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Cancer Care > GI > Flashcards

GI Flashcards

1
Q

Give an example of a VEGF inhibitor

A

Bevacizumab

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2
Q

Give an example of a EGFR inhibitor

A

Cetuximab

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3
Q

What tumour marker do we look for in HCC?

A

AFP

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4
Q

CA19-9 is a tumour marker for…

A

Pancreatic
Gallbladder
Bile duct
Gastric

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5
Q

What is the tumour marker for colorectal?

A

CEA

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6
Q

What are the upper GI red flags?

A 
Dysphagia
Abdominal or back pain with weight loss
Haematemesis
Jaundice
Abdominal mass
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7
Q

What are the lower GI red flags?

A

Changes in bowel habit
Rectal bleeding
Anaemia
Perianal pain

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8
Q

Describe Dukes staging

A

A confined to bowel wall
B through the muscularis propria
C lymph node involvement
D metastasised

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9
Q

What factors increase the risk of colorectal cancer?

A

Diet: red meat, alcohol and high calories
Smoking, obesity
IBDs
Genetics - HNPCC, FAP, Lynch

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10
Q

FAP is linked to mutations in which gene?

A

APC tumour suppressor gene

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11
Q

70% of all colorectal cancers are what type?

A

Adenocarcinomas

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12
Q

How does a right sided bowel cancer present?

A 
Palpable mass in RIF
Diarrhoea
Weight loss
Anaemia
Occult GI bleeding - Melaena
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13
Q

How does a left sided bowel cancer present?

A 
Palpable mass LIF
change to bowel habit
Tenesmus
PR bleeding 
Bowel obstruction
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14
Q

What investigations would you order for suspected bowel cancer?

A 
DRE
FBC, U+E, LFTs, bone profile
CEA 
Colonoscopy
CT CAP
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15
Q

What is the percentage 5 year survival for each Dukes staging?

A

A 93
B 77
C 48
D 7

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16
Q

How is bowel screening done?

A

Everyone over 50 years sent a faecal occult blood kit every 2 years
One off flexible sigmoidoscopy between 55-59 years

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17
Q

What percentage of gallbladder polyps are benign?

A

95

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18
Q

When do we need to worry about gallbladder polyps?

A

> 1cm likely to be or become malignant

>1.8cm significant risk

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19
Q

What type of cancer occurs in the gallbladder most commonly?

A

Adenocarcinomas

20
Q

At what age do most patients present with gastric cancer?

A

55 years old plus

21
Q

Gastric cancer is most common in what blood group?

22
Q

Name risk factors of gastric cancer

A

Dietary carcinogens - nitrosamines and salty foods
H pylori
Chronic atopic gastritis
Familial mutations of cadherin 1 gene

23
Q

What are the 2 types of gastric adenocarcinomas?

A

Intestinal

Diffuse

24
Q

Which type of gastric cancer has the worst prognosis?

25
Q

What are the symptoms of advanced gastric cancer?

A

Ascites
Jaundice
Melaena
Virchows node

26
Q

What is the treatment of gastric cancer?

A

Surgery

Combination chemotherapy

27
Q

What is the 5 year survival for gastric cancer?

28
Q

What is the biggest risk factor for pancreatic cancer?

29
Q

What proportion of cancers occur in the pancreatic head?

30
Q

What investigations are needed for suspected pancreatic cancer?

A

Endoluminal USS
CT staging
ERCP for biopsy
Bloods: FBC, U+E, LFT, CA19-9

31
Q

What proportion of patients present with advanced pancreatic Ca that can only be Sx controlled?

32
Q

What is the treatment of pancreatic cancer?

A

Surgery
Radiotherapy - locally advanced disease
Chemo for palliation

33
Q

What is the 5 year survival of pancreatic cancer?

34
Q

Anal cancer is usually what type?

A

Squamous cell carcinoma

35
Q

What is the origin of the oesophagus?

A

Inferior border of cricoid cartilage at C6

36
Q

Describe the muscular layers found in the different third of the oesophagus

A

Superior - voluntary striated
Middle - voluntary striated and smooth
Inferior - smooth muscle

37
Q

What vertebral level is the gastro-oesophageal junction found?

38
Q

What are the 4 mechanisms of LOS formation?

A

Oesophagus enters stomach at acute angle
Intraabdominal section of abdomen compressed when positive pressure in abdomen
Folds of mucosa present aid to occlude junction
Right crus of the diaphragm has a pinch cock effect

39
Q

Where does the lymphatics of the oesophagus drain?

A

Deep cervical LNs
Superior and posterior mediastinal nods
Left gastric and coeliac LNs

40
Q

What is Barrett’s oesophagus?

A

Metaplasia of the lower oesophageal squamous epithelium to columnar
Usually caused by chronic acid exposure

41
Q

What is the most common type of oesophageal cancer?

A

Squamous cell carcinoma

42
Q

What part of the stomach joins to the oesophagus?

43
Q

What is the superior curved part of the stomach called?

44
Q

What vertebral level does the transpyloric plane lie on?

45
Q

The portal vein is formed by the convergence of …

A

Superior mesenteric vein

Splenic vein

46
Q

What structure runs directly behind the neck of the pancreas?

A

Superior mesenteric vessels

47
Q

Which part of the pancreas is intraperitoneal?

Cancer Care (7 decks)

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