Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Week 1 Revision > GI Malignancies > Flashcards

GI Malignancies Flashcards

1
Q

What are the most common GI malignancies?

A

Oesophageal, gastric, large intestine, pancreas and liver

Most common is colorectal carcinoma

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

How does oesophageal carcinoma present clinically?

A

dysphagia - progressively worsening as tumour grows and occludes lumen

weight loss as it affects the ability to eat and swallow

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

How do you investigate oesophageal carcinoma?

A

endoscopy, biopsy and barium swallow

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

What two types of carcinomas occur in the oesophagus?

A

Squamous cell carcinoma or adenocarcinoma

squamous cell is most common and can occur at any level

adenocarcinoma is associated with the lower third of the oesophagus and barrett’s oesophagus

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

What is the prognosis of oesophageal carcinoma?

A

Poor due to clinical presentation usually occurs at advanced stages of disease. The tumour can directly spread through the oesophageal wall and only 40% can be resected (cut out)

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

How common is gastric cancer?

A

Common - 15% worldwide

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

Is gastric cancer more common in men or women?

A

Men

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

Where worldwide is gastric cancer most common?

A

Japan, Columbia (high prevalence of H. pylori infectons), Finland

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

With which blood group is gastric cancer most commonly associated?

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

With what disease is gastric cancer associated?

A

Gastritis and H. pylori infections

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

How does gastric cancer present clinically?

A

Vague symptoms

Epigastric pain, vomiting, weight loss

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

How would you investigate gastric cancer?

A

Endoscopy, biopsy, barium swallow

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

What are the macroscopic features of gastric cancer?

A

Fungating (a fungating lesion is marked by ulcerations and areas of necrosis)

Ulcerating

Infiltrative -> linitis plastica

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

What are the microscopic features of gastric cancer?

A

Gastric tissue resembles intestinal with variable degree of gland formation, and is diffuse with single cells and small groups, as well as signet ring cells

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

What is the difference between early and advanced gastric cancer?

A

Early gastric cancer is confined to the mucosa/sub-mucosa and has a good prognosis

Advanced gastric cancer has spread and has a poor prognosis

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

How can gastric cancer spread?

A

Directing through gastric wall -> duodenum, transverse colon or pancreas

via lymph nodes

to the liver

trans-coelomic - around the peritoneum, or to the ovaries

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

Where can gastric cancer spread to in females that it cant in males

A

Ovaries

18
Q

What types of tumours can you get in the large intestine? (remember that the large bowel extends from cecum -> anus)

A

Adenomas - benign neoplastic lesions in the large bowel, FAP, Gardner’s syndrome

Adenocarcinomas

Polyps

Anal carcinoma

19
Q

What are benign neoplastic lesions in the large bowel?

A

Dysplastic changes

Macroscopic appearance - sessile (direct attachement at base without stalk like if it were pedunculated) or pedunculated

microscopic changes - variable degree of dysplasia

Can become malignant

Can come about due to genetic syndromes - and incidence increases with age

20
Q

What is FAP?

A

Familial adenomatous polyposis

Autosomal dominant condition on chromosome 5 -> formation of thousands of adenomas in the large intestine

Increase risk of malignancy - especially colorectal carcinoma

21
Q

What is Gardner’s syndrome?

A

Similar to FAP, autosomal dominant condition that causes bone and soft tissues (large colon) tumours

22
Q

What are the macroscopic features of colorectal carcinoma?

A

fungating or stenosis of the sigmoid colon and rectum

23
Q

What are the microscopic features of colorectal adenocarcinoma?

A

there are different types of colorectal adenocarcinomas - they can be mucinous or signet ring cell types - histology varies depending on the type

24
Q

How does colorectal adenocarcinoma spread?

A

through bowel wall to adjacent organs such as the bladder

via lymphatics -> mesenteric lymph nodes

via portal venous system -> liver

25
Q

What is the staging for colorectal adenocarcinoma?

A

Duke’s

A - confined to wall
B - through wall, no lymph involvement 
C - lymph node involved 
C1 - highest lymph node clear 
C2 - high lymph node involved
26
Q

What mutations give rise to colorectal adenocarinoma?

A

Ras mutations, p53 mutations, FAP - mutation on chromosome 5 -> lots of adenomas -> can lead to colorectal adenocarcinoma

27
Q

What IBD conditions can give rise to colorectal adenocarcinoma?

A

UC and Crohn’s

28
Q

Apart from mutations, what else can cause colorectal adenocarcinoma?

A

Low residue diet - one that reduces frequency and volume of stool production and prolongs gut transit time

slow gut transit time

high fat intake

29
Q

What is the prognosis of colorectal carcinoma?

A

Prognosis worsens with increasing Duke’s staging.

Metastases to liver are common in advance stages

30
Q

Apart from colorectal adenocarcinoma, what other malignant tumours can you get in the large intestine?

A

Carcinoid tumour - unpredictable neuro-endocrine tumour that is rare

Lymphoma - primary and secondary but rate

Smooth muscle/stromal tumours - rare and unpredictable

31
Q

Where in the pancreas is pancreatic carcinoma most common?

A

in the head of the pancreas

32
Q

What are the macroscopic features of pancreatic cancer?

A

Firm pale mass - necrotic core that may infiltrate other structures that are adjacent e.g. the spleen

33
Q

What is the most common type of pancreatic cancer?

A

Ductal adenocarcinoma

34
Q

What are the microscopic features of ductal adenocarcinoma

A

well formed glands

35
Q

What are the microscopic features of acinar adenocarcinoma?

A

zymogen granules

36
Q

What is the prognosis of pancreatic carcinoma?

A

Poor

37
Q

What can carcinoma of the ampulla of vater present as clinically?

A

Jaundice due to obstruction of the bile duct - early presentation = good prognosis

38
Q

What are the types of islet cell tumours?

A

Insulinoma -> hypoglycaemia

Glycagonoma -> characteristic skin rash

Vasoactive intestinal peptideoma

Gastrinoma

39
Q

What are the types of benign tumours of the liver?

A
  • Hepatic adenoma
  • Bile duct adenoma
  • Hemangioma (benign tumour of blood vessels -> red birth mark)
40
Q

what are the types of malignant tumours of the liver?

A

Hepatocellular carcinoma

Cholangiocarcinoma

Hepatoblastoma (rare, in children, tissue resembles fetal liver cells, mature liver cells or bile duct cells)

Week 1 Revision (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions