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General Surgery > GI Cancers > Flashcards

GI Cancers Flashcards

1
Q

Most common type of pancreatic cancer

A

Ductal carcinoma

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2
Q

Risk factors for pancreatic cancer

A 
60+
Males
Family history
Diabetes mellitus
Chronic pancreatitis
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3
Q

Clinical presentation of pancreatic cancer

A

Normally asymptomatc

Head of pancreas

  • obstructive jaundice
  • abdominal pain
  • weight loss
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4
Q

What is Courvoisier’s sign?

A

Painless jaundice + enlarged gallbladder

Pancreatic neoplasm until proven otherwise

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5
Q

What is Trousseau sign of malignancy?

A

Medical sign involving episodes of vessel inflammation due to recurrent blood clots

Syndrome associated with pancreatic cancer

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6
Q

Investigations for suspected pancreatic cancer

A

CT
ERCP

Tumour markers

  • CA19-9
  • CEA
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7
Q

Management of pancreatic cancer

A

Radical resection- T1-2N0M0
remove pancreas head, antrum of stomach, 1st+2nd parts duodenum, CBD, gall bladder

Adjuvant chemotherapy

Adjuvant radiotherapy

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8
Q

What is the Cochrane review?

A

Pancreatic resection increases survival and reduces costs compared to palliative treatment

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9
Q

What is hepatocellulatr carcinoma?

A

Primary liver cancer

Associated with chronic inflammatory proceses affected the liver

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10
Q

Risk factors of hepatocellular carcinoma

A 
Hep B
Hep C
High alcohol intake
Aflatoxin
Smoking
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11
Q

Clinical features of hepatocellular carcinoma

A

Dull upper abdo pain
Enlarged liver
Weight loss
Ascites

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12
Q

Investigations for suspected hepatocellular carcinoma

A

LFTs
AFP - raised in 80% of cases
Ultrasound
CT

DO NOT BIOPSY

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13
Q

Management of hepatocellular carcinoma

A

Surgical resection

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14
Q

Common sites for liver metastases to come from

A 
Bowel
Breast
Stomach
Pancreas
Lung
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15
Q

What is cholangiocarcinoma?

A

Cancer of the biliary system

Common site = bifurcation of right and left hepatic ducts

Commonly adenocarcinomas

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16
Q

Risk factors for cholangiocarcinoma

A

Primary sclerosing cholangitis
Ulcerative colitis
Infective (HIV, hepatitis)
Diabetes mellitus

17
Q

Clinical features of cholangiocarcinoma

A

Asymptomatic until late stage

Jaundice
Weight loss
Pruritus

18
Q

Investigations for suspected cholangiocarcinoma

A

Bloods - test for obstructive jaundice
Tumour markers - CA19-9
MRCP

19
Q

Management of cholangiocarcinoma

A

Surgical resection

PAliative stenting of bile duct

20
Q

Types of oesphageal cancer

A

Squamous cell carcinoma

  • middle/upper thirds
  • associated with smoking/alcohol consumption

Adenocarcinoma

  • lower third
  • consequence of Barrett’s oesophagus
  • risk factor = GORD
21
Q

Clinical features of oesphageal cancer

A

Dysphagia - progressive solids to liquids
Significant weight loss
Dyspepsia

22
Q

Investigations for suspected oesphageal cancer

A

Endoscopy

23
Q

Management for oesphageal cancer

A

Mostly palliative

24
Q

Risk factors for gastric cancer

A

Male
H.pylori infection
Increasing age
Smoking

25
Q

Clinical features of gastric cancer

A

Dyspepsia
Dysphagia
Early satiety

Possibility of epigastric mass

26
Q

Investigations for suspected gastric cancer

A

Endoscopy
- biopsy

CT for staging

27
Q

Management of gastric cancer

A

Gastrectomy

  • total for proximal tumour
  • subtotal for distal tumour

Nutritional assessment

Peri-operative chemotherapy

28
Q

What is colorectal cancer?

A

Cancer affecting large bowel

50% affect rectum + left colon

Majority arise from adenomatous polyps

29
Q

How do colorectal cancers spread?

A

Direct

  • radial from retropeitoneal organs
  • radial from intraperitoneal organs

Lymphatic

  • paracolic nodes
  • intermediate colic nodes
  • para-aortic node

Blood borne

  • liver via portal system
  • lungs

Transcoloemic

30
Q

Risk factors for colorectal cancers

A

Genetic

  • lynch syndrome
  • FAP

Diet

  • alcohol
  • red meat
  • obesity

Predisposing conditions

  • IBD
  • previous abdo surgery
31
Q

Clinical features of right sided colon cancer

A 
Abdominal pain
Occult bleeding
Mass in RIF
Change in bowel habits 
Iron deficiency anaemia
32
Q

Clinical features of left sided colon cancer

A 
Changes in bowel habits
Rectal bleeding
Tenesmus
Mass in LIF
Iron deficiency anaemia
33
Q

Investigations for suspected colorectal cancer

A

Full blood count (microcytic anaemia)
Colonoscopy + biopsy

CT for staging

34
Q

Management of colorectal cancer

A

Surgery

  • right hemicolectomy for caecal/ascending colon tumours
  • left hemicolectomy for descending colon tumours
  • Hartmann’s procedure

Chemotherapy

35
Q

What is anal caner?

A

Cancer of anus

Majority are squamous cell carcinoma arising below dentate line

36
Q

Risk factors for anal cancer

A

HPV
HIV
Smoking
Crohn’s disease

37
Q

Clinical features of anal cancer

A

Rectal pain
Rectal bleeding
Mass on PR

38
Q

Investigations for suspected anal cancer

A

Proctoscopy

- biopsy if indicated

39
Q

Management of anal cancer

A

Chemo-radiotherapy is first choice

T1N0 - surgical excision

General Surgery (15 decks)

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