ABSITE - STOMACH – QUESTIONS WITH
CORRECT ANSWERS 2025
AM60-year-
oldMmanMpresentsMwithMweightMloss,MearlyMsatiety,MandMmildManemia.MUpperMendoscopyMrevealsManMulc
eratedMmucosalMmassMinMtheMantrumMofMtheMstomach.MBiopsyMrevealsMgastricMadenocarcinoma.MTheMen
doscopicMultrasoundMstageMisMT2N1.MAMCTMofMtheMchest,Mabdomen,MandMpelvisMisMobtainedMandMthereMis
MnoMevidenceMofMmetastaticMdisease.MInMorderMtoMcompleteMtheMstaging,MheMwillMrequire:
A.MPETMscan
B.MCEAMandMCAM19-9Mlevels
C.MMRIMofMtheMabdomen
D.MDiagnosticMlaparoscopy
E.MGeneticMriskMassessmentM-MCORRECTMANSWERM-DiagnosticMlaparoscopy
Correct.
PETMisMnotMusedMroutinelyMforMtheMstagingMofMgastricMcancerMasMonlyM50%MofMgastricMcancersMareMPET-
avid.MStagingMlaparoscopyMidentifiesMoccultMmetastaticMdiseaseMinM23-
37%MofMpatientsMthoughtMtoMhaveMlocalizedMdiseaseMasMassessedMbyMCT.MThisMisMaMsafe,Mlow-
riskMprocedureMthatMhelpsMtoMpreventMunnecessaryMlaparotomiesMinMpatientsMwithMotherwiseMundetecta
bleMmetastaticMdisease.MStagingMlaparoscopyMshouldMbeMperformedMpriorMtoMneoadjuvantMtherapy.
AM72-year-oldMwomanMhadMupperMendoscopyMbecauseMofManemia.MAM1.5-
cmMsubmucosalMmassMinMtheMbodyMofMtheMstomachMinMadditionMtoM3MsmallM(<M0.5Mcm)MnodulesMwereMfo
undMalongMwithMaMlackMofMrugalMfolds.MBiopsiesMshowMtheMsmallMnodulesMandMlargestMmassMareMcarcinoi
dMtumorsMandMotherMbiopsiesMshowMatrophicMgastricMmucosa.MHerMserumMgastrinMlevelMisM550Mpg/mLM(
normalM<M100Mpg/mL).MOptimalMtreatmentMatMthisMtimeMwouldMbe:
A.MTotalMgastrectomy
B.MObservation
C.MWedgeMexcisionMofMtheMlargestMtumor
D.MAntrectomyMinMadditionMtoMenucleationMorMwedgeMexcisionMofMtheMlargestMtumor
E.MProximalMgastrectomyMwithMesophagogastrostomyM-MCORRECTMANSWERM-
AntrectomyMinMadditionMtoMenucleationMorMwedgeMexcisionMofMtheMlargestMtumor
Correct.
TheMtreatmentMofMpatientsMwithMgastricMcarcinoidMtumorsMdependsMonMtheMsizeMofMtheMtumorMandMtheM
cause.MThereMareM3MgroupsMofMpatients:MthoseMwithMatrophicMgastritisMorMperniciousManemia,MthoseMwit
hMZollinger-
, EllisonMsyndrome,MorMthoseMwhoseMtumorsMoccurMsporadically.MSporadicMtumorsMareMassumedMtoMbeMm
alignantMuntilMprovenMotherwise.MTumorsMassociatedMwithMhypergastrinemiaM(Zollinger-
EllisonMsyndromeMorMatrophicMgastritis)MareMlessMaggressive,MandMtreatmentMofMtheseM2MpopulationsMisM
directedMtowardMeradicationMofMhypergastrinemia.MInMfact,McompleteMregressionMofMallMtumorsMafterMant
rectomyMaloneMhasMbeenMdocumentedMinMpatientsMwithMatrophicMgastritisMandMmultipleMsmallMcarcinoid
s.
ThisMpatient'sMtumorMisMdueMtoMhypergastrinemiaMinMtheMsettingMofMatrophicMgastritis.MAMwork-
upMtoMruleMoutMZollinger-
EllisonMsyndromeMisMnotMindicatedMbecauseMtheMmucosaMinMpatientsMwithMZollinger-
EllisonMsyndromeMisMhypertrophic.MInMaMpatientMwithMatrophicMgastritis,MtheMbestMtreatmentMforMaMtumo
rM<M2McmMwouldMbeMlocalMexcisionMofMtheMdominantMtumorMwithMantrectomy.
AM50-year-
oldMmanMpresentsMwithManMasymptomatic,MincidentallyMdiscoveredMmassMarisingMfromMtheMstomach.MThi
sMisMaM10-cm,MpartiallyMcysticMlesionMarisingMfromMaM2-
cmMstalkMonMtheMgreaterMcurvatureMofMtheMstomach.MBiopsyMrevealsMaMGISTMwithM4Mmitoses/10Mhpf.MTh
eMtumorMisMpositiveMforMaMc-
kitMexonM11Mmutation.MAxialMimagingMrevealsMnoMevidenceMofMmetastaticMdisease.MTheMmostMappropriat
eMtreatmentMis:
A.MWatchfulMwaitingMwithMserialMCTMscansMeveryM3-6Mmonths
B.MWedgeMresectionMofMtheMgreaterMcurvatureMofMtheMstomachMtoMremoveMtheMcysticMmassMandMassocia
tedMstalk
C.MDistalMgastrectomyMwithMD1Mlymphadenectomy
D.MDistalMgastrectomyMwithMD2Mlymphadenectomy
E.MNeoadjuvantMimatinibM-MCORRECTMANSWERM-
WedgeMresectionMofMtheMgreaterMcurvatureMofMtheMstomachMtoMremoveMtheMcysticMmassMandMassociated
Mstalk
Correct.
SmallMgastricMGISTsMwithMlowMmalignantMpotentialMareMoccasionallyMidentifiedMincidentallyMduringMroutin
eMendoscopicMevaluation.MObservationMwithMendoscopicMsurveillanceMcanMbeMconsideredMforM<M2-
cmMgastricMGISTsMwithoutMhigh-
riskMfeaturesM(irregularMborder,McysticMspaces,Mulceration,MechogenicMfoci,MandMheterogeneity).MPrimaryM
GISTsMexhibitMlimitedMintramuralMextensionMandMrarelyMmetastasizeMtoMregionalMlymphMnodes;Mtherefore
,MwedgeMresectionMtoMnegativeMmarginsMwithoutMlymphadenectomyMisMtheMfavoredMoperativeMapproach
.MNeoadjuvantMimatinibMisMconsideredMifMtheMlocationMorMsizeMofMtheMtumorMwillMrequireMcomplexMorMm
ultivisceralMresection;MshrinkingMtheMtumorMmayMfacilitateMtheMoperationMand/orMallowMorganMpreservati
on.
CORRECT ANSWERS 2025
AM60-year-
oldMmanMpresentsMwithMweightMloss,MearlyMsatiety,MandMmildManemia.MUpperMendoscopyMrevealsManMulc
eratedMmucosalMmassMinMtheMantrumMofMtheMstomach.MBiopsyMrevealsMgastricMadenocarcinoma.MTheMen
doscopicMultrasoundMstageMisMT2N1.MAMCTMofMtheMchest,Mabdomen,MandMpelvisMisMobtainedMandMthereMis
MnoMevidenceMofMmetastaticMdisease.MInMorderMtoMcompleteMtheMstaging,MheMwillMrequire:
A.MPETMscan
B.MCEAMandMCAM19-9Mlevels
C.MMRIMofMtheMabdomen
D.MDiagnosticMlaparoscopy
E.MGeneticMriskMassessmentM-MCORRECTMANSWERM-DiagnosticMlaparoscopy
Correct.
PETMisMnotMusedMroutinelyMforMtheMstagingMofMgastricMcancerMasMonlyM50%MofMgastricMcancersMareMPET-
avid.MStagingMlaparoscopyMidentifiesMoccultMmetastaticMdiseaseMinM23-
37%MofMpatientsMthoughtMtoMhaveMlocalizedMdiseaseMasMassessedMbyMCT.MThisMisMaMsafe,Mlow-
riskMprocedureMthatMhelpsMtoMpreventMunnecessaryMlaparotomiesMinMpatientsMwithMotherwiseMundetecta
bleMmetastaticMdisease.MStagingMlaparoscopyMshouldMbeMperformedMpriorMtoMneoadjuvantMtherapy.
AM72-year-oldMwomanMhadMupperMendoscopyMbecauseMofManemia.MAM1.5-
cmMsubmucosalMmassMinMtheMbodyMofMtheMstomachMinMadditionMtoM3MsmallM(<M0.5Mcm)MnodulesMwereMfo
undMalongMwithMaMlackMofMrugalMfolds.MBiopsiesMshowMtheMsmallMnodulesMandMlargestMmassMareMcarcinoi
dMtumorsMandMotherMbiopsiesMshowMatrophicMgastricMmucosa.MHerMserumMgastrinMlevelMisM550Mpg/mLM(
normalM<M100Mpg/mL).MOptimalMtreatmentMatMthisMtimeMwouldMbe:
A.MTotalMgastrectomy
B.MObservation
C.MWedgeMexcisionMofMtheMlargestMtumor
D.MAntrectomyMinMadditionMtoMenucleationMorMwedgeMexcisionMofMtheMlargestMtumor
E.MProximalMgastrectomyMwithMesophagogastrostomyM-MCORRECTMANSWERM-
AntrectomyMinMadditionMtoMenucleationMorMwedgeMexcisionMofMtheMlargestMtumor
Correct.
TheMtreatmentMofMpatientsMwithMgastricMcarcinoidMtumorsMdependsMonMtheMsizeMofMtheMtumorMandMtheM
cause.MThereMareM3MgroupsMofMpatients:MthoseMwithMatrophicMgastritisMorMperniciousManemia,MthoseMwit
hMZollinger-
, EllisonMsyndrome,MorMthoseMwhoseMtumorsMoccurMsporadically.MSporadicMtumorsMareMassumedMtoMbeMm
alignantMuntilMprovenMotherwise.MTumorsMassociatedMwithMhypergastrinemiaM(Zollinger-
EllisonMsyndromeMorMatrophicMgastritis)MareMlessMaggressive,MandMtreatmentMofMtheseM2MpopulationsMisM
directedMtowardMeradicationMofMhypergastrinemia.MInMfact,McompleteMregressionMofMallMtumorsMafterMant
rectomyMaloneMhasMbeenMdocumentedMinMpatientsMwithMatrophicMgastritisMandMmultipleMsmallMcarcinoid
s.
ThisMpatient'sMtumorMisMdueMtoMhypergastrinemiaMinMtheMsettingMofMatrophicMgastritis.MAMwork-
upMtoMruleMoutMZollinger-
EllisonMsyndromeMisMnotMindicatedMbecauseMtheMmucosaMinMpatientsMwithMZollinger-
EllisonMsyndromeMisMhypertrophic.MInMaMpatientMwithMatrophicMgastritis,MtheMbestMtreatmentMforMaMtumo
rM<M2McmMwouldMbeMlocalMexcisionMofMtheMdominantMtumorMwithMantrectomy.
AM50-year-
oldMmanMpresentsMwithManMasymptomatic,MincidentallyMdiscoveredMmassMarisingMfromMtheMstomach.MThi
sMisMaM10-cm,MpartiallyMcysticMlesionMarisingMfromMaM2-
cmMstalkMonMtheMgreaterMcurvatureMofMtheMstomach.MBiopsyMrevealsMaMGISTMwithM4Mmitoses/10Mhpf.MTh
eMtumorMisMpositiveMforMaMc-
kitMexonM11Mmutation.MAxialMimagingMrevealsMnoMevidenceMofMmetastaticMdisease.MTheMmostMappropriat
eMtreatmentMis:
A.MWatchfulMwaitingMwithMserialMCTMscansMeveryM3-6Mmonths
B.MWedgeMresectionMofMtheMgreaterMcurvatureMofMtheMstomachMtoMremoveMtheMcysticMmassMandMassocia
tedMstalk
C.MDistalMgastrectomyMwithMD1Mlymphadenectomy
D.MDistalMgastrectomyMwithMD2Mlymphadenectomy
E.MNeoadjuvantMimatinibM-MCORRECTMANSWERM-
WedgeMresectionMofMtheMgreaterMcurvatureMofMtheMstomachMtoMremoveMtheMcysticMmassMandMassociated
Mstalk
Correct.
SmallMgastricMGISTsMwithMlowMmalignantMpotentialMareMoccasionallyMidentifiedMincidentallyMduringMroutin
eMendoscopicMevaluation.MObservationMwithMendoscopicMsurveillanceMcanMbeMconsideredMforM<M2-
cmMgastricMGISTsMwithoutMhigh-
riskMfeaturesM(irregularMborder,McysticMspaces,Mulceration,MechogenicMfoci,MandMheterogeneity).MPrimaryM
GISTsMexhibitMlimitedMintramuralMextensionMandMrarelyMmetastasizeMtoMregionalMlymphMnodes;Mtherefore
,MwedgeMresectionMtoMnegativeMmarginsMwithoutMlymphadenectomyMisMtheMfavoredMoperativeMapproach
.MNeoadjuvantMimatinibMisMconsideredMifMtheMlocationMorMsizeMofMtheMtumorMwillMrequireMcomplexMorMm
ultivisceralMresection;MshrinkingMtheMtumorMmayMfacilitateMtheMoperationMand/orMallowMorganMpreservati
on.