Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med III - Heme/Onc > GI Cancers > Flashcards

GI Cancers Flashcards

1
Q

How are GI cancers generally staged?

A

Depth of penetration and then degree of spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the globally recognized staging of malignant tumors?

A

T - size of original tumor
N - lymph node invovlement
M - metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most GI cancers arise from what layer?

A

Epithelial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most GI cancers are what type?

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Upper and mid esophageal cancers are mostly what type?

A

Squamous cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risks for esophageal cancer?

A

Tobacco 10x

ETOH 100x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MC type of esophageal cancer in the US?

A

Adenocarcinoma of distal esophagus or GE junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is adenocarcinoma of the distal esophagus/GE junction a/w?

A
  • Reflux and dysplastic changes of mucosa

- Barrett Esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Evaluation and staging of esophageal cancer

A
  • Barium swallow showing “esophageal shelf”
  • EGD w/biopsy
  • If cancer found, endoscopic ultrasound to stage depth of invasion
  • CT scan to look for mets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment of T0/high grade dysplasia/T1 adenocarcinoma of esophagus?

A
  • Endoscopic ablation

- Esophageal resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do most cancers of the esophagus present?

A

At stages higher than T0/high grade dysplasia/T1 adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of higher stages esophageal cancer?

A
  • RT or chemo-RT

- Stage IV: Palliative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Prognosis of T0 and T1 esophageal cancer

A

5 year survival is 98%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prognosis of stage II and III esophageal cancer

A

Median survival is approx 4 years with tri-modality treatment of chemo-RT and then esophagectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stage IV esophageal cancer prognosis

A

Median survival is approx 9 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where is gastric cancer a common problem?

A

Japan and some other areas of Asia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risks for gastric cancer

A
  • Diets LOW in Vit A and C
  • Consumpton of smoked/cured foods
  • Tobacco
  • Untreated H. pylori
  • Genetic (Type A blood, pernicious anemia, HNPCC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MC type of gastric cancer?

A

Adenocarcinoma (95% cases)

  • Diffuse infiltration (linitus plastica)
  • Polypoid or ulcerative masses (intestinal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical presentation of gastric cancer

A
  • Melena
  • Ascites of unclear etiology
  • Virchow’s node
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is needed for diagnosis of gastric cancer?

A

Endoscopic biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Virchow’s node and what does it indicate?

A
  • L supraclavicular adenopathy

- Gastric, pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Prevention of gastric cancer?

A
  • Screening EGD in endemic areas (e.g. Japan)

- Treat H. pylori infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment of Stage I-III gastric adenocarcinoma

A

Surgical resection

  • D1 in the US (and adjuvant chemo-RT)
  • D2 in Japan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When does gastric cancer typically present?

