GI Carcinomas Flashcards
What percentage of cancer diagnoses are gastric?
2%
What is the epidemiology of gastric cancers (age, sex)
> 75 years, male predominance 2:1
Risk factors of gastric cancer (5)
H.Pylori
Atrophic gastritis
Diet (salt, nitrates)
Smoking
Blood group
Red flag symptom of gastric cancer
Early satiety
Features of gastric cancer
Abdo pain, weight loss and anorexia, nausea and vomiting, dysphagia (proximal stomach), overt upper GI bleed, left supraclavicular node, periumbilical nodule
Periumbilical nodule is known as what?
Sister Mary Joseph’s node
Left supraclavicular node is known as what and associated to what?
Virchows node - gastric cancer
What are signet ring cells
Cells with a large vacuole, nucleus pushed to the top of the cell
Found in glandular cells that line digestive organs associated to gastric cancer
What is used to diagnose gastric cancer
OGD with biopsy
How is staging done in gastric cancer
CT
How do signet cells associated with prognosis
Higher number of signet cells = worse prognosis
How to manage gastric cancer (3 surg, 1 med)
Surgical options - endoscopic mucosal resection, partial gastrectomy, total gastrectomy
Chemo
What is intussusception
Part of the bowel sliding into an adjacent part of the bowel
Where does intussusception occur mostly
Ileo-caecal region
What age does intussusception occur mostly and sex
6-18 months, boys 2:1
Key features of intussusception
- Intermittent cramping/Abdo pain
- Inconsolable crying
- Drawing of knees and pale
- Vomiting
- Bloodstained stool (red-currant jelly, late sign)
- Sausage shaped mass in the RUQ
How to diagnose intussusception, first line investigation
USS
Management of intussusception
- Antibiotics
- Push bowel back using air enema
(Tube inserted into child’s bottom, air passed under pressure). Monitor using x-ray - If that doesnt work - surgical correctionn
Telescoping is a sign of what
Intussusception
Rovsings sign is?
Pain that’s referred to the opposite side of palpation
Palpate left = pain on right
Appendicitis is indicated by what positive sign
Rovsings
What does Murphys sign indicate
Gallbladder inflammation
What does inhalation on palpation cause in RUQ
Gallbladder to descend
What is murphys sign
Upper border of examiners hand in RUQ of abdomen under rib cage - patient inhales - drops gallbladder - gallbladder catches fingers = pain
Cullens sign is suggestive of
Ectopic pregnancy or acute pancreatitis
What is cullens sign
Bruising around the umbilicus
