GI cancer

Question 1

risk factors for adenocarcinoma of oesophagus

Answer 1

tobacco and alcohol (due to aldehyde metabolites)
obesity
Barrett’s oesophagus

Question 2

signs of oesophageal cancer

Answer 2

difficulty swallowing (dysphagia)
weight loss
swollen lymph nodes in neck 
hoarse voice
haemoptysis
haematemesis
retrosternal chest pain

Question 3

diagnosis of oesophageal cancer

Answer 3

oesophagogastroduodenoscopy
biopsy –> histopathology
contrast CT
radial endoscopic ultrasound

Question 4

treatment of oesophageal cancer

Answer 4

endoscopic mucosal resection if small
oesophagectomy if large
chemotherapy (cisplatin)
radiotherapy

Question 5

risk factors for squamous cell carcinoma of oesophagus

Answer 5

very hot drinks
tobacco 
alcohol 
obesity
male

Question 6

risk factors for stomach cancer

Answer 6

pernicious anaemia
blood group A
H.pylori infection 
atrophic gastritis
adenomatous polyps
smoking
diet
low socioeconomic groups 
high salt intake
pickled food
E-cadherin mutation

Question 7

signs of stomach cancer

Answer 7

epigastric mass
hepatomegaly
jaundice
dyspepsia
weight loss
vomiting
dysphagia
anaemia

Question 8

5 year survival rate for stomach cancer

Answer 8

10%

Question 9

diagnosis for stomach cancer

Answer 9

gastroscopy
biopsy all ulcers
CT/MRI for staging

Question 10

treatment of stomach cancer

Answer 10

resect if possible
endoscopic mucosal resection 
chemoradiotherapy
combined chemo 
targeted therapy - e.g. trastuzumab for HER2 positive tumours

Question 11

risk factors for small bowel cancer

Answer 11

Crohn's disease
Coeliac disease
male
radiation exposure 
familial adenomatous polyposis
hereditary nonpolyposis
colorectal cancer
Peutz-Jegher's syndrome

Question 12

which types of cancer affect the small bowel?

Answer 12

adenocarcinoma
GI stromal tumour
lymphoma

Question 13

signs of small bowel cancer

Answer 13

GI bleeding
liver metastases
dysphagia
abdominal pain

Question 14

diagnosis of small bowel cancer

Answer 14

CT scan
endoscopic biopsy
immune-histochemistry
barium fluoroscopy

Question 15

treatment of small bowel cancer

Answer 15

surgery
chemotherapy
radiotherapy

Question 16

risk factors for large bowel cancer

Answer 16

neoplastic polyps
IBD
genetics (8%)
diet
alcohol 
smoking
previous cancer
juvenile polyposis syndrome

Question 17

pathology of large bowel cancer

Answer 17

usually an adenocarcinoma (arises from glandular tissue of epithelium) due to prolonged exposure to carcinogenic factors

Question 18

symptoms of left sided large bowel cancer

Answer 18

bleeding
mucous
altered bowel habit
obstruction 
mass
haemorrhage
fistula

Question 19

symptoms of right sided large bowel cancer

Answer 19

weight loss
decrease in Hb
abdominal pain 
less likely to have obstruction 
haemorrhage
mass
fistula

Question 20

complications of large bowel cancer

Answer 20

bowel obstruction

Question 21

diagnosis of large bowel cancer

Answer 21

FBC (microcytic anaemia)
faecal occult blood
sigmoidoscopy
colonscopy
CT 
DNA test when older than 15 years if there is a family history

Question 22

treatment of large bowel cancer

Answer 22

surgical resection
radiotherapy
chemotherapy

Question 23

what percentage of large bowel cancers occur in the rectum and how can they be identified?

Answer 23

38%

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