Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Big Surgery > Gastric cancer > Flashcards

Gastric cancer Flashcards

1
Q

What is the sister Mary Joseph nodule?

A

It is a swollen lymph node in the umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the Blumers shelf?

A

A collection of tumour cells we feel rectally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 4 regions of the stomach?

A
  1. Fundus
  2. Body
  3. Antrum
  4. Pyloric sphincter
  5. Cardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 types of gastric cancer?

A
  1. Adenocarcinoma-95%
  2. lymphoma-15%
  3. GIST-3%
  4. Carcinoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What age is the peak incidence of gastric cancer?

A

6rth decade/70 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the risk factors for gastric cancer?

A
  1. Nutritional
    - high nitrate diet, smoked and pickled food, dirty drinking water, not enough fruits and vegetables
  2. Medical:
    - obesity
    - smoking
    - family history
    - H.Pylori
    - poor socio-economic background
    - previous gastric surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do we classify gastric CA according to Bormann’s classification?

A 
1. type 1- polyploid or fungating
type 2-ulcerating with raised edges
type 3- ulcerating with infiltration into wall
type 4-diffuse infiltration
type 5-unclassified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is linitus plastica?

A

It is when the entire stomach is lined with type 4 cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the initial presentation of patients with gastric ca?

A
  1. early satiety
  2. abdominal pain
  3. weight loss
  4. fatigue to iron deficiency
  5. nausea+vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the physical examination signs you would find?

A
  1. hepatomegaly and epigastric mass
  2. ascites
  3. sister mary jospeh nodule at the umbilcus
  4. Virchows lymph node at the supra-clavicular region
  5. Krukeneberg- ovarian mass
  6. Blumer’s shelf-palpable mass in pouch of douglas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What special investigations do we do here?

A
  1. Upper gastroscopy with biopsy

2. Bloods: FBC, Urea and electrolytes, creatinine, liver function tests, coagulation studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What special investigations do we do here?

A
  1. Upper gastroscopy with biopsy
  2. Bloods: FBC, Urea and electrolytes, creatinine, liver function tests, coagulation studies
  3. ascitic tap for cytology
  4. CXR and liver ultrasound to stage
  5. CT scan is expensive but more effective-chest and abdomen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for gastric ca?

A
  1. surgical resection if there’s no metastases

2. palliation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What surgery do we do for distal ca?

A

sub total gastrectomy with billroth 1,2 or roux and y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do we do for more proximal tumours?

A

Total gastrectomy with roux and y and ossible lymph node resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the magic regime?

A

This is when the patient who has neoadjuvant therapy is given a further 3 cycles of chemotherapy after surgery
This increases the survival rates by at least 15%

17
Q

What are the different palliative options?

A
  1. Radiotherapy for pain or bleeding that opiates cannot fix
  2. bypass with gastrojejunostomy to pass through the tumour
  3. self expanding metal stent
18
Q

What are the two main causes of gastric lymphoma?

A
  1. H. pylori and immunsuppression(HIV)
19
Q

Which age is affected by gastric lymphoma?

A

60-70 years

20
Q

What are the two ways we can stage gastric lymphoma?

A
  1. low grade MALT-mucosa associated lymphoid tissue usually requires H. pylori eradication
  2. high grade MALT- usually requires chemotherapy and radiotherapy
21
Q

What special investigations would you do in Gastric lymphoma?

A
  1. bone marrow biopsy and CT abdo, chest and neck

2. test for H. pylori

22
Q

What are the GIST tumours?

A

gastrintestinal stromal tumours that occur in the 6th decade

They are submucosal or originate from the muscularis propria and release tyrosine kinase from the cells of Cajal

23
Q

What is the survival rate of gastric lymphomas?

A

75-95%

24
Q

What is the survival rate of GIST?

A

50%

25
Q

How does GIST usually present?

A
  1. usually with epigastric pain and upper GI bleeding from the ulceration
26
Q

What special investigatons do you need to do for a GIST?

A

CT abdomen and chest to look for mets

endoscopy but not biopsy

27
Q

What is the treatment for GIST?

A

Surgical resection with no lymph node dissection

  • usually gastric wedge dissection
  • we can try imitinab (gleevec) which is a tyrsine kinase inhibitor

Big Surgery (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions