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Surgery Recall General Surgery > Gastric CA > Flashcards

Gastric CA Flashcards

1
Q

Incidence of Gastric CA

A

High in japan

low in US

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2
Q

What are the risk factors?

A

Diet - smoked meats, high nitrates, alcohol, tobacco

Environment - high risk area, poor socioeconomic status, atrophic gastritis, H.pylor, pernicious anemia, polyps

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3
Q

Average age of Gastric CA

A

> 60 years

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4
Q

What are the symptoms?

A 
WEPON:
Weight loss
Emesis
Anorexia
Pein/epigastric discomfort
Obstruction
Nausea
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5
Q

Most common early symptoms

A

Mild epigastric discomfort and indigestion

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6
Q

What is the most common symptom

A

Wt loss

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7
Q

What are the signs

A

Anemia, melena, heme occult, epigastric mass, hepatomegaly, Blumer’s shelf, Virchows node

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8
Q

What does the patient with gastric CA have if he has proximal colon distension

A

coloni obsturction by direct invasion

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9
Q

What is the symptom of proximal gastic CA

A

Dysphagia

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10
Q

Solid peritoneal deposit anterior to the rectum, forming a “shelf”, palpated on rectal examination

A

Blumer’s shelf

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11
Q

Metastatic gastric cancer to the nodes int the left supraclavicular fossa

A

Virchow’s node

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12
Q

Periumbilical lymph node gastric cancer metastasis, presents PERIUMBILICAL MASS

A

Sister Mary Joseph sign

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13
Q

Gastric cancer (or other adenocarcinoma) that metastasized to the ovary

A

Krukenburg tumor

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14
Q

Left axillary adenopathy from gastric ccncer metastasis

A

Irish node

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15
Q

Lab finding

A

CEA elevated

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16
Q

Hisotlogy

A

adenocarcinoma

17
Q

Differentals

A

AdenoCA, leiomyoma, leiomyosarcoma, lymphoma, carcinoid

18
Q

Two histologic types gastric CA

A

Intestinal (glands)

Diffuse (no glands)

19
Q

What is the morphology

A

Ulcerative (75%)
Polypoid
Scirrhous
Superficial

20
Q

Common in Lesser or Greater curvature?

A

LESSER (less is more)

21
Q

What is more common?proximal or distal gastric CA

A

Proximal

22
Q

“LEATHER BOTTLE” sign

A

Linitis plastica - entire stomach is involved and looks thickened

23
Q

Mode of metastasis

A

Hematogenously and lymphatycally

24
Q

Which patients with gastric CA are NON operative?

A

Distant metastasis

Peritoneal implants

25
Q

Genetic alteration seen in >50% of patients with gastric cancer?

A

P53

26
Q

Distal subtotal gastrectomy is performed for tumor in the?

A

Antrum

27
Q

What is subtotal gastrectomy?

A

75% of stomach removed

28
Q

What is a total gastrectomy?

A

Stomach removed and Roux-en-Y limb is sewn to the esophagus

29
Q

Define extende lymph node dissection

A

usually D1 and D2:
D1 are perigastric LNs
D2 splenic aretery LNs, Hepatic

30
Q

What is the adjuvant treatment?

A

Stages II and III: postoperative chemo and radiation

31
Q

What is the 5-year survival rate for gastric CA?

A

25% 5 year survival rate

50% 5 year survival rate in japan

Surgery Recall General Surgery (21 decks)

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