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Phase 2a Gastrointestinal system > GI tumours > Flashcards

GI tumours Flashcards

1
Q

What are the two types of oesophageal tumour (pathology)?

A

Adenocarcinoma and squamous cell carcinoma

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2
Q

What part of the oesophagus does an adenocarcinoma usually affect?

A

The lower 1/3 of the oesophagus

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3
Q

What is pre-malignant for oesophageal adenocarcinoma?

A

Barret’s oesophagus

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4
Q

What is associated with oesophageal adenocarcinoma?

A

GORD (obesity)

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5
Q

What part of the oesophagus does SCC affect usually?

A

Middle 1/3 of the oesophagus

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6
Q

What is the mechanism for the formation of adenocarcinoma in the oesophagus?

A

Squamous ep. –> metaplasia (Barret’s oesophagus) –> dysplasia –> neoplasia (adenocarcinoma)

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7
Q

What is SCC assoc. w/?

A

Smoking, excessive alcohol, HOT foods (coffee)…

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8
Q

What does metaplasia mean? Give an example

A

The change in epithelium of one fully differentiated cell type to another fully differentiated cell type - e.g. Barrett’s oesophagus

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9
Q

What are the symptoms of oesophageal cancer?

A

PROGRESSIVE DYSPHAGIA (first solids and then liquids), weight loss, chest pain, hoarse voice

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10
Q

How would you diagnose oesophageal cancer?

A

Endoscopy + tumour biopsy

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11
Q

What is the treatment for oesophageal cancer if it is local?

A

Pre-op CTx + RTx and surgical resection

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12
Q

What is the prognosis for oesophageal cancer?

A

Poor

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13
Q

Which country has a high prevalence of gastric cancer?

A

Japan

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14
Q

What type of symptoms will be present in gastric cancer?

A

TARRY STOOLS, pain, dysphagia (if cardia), vomiting + outflow obstruction (pylorus), nausea, weight loss…

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15
Q

What type of cancer is gastric cancer? Where does it normally affect?

A

Adenocarcinoma - the antrum

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16
Q

What investigations would you do for gastric cancer diagnosis?

A

Endoscopy + biopsy

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17
Q

What nodes are commonly palpable in gastric cancer?

A

Supraclavicular

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18
Q

What two features might you find on examination for someone with gastric cancer?

A

Palpable epigastric mass and supraclavicular nodes

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19
Q

What is associated with the development of gastric adenocarcinoma?

A

Pernicious anaemia, smoking, H. pylori, pickles/preserved foods…

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20
Q

What is associated with gastric lymphoma?

A

H. pylori infection

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21
Q

Give 3 examples of small intestine tumours:

A

Carcinoid (neuroendocrine tumour), adenocarcinoma, NHL

22
Q

What do carcinoid tumours develop from? What do they secrete?

A

Enterochromaffin cells (secrete SEROTONIN,

23
Q

what is the 1st metastases site for small intestine tumours/

A

Liver (through the portal vein)

24
Q

How would you investigate carcinoid tumour

A

5HIAA in the urine, liver mets (USS)

25
Q

What is the treatment for carcinoid tumour?

A

5-HT antagonist (cyproleptadine), RTx, surgical resection…etc

26
Q

What is pre-malignant for pancreatic cancer?

A

Chronic pancreatitis

27
Q

What are the commonest pancreatic cancers?

A

Adenocarcinoma of the pancreatic ducts

28
Q

What clinical features would be present if the pancreatic cancer is at the head of the pancreas or ampulla of vater?

A

Jaundice, scratch marks, Distended gall bladder, central abdominal mass, weight loss

29
Q

What clinical features would be present if the pancreatic cancer is in the body or tail of the pancreas?

A

Weight loss, anorexia, abdominal pain (epigastric)

30
Q

What are the general features of pancreatic cancer?

A

DM, weight loss, epigastric pain, central abdominal mass, anorexia

31
Q

What tumour marker is raised in pancreatic cancer?

A

CA19-9

32
Q

What investigations would you carry out to diagnose pancreatic cancer and what would you see?

A

Serum tumour marker CA19-9 ^
ERCP for cytology
USS (dilated bile ducts + mass lesion) - same with CT scan

33
Q

What are most intestinal polyps?

A

Adenomas

34
Q

What is an adenoma?

A

A benign neoplasm of glandular epithelium

35
Q

What is the precursor lesion for an colorectal cancer?

A

Adenoma polyps

36
Q

What is are the causes of adenomatous polyps?

A 
Most = idiopathic
5% = Family colon cancer sydromes (HNPCC and FAP)
37
Q

Which family colon cancer syndrome has 100% risk of getting colorectal cancer?

A

FAP

38
Q

What are the risk factors for developing colorectal cancer?

A

HNPCC, FAP, FHx of colorectal cancer, increase in age, diet high in meat but low in fibre

39
Q

What is the commonest colorectal cancer pathology?

A

Adenocarcinoma

40
Q

In which region of the large intestine do most tumours occur?

A

L side

41
Q

What criteria is used to stage colorectal cancer?

A

TNM or Duke’s criteria

42
Q

Do all adenomatous polyps develop into adenocarcinomas? What happens if one is seen on endoscopy?

A

No - most don’t. If seen on endoscopy it is removed

43
Q

What are the symptoms of colorectal cancer?

A

CHANGE IN BOWEL HABIT, Rectal bleeding, weight loss, lethargy, malaise, INTESTINAL OBSTRUCTION (colicky pain and constipation)

44
Q

What are the signs of colorectal cancer?

A

Distension (abdomen), palpable mass

45
Q

What is the gold standard investigation for colorectal cancer?

A

Colonoscopy with biopsy

46
Q

What blood tests would you do to investigate colorectal cancer?

A

FBC (anaemia), tumour marker (^), LFTs (liver mets = abnormal LFTs)

47
Q

What radiological investigations would you do?

A

PET scan, CT (chest, abdo and pelvis)

48
Q

What tumour marker is raised in colorectal cancer?

A

CEA (carcinoembryonic antigen)

49
Q

Describe the screening programme for colorectal cancer in the UK

A

M + W (60-74); biannual (2x/yr) faecal occult blood test; if +ve then colonoscopy indicated

50
Q

What part of the large colon is most affected by colorectal cancer?

A

Sigmoid colon + rectum

Phase 2a Gastrointestinal system (4 decks)

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