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3 Gastrointestinal System > 15 GI Malignancy > Flashcards

15 GI Malignancy Flashcards

1
Q

How prevalant are GI malignancies?

A

Bowel cancer= 4th most common cancer

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2
Q

What 2 types of carcinoma can occur in the oesophagus ?

A
  • Squamous cell carcinoma
  • Adenocarcinoma
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3
Q

Why are metastases common at presentation in patients with oesophageal carcinoma? What is the prognosis like?

A

Once dysphagia presents- usually later stages

Prognosis= poor - 5% survival in 5 years

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4
Q

What investigations can be carried out into oesophageal malignancies?

A

Barium swallow

OGD- endoscopy

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5
Q

A patient presents to you with dysphagia. What are the red flags you should check for if you are concerned about a possible malignancies?

A
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6
Q

A patient presents to you with epigastric pain. What are the red flags you should check for if you are concerned about a possible malignancies?

A

Malaena

Haematemesis

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7
Q

A patient presents with epigastric pain, haematemesis and malaena. Apart from malignancies what else may have caused by this?

A
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8
Q

Where are gastric cancers likely to be located in the stomach?

A

Cardia/antrum (adenocarcinomas)

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9
Q

How may gastric cancers present?

A

Malaena

Haematemesis

Epigastric pain

Weight loss

Early satiety

50% will have palpable mass

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10
Q

What are the risk factors for gastric cancer?

A
  • Smoking
  • High salt diet
  • Family history
  • H.pylori

ie Chronic inflammation

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11
Q

What is the prognosis for gastric cancer?

A

Generally poor:

10% chance- 5 year survival

50% after curative surgery

SCREENING= V.important

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12
Q

Apart from adenocarcinomas, what other forms of cancers found in the stomach are there?

A
  • Gastric lymphoma
    • MALT- mucosal associated lymphoid tissue
    • (associated with H-pylori)- prognosis= better than gastric cancer
  • Gastrointestinal stromal tumours (GISTs)
    • Sarcomas (not epithelial)
    • tends to be incidental finding on endoscopy
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13
Q

A patient presents to you with jaundice. What are the red flags you should check for if you are concerned about a possible malignancies?

A

Weight loss

Hepatomegaly w./ irregular border

Painless (so not gallstone)

Ascites (fluid build up in abdomen)

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14
Q

A primary malignancy of the liver is rare. Why is this important to know?

A

Common site for metastases- likely to be somewhere else ie (GI- portal vein drains directly into liver)

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15
Q

What cancer can spread to the liver transcoelomic (through the peritoneal cavity)?

A

Ovarian

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16
Q

How does pancreatic cancer present? (depends on where in pancreatic)

A

Head: Jaundice

Body/tail: symptoms more vague- relate to structure of pancreas (eg steatorrhea)

17
Q

What are the risk factors for pancreatic cancer?

A

Family history

Being male

Smoking

Chronic pancreatitis

18
Q

What is the prognosis for pancreatic cancer?

A

Very poor- usually talking months

19
Q

What are the three key symptoms associated with a lower GI malignancy?

A
  • Obstruction
  • Per rectum bleeding
  • Change in bowel habit
20
Q

What are the 3 main symptoms associated with an upper GI malignancy?

A
  • Jaundice
  • Dysphagia
  • Epigastric pain
21
Q

A lower GI malignancy can cause an obstruction. How do we investigate an obstruction?

A

Patient presents with: abdominal distension, abdominal pain

Abdominal x-ray- measure diameter- widened by gas (absolute constipation)

3, 6, 9cm rule- if greater= pathological

3- small bowel

6- large bowel

9- caecum dilation

22
Q

List some benign differentials for bowel obstruction.

A
  • Volvulus
  • Hernia
  • Intussusception- inversion of tube
  • Strictures
  • Pyloric stenosis
23
Q

Give some of the benign differentials for per rectum bleeding.

A
  • Haemorrhoids
  • Anal fissures
  • Infective gastroenteritis
  • IBD
  • Diverticular disease
24
Q

What determines the nature of per rectal bleeding?

A
25
Q

A patient presents to you with per anal bleeding. What are the red flags you should check for if you are concerned about a possible malignancies?

A
  • Iron deficiency anaemia
  • Explained weight loss
  • Change in bowel habit
  • Tenesmus (growth in rectum- always feeling like you need the toilet and not feeling fully empty)
26
Q

What changes in bowel habit can occur (ie symptoms)?

A
27
Q

Give some other causes of changes in bowel habit (not malignancy).

A

Thyroid disease

Irritable bowel disease

Irritable bowel syndrome

Medication related

Coeliac disease

Inflammatory bowel disease

28
Q

A patient presents to you with changes in bowel habit. What are the red flags you should check for if you are concerned about a possible malignancies?

A
  • PR blood loss
  • Unexplained weight loss
  • Iron deficiency anaemia
29
Q

How is screening for large bowel cancer carried out?

A

Faecal occult blood samples

30
Q

What are the risk factors for large bowel cancer?

A
  • Family
  • Inflammatory bowel disease
  • Polyposis syndromes
  • Diet and lifestyle
31
Q

How do polyps develop into adenocarcinoma?

A
32
Q

Differentiate between the presentation of right sided colon cancer and left sided colon cancer.

A
33
Q

What sign might you get on an x-ray with colon cancer?

A
34
Q

List the 5 different types of small bowel cancer. What are the risk factors and what are the symptoms?

A
35
Q

Outline dukes’ staging (used for bowel cancers).

A
36
Q

Outline the general management for bowel cancers

A
37
Q

What type of cancers are colorectal cancers?

A

Adenocarcinomas

50% in rectum

30% in sigmoid colon

3 Gastrointestinal System (19 decks)

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