Cancer

Question 1

Difference between primary and secondary cancers?

Answer 1

Primary = directly from cells in organ

Secondary/metastases = spread from another organ

Question 2

Give some examples of GI cancers

Answer 2

1. Oesophageal
2. Stomach
3. Biliary system
4. Pancreatic
5. Colorectal (SI/LI/Colon/Anus)

Question 3

What are the 3 most common GI cancers?

Answer 3

Oesophageal
Colon
Pancreatic

Question 4

Distinguish adenocarcinomas and squamous cell carcinomas.

BOTH OESOPHAGEAL

Answer 4

Adenocarcinoma:

1. Columnar epithelium
2. Lower 1/3 oesophagus
3. Acid reflux
4. More developed world

Squamous cell carcinoma::

1. Oesophageal squamous epithelium (upper 2/3 oesophagus)
2. Acetaldehyde pathway
3. Less developed world

Question 5

What are 5 investigations for colon cancers are there?

Answer 5

1. Abdominal wall X ray
2. CT
3. Barium enema
4. Colonoscopy (good but needs prep time)
5. CT virtual colonoscopy

Question 6

Describe signs of pancreatic cancer

1 yr survival = 18%
5 yr survival = 2%

Answer 6

Depression, abdominal pain, glucose intolerance.

Subsequent advanced symptoms - weight loss, jaundice, ascites, gall bladder obstruction

Question 7

Are adenocarcinomas more common in men or women?

Answer 7

Men, more in developed world

Question 8

Describe the development of adenocarcinoma

Answer 8

1. Normal epithelium
2. Hyperplasia
3. Adenomatous polyps
4. Adenocarcinoma
5. Metastatic cancer

Question 9

What are the main causes of squamous cell carcinoma?

Answer 9

1. Smoking/chewing tobacco
2. Alcohol consumption (acetaldehyde metabolite)
3. Ingesting caustic substances

Question 10

Describe the development of squamous cell carcinoma?

Answer 10

1. Normal epithelium
2. Metaplasia
3. Dysplasia
4. Severe dysplasia
5. Squamous cell carcinoma development
6. Metastasis

Question 11

What clinical investigations can be done for oesophageal cancers?

Answer 11

1. Endoscopy
2. CT Scan
3. Endoscopic ultrasound

Question 12

Describe the stages of colon cancer

Answer 12

1. Normal epithelium
2. Hyperproliferatuve epithelium
3. Small adenoma
4. Large adenoma
5. Colon carcinoma

Question 13

Symptoms of colon cancer?

can be asymptomatic

Answer 13

1. Change in bowel habit
2. Blood in stool
3. Acute intestinal obstruction

Question 14

Which metal is used in CTVC?

Answer 14

Bismuth

Question 15

What is acute pancreatitis?

Answer 15

Acute inflammatory process leading to necrosis of pancreatic parenchyma

Question 16

Signs and symptoms of acute pancreatitis

Answer 16

Abdominal pain, nausea, vomiting, diarrhoea, fever, shock

Question 17

Tests method

Answer 17

Simple
Blood Tests
Complex blood tests
Simple imaging
Complex imaging
Invasive test

Question 18

Causes of acute pancreatitis

Answer 18

Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion bite
Hyperlipidaemia
ERCP
Drugs (valproate/azathioprine)

Question 19

What are complications of pancreatitis?

Answer 19

Systemic: hypovolaemia, hypoxia, hyperglycaemia, hypocalcaemia, multiple organ failure

Localised: pancreatic necrosis, fluid collections, splenic vein thrombosis, chronic pancreatitis

Question 20

What treatment is there for pancreatitis?

Answer 20

Fluids, painkillers, nutrition, organ support

Question 21

Define chronic pancreatitis

can cause steatorrhea, ADEK

Answer 21

Progressive fibroinflammatory process of the pancreas - results in permanent structural damage, leading to impaired endocrine and exocrine function.

Question 22

Management of chronic pancreatitis?

Answer 22

1. Stop smoking and alcohol
2. Small meals with low fat
3. PPI/Pancreatic supplements
4. Analgesia