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GIR Test 2 > B5-071 GI Cancers: Tubal Gut > Flashcards

B5-071 GI Cancers: Tubal Gut Flashcards

1
Q
  • distal/lower esophagus
  • arises from Barrett’s
A

esophageal adenocarcinoma

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2
Q
  • mid esophagus
  • not associated with Barretts
A

esophageal squamous cell carcinoma

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3
Q

in adenocarcinoma, columnar epithelium is replaced with […] cells

A

goblet

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4
Q

treatment of Barrett’s

A

no/low dysplasia: increased surveillance
high dysplasia: ablation

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5
Q

risk factors for esophageal adenocarcinoma

5

A
  • GERD
  • obesity
  • male sex
  • smoking
  • H. pylori
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6
Q
  • long standing GERD
  • dysphagia
  • weight loss, pain, vomiting
A

esophageal adenocarcinoma

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7
Q

flat/slightly raised lesion early
ulcerated mass later on

A

esophageal adenocarcinoma

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8
Q
  • gland formation and mucus production
  • may have signet ring formation
A

esophageal adenocarcinoma

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9
Q

genes associated with esophageal adenocarcinoma

A
  • p53, CDKN2A, APC inactivation
  • ERBB2/HER2 amplification
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10
Q

risk factors for squamous cell carcinoma

5

A
  • low SES
  • tobacco
  • alcohol consumption
  • drinking hot beverages
  • diet
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11
Q
  • dysphagia, odynophagia, obstruction
  • weight loss
A

esophageal squamous cell carcinoma

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12
Q
  • mass-like lesion, may protrude into lumen, ulcerate
  • may infiltrate and cause diffuse thickening
A

esophageal squamous cell carcinoma

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13
Q
  • malignant squamous epithelium invading into submucosa or deeper
  • variably sized nests of epithelial tumor cells, ample eosinophilic cytoplasm, keratinization
A

esophageal squamous cell carcinoma

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14
Q

risk factors for gastric adenocarcinoma

4

A
  • H. pylori
  • rubber manufacturing
  • tobacco
  • radiation
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15
Q
  • often asymptomatic or have dyspepsia, dysphagia, nausea
  • weight loss, anorexia, early satiety at later stages
  • metastasis often present at diagnosis
A

gastric adenocarcinoma

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16
Q

which type of gastric adenocarcinoma is associated with WNT mutations?

A

intestinal

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17
Q

which type of gastric adenocarcinoma is associated with CHH1 mutations?

A

diffuse

associated lobular breast cancer as well

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18
Q

which type of gastric adenocarcinoma is comprised of infiltrating malignant glands with mucin production?

A

intestinal

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19
Q

which type of gastric adenocarcinoma is associated with sheets of cells and diffuse thickening?

A

diffuse

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20
Q

elevated mass with central ulceration

A

intestinal type gastric adenocarcinoma

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21
Q

infiltrating and anastomosing glands with various degrees of differentiation

A

intestinal type gastric adenocarcinoma

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22
Q
  • gastric wall markedly thick, rugal folds lost
  • stomach may appear shrunken
A

diffuse type gastric adenocarcinoma

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23
Q
  • signet ring cells
  • sheets of cells
A

diffuse type gastric adenocarcinoma

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24
Q

most common type of gastric lymphoma

A

MALT lymphoma

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25
Q

major risk factor for gastric lymphoma

A

H. pylori

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26
Q
  • often asymptomatic
  • may present with dyspepsia, epigastric pain, hematememsis, melena
A

gastric lymphoma

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27
Q
  • thickening of the wall of stomach
  • nodular mucosa
A

gastric lymphoma

MALT

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28
Q
  • diffuse sheets of lymphocytes
  • lymphocytes in the glandular epithelium
  • comprised of B lymphocytes positive for CD20
A

gastric lymphoma

MALT

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29
Q

comprised of B lymphocytes positive for CD20

A

gastric lymphoma

MALT

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30
Q

well differentiated epithelial neoplasms with neuroendocrine differentiation

A

NET

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31
Q

risk factors for gastric NET

2

A

MEN-1
AMAG

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32
Q

acid hypersecretion/peptic ulceration secondary to high gastrin levels from duodenal/pancreatic gastrinomas

A

Zollinger-Ellison syndrome

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33
Q

symptoms of carcinoid syndrome

A

flushing, bronchospasm, diarrhea

maybe sweating and abdominal pain as well

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34
Q

may present with Zollinger-Ellison or carcinoid syndromes

A

gastric NET

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35
Q

what type of gastric NET?

  • arise in AMAG
  • high gastrin
  • 75% of GNETs
  • good prognosis
A

type 1

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36
Q

what type of gastric NET?

  • associated with MEN-1
  • high gastrin
  • zollinger ellison
  • 5-10% of GNETs
  • moderate prognosis
A

type 2

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37
Q

what type of gastric NET?

  • sporadic GNETs
  • normal gastrin levels
  • 15% of GNETs
  • poor prognosis
A

type 3

38
Q

mass like lesion/nodule

A

GNET

39
Q
  • may have nests, trabeulae, or be solid
  • cells are uniform, moderate cytoplasm
  • stipple “salt and pepper” chromatin
A

GNET

40
Q
  • may have nests, trabeulae, or be solid
  • cells are uniform, moderate cytoplasm
  • stipple “salt and pepper” chromatin
A

GNET

41
Q
  • most commonly mesenchymal tumor of the abdomen
  • arise from interstitial cells of Cajal within muscularis propria
A

GIST

42
Q

risk factor for GIST

A

NF1

43
Q
  • asymptomatic when small
  • symptomatic when large, may ulcerate causing bleeding
A

GIST

44
Q

genetic associations with GIST

A
  • activating mutation in KIT (80%)
  • activating mutation in PDGFRA

can use imatinib

45
Q
  • solid, well circumscribed mass with pink-tan fleshy cut surfaces in the wall of stomach
  • centered on muscularis propria but may involve muscosa
A

GIST

46
Q
  • spindled cells or epithelioid cells
  • IHC positive for KIT and DOG1
A

GIST

47
Q

second leading cause of cancer deaths

A

colorectal cancer

48
Q
  • most common GI cancer
  • incidence peak 60-70 y.o.
  • incidence under 40 increasing
A

colonic adenocarcinoma

49
Q

risk factors for colonic adenocarcinoma

5

A
  • diet (red meat, low fiber)
  • alcohol
  • obesity
  • genetics
  • IBD
50
Q

protective factors against colon cancer

A
  • increased physical activity
  • hormone replacement therapy in women
51
Q

advanced left sided colon cancer may present with

A

change in bowel habits, abdominal distension, hematochezia, obstruction

52
Q

advanced right sided colon cancer may present with

A

fatigue, weight loss, anemia

53
Q

colonoscopy screenings begin at age

A

45

earlier if family hx

54
Q

which pathway of genetic stability affects a small number of genes

A

APC

chromosomal instability

55
Q

which pathway of genomic instability affects a large number of genes?

A

MSI

microsatellite instability

56
Q

precursor lesion in the APC/WNT pathway

A

adenoma

57
Q
A

adenoma

APC/WNT pathway

58
Q

FAP is inherited in a […] pattern

A

autosomal dominant

59
Q

FAP is caused by mutations in the […] gene

A

APC

key regulator of the WNT pathway

60
Q

how many polyps are necessary for FAP?

A

at least 100

61
Q
A

FAP

62
Q

mutations associated with Lynch syndrome

A

MSH2 and MLH1
also PMS2 and MSH6

mismatch repair genes

63
Q

no substantial malignant potential and do not affect colonoscopic surveillance intervals

A

hyperplastic polyp

64
Q
  • precursor to adenocarcinoma
  • serrated polyp with widened base
A

sessile serrated polyp

65
Q
  • often exophytic mass
  • may present as diffuse, circumfrential thickening
A

colon-adenocarcinoma

66
Q
  • invasive malignant glands extending into submucosa or deeper
  • often has central necrosis
  • may have no glands or signet features
A

colon adenocarcinoma

67
Q

FAP results from inheritance of one mutant copy of

A

APC

68
Q

genes affected in HNPCC

A

mistmatch repair
* MLH1
* MSH2
* MSH6
* PMS2

69
Q

NOD52 mutations are linked with

A

Crohn’s

70
Q

in FAP, polyps form when

A

the second copy of APC is lost due to additional mutations

two hit hypothesis

71
Q

the cells of origin of GIST

A

intersitial cells of Cajal

72
Q

neuroendocrine tumors arise from

A

G cells

73
Q

adenocarcinomas arise from

A

gastric epithelial cells

74
Q

leiomyomas arise from

A

smooth muscle cells of muscularis propria

75
Q

HNPCC is associated with an increased risk of what cancers

2

A

colon
endometrial

76
Q

homozygous loss of the DNA mismatch repair genes can give rise to

A

right sided colon cancer
endometrial cancer

77
Q

associated with microsatellite instability

A

HNPCC

78
Q

associated with beta catenin pathway

A

FAP

79
Q

loss of CDH1 gene is associated with

A

hereditary gastric carcinoma

80
Q

mutation with activation of c-kit tyrosine kinase activity is associated with

A

gastrointestinal stromal tumors

81
Q

treatment for gastrointestinal stromal tumors

A

imatinib

82
Q

develops at the site of long-standing GERD

A

barrett’s

83
Q

adenocarcinomas of the esophagus are typically located in the

A

distal esophagus

84
Q

squamous cells carcinomas of the esophagus are typically located in the

A

mid esophagus

85
Q

squamous cells carcinomas are associated with what risk factors

A

chronic alcoholism
smoking

86
Q

major risk factor for adenocarcinoma

A

Barrett’s esophagus

87
Q

intranuclear inclusions

A

CMV or HSV esophagitis

88
Q

precursor lesion to invasive adenocarcinomas

A

adenomas

89
Q
  • typically small and yellowish
  • slow growing
A

carcinoid tumors

90
Q

squamous cell carcinomas can arise where?

2

A

esophagus
anal-rectal junction

GIR Test 2 (18 decks)

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