GI Neoplasia I Flashcards

1
Q

What are factors associated with squamous cell carcinoma?

A

alcohol, smoking, urban and lower SEC pop, dietary and environmental factors that cause chronic esophageal irritation, hpv, achalasia, high red meat consumption

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2
Q

What are risk factors associated with adenocarcinoma of esophagus?

A

barrett’s esophagus
GERD
Truncal obesity

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3
Q

What is the stereotypical squamous esophageal cancer patient?

A

60-70 black male smoking alcoholic in the midesophagus

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4
Q

What the steroetypical pt with adenocarcinoma of esophagus

A

white male with barrett’s esophagus in 50s or 60s in the distal esophagus

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5
Q

What are symptoms of esophageal carcinoma?

A

dysphagia, weight loss, odynophagia, aspiration anemia

largely due to narrowing or olceration of esophagus

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6
Q

when do you see hyperplastic gastric polyps?

A

chronic inflammation, h pylori, atrophic gastritis, usually asx (75% of gastric polyps)

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7
Q

What are fundic gland gastric polyps associated with?

A

PPI use or FAP

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8
Q

What are adenomatous gastric polyps?

A

10% of gastric polyps
most are in antrum associated with atrophic gastritis
may be sessile or pendunculated
precursor lesion of some cancers

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9
Q

What is the epidemiology of gastric cancer?

A

lower sec and in developing countries, males more than females, 70s

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10
Q

what are risk factors for gastic cancers?

A
chronic atrophic gastritis
pernicious anemia
prior gastric surgery
high dietary nitrates
adenomatous gastric polyps
h pylori infxn (increases risk 3-6 times)
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11
Q

What are the two most common types of gastric neoplasia?

A

adenocarcinoma and lymphoma

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12
Q

What are symptoms of gastric cancer?

A

early perineural invasion - pain
diaphragmatic invasion leading to hiccoughs
Infiltration - decreased compliance and early satiety with weight loss

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13
Q

What are additional symptoms of gastric cancer in order of frequency?

A

weight loss, abd pain, nausea, dysphagia, melena, early satiety, ulcer-type pain

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14
Q

What are two common physical findings in gastric cancer?

A

virchow’s node - left supraclavicular node

sister mary joseph node - periumbilical nodule

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15
Q

What is linitis plastica?

A

an aggressive diffused gastric cancer that infiltrates the gastric wall with a rigid thickened stomach

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16
Q

what is the waterbottle stoamch associated with?

A

linitis plastica

17
Q

What type of gastric cancer doesn’t require surgery?

18
Q

What mutuation is present in sqcca of esophagus?

Not present

A

p53 is commonly present

KRAS and APC gene are not present in sqcca of esophagus

19
Q

What are the gross appearance of sqcca of esophagus?

A

small gray-white plaque-like thickenings

become protruding flat or excavated

20
Q

What is the molecular pathogenesis of esophageal adenocarcinoma? important question

A

early: p53 mutation or overexpression in barrett’s
allelic loss of silencing by hypermethylation of p16/ink4 cyclin-dependent kinase inhibitor
amplification of HER2 (cERBB2), cyclin D1 or cyclin E

21
Q

Are cellular bridges present in progressed barrett’s esophagus?

22
Q

Why is it hard to determine that esophageal cancer was adenocarcinoma from barrett’s as opposed to mets?

A

Barrett’s causes intestinal epi. So once goblet cells decrease (with increasing malignancy), less signs that it was stoamch-induced metaplasia initially.

23
Q

On histo, what do you see with hyperplastic gastric polyp?

A

hyperplastic mucosal epi

inflamed edematous stroma

24
Q

What are the two types of gastric carcinoma?

A

intestinal type and diffuse type

25
What is the intestinal type of gastric carcinoma?
typically masses, with intestinal metaplasia as precursor
26
What is the diffuse type of gastric carcinoma?
typically linitis plastic, infiltration by single cells resembling signet rings
27
Where is linits plastica typically seen?
lesser curve of stomach
28
T or F: h pylori causes chronic gastritis which causes gastric adenocarcinoma
true
29
linitis plastic has no discrete masses: t or f
true