This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Stomach & Duodenum, Subject name: Surgery
[{'content': 'In case upper GI bleed associated with stress gastritis all are true except: \nSelect and explain. \nA. Surgery should be done if transfusion requirements is >6 units., B. Vagotomy may be added, C. Surgery involves anterior gastrotomy with ligation of bleeding ulcers and superficial erosions, D. Total gastrectomy is rarely indicated', 'role': 'user'}, {'content': 'Answer: C \nExplanation: Ans. (c) Surgery involves anterior gastrotomy with ligation of bleeding ulcers and superficial erosionsRef: Sabiston 19th Edition, Pages 1167-11685 Salient points for Stress gastritis/ Stress Ulcers:* Multiple superficial erosions are stress ulcers* Most common in fundus of stomach* Cushing and curling ulcers are stress ulcers. Cushing ulcer is due to increased acid but not curling ulcer.* Only presentation is bleeding* Medical management with PPI and H2 blockers are used to maintain the intragastric pH >5. But sometimes surgery may be needed to control the bleeding. (Anterior gastrotomy and ligate the bleeding vessel and also accompanied with TV with pylorplasty)', 'role': 'assistant'}]