Gastric carcinoma

Question 1

Name four ways in which a gastric carcinoma presents

Answer 1

1. upper abdo pain after eating
2. weight loss/loss of appetite
3. anaemia
4. N/V
5. signs of metastatis (virchow’s node, jaundice)
6. Dyspepsia
7. Dysphagia

Question 2

List four risk factors for gastric carcinoma

Answer 2

H.pylori, autoimmune gastritis, genetic, smoking, diet (smoke, pickled, salted -> Japan), familial

Question 3

Which is the most common type of gastric cancer?

Answer 3

adenocarcinoma (90%) (other types include lymphoma and carcinoid)

Question 4

Name two complications of gastric cancer

Answer 4

perforation, upper GI bleed, gastric outlet obstruction

Question 5

What are the investigations for gastric carcinoma?

Answer 5

Bloods- FBC, LFTs and clotting

Imaging- upper GI endoscopy/gastroscopy + biopsy, CXR +USS (mets)

Question 6

How is gastric carcinoma staged?

Answer 6

endoluminal US
CT/MRI
diagnostic lapraroscopy

Question 7

What is the treatment of gastric carcinoma

Answer 7

surgery- gastrectomoy +regional lymph node 
excision
bypass procedures, pyloric stenting
chemo
analgesia
PPI
palliative care

Question 8

Three signs of gastric cancer

Answer 8

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

Question 9

Three modes of spread for gastric cancer?

Answer 9

lymphatic
blood
direct
transcoelomic