Gastrointestinal surgery: Lauren classification and D2 gastrectomy: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Gastrointestinal surgery: Lauren classification and D2 gastrectomy

Sample item

Which statement about gastric cancer is correct?

AThe diffuse type is commoner in older men with Helicobacter gastritis and metaplasiaBD1 lymphadenectomy is the standard in curative resectionCThe diffuse type of Lauren has poorly cohesive cells and a worse prognosis than the intestinal typeDThe intestinal type is linked to CDH1 mutation

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. The diffuse type of Lauren has poorly cohesive cells and a worse prognosis than the intestinal type

Lauren's diffuse type has signet ring, poorly cohesive cells, occurs in younger patients, is linked to CDH1, and has poorer outcomes. The intestinal type follows H pylori, atrophy and metaplasia. Curative gastrectomy is accompanied by D2 nodal dissection.

Option by option

A. The diffuse type is commoner in older men with Helicobacter gastritis and metaplasia
That description fits the intestinal type.
B. D1 lymphadenectomy is the standard in curative resection
D2 dissection, not D1, is the standard.
C. The diffuse type of Lauren has poorly cohesive cells and a worse prognosis than the intestinal type (correct)
Correct. Diffuse type carries the worse outlook.
D. The intestinal type is linked to CDH1 mutation
CDH1 mutation underlies hereditary diffuse, not intestinal, gastric cancer.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, The diffuse type of Lauren has poorly cohesive cells and a worse prognosis than the intestinal type. Lauren's diffuse type has signet ring, poorly cohesive cells, occurs in younger patients, is linked to CDH1, and has poorer outcomes.

Why is "The diffuse type is commoner in older men with Helicobacter gastritis…" not the answer?

That description fits the intestinal type.

Why is "D1 lymphadenectomy is the standard in curative resection" not the answer?

D2 dissection, not D1, is the standard.

Why is "The intestinal type is linked to CDH1 mutation" not the answer?

CDH1 mutation underlies hereditary diffuse, not intestinal, gastric cancer.

What concept does this question test?

It tests Gastrointestinal surgery: Lauren classification and D2 gastrectomy in General Surgery. The intestinal type follows H pylori, atrophy and metaplasia. Curative gastrectomy is accompanied by D2 nodal dissection.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastrointestinal surgery: Lauren classification and D2 gastrectomy?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.