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GI Extra > 8. GI Cancers > Flashcards

8. GI Cancers Flashcards

1
Q

For oesophageal cancer, where are SCCs and adenocarcinomas?

A

SCC: upper 2/3
Adenocarcinoma: lower 1/3

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2
Q

Odonophagia

A

Pain on swallowing

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3
Q

How can GI cancers cause anaemia?

A

Malignant cells erode and damge surrounding strctures, causing bleeding

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4
Q

Prognosis of oesophageal cancer

A

5% at 5 years

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5
Q

Curative treatment for oesophageal cancer

A

Oesophagectomy

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6
Q

Lauren classifications of gastric cancer

A

Diffuse: younger people, cells poorly differentiated so worse outocme
Intestinal

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7
Q

Age and gender most likley for gastric cancer

A

Male 50-70

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8
Q

String risk factors for gastruc cancer

A

Penicious anaemia
H pylori
N nitroso compunds e.g. processed meats

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9
Q

Clinical presentation of gastric cancer

A

Epigastric abdo pain
Lymphadenopathy of virchows node
Dyshpagia (if round cardia)
Unexplained weight loss

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10
Q

Prognosis of gastric cancer

A

70% 5 year local
5% if distant metastases

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11
Q

Investigation for gastric cancer

A

Bloods for iron deficiency anaemia
Upper GI endoscopy and biopsy
CT chest abdo pelvis

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12
Q

Management depending on stage of gastric cancer

A

Superficial: endoscopic mucosal resection
Localised: surgery to remove all/oart stomach or chemoradiotherpay
Metastatic: hemo immunitherpay, supportive care

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13
Q

Main histological type of pancreatic cancer

A

Pancreatic ductal carcinoma

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14
Q

Rarer type of pancreatic cancer

A

Insulinoma (endocrine cell tumour)

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15
Q

Risky mutations for pancreatic cancer

A

BRCA1, BRCA2, familial syndromes

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16
Q

Why is painless jaundice a worrying sign for pancreatic cancer?

A

Tunour in head if pancreas can onstruct the biliary system

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17
Q

What to suspect in new onset type 2 diabetic over 50 without obesity symptoms

A

Pancreas cancer

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18
Q

Why do pancreatic tumours in the body/ tail have poor prognosis?

A

Symptoms vague so usually present late and have advanced disease

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19
Q

Investigations for pancreatic cancer

A

LFTs, Ca 19-9
Pancreatic CT
US for head tumour

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20
Q

Management of pancreatic cancer

A

Surgical resection
Biloary stenting for jaundice
Chemo and symptom management (if surgeyr not possible)

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21
Q

Risk factors for hepatocellular carcinoma

A

Cirrhosis
Alcohol
Hep B,C

22
Q

Clinical presentation of hepatocellular carcinoma

A

Vague symptoms of liver disease e.g. ascites, fatigue
RUQ pain
Acute helatic decompensation

23
Q

Prognosis of hepatocellular carcinoma

A

50% with surgucal resection or liver trabsplant

Or 1 year max if not

24
Q

Investigations for hepatocellular carcinoma

A

LFTs
PT time/INR (check liver synthetic function)
Biral hepatitis panel
US for screening hugh risk people
CT/MRI abdo for staging
Lover biopsy for diagnosis

25
Q

Treatment of hepatocellular carcinoma

A

Ablation, resection or transplant
Chemo/ immunotherapy if not suitable

26
Q

What are cholangiocarcinomas?

A

Cancers of the biliary system, usually adenocarcinoma

27
Q

Risk factors for cholangiocarcinoma

A

-cirrhosis, alcoholic liver disease, gallstones, PSC
-infection e.g. chronci typhoid
- high alcohol consumption

28
Q

Clinical presentation of cholangiocarcinoma

A

Painless jaundice, dark urine, light stool (if extrahepatic), pruritis

29
Q

Prognosis of cholangiocarcinoma

A

2% if metastatic

30
Q

Clinical presentation of colorectal cancer

A

Blood stool, altered bowel habits
Advanced may have bowel obstruction or perforation, abdo pain, as ites

31
Q

Prognosis of colorectal cancer

A

50-95% if not metastatic

32
Q

Tenesmus

A

Feeling of incomplete evacuation

33
Q

Overflow diarrhoea is a red flag symptom for colorectal cancer. What is it?

A

Cycling of constipation then diarrhoea, where a blockage is causing constipation but fluid forces its way around so get diarrhoea, every few days

34
Q

Why is bowel obstruction more likely in left sided colorectal cancer?
Why is there less advanced disease at presentation?

A

Lumen smaller
Notice symptoms eatlier

35
Q

L vs R side colorectal cancer
-locations
-description

A

R is asc colon, L is desc/sigmoid
R is fungating (ulcerations), L is stenosing (narrowing)

36
Q

Barium enema sign of L sided colorectal cancer

A

Apple core deformity, lumen narrowed by stenosing malignancy

37
Q

Investigations for colorectal cancer

A

Faecal occult blood test
FBc anaemaia, CEA
Colonoscopyy
Biopsy
CT MRi

38
Q

Management of colorectal cancer

A

Surgery and ore/post op chemo/ immunotherpay
Or chemo/immunotherapy wihtout surgery

39
Q

Who is screened for bowel cancer?

A

60-74
Maybe also over 50 if risk factors

40
Q

Histology of anal cancer

A

SCC

41
Q

Risk factors for anal cancer

A

HPV
HIV
IiBD or anal fissures

42
Q

Clinical presentation of anal cancer

A

Perianal pruritis, bleeding, discharge, mass sensation

43
Q

Prognosis of anal cancer

A

70% cure with chemo and radiotherapy

44
Q

What could help dysphagia in Gi malignancy?

A

Nasogastric tube

45
Q

Mallory weiss

A

Tears in GI tract due to repeated vomiting

46
Q

Explain how metastases can cause ascites

A

Exert direct pressure on portal system, increases hydrostatic pressure
Also liver function is affected so albumin decreases and oncotic pressure decreases

47
Q

Are most pancreatic cancers exo or endocrine?

A

Exocrine

48
Q

What comes first in small and large bowel cancers out of vomiting or constipation?

A

Small- vomiting
Large- constipation

49
Q

Exampkes of medications that could cause a change in bowel habit

A

ABx
Iron tablets

50
Q

Prognosis of rR vs L colon cancer

A

R poorer

GI Extra (16 decks)

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