NBME 21 Short gastric (NBME Answers)

Retired NBME 21 Answers

nbme21/Block 3/Question#17 (reveal difficulty score)
A 66-year-old woman with pancreatic cancer ...
Short gastric 🔍 / 📺 / 🌳 / 📖
tags:

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submitted by saifshaikh(13)

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There is splenic vein thrombosis. The short gastric veins normally drain into the splenic vein. Due to the thrombosis, there may be fluid backup and increased pressure, resulting in varices.

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sononono UWORLD ID: 11795 +1

+1 upvote downvote
submitted by ∗dr.xx(176)

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Gastric varices are fed by the short gastric veins.

https://www.sciencedirect.com/science/article/pii/B9781437707748100764

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cienfuegos Add'l UW fun fact is differentiating from gastric varices 2/2 PHTN: Gastric varices: can also be seen w/ splenic vein throbmobis 2/2 chronic panceatitis, pancreatic cancer and abdominal tumors - gause gastric varices only in the fundus (remainder of stomach and esophagus usually not affected vs. PHTN: increased pressure in left gastric vens thus both gastric and esophageal varices) +5

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submitted by ∗sahusema(173)

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The question says GASTRIC varices, not ESOPHAGEAL varices. My stupid brain. Plus I'm assuming left gastroepiploic would be a correct answer if it was listed.

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cmun777 While L gastroepiploic would make more sense than the other answers, considering it has an anastomosis (and therefore an outlet for the increased blood) I think it would have much less risk of varices/bleeding than the short gastric would +1

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submitted by xw1984(8)

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Right gastroepiploic V can also be drained into its counterpart on the left, but short gastric V does not have anastomoses, so the varices of short gastric V leads to bleeding.

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-1 upvote downvote
submitted by ∗dr.xx(176)

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More fully: Afferents to gastric varices. The afferents to GV come from left gastric vein, short gastric veins and posterior gastric vein the left gastric vein mainly contributes to formation of cardiac varices whereas the short gastric vein and posterior gastric vein contribute to formation of fundal varices. Isolated gastric varices are more likely to be related to gastroepiploeic veins.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940321/

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