Gastric Cancer

Question 1

state some risk factors of gastric cancer?

Answer 1

atrophic gastritis 
increased nitrates in diet 
smoking 
blood group A
E cadherin abnormality 
partial gastrectomy 
lower social class

Question 2

what gastric cancer is associated with H pylori ?

Answer 2

MALToma

Question 3

state some symptoms of gastric cancer?

Answer 3

Usually present late
􏰀 Wt. loss + anorexia
􏰀 Dyspepsia: epigastric or retrosternal pain/discomfort
􏰀 Dysphagia

Question 4

state some signs of gastric cancer?

Answer 4

Anaemia
􏰀 Epigastric mass
􏰀 Jaundice
􏰀 Ascites
􏰀 Hepatomegaly
􏰀 Virchow’s node (= Troisier’s sign)
􏰀 Acanthosis nigricans

Question 5

where does gastric cancer invasive directly?

Answer 5

pancreas

Question 6

where does gastric cancer haemolytically spread most common?

Answer 6

liver lung

Question 7

what lymph node does gastric cancer spread to ?

Answer 7

Virchows

Question 8

what is Sister Mary Joseph nodule?

Answer 8

transcoelomic spread to umbilical mets

Question 9

what is a Krukenberg tumour ?

Answer 9

ovary tumour metastasis from gastric cancer

Question 10

where are Krukenburg tumours characterised by?

Answer 10

mucin-secreting signet-ring cells in the tissue of the ovary

Question 11

how is staging of gastric cancer determined ?

Answer 11

Endoluminal US
􏰁 CT/MRI
􏰁 Diagnostic laparoscopy

Question 12

what is the commonest mesenchymal tumour of the GIT?

Answer 12

gastrointestinal stromal tumour

Question 13

what sex is most affected by gastrointestinal stromal tumour ?

Answer 13

equal

Question 14

what cells does gastrointestinal stromal tumours come from?

Answer 14

Arise from intestinal cells of Cajal

􏰁 Located in muscularis propria 􏰁 Pacemaker cells

Question 15

what treatment can cure MALT lymphoma

Answer 15

H. pylori eradication can be curative

Question 16

what is zollinger ellison syndrome

Answer 16

Gastrin-secreting tumour (gastrinoma) most commonly found in the small intestine or pancreas.

Question 17

what genetic condition is associated with gastrinomas

Answer 17

25% assoc. ̄c MEN1

Question 18

what is the presentation of zollinger ellisons syndrome ?

Answer 18

Abdominal pain and dyspepsia

􏰀 Chronic diarrhoea / Steatorrhoea

􏰀 Refractory PUD

Question 19

what are the levels of gastrin and HCL with zollinger ellison syndrome ?

Answer 19

↑ gastrin ̄c ↑↑ HCl (pH<2)

Question 20

what is the treatment of zollinger ellison syndrome ?

Answer 20

high dose PPI

surgery - tumour resection