):

The most common complication of both acute and chronic peptic ulcers is gastrointestinal haemorrhage. `Haemorrhage is the commonest complication of chronic peptic ulcers

Quiz In Between



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