Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FUN MED SPRING 2018 > 5. Gastric Cancer, Zollinger-Ellison Syndrome, & Pyloric Stenosis > Flashcards

5. Gastric Cancer, Zollinger-Ellison Syndrome, & Pyloric Stenosis Flashcards

1
Q

What is the 5 year survival rate for localized stomach cancer?

A

67%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does gastric cancer spread?

A

Direct extension through the GASTRIC WALL and LYMPHATICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the most common type of gastric cancer?

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Type of cells in the cardia

A

Mucus secreting cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Type of cells in the fundus and body of stomach

A

Mucoid, Chief, and Parietal Cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cells in the pylori

A

Mucus secreting cells and endocrine cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

30% of gastric cancers originate in the_______stomach, 20% in ________, and 40% in ___________.

A

Distal
Mid
Proximal third

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What kind of fungus is a risk factor for gastric cancer?

A

Aflatoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What kind of blood type is a risk factor for gastric cancer?

A

Group A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common symptom of gastric cancer

A

Postprandial fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A patient presents with palpable enlarged stomach with succession splash…….

A

Gastric Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which lymph nodes are generally enlarged in gastric cancer?

A

Virchow Nodes

Irish Nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Test used to evaluate the gastric wall, obtain a biopsy and establish lymph node involvement.

A

EGD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If you wanted to assess the tumor stage for preoperation what test would you use?

A

EUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Metastatic ovarian nodules (tumor).

A

Krukenberg’s tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Periumbilical nodes (tumor).

A

“Sister Mary Jospeh node”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Metastasis to the peritoneal cul-de-sac (tumor)

A

Blumer’s shelf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What test would you use when obstructive sx are present?

A

Double-contrast upper GI series and barium swallows.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tests used to evaluate for metastatic lesions.

A

Chest Radiography

CT or MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lab tests for Gastric Cancer

A

CBC-id anemia (found in 30% of pt’s b/c of bleeding)

CMP:used to characterize the patient’s clinical state

Carcinoembryonic antigen (CEA): inc. in 45-50%

Cancer Antigen 19-9: elevated in 20%

Stool occult blood test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx of gastric adenocarcinoma

A

Complete surgical removal of the tumor with RESECTION of adjacent lymph nodes (only chance of survival)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cure rate for early lesions limited to the mucosa or submucosa in gastric adenocarcinoma

A

> 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What additional tx would you give to medically fit patients with potentially resectable tumors?

A

Preoperative chemo or chemoradiotherpy followed by surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tx of choice for pt’s with DISTAL carcinomas.

