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GI > Lecture 17 GI malignancy > Flashcards

Lecture 17 GI malignancy Flashcards

1
Q

Benign differentials of upper GI pathology

A

Dysphagia
Jaundice
Epigastric pain

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2
Q

Benign differentials of lower GI pathology

A

Change in bowel habit
PR bleeding
Bowel obstruction

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3
Q

Categories of dysphagia

A

Extraluminal - From outside
Luminal - inside wall
Intraluminal - inside lumen e.g. foreign body obstruction

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4
Q

Red flags for dysphagia

A 
Anaemia
Loss of weight
Anorexia
Recent onset of progressive symptoms
Masses/maleana
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5
Q

Malignancies of GI

A

Oesophagus - Squamous cell carcinoma

Rest of GI tract - adenocarcinoma

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6
Q

Barret’s oesophagus

A
  1. GORD
  2. SSC - Columnar
  3. Adenocarcinoma
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7
Q

Oesophageal carcinoma

A

Presents with: progressive dysphagia
[common spread]

Risk factors: Smoking, Barret’s oesophagus

Prognosis: 5% survival at 5 years (poor)

Investigation:
Barium swallow - narrowing of oesophagus due to outgrowth

Endoscopic biopsy

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8
Q

Causes of epigastric pain

A

Oesophageal varices
Duodenal ulcer
Gastric ulcer
Acute gastritis

Can cause malaena or haematemsis

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9
Q

Gastric cancer

A

Adenocarcinoma in cardia or antrum

Similar pain to peptic ulcer with 50% having a palpable mass

RF:
Smoking 
High salt diet
Family history 
H pylori and gastric ulcers 
Chronic inflammation

Prognosis: 10% 5 year survival (poor)
Post curative surgery 50%

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10
Q

Other gastric cancers

A

MALT - gastric lymphoma

Gastrointestinal stromal tumours - sarcomas

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11
Q

Red flags for liver cancer

A 
Jaundice
Hepatomegaly - irregular border
Painless
Unintentional weight loss
Ascites
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12
Q

Hepatocellular carcinoma

A

Primary malignancy rare

Portal vein drains GI therefore common site for metastases

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13
Q

Malignancies that commonly metastasis to liver

A 
Prostate
Breast 
Kidney
Lungs
Skin
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14
Q

Pancreatic cancer

A

Pancreatic head: Jaundice - obstruct common bