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3 - GI > deck_1672085 > Flashcards

deck_1672085 Flashcards

1
Q

Name five common GI malignancies

A

• Oesophagus • Stomach • Large intestine • Pancreas • Liver

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2
Q

Outline the epidemiology of oesophageal carcinoma

A

• Wide geographical variation ○ Incidence low in USA and high around caspian sea and parts of china • 2% of malignancies in the UKMales > Females

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3
Q

Give the two main features of oesophageal carcinoma

A

• Progressively worsening DysphagiaWeight loss

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4
Q

Give three investigations for oesophageal carcinoma

A

• Endoscopy • Biopsy • Barium

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5
Q

Give the two main types of oesophageal cancer

A

• Squamous cell carcinoma • Adenocarcinoma

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6
Q

Which is the most common type of oesophageal cancer

A

Squamous cell

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7
Q

Where is oesophageal adenocarcinoma found

A

• Lower third of the oesophagus • Association with Barrett’s oesophagusProgresses through dysplasia

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8
Q

What is the prognosis of oesophageal cancer?

A

• Advance disease presentation in most cases • 40% resectable • 5% five year survival

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9
Q

What causes oesophageal carcinoma

A

• HPV • Tannins • Vitamin A deficiency

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10
Q

How common is gastric cancer?

A

• Second most common GI malignancy • 15% of cancer deaths worldwideMen >women

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11
Q

What countries is the incidence of gastric cancer highest?

A

• Japan • Columbia • Finland

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12
Q

What condition is gastric cancer associated with?

A

Gastritis

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13
Q

What blood group is gastric cancer most commonly associated with?

A

• Blood group A

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14
Q

Give three symptoms of gastric cancer

A

• Epigastric pain • Vomiting Weight loss

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15
Q

Give three investigations for gastric cancer

A

• Endoscopy • BiopsyBarium

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16
Q

Give three macroscopic features of gastric cancer

A

• Fungating • Ulcerating • Infiltrative ○ Linitis plastica

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17
Q

What is linitis plastica?

A

• A rare type of stomach adenocacrinoma • Tumour spreads to muscles of stomach making it thicker and more rigid

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18
Q

Give two microscopic features of gastric cancer

A

• Intestinal ○ Variable degree of gland formation • Digguse ○ Single cells and small groups, signet ring cells

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19
Q

What is early gastric cancer?

A

• Confined to sub-mucosa • Good prognosis

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20
Q

Describe advanced gastric cancer?

A

• Far spread of cancer10% 5 year survival

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21
Q

Give four methods of spread of gastric cancer?

A

• Direct • Lymph nodes • Liver • Trans-coelomic ○ Periotneum Ovaries

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22
Q

Outline direct spread of gastric cancer

A

• Through gastric wall into duodenum, transverse colon, pancreas

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23
Q

Outline the development of gastric cancer

A

• Normal gastric mucosa • H pylori infection • Acute gastritis • Chronic active gastritis • Atrophic gastritis • Intestinal metaplasia • Dysplasia • Advanced gastric cancer

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24
Q

What is intestinal metaplasia in gastric cancer?

A

• Metaplasia of gastric cells to intestinal

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25
Q

What is the association of gastric cancer with H.pylori?

A

H.pylori causes chronic inflammation which is strongly associated with gastric cancer

26
Q

Give three treatments for gastric cancer

A

• Surgery • ChemotherapyHerceptin

27
Q

What is gastric lymphoma?

A

• Commonest GI lymphoma • Starts as a low-grade lesion, strong association with H.pylori • Eradication of H.pylori may lead to regression of tumour

28
Q

How does the prognosis of gastric lymphoma compare to gastric carcinoma?

A

Much better

29
Q

What is a gastrointestinal stromal tumour?

A

• Derived from interstitial cells of cajalCaused by C-kit mutation which makes it vulnerable to targeted treatment

30
Q

What is the behaviour of gastrointestinal stromal tumours?

