GASTRIC CANCER

Question 1

two types of oesophageal cancer

Answer 1

adenocarcinoma
squamous

Question 2

where is adenocarcinoma more present

Answer 2

in the developed world

Question 3

aetiology of adenocarcinoma oesophageal cancer

Answer 3

GORD
Barretts oesophagus
Smoking
Achalasia
Obesity

Question 4

location of adenocarcinoma

Answer 4

lower 1/3 near the GO junction

Question 5

Presentation of oesopphgeal cancer

Answer 5

vomiting
PROGRESSIVE DYSPLASIA
anorexia and weight loss
odynophagia, hoarseness, melaena, cough

Question 6

risk factors for oesophageal caner

Answer 6

SMOKING
Alcohol
achalasia
obesity
low veg, fruit
hot drinks

Question 7

location of squamous cell carcinoma

Answer 7

upper 2/3

Question 8

what is ALARMS

Answer 8

Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Melaena
Swallowing issues

Question 9

investigations for oesophageal cancer

Answer 9

1st line- upper GI endoscopy + biopsy
CT scan or endoscopic US

Question 10

Management of oesophageal cancer

Answer 10

-operable disease- surgical resection
- chemotherapy
-palliation

Question 11

two types of gastric cancer

Answer 11

1- intestinal / differentiated
2- diffuse/ undifferentiated

Question 12

rf for type 1 gastric cancer

Answer 12

Male
H. pylori
chronic gastritis
old age

Question 13

histology and appearance of T1GC

Answer 13

glandular
large irregular

Question 14

location of T1GC

Answer 14

antrum and lesser curvature

Question 15

rf for T2GC

Answer 15

blood type a
younger age

Question 16

histology and appearance of t2gc

Answer 16

• poorly differentiated
• signet ring cells
• gastric linitis - submucosa invasion

Question 17

location OF T2GC

Answer 17

anywhere- esp cardia of the stomach

Question 18

why is T2GC more common in the cardia of stomach

Answer 18

defective adhesion bc CDH-1 mutation — defective e cadherin —- increase in ability to invade and spread

Question 19

red flags for GI cancer that would make you do an urgent 2 week referral

Answer 19

• dysphagia of any age
• over 55 and weight loss with:
  upper abdo pain
  reflux
  dyspepsia

Question 20

consider non urgent endoscopy if …?

Answer 20

haematememsis
treatment resistant dyspepsia
upper abdo pain
anaemia

Question 21

clinical presentation of Gastric cancer

Answer 21

anorexia
nausea
anaemia
fatige
epigastric pain

Question 22

investigation for GC

Answer 22

Gastroscopy - 8-10 biopsies
endoscopic US
CT/MRI

Question 23

management of GC

Answer 23

Nutritional support
surgical resection
chemo

Question 24

protective mechanisms against gastric cancer

Answer 24

fruit, veg, folate, fibre

Question 25

What is a Mallory Weiss tear

Answer 25

Tear in Oesophagus due to sudden increases in intra abdominal pressure

Question 26

What can cause a MW tear

Answer 26

Forceful vomiting Chronic coughing Weight lifting Hiatus hernia

Question 27

Signs and symptoms of a Mallory Weiss tear

Answer 27

Haematamesis Melena Postural hypertension Dizziness

Question 28

What are oesophageal varices

Answer 28

Enlarged veins that protrude into the Oesophagus

Question 29

Cause of oesophageal varies

Answer 29

Hypertension in portal venous system due to underlying liver issues

Question 30

Key phrase for oesophageal varies

Answer 30

Coughing out a lot of blood

Question 31

Signs and symptoms of oesophageal varies

Answer 31

Haematamesis Ab pain Systemic shock

Question 32

Acute bleed emergency response would involve …

Answer 32

ABCDE VASOPRESSIN Bleeding abnormality- then Vit k then infusion