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Semester 3-GI > Lecture 16-GI Malignancy > Flashcards

Lecture 16-GI Malignancy Flashcards

1
Q

What are the differentials for dysphagia?

A
  • extraluminal: compression of another structure on the oesophagus
  • luminal: wall integrity problems
  • intraluminal: foreign body
  • malignancy: SSC, adenocarcinomas
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2
Q

What are the red flags of dysphagia? HINT: alarm

A 
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Masses/Melaena
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3
Q

What type of carcinoma can develop in the:

1) oesophagus
2) rest of GI tract

A

1) squamous cell carcinoma (SCC)

2) adenocarcinoma

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4
Q

Why can the lower 1/3 of the oesophagus develop adenocarcinoma?

A

If Barrett’s oesophagus has occured

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5
Q

What are the risk factors for oesophageal carcinomas?

A

Smoking, obesity, Barrett’s

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6
Q

What are the red flags for epigastric pain?

A
  • melaena

- haematemesis

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7
Q

What are the commonest causes of epigastric pain?

A
  • oesophageal varices
  • gastric or duodenal ulcers
  • acute gastritis
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8
Q

Where does gastric cancer commonly present?

A

Cardia or antrum

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9
Q

What are the risk factors for gastric cancer?

A

Smoking, high salt diet, family history, chronic inflammation

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10
Q

What is gastric lymphoma?

A

Affects MALT tissue, presents like gastric cancer

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11
Q

How can gastric cancer be treated?

A

Commonly associated with H. Pylori so treat this condition and the cancer should regress

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12
Q

What are GI stromal tumours?

A

Sarcomas (not epithelium)

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13
Q

What are the differentials for jaundice?

A
  • pre-hepatic
  • hepatic
  • post-hepatic
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14
Q

What are the red flags for jaundice?

A
  • hepatomegaly
  • ascites
  • painless (painful more likely to be inflammation or infection)
  • unintentional weight loss
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15
Q

How does pancreatic cancer present?

A
  • if in head: painless jaundice

- if in body/tail: vaguer symptoms of abdo pain

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16
Q

What are the risk factors for pancreatic cancer?

A

Family history, smoking, men > women, chronic pancreatitis

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17
Q

True or false: primary malignancy in the liver is common

A

FALSE - rare

18
Q

Why are metastases common in the liver?

A

Portal system drains all of the GI tract so any malignant cells in the GI organs will go to the liver

19
Q

Which other cancers metastasise to the liver?

A

Breast, prostate

20
Q

What are the symptoms of obstruction?

A

Abdo distension, pain, constipation, nausea and vomiting

21
Q

What are the red flags for obstruction?

A
  • unexplained abdo pain

- unintentional weight loss

22
Q

What are the differentials of obstruction?

A
  • benign: diverticular disease, volvulus, hernias

- malignant: adenocarcinoma of LI, SI cancer

23
Q

What are the symptoms of per rectum bleeding?

A

Fresh bright red bleeding, melaena, anal pain, tenesmus

24
Q

What is tenesmus?

A

Feeling of incomplete emptying of the bowel

25
Q

What are the red flags for per rectum bleeding?

A
  • iron deficient anaemia
  • unexplained weight loss
  • age dependent
  • change in bowel habit
26
Q

What are the differentials of per rectum bleeding?

A
  • benign: haemorrhoids, anal fissures, infective gastroenteritis, IBD, diverticular disease
  • malignant: adenocarcinoma of LI, SI cancer
27
Q

What are the symptoms of change in bowel habit?

A
  • change in frequency
  • change in consistency
  • bloating
  • abdo discomfort
28
Q

What are the red flags for change in bowel habit?

A
  • iron deficient anaemia
  • unexplained weight loss
  • age dependent
  • PR blood loss
29
Q

What are the differentials of change in bowel habit?

A
  • benign: thyroid disorder (underactive -> constipation and vice versa), IBD, medication related (metformin -> runny, opiods -> constipation), IBS, coeliac disease
  • malignant: adenocarcinoma of LI, SI cancer
30
Q

Which cancer is the 3rd commonest in the UK?

A

Large bowel adenocarcinoma

31
Q

What are the risk factors of large bowel cancer?

A

Family history, IBD, FAP, diet

32
Q

At what age are people screened for large bowel cancer and how often?

A

60-74 y/o

Every 2 years

33
Q

How can polyps cause adenocarcinoma?

A

-benign growth from genetic changes -> abnormal differentiation -> dysplastic cells -> carcinoma

34
Q

True or false: left sided colon cancer is more common than right side

A

TRUE

35
Q

What are the symptoms of left sided colon cancer?

A

Overflow diarrhoea, weight loss, abdo pain, rectal bleeding, bowel obstruction, tenesmus

36
Q

What are the symptoms of right sided colon cancer?

A

Weight loss, anaemia, RIF mass

37
Q

What are the five types of small bowel cancer?

A
  • stromal
  • lymphoma
  • adenocarcinoma
  • sarcoma
  • carcinoid tumours
38
Q

What are the risk factors for small bowel cancer?

A

IBD, coeliac disease, FAP, diet, any chronic inflammatory process

39
Q

What are the symptoms of small bowel cancer?

A

Weight loss, abdo pain, blood in stools

40
Q

Which tumour marker can indicate GI malignancy (adenocarcinoma)?

A

CEA = carcinoembryonic antigen

41
Q

What are the treatment options for GI malignancy?

A

Chemo, radiotherapy, surgical resections

Semester 3-GI (14 decks)

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