A

• Pleomorphism • MitosesNecrosis

31
Q

What is a key feature of gastric lymphoma

A

• Gastro-intestinal haemorrhage

32
Q

Give four types of tumours of the large intestine

A

• Adenomas • Adenocarcinomas • Polyps • Anal carcinoma

33
Q

Give three types of adenomas in the large intestine

A

• Benign, neoplastic lesions in the large bowel • Familial adenomatous polyposis • Gardner’s syndrome

34
Q

Give two macroscopic features of adenoma of the large intestine

A

• Sessile (immobile)OR pedunculated (small growth on stalk)

35
Q

Give two microscopic features of adenoma of the large intestine

A

• Variable degree of dyplasiaMalignant potential

36
Q

What is the most common risk factor for large intestinal adenoma?

A

• Advancing age

37
Q

What is familial adenomatous polyposis?

A

• An autosomal dominant condition on chromosome 5 • Large number of adenomas form giving high risk of cancer

38
Q

What is gardner’s syndrome?

A

• Similar to familial adenomatous polyposis • Bone and soft tissue tumours also

39
Q

What is the most common type of GI malignancy?

A

• Colorectal adenocarcinoma

40
Q

Give two macroscopic features of colorectal adenocarcinoma

A

• Rectosigmoid fungating/stenotic

41
Q

Give two microscopic features of colorectal adenocarcinoma

A

• Mucinous Signet ring cell types

42
Q

Give three ways in which colorectal adenocarcinoma spreads

A

• Direct through bowel wall to adjacent organs • Via lymphatics to mesenteric lymph nodesVia portal venous system to liver

43
Q

Give two ways in which colorectal adenocarcinoma is staged

A

• Dukes staging • TMN

44
Q

Outline duke’s staging of colorectal adenocarcinoma

A

• A - Confined to bowel wall • B - Through wall, lymph nodes clear • C - Lymph node involvement • C1/C2 - Highest node clear/ involved

45
Q

Give three main mutations in colorectal adenocarcinoma

A

• FAP - Chromosome 5 • Ras mutations • P53 loss/inactivation • K-ras - Guides treatment with cetuximab

46
Q

At what age is colorectal adeno carcinoma?

A

• Peak at 60-70 • High in UK/USA, low in Japan

47
Q

Give two diseases which predispose a patient to colorectal adenocarcinoma

A

• Ulcerative carcninoma • Crohn’s disease

48
Q

Give four predisposing aeitological factors to colorectal adenocarcinoma

A

• Low residue diet • Slow transit time • High fat intake • Genetic predisposition

49
Q

Give three carcinomas of the large intestine of the colorectal adenocarcinoma

A

• Carinoid tumoure ○ Rare and unpredictabel neuro-endocrine tumour • Lymphoma ○ Rare, may be primary • Smooth muscle/stromal tumours ○ Rare and unpredictable

50
Q

Outline the morphology of pancreatic carcinoma

A

• 2/3 in the head • Firm pale mass with a necrotic centreMay infiltrate adjacent structures

51
Q

What is the histology of a pancreatic carcinoma

A

• 80% are ductal adenocarcinomas • Well formed glands • Some may contain zymogen granulesAll have poor prognosis

52
Q

Give three symptoms of pancreatic cancer

A

• Weight loss • JaundiceTrousseau’s signDARK RED PATCH

53
Q

Describe a carcinoma of the ampulla of vater

A

• Bile duct blocked with a small tumour, leading to jaundice and early presentation when the tumour is still treatable

54
Q

Give four islet cell tumours

A

• Insulinoma • Glycagonoma • Vasoactive intestinal peptideoma • Gastrinoma

55
Q

What does insulinoma cause?

A

• Hypoglycaemia

56
Q

What is a characteristic sign of glycagonoma

A

• Characteristic skin rash - Thrombophlebitis migrans

57
Q

What syndrome is associated with gastrinoma

A

Zollinger - Ellison syndrome (Ectopic gastrin production)

58
Q

Give three types of benign liver tumour

A

• Hepatic adenoma • Bile duct adenoma • Haemangioma

59
Q

Give three types of malignant liver tumours

A

• Hepatoceullarcarcinoma • Cholaniocarcinoma - liver flukes • Hepatoblastoma

60
Q

What are the four most common GI malignancies in order

A

• Colorectal • Stomach • Pancreas • Oesophagus

61
Q

What are two types of malignant tumour

A

• Primary • Malignant

3 - GI (36 decks)

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