Carcinoma Stomach MCQs

Resection of the stomach does lead to loss of intrinsic factor and the patient will be deficient in vitamin B12. Prevention or treatment of iron deficiency anemia (microcytic cell size) is the only indication for iron administration. Sargramostim is a GM-CSF and is used to stimulate the production of neutrophils and other myeloid and megakaryocyte progenitors. Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 834-39

Incidence of distal stomach tumors is actually decreasing while the incidence of tumors in the proximal stomach is increasing. Nonsteroidal anti-inflammatory drug (NSAID) use is associated with decreased risk of certain gastric tumors. pylori infection has been associated in a number of studies with increased risk of gastric carcinoma. Screening for gastric carcinoma in Japan detects up to 40% of gastric carcinomas at an early stage and in skilled hands five year survival can be upwards of 90%. Computed tomography (CT) with gastric dilatation is a useful complementary investigation in the staging of gastric carcinoma, but endoscopic ultrasonography is superior to conventional CT scanning as it is able to assess depth of infiltration and lymphatic dissemination of tumor. Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 80, Pg: 629-632

Gastrointestinal stromal tumours (GISTs) may arise in any part of the gastrointestinal tract but 50% will be found in the stomach. Previously named leiomyoma and leiomyosarcoma, the term GIST is now used, recognising the distinct phenotype. They are tumours of mesenchymal origin and are observed equally commonly in males and females. The tumours are universally associated with a mutation in the tyrosine kinase c-kit oncogene. Most GISTs occur due to gain of function mutation in receptor tyrosine kinase KIT or PDGFR-alpha. Most useful marker is CD-117. Carney triad - GIST + paraganglioma + pulmonary chondroma.