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ANKI GI > [34] Carcinoid Tumours > Flashcards

[34] Carcinoid Tumours Flashcards

1
Q

What are carcinoid tumours?

A

A diverse group of neuroendocrine tumours of enterochromaffin cell origin

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2
Q

What are carcinoid tumours capable of producing?

A

5HT

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3
Q

Where can carcinoid tumours be derived from?

A 
Respiratory tract
Stomach
Ileum 
Appendix
Colorectum
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4
Q

What might carcinoid tumours secrete?

A 
5-HT
VIP
Gastrin
Glucagon 
Insulin 
ACTH
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5
Q

What kind of carcinoid tumours rarely secrete 5-HT?

A

Hindgut tumours

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6
Q

What does carcinoid syndrome suggest?

A

The bypass of first-pass metabolism

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7
Q

What is carcinoid syndrome strongly associated with?

A

Metastatic disease

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8
Q

What % of carcinoid tumours are associated with MEN?

A

10%

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9
Q

What % of carcinoid tumours occur in the appendix?

A

45%

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10
Q

What % of carcinoid tumours occur in the ileum?

A

30%

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11
Q

What % of carcinoid tumours occur in the colorectum?

A

20%q

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12
Q

What % of carcinoid tumours are in the stomach?

A

10%

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13
Q

What % of carcinoid tumours are in the bronchus?

A

10%

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14
Q

What presentations might carcinoid tumours cause locally?

A

Appendicitis
Intussusception or obstruction
Abdominal pain

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15
Q

What are the symptoms of carcinoid syndrome?

A 
Flushing
Diarrhoea
Valve fibrosis
Wheeze
Hepatic involvement
Tryptophan deficiency
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16
Q

Describe the flushing in carcinoid syndrome

A

Paroxysmal
Occurs in upper body
May be wheals

17
Q

What does valve fibrosis cause in carcinoid syndrome?

A

Tricuspid regurgitation

Pulmonary stenosis

18
Q

What produces the wheeze in carcinoid syndrome?

A

Bronchoconstriction

19
Q

What does tryptophan deficiency lead to in carcinoid syndrome?

A

Pellagra

20
Q

What may be found on examination in carcinoid syndrome?

A

Increased urine 5-hydroxyindoleacetic acid

Increased plasma chromogranin A

21
Q

What is the purpose of CT/MRI in carcinoid syndrome?

A

Find primary

22
Q

What can be used to manage the symptoms in carcinoid syndrome?

A

Octreotide or loperamide

23
Q

What is the curative treatment for carcinoid syndrome?

A

Resection

24
Q

What is given post-carcinoid tumour resection?

A

Octreotide

25
Q

Why is octreotide given post-carcinoid tumour resection?

A

To avoid carcinoid crisis

26
Q

When does a carcinoid crisis occur?

A

If the tumour outgrows its blood supply, or is handled too much

27
Q

What happens in carcinoid crisis?

A

There is massive mediator release, leading to vasodilation, hypotension, bronchoconstriction, and hyperglycaemia

28
Q

How is carcinoid crisis managed?

A

High-dose octreotide

29
Q

What is the median survival of carcinoid tumours?

A

5-8 years

ANKI GI (43 decks)

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