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2.3.5. Gastrointestinal System > GI Cancers > Flashcards

GI Cancers Flashcards

1
Q

Describe the incidence of various common cancers of the G.I. tract

A

Bowel = 4th most common malignancy

Pancreas, oesophagus, stomach, liver = top 20 most common malignancies

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2
Q

What is the differential diagnosis for dysphagia?

A

Extraluminal = compression

Luminal = integrity problem with the lumen

Intraluminal = foreign body

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3
Q

What are the red flags for dysphagia?

A

ALARM

Anaemia

Loss of weight

Anorexia

Recent onset of progressive symptoms

Masses/malaena

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4
Q

What type of cancer is mainly seen in the oesophagus?

A

Due to the presence of stratified squamous ep = squamous cell carcinoma

Lower third = adenocarcinoma

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5
Q

What type of cancer is mainly seen in the GI tract (other than oesophagus)?

A

Due to presence of columnar ep = adenocarcinoma

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6
Q

How does oesophageal carcinoma present?

A

Progressive dysphagia

Barium swallow = narrowing

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7
Q

What is malaena?

A

Bleeding in upper GI tract

Gets metabolised

In stool = black, tar, offensive smell

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8
Q

Define haematemesis

A

Vomiting blood

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9
Q

What are the red flags when investigating epigastric pain?

A

Malaena

Haematemesis

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10
Q

What are the risk factors for gastric cancer?

A

Smoking

High salt diet

Family history

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11
Q

Where are gastric cancers typically found?

A

Cardia or antrum

Typically adenocarcinoma

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12
Q

How do gastric cancers present?

A

Similar pain to peptic ulcer

50% have palpable mass

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13
Q

Other than adenocarcinoma what other stomach cancer can occur?

A

Gastric lymphoma = most associated with H pylori

Gastrointestinal stromal tumours

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14
Q

What are the reg flags of jaundice?

A

Hepatomegaly = irregular border (worry about mets)

Ascites = pressure build up in portal system due to excess tissue build up, reduced liver function lower

Albumin levels

Painless = typically

Unintentional weight loss

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15
Q

What is the most common way GI cancer spreads?

A

Blood

Lymph

Transcoelomic – via a cavity

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16
Q

What cancers most commonly metastasise to the liver?

A

Breast

GI

17
Q

How does pancreatic cancer present?

A

Pancreatic head = painless jaundice

Pancreatic tail = abdo pain, malabsorption, endocrine dysfunction

18
Q

If someone has an enlarged, palpable, non-tender gallbladder then what is not the cause?

A

not gallstones

19
Q

What symptoms are seen in a lower GI obstruction?

A

Abdo distention

Abdo pain

Constipation

Nausea and vomiting

20
Q

What is a differential diagnosis for lower GI obstruction?

A

Benign = diverticular disease, volvulus, hernia

Malignant = adenocarcinoma of the large colon, small bowel cancer

21
Q

Describe the symptoms of PR bleeding

A

Fresh bright red bleeding

Melena

Anal pain

Tenesmus

22
Q

What is melena?

A

Bleeding higher up in the GI tract

Dark black, tarry stools

Foul smelling

23
Q

Define tenesmus

A

Feeling of incomplete emptying

24
Q

Name the reg flags of PR bleeding

A

Iron def anaemia = insidious bleeding higher up in GI tract

Unexplained weight loss

Age dependent

Change in bowel habit

25
Q

What are the different causes of PR bleeding?

A

Benign = haemorrhoids, anal fissures, IBD

Malignancy = adenocarcinoma, small bowel cancer

26
Q

What can cause a change in bowel habits?

A

Over active thyroid = looser stools

Under active thyroid = constipation

Metformin = runny stool

Irritable bowel

Coeliac disease

Malignancy = adenocarcinoma, small bowel cancer

27
Q

What are the risk factors for large bowel cancer?

A

Family history

Inflammatory bowel disease

Polyposis syndromes - FAP

Diet and lifestyle

28
Q

Describe the adenoma-carcinoma sequence relating to colorectal cancer

A

Genetic changes = polyp (benign growth) = can become hyperplastic = abnormal diff of cell type = dysplastic = potential to become cancerous

29
Q

What are the risk factors for small bowel cancer?

A

IBD

Coeliac disease

FAP – polyposis syndromes

Diet

30
Q

Any inflammatory process in the bowel puts you at a higher risk of what?

A

Bowel cancer

31
Q

How is GI cancer managed?

A

TNM staging

Blood test- FBC (looking for iron def anaemia), tumour markers(CEA)

CT/MRI

Endoscopy/Colonoscopy

Capsule endoscopy

Treatment = Chemotherapy, radiotherapy, surgical resections

2.3.5. Gastrointestinal System (17 decks)

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