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Kofi: Pure Clinical Sem 3 > GI: Cancer > Flashcards

GI: Cancer Flashcards

1
Q

How are GI infections treated?

A
  • Fluid resuscitation
  • Antibiotics if immunocompromised
  • Treatment of underlying conditions
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2
Q

Describe how G.I. cancers may spread within the body

A
  • Blood stream

- Lymph

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3
Q

What are risk factors of oesophageal carcinomas?

A
  • Smoking
  • Obesity
  • Barrett’s
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4
Q

What are histological features of malignancies in the oesophagus?

A
  • Squamous cell carcinoma

- Lower third can develop adenocarcinoma from Barretts

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5
Q

What is the incidence of GI cancer from most common to least common?

A
  1. Bowel
  2. Pancreas
  3. Oesophagus
  4. Stomach
  5. Liver
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6
Q

What is the clinical presentation of Gastric Cancer?

A
  • Similar pain to peptic ulcer

- 50% have palpable mass

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7
Q

What are risk factors of Gastric Cancer?

A
  • Smoking
  • High salt diet
  • Family history
  • Chronic inflammation (chronic gastritis by H.Pylori)
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8
Q

What is the most important environment factor for stomach cancer?

A

-H.Pylori

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9
Q

Which part of the GI tract is the most common site for a primary gastrointestinal lymphoma?

A

Stomach

  • MALT tissue
  • Most associated with H.Pylori
  • Similar presentation to gastric carcinoma but prognosis better
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10
Q

What are the histological features of stomach cancers?

A
  • Adenocarcinomas
  • Arise from chronic gastritis common or metaplasia.

Stomach ulcers potentially malignant

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11
Q

Why does gastric cancer have a poor prognosis?

A

-Present late and are therefore advanced

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12
Q

How does pancreatic cancer present?

A

Head

  • Painless jaundice (Interferes with biliary flow into duodenum. )
  • Persistent pain
  • Weight loss anorexia
  • Fatigue

Body/Tail
-Symptoms more vague

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13
Q

What are the risk factors for pancreatic cancer?

A
  • Family history
  • Smoking
  • Chronic pancreatitis
  • Men more than women
  • Incidence increases with age. Typical over 60 years
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14
Q

What is the histological features of pancreatic cancer?

A
  • Commonly (80%) are ductal adenocarcinomas

- Commonly affects head of pancreas

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15
Q

What is the clinical presentation of small bowel cancer?

A
  • Per rectum bleeding
  • Change in bowel habit (frequency, consistency, discomfort)
  • Weight loss
  • Abdominal pain
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16
Q

What are risk factors of small bowel cancer?

A
  • Inflammatory bowel disease
  • Coeliac disease
  • Familial adenomatous polypoids
  • Diet
17
Q

What are risk factors of large bowel cancer?

A
  • Family history
  • Inflammatory bowel disease
  • Polyposis syndromes (FAP)
  • Diet and lifestyle
18
Q

What the histological features of small bowel cancer?

A

Rare!

  • Stromal
  • Lymphoma
  • Adenocarcinoma
  • Sarcoma
  • Carcinoid tumours
19
Q

What are the histological features of large bowel cancer?

A

-Adenocarcinoma (mostly in rectum and sigmoid colon)

Most can be viewed with sigmoidoscope

20
Q

What is the basis for most colorectal cancer?

A
  • Adenomas are the basis of most colorectal cancers.
  • Demonstrated by 
familial adenomatous polyposis, an inherited condition where invariably the 
numerous adenomas present will undergo malignant change.
21
Q

What genetic events are coleorectal cancers related to?

A
  • Activation of oncogene
  • Ineffective DNA repair
  • Loss of tumour suppressor genes
22
Q

What are the features of rectal cancers?

A

Usually ulcerating and therefore give PR bleeding. They 
can also produce the symptom of tenesmus due to distension of the rectum.

23
Q

What is the clinical presentation of left sided colon cancer?

A
  • Weight loss
  • Bowel obstruction (Contents are more solid on left side)
  • Tenesmus
  • Early change in bowel habit
  • Less advanced disease at presentation
  • Rectal bleeding
  • Abdominal pain
  • Mass in left illiac fossa
24
Q

What is the clinical presentation right sided colon cancer?

A
  • Weight loss
  • Anaemia
  • Occult bleeding
  • Mass in right iliac fossa
  • Disease more likely to be advanced at presentation
  • Caecum and colon are more distensible so obstruction doesn’t occur early
25
Q

Describe the adenoma-carcinoma sequence

A

Benign growth derived from genetic changes

  • Become hyperplastic
  • Abnormal differential leads to dysplasia of the cells
  • Dysplastic cells have potential to become cancerous

Kofi: Pure Clinical Sem 3 (44 decks)

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