GI Malignancy

Question 1

Risk factors for esophageal squamous cell cancer?

Answer 1

tobacco, alcohol, and caustic ingestion

Question 2

when screening for esophageal cancer after lye ingestion?

Answer 2

20 years post ingestion

Question 3

Populations that should have gastric cancer screening in the US?

Answer 3

strong family history of gastric cancer
FAP or Lynch syndrome,
extensive intestinal metaplasia

Question 4

MALT lymphomas are characterized by presence of this genetic mutation?

Answer 4

the 11:18 chromosome translocation

Question 5

celiac disease is associated with this tumor?

Answer 5

Enteropathy-associated T cell lymphoma

Question 6

Tumor with positive synaptophysin and neuron-specific enolase

Answer 6

carcinoid tumor

Question 7

PSC vs PBC in the risk of cholangiocarcinoma?

Answer 7

PSC increases risk; PBC does not

Question 8

Patients who are co-exposed hepatitis B and THIS, have a dramatically higher risk of HCC than those with either risk factor individually. (produced by/)

Answer 8

Aflatoxin B1 (aspergillus)

Question 9

exposure to this is associated with hepatic angiosarcoma?

Answer 9

vinyl chloride

Question 10

African immigrants with hepatitis B virus should be screened starting at age?

Answer 10

20

Question 11

Colonoscopy Surveillance After Colorectal Cancer Resection?

Answer 11

1 year -> 3 years -> every 5 years

Question 12

congenital hypertrophy of the retinal pigment epithelium (CHRPE; ie “bear tracks”) found on eye exam.

next step? (why)

Answer 12

EGD/COLO (PPV of 90% for FAP)

Question 13

Additional cancer surveillance in
1) FAP

Answer 13

1) Thyroid US; duodenoscope

Question 14

Lynch Syndrome cancer screenings

Answer 14

colonoscopy every one to two years starting age 20 years,

After 30,
-EGD with antral biopsies q2-3 years
-pelvic exam with endometrial sampling and transvaginal ultrasound every year,
-urinalysis annually starting age 30 years.

Question 15

Cowden - GI pathology?

Answer 15

-hamartomas and ganglioneuromas in the GI tract
-glycogenic acanthosis of the esophagus

Question 16

Hereditary Diffuse Gastric Cancer - associated with this gene?

Answer 16

CDH1 (e-cadherin)

Question 17

Unfavorable histologic features of malignant polyps:

Answer 17

-poorly differentiated
-presence of angiolymphatic invasion
and/or
-positive margin of resection (<1-2 mm from the transected margin)

Question 18

Patient with freckles on her lips and colon polyps - diagnosis? Gene? polyp pathology?

Also needs to be screened for?

Answer 18

Peutz-Jeghers syndrome; STK11, hamartomas

Pancreatic cancer

Question 19

Management strategy for sessile serrated polyposis syndrome?

Answer 19

Colonoscopy every six to 12 months depending on polyp burden.

Colectomy for patients in whom endoscopic surveillance is not possible

Question 20

CDKN2A is the gene for?

Answer 20

familial atypical multiple melanoma and mole (FAMMM) syndrome

Question 21

paraneoplastic condition characterized by migratory superficial thrombophlebitis - aka? Associated with what malignancy?

Answer 21

Trousseau’s syndrome, suggestive of pancreatic adenocarcinoma

Question 22

Pathology of the polyp shows a saw-tooth appearance of the epithelium with basal crypt dilation and boot-shaped crypts without cytologic dysplasia. Type? Associated mutations?

Answer 22

sessile serrated polyp

BRAF mutations and CpG island methylation

Question 23

Tumor with spindle cells.

Metastatic or recurrent lesions are treated with?

Answer 23

GIST

imatinib

Question 24

Pancreatic cyst with columnar epithelium surrounded by ovarian-type stroma. Dx?

After surgical removal, postoperative surveillance?

Answer 24

mucinous cystic neoplasm

None. No role for imaging or EUS