29- Pathology Explains 1 Flashcards
What does the Dukes classification system determine?
The Dukes classification system determines the extent of spread of colorectal cancer.
What does Dukes A indicate?
Dukes A indicates that the tumor is confined to the bowel without extending beyond it, and there are no nodal metastases. This accounts for approximately 95% of cases.
What does Dukes B indicate?
Dukes B indicates that the tumor has invaded the bowel wall but there are no nodal metastases. This accounts for approximately 75% of cases.
What does Dukes C indicate?
Dukes C indicates the presence of lymph node metastases. This accounts for approximately 50% of cases.
What does Dukes D indicate?
Dukes D indicates the presence of distant metastases. This accounts for approximately 6% of cases (25% if the metastases are resectable).
Who is stereotypically affected by primary hyperparathyroidism?
Primary hyperparathyroidism is stereotypically seen in elderly females.
What are common symptoms of primary hyperparathyroidism?
Common symptoms include unquenchable thirst, an inappropriately normal or raised parathyroid hormone level, and it is most commonly due to a solitary adenoma.
What are the causes of primary hyperparathyroidism?
The causes of primary hyperparathyroidism are: 80% solitary adenoma, 15% hyperplasia, 4% multiple adenoma, and 1% carcinoma.
What are the features associated with primary hyperparathyroidism?
The features associated with primary hyperparathyroidism are often remembered by the phrase ‘bones, stones, abdominal groans, and psychic moans.’ These include polydipsia and polyuria, peptic ulceration, constipation, pancreatitis, bone pain/fracture, renal stones, and depression.
What are the associations of primary hyperparathyroidism?
Associations include hypertension and multiple endocrine neoplasia (MEN I and II).
What are the typical findings on investigations for primary hyperparathyroidism?
Typical findings on investigations include raised calcium levels, low phosphate levels, and the possibility of a raised or normal parathyroid hormone (PTH) level. A technetium-MIBI subtraction scan may also be performed.
What is the treatment for primary hyperparathyroidism?
The treatment for primary hyperparathyroidism is parathyroidectomy. If imaging suggests a target gland, a focused approach may be used.
What are the characteristics of adenomas that correlate with malignant potential?
Three characteristics of adenomas that correlate with malignant potential are increased size, villous architecture, and dysplasia.
What are the different types of polyps seen in colorectal cancer?
Polyps can be categorized as neoplastic polyps, adenomatous polyps, and non-neoplastic polyps.
What genetic changes accompany the transition from adenoma to carcinoma?
Genetic changes that accompany the transition from adenoma to carcinoma include APC, c-myc, K RAS mutations, and p53 deletions.
What is the transformation process from polyp to cancer called?
The transformation from polyp to cancer is described by the adenoma-carcinoma sequence.
What are some examples of non-neoplastic polyps?
Non-neoplastic polyps include hyperplastic, juvenile, hamartomatous, inflammatory, and lymphoid polyps.
Why should most polyps identified at colonoscopy be removed?
Most polyps identified at colonoscopy should be removed because they may have malignant potential.
What is the most common type of oesophageal cancer in the Western world?
In the Western world, the most common type of oesophageal cancer is adenocarcinoma.
What is a major risk factor for oesophageal adenocarcinoma?
Barrett’s oesophagus is a major risk factor for most cases of oesophageal adenocarcinoma.
What are some risk factors for squamous cell oesophageal cancer?
In other regions of the world, squamous cell oesophageal cancer is more common and is linked to smoking, alcohol intake, diets rich in nitrosamines, and achalasia.
Why is surveillance of Barrett’s oesophagus important?
Surveillance of Barrett’s oesophagus is important because it imparts a 30-fold increase in cancer risk. Early diagnosis of invasive malignancy may lead to a 5-year survival rate of approximately 85%.
What is the first-line test for the diagnosis of oesophageal cancer?
Upper GI endoscopy is the first-line test for the diagnosis of oesophageal cancer.
What imaging modality is used for staging oesophageal cancer?
CT scanning of the chest, abdomen, and pelvis is used for staging oesophageal cancer.