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General Surgery > Gastric Cancer > Flashcards

Gastric Cancer Flashcards

1
Q

Those That Increase the Risk of Gastric Cancer:

A

**Hypoacidity (85% of all gastric cancers)
** H. Pylori

• Atrophic gastritis (95% of all gastric cancers)

• Adenomatous polyp (especially > 2cm)

• Genetics

• Pernicious anemia

• A blood group

• Environmental factors

• Nitrites and Smoked
fish(3,4 benzopyrene)

• Aflatoxin

• Duodenal ulcer surgery

• Residual stomach after resection (especially Billroth II operation)

• Presence of gastric ulcer

• Presence of intestinal metaplasia

• Epstein Barr Virus (EBV)

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2
Q

Those that Reduce the Risk of Gastric Cancer:

A

Aspirin(salicylates)
Diet(fresh fruits, vegies)
Vitamin C

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3
Q

Which condition has highest risk for premalignancy in gastric ca?

A

Atrophic gastritis

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4
Q

Which condition has lowest risk for premalignancy in gastric ca?

A

Hyperplastic polyp

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5
Q

Early stage of gastric cancer is most common in ……?

A

Corpus/body of stomach

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6
Q

In which layer of the stomach is the early stage of gastric ca confined in?

A

Mucosa and submucosa of stomach

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7
Q

Tx of early stage gastric ca?

A

EMR (no need for surgery)
Or ESD

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8
Q

**Which is the most common subtype of type 2 early gastric ca classification?

A

Depressed-corpus

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9
Q

What is the classification of type 3 EARLY gastric ca ?

A

Excavated -corpus

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10
Q

Which type of gastric carcinoma is associated with H.pylori?

A

Intestinal type gastric carcinoma

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11
Q

Which type of gastric carcinoma is associated with poorly differentiated signet ring cells?

A

Diffuse type gastric carcinoma

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12
Q

Which type of metastasis is in intestinal vs. diffuse type gastric carcinoma?

A

In intestinal type —>hematogenous metastasis
(Lymphatic met is lower)
In diffuse type—> lymphatic metastasis (is more)

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13
Q

Which type of Lauren classification is more in female and which is more in male?

A

In female Diffuse
While
In males it is intestinal type gastric ca

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14
Q

Which cancer is treated with antibiotic?

A

Low-grade MALT Lymphoma (MALTOMA) ;caused by H pylori

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15
Q

Is a 10 cm submucosal gastric cancer early or late?

A

It is early bcz it is sill in submucosa

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16
Q

Tumor size is imp in GIST(intestinal);

A

Lesion 1cm> may behave as malignant

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17
Q

Gastric tumor size is

A

Not imp; only the layer in which the tumor invades is imp

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18
Q

Tx for gastric carcinoid?

A

Resection

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19
Q

Which type of gastric carcinoma is familial vs environmental?

A

Diffuse type is familial
Intestinal type is environmental

20
Q

** what is the mutations that occur in diffuse vs intestinal types of gastric carcinoma?

A

Intestinal type—>APC gene mutation
Diffuse type—> E-cadherin (CDH1) expression decreased

21
Q

Which type of gastric carcinoma is endemic vs epidemic?

A

Intestinal type—>epidemic
Diffuse type—>endemic

22
Q

Which type of gastric carcinoma secretes mucin and is infiltrative

A

Diffuse type gastric carcinoma

23
Q

Which type of gastric carcinoma looks like a polypoid?

A

Intestinal type gastric carcinoma

24
Q

Which type of gastric carcinoma has better vs poor prognosis and differentiation ?

A

Intestinal type—> better prognosis &better differentiation
Diffuse type—>poor prognosis /worse differentiation

25
Q

What are the most common symptoms of gastric carcinoma?

A

Anorexia(restriction of food)
Weight loss

26
Q

Diagnosis for gastric cancer?

A

Endoscopy+golden standart: Biopsy

27
Q

How many lymph nodes must be resected for adequate staging of gastric ca?

A

15

28
Q

Tx for gastric ca?

A

Surgical+15 lymph nodes resected

29
Q

When is neoadjuvant tx of gastric adenocarcinoma being evaluated?

A

In cases with clinical T3 or N1 disaese

30
Q

When is Endoscopic submucosal dissection (ESD) performed for gastric ca?

A

In mucosal and SUBMUCOSAL metastasis and in EARLY lymph node metastasis

31
Q

When is Endoscopic mucosal resection (EMR) performed for gastric ca?

A

In differentiated MUCOSAL gastric cancer less than 2cm and have no risk for lymph node metastasis and no sign for ulcereation
(If larger than 2cm there’s a risk for perforation)

32
Q

When is TNM staging used for in gastric cancer

A

For prognosis depends on invasion depth of layers for DIFFUSE type of gastric cancer

33
Q

what is the definition of krukenberg tumor?

A

implantation in the ovary

34
Q

def of Blummer’s shelf

A

implantation into the rectouterine fascia

35
Q

sister joseph nodule def?

A

umbilicus metastasis

36
Q

virchow nodule def?

A

left supraclavicular LN metastasis

37
Q

Irish nodule def?

A

left axilla LN metastasis

38
Q

peritonitis carcinomatosis and M1

A
39
Q

Which protein is responsible for the pathogenesis of Menetrier’s disease (hypertrophic gastritis)?

A

TNF-α is responsible for the
pathogenesis. (The disease is thought to be of autoimmune origin.)

40
Q

Which disease is an inflammatory disease of the gastric epithelium

A

Menetrier’s disease

41
Q

Which disease is characterized by hypochlorhydria, hypoproteinemia, anemia, pain

A

MENETRIER’S DISEASE (HYPERTROPHIC GASTRITIS)

42
Q

What is the scan used for gastric carcinoid?

A

Octreotide scan

43
Q

Definitive diagnosis of menetrier’s disease (hypertrophic gastritis) is made by biopsy that shows……?

A

Loss of oxyntic gland/parietal cell and detection of foveolar hyperplasia

44
Q

Imatinib and Sunitinib are usually drugs given for which neoplastic tumor?

A

Gastrointestinal stromal tumors (GIST)

45
Q

If KIT rec is not expressed in GIST then which other protein is?

A

TNF-alpha

46
Q

Where is tumor size important?

A

It is imp in small intestines, while it is not imp in colon

47
Q

GIST tumors are mainly in which layer?

A

Submucosa

General Surgery (28 decks)

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