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BRS Y2 > GI cancers > Flashcards

GI cancers Flashcards

1
Q

Pancreatic types

A

Insulinoma
Glucagonoma

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2
Q

Pancreatic/duodenal type

A

Gastrinoma

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3
Q

Entire GI type

A

VIPoma
Somatostatinoma

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4
Q

Insulinoma clinical features and cell type

A

Hypoglycaemia
Whipple’s triad

Beta

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5
Q

Glucagonoma clinical features and cell type

A

DM
necrolytic migratory erythema

Alpha

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6
Q

Gastrinoma clinical features and cell type

A

Zollingere-Ellison syndrome

G

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7
Q

VIPoma clinical features and cell type

A

Verner-morrison syndrome
Watery diarrhea

VIP

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8
Q

Somatostatinoma clinical features and cell type

A

Gallstone
DM
steatorrhoea

D

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9
Q

Midgut clinical features

A

Most non functioning
40%- carcinoid syndrome

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10
Q

Hindgut clinical features

A

Usually non functioning

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11
Q

cancer connective tissue: smooth muscle/adipose tissue name

A

smooth muscle= leiomyoma

adipose tissue= liposarcoma

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12
Q

cancer of Neuroendocrine Cells:
Enteroendocrine cells
Interstitial cells of Cajal
name

A

Enteroendocrine cells = neuroendocrine tumours (NET)

Interstitial cells of Cajal= gastrointestinal stromal tumours

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13
Q

cancer cells of epithelial cells:
squamous

glandular epithelium
name

A

-squamous= squamous cell carcinoma

-glandular epithelium =adenocarcinoma

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14
Q

histopathology of colorectal cancer

A

adenocarcinoma

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15
Q

clinical presentation of colorectal cancer - caecal+right sided cancer,
Left sided & sigmoid carcinoma,
Rectal carcinoma,
Bowel obstruction (late)

A

caecal+right sided cancer=
-Iron deficiency anaemia (most common)
-Change of bowel habit (diarrhoea)

Left sided & sigmoid carcinoma=
PR bleeding, mucus
Thin stool (late)

Rectal carcinoma=
PR bleeding, mucus
Tenesmus
Anal, perineal, sacral pain (late)

Bowel obstruction (late)

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16
Q

colorectal cancer-presentation (late) - local invasion vs metastasis

A

Local invasion (late)​
-Bladder symptoms​
-Female genital tract symptoms​

Metastasis (late)​
-Liver (hepatic pain, jaundice)​
-Lung (cough)​
-Regional lymph nodes​=Sister Marie Joseph nodule

17
Q

Colorectal cancer - investigations

A

Faecal occult blood – detects tiny amounts of blood in faeces​

FBC – anaemia ​

Tumour markers – CEA (for monitoring – NOT diagnostic)​

Imaging – colonoscopy= visualise lesions smaller than 5mm; small polyps can be removed too​

Imaging - CT colonoscopy for lesions bigger than 5mm

18
Q

Colorectal cancer - management​

A

Surgery​

Right + transverse=
resection + primary anastomosis​

Left sided= hartmanns procedure

19
Q

liver cancer-> Primary liver cancer (hepatocellular carcinoma)

A

Maj- underlying CIRRHOSIS​

Poor prognosis​

Chemotherapy is ineffective​

Surgical RESECTION is optimal but only 5-15% are suitable for surgery​

Affected part removed and nothing else

20
Q

liver cancer-> Gallbladder cancer

A

Poor prognosis​

Chemotherapy ineffective​

Surgical EXCISISON is optimal​

Gallbladder and part of liver is removed

21
Q

liver cancer-> Cholangiocarcinoma

A

Poor prognosis​

Chemotherapy ineffective​

Surgical RESECTION is optimal​

Entire half of liver is removed

22
Q

Liver cancer-> Secondary liver metastases​

A

Liver common site of cancer metasteses​

Surgical resection is optimal

23
Q

pancreatic cancer- histopathology, onset of presentation, what increases the risk?

A

Common and highly lethal​

Histopathology – pancreatic ductal adenocarcinoma​

Late presentation​

Very few have resectable disease ​

Chronic pancreatitis increases the risk

24
Q

pancreatic cancer: presentation of head vs [body+ tail] cancer.

A

Head cancer presents with: Jaundice + weight loss + pain​

Body + tail presents with: Asx early; weight loss + back pain + vomiting (late)​

25
Q

Neuroendocrine tumours​- where do they arise? what do they secrete?

A

Arise from gastroenteropancreactic tract ​

Secretes HORMONES​

Most asymptomatic + incidental finding ​

Carcinoid syndrome

25
Q

pancreatic cancer- Investigation? treatment: head vs [body+ tail]

A

Investigation – 1st Abdo US; CA19-9 ​

Treatment – Head – whipples resection.
Body + tail – remove tail w/ spleen​

26
Q

symptoms of carcinoid syndrome

A

vasodilation,
bronchoconstriction,
increased intestinal motility,
endocardial fibrosis

27
Q

Neuroendocrine tumours - diagnosis- biochemical assessment

A

Chromogranin A – secretory produce of neuroendocrine tumours​

Other gut hormones: insulin, gastrin, somatostatin, PPY (measure when fasting)​

Other screening: Calcium, PTH, prolactin, GH​

24 hr urinary 5-HIAA (serotonin metabolite)

28
Q

Neuroendocrine tumours - diagnosis​- imaging

A

CT and/or MRI​

Bowel imaging (endoscopy, barium follow through, capsule endoscopy)​

Endoscopic ultrasound​

Somatostatin receptor scintigraphy​

​

29
Q

Neuroendocrine tumours- treatment

A

Surgery​- curative resection

Somatostatin analogues (e.g. octeotride)​

BRS Y2 (60 decks)

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