A

Subtotal gastrectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What kind of gastrecomy is required for PROXIMAL tumors?
TOTAL or NEAR-TOTAL gastrectomy
26
What is the best form of palliation?
Reduction of tumor bulk
27
A relatively radioresistant tumor?
Adenocarcinoma
28
What can prolong survival in pt’s with adenocarcinoma?
Combo radiotherapy and 5-fluorouracil (5-FU)
29
Probability of survival after 5 yrs for the 25-30% of pt’s unable to complete resection is 20% for _________and <10% for _______
Distal Proximal
30
What reduces the recurrence rate and prolongs survival in pt’s with gastric adenocarcinoma?
Combo chemo before and after surgery along with postoperative chemo with radiation therapy
31
What is the most frequent extranodal site for lymphoma?
Stomach
32
The majority of gastric lymphoma’s are __________.
B Cell lymphomas
33
S/S of Gastric Lymphoma
- 6th decade - Epigastric pain - Early satiety - Generalized fatigue - Ulcers with a ragged, thickened mucosal pattern
34
What do you need to get to diagnose gastric lymphoma?
DEEP GASTRIC BIOPSY
35
Is gastric lymphoma more treatable than adenocarcinoma?
Yes
36
First step in Tx for gastric lymphoma
Antibiotic tx. For H. Pylori
37
If a pt has. a lack of response to antimicrobial treatment during antibiotic tx for gastric lymphoma what would you consider?
Chromosomal abnormality
38
What is a highly effective therapy for gastric lymphoma?
CHOP + rituximab
39
What has led to a 5 yr survival rate of 40-60% in pt’s with localized high-grade lymphomas?
Subtotal gastrectomy with chemo
40
Also known as gastrinoma....
ZES
41
A pancreatic neuroendocrine tumor that secretes gastrin:
ZES
42
ZES causes: (2 things)
Gastric acid hypersecretion Growth of the gastric mucosa (more parietal and ECL cells)
43
Where is ZES usually located?
Doudenal ulcers
44
A pt. presents with duodenal ulcers, a NEGATIVE H. Pylori test and chronic diarrhea......
ZES
45
The high acidity of chyme in intestines from ZES causes______and _______.
Diarrhea Malabsorption
46
20-25% of pt’s with ZES have_______
MEN 1
47
Mutations of the MEN1 tumor suppressor gene at the ________
11q13 locals
48
What should you measure in pt’s with ZES?
MEN1! | -plasma ionized calcium, prolactin levels, plasma hormone levels
49
A patient presents with abdominal pain and GERD, diarrhea and weight loss. On exam you find epigastric tenderness and note dental caries. Stool samples show steotorrhia with some bleeding.
ZES
50
3 tests for diagnosis ZES
Fasting Gastrin Level Basal Gastric Acid Output Secretin Provocative Test
51
Results of Fasting Gastrin Level in ZES
Inappropriate fasting hypergastrinemia | Gastrin >1000 pg/mL
52
Results of Basal gastric acid output in ZES
Fasting pH< or = to 2 when OFF antisecretory drugs
53
Results of secretin provocative test
Positive-gastrin levels rise 120 pg w/in 15 min of injection
54
This test uses radioactive tracers to help locate tumors.
Somatostatin receptor scintigraphy
55
The most sensitive imaging modality for detection of primary or metastatic lesions.
Somatostatin receptor scintigraphy
56
This test is used to locate a tumor and evaluate for metastatic disease (less sensitive).
CT
57
What test would you use if you wanted to look for duodenal ulceration and hypertrophy of gastric folds in pt’s with ZES?
EGD
58
What test would use if you wanted to localize the gastrinoma?
EU
59
Tx for ZES
PPI H2 B 12 may be needed
60
Successful resection of gastrinoma results in :
Dec/ chance of liver metastasis. Inc. disease-related survival rate.
61
What must you do in tx. for pt’s with MEN1 and ZES?
Must treat hyperparathyroidism for antisecretory drugs BEFORE MEDS
62
5-yr survival rate for pt’s WITH metastatic gastrinoma to the LIVER is _______with 10 yr_______
20% | 10%
63
Newborn has projectile postprandial vomiting.
Pylori Stenosis
64
Age that vomiting begins in pyloric stenosis
Between 2-4 weeks
65
Risk factors for Pyloric Stenosis
``` Male Caucasian Premature Family Hx Smoking during pregnancy Erythromycin ```
66
What type of alkalosis do you see in pyloric stenosis?
Hypochloremic, hypokalemic, metabolic alkalosis
67
You see peristaltic waves from left to right and an oval mass on RIGHT UPPER abdomen?
Pyloric stenosis
68
The diagnostic tool of choice for pyloric stenosis?
Ultrasonography
69
What would you expect to find an ultrasound of a pt with pyloric stenosis?
Hypoechoic muscle ring > 4 mm with hyper dense center and a pyloric channel length >15mm
70
Immediate tx for pyloric stenosis.
Need to correct fluid looks, electrolytes and acid-base imbalance.
71
What kind of surgery is common in the tx pyloric stenosis?
RAMSTEDT pyloromyotomy
72
When can infants feed after recovery from anesthesia during surgery for pyloric stenosis?
4-8 hrs
73
Is it normal for pt’s to regurgitate after surgery for pyloric stenosis?
YES, worrisome if 5 days after
74
Pt’s with pyloric stenosis have 4x greater risk for developing_______
Chronic abdominal pain

FUN MED SPRING 2018 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions