GI malignancies

Question 1

Give 5 risk factors for gastric cancer.

Answer 1

Increasing age
HNPCC
H. pylori
family history of gastric cancer
Lack of fruit and veg in the diet
smoking!
rubber production

Question 2

How do polyps form and what can they cause?

Answer 2

Polyps are present in 1/3 of people over 60. Excessive beta-catenin upregulates genes which cause excessive epithelial proliferation and adenomas. (lecture 15.1.8)

Question 3

What part of the GI tract is the most common site of colorectal tumours?

Answer 3

Rectum (DRE useful)

Question 4

What is resection coding?

Answer 4

A scale describing how much of the tumour has been resected. 
R0
R1
R2
(lecture)

Question 5

What are the benefits of staging cancers?

Answer 5

Obtain survival curves and estimate prognosis for individual patients.
(lecture 28.1.18)

Question 6

Describe a dukes stage B tumour.

Answer 6

A; not in bowel wall
B: invading bowel wall
C; invading local lymph nodes
D: metastases.

Question 7

Decribe the treatment for colonic adenoma.

Answer 7

Endoscopic resection.

Question 8

Describe the treatment for colorectal adenocarcinoma with no metastases.

Answer 8

Surgical resection (progressed from adenoma)

Question 9

Describe the treatment for metastatic colorectal adenocarcinoma.

Answer 9

Chemotherapy; palliative care.

Question 10

Give 5 indications for upper GI endoscopy.

Answer 10

1. Haematemesis
2. Gastric or duodenal biopsy with ?cancer
3. persistent vomiting
4. iron deficiency (?cancer, ?hiatus hernia)
5. stent insertion
   (OHCM)

Question 11

Give 5 indications for colonoscopy.

Answer 11

1. Rectal bleeding - when settled, if acute
2. iron deficiency anaemia (?bleeding cancer)
3. persistent diarrhoea
4. ?IBD
5. stents