A

6th decade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Describe gastric lymphoma
- Relatively rare - Submucosal or ulcerated mass - Histologically most are MALT - H. pylori etiology MC
26
Treatment of gastric lymphoma
- Eradicate H. pylori - 75% will achieve CR with abx - High grade lymphomas are treated with multi-agent chemo (40-50% 5 yr survival)
27
MC type of small bowel cancer
Adenocarcinoma
28
What types of small bowel cancer arise from polyps?
Autosomal dominant: - Gardener's syndrome - Peutz-Jeghers syndrome
29
What are carcinoid tumors of the small bowel?
- Uncommon - Cancers of neuroendocrine cells - Mostly arise in distal ileum or appendix
30
Treatment of carcinoid tumors of small bowel
- Resection if localized | - Control endocrine manifestations if metastatic (octreotide)
31
Where is colorectal cancer MC?
Western countries with high fat, low fiber diets
32
NSAIDs and colorectal cancer
NSAIDs may be protective against colorectal cancer
33
Genetic risks for colon cancer?
- Familial Adenomatous Polyposis (FAP) syndrome | - HNPCC or Lynch syndromes
34
Describe familial adenomatous polyposis
- Autosomal dominant - Development of hundreds to thousands of adenomatous polyps in colon - Symptoms usually by 25 yo - Increased risk of colon cancer
35
Initial treatment of patients with FAP or other familial syndromes?
Frequent colonoscopies
36
Definitive treatment of FAP/other familial syndromes?
Total colectomy
37
What can attenuate polyp formation?
NSAIDs and omega fatty acids
38
How is Lynch Syndrome or HNPCC diagnosed?
Bethesda Criteria
39
What are the Bethesda criteria?
Diagnose LS or HPNCC - 3 or more family members w/colon cancer (2 must be 1st degree relatives) - 2 successive generations w/colon cancer - 1 family member had colon cancer under 50 yo - NO FAP - 1 family member w/one of the extra-colonic cancers
40
What are LS and HNPCC characterized by?
Microsatellite instability on immunohistochemical staining
41
Colon cancers in HNPCC tend to occur:
Age 50 or less
42
Primary prevention of colorectal cancer:
- NSAIDs - High fiber, low fat diets - Ca, folic acid, Vit D? - Exercise? - HRT?
43
Secondary prevention of colorectal cancer:
Screening to start at 50 yo (or 10 years under the age your 1st degree relative was diagnosed)
44
Approved screening for colorectal cancer:
- Annual DRE w/FOB - Flexible sigmoidoscopy every 5 yrs - Colonoscopy every 10 yrs - Double contrast Ba enema every 5 yrs - CT colonography every 5 yrs
45
Drawback of flex sigmoidoscopy?
Can check bowel to approx 60 cm but 50% of colon cancers are R sided and cannot be reached by flex sig
46
Presenting symptoms of colorectal cancer
- Fe deficiency anemia in men or post-menopausal women - Stools positive for occult blood - Hematochezia - Change in bowel habits - Tenesmus
47
What is essential for a curative outcome of colorectal cancer?
Complete resection of all cancer and regional lymph nodes
48
What is the backbone of treatment for almost all GI cancers?
5-FU
49
What is cancer of the anus associated with?
- HPV - Genital warts and condyloma - MC in HIV
50
CDC recommendations for HPV vaccination?
Males 11-21 yo | Females 11-26 yo
51
Anal cancers are MC what type?
Squamous cell
52
How are anal cancers staged?
Unlike other GI cancers, it is staged by diameter of tumor (T3 is over 5 cm) and LN involvement
53
Preferred curative treatment for anal cancer?
Chemo (mitomycin C and 5FU) + RT | NOT surgery
54
Prognosis of pancreatic cancer
90% inoperable at time of diagnosis
55
What is Courvoisier's sign?
Palpable gallbladder (sign of pancreatic cancer)
56
What is Sister Mary Joseph Node?
Peritoneal carcinomatosis w/mets to umbilicus (sign of pancreatic cancer)
57
Where does hepatocellular carcinoma MC occur?
Sub-Saharan Africa | China and other parts of Asia (western)
58
What is hepatocellular carcinoma highly associated with?
Chronic hepatitis (HBV, HCV, ETOH)
59
Etiology of hepatocellular carcinoma in poorer countries
Contaminated food (Aflatoxin B1 from Aspergillus)
60
Treatment of hepatocellular carcinoma
- If localized, partial hepatectomy - If more generalized, transplant - Chemo-RT
61
What are pancreatic neuroendocrine cancers characterized by?
The hormones they secrete - Gastrinomas - VIPomas - Insulinomas - Glucagonomas
62
Describe MEN1
- Inherited syndrome of multiple endocrine neoplasms | - Pituitary adenomas, Parathyroid tumors, Pancreatic neuroendocrine tumors (PPP)
63
Describe MEN2
- Inherited syndrome | - Parathyroid tumors, Pheochromocytomas, Medullary thyroid cancer
64
Describe gastrointestinal stromal cell tumors (GIST)
Unique sarcomas of GI tract
65
MC form of GI sarcoma?
GIST
66
GISTs arise mostly in:
Stomach or small intestine
67
Treatment of GISTs
- Surgical resection (most important) | - 3 yrs of adjuvant PO Imatinib

Clin Med III - Heme/Onc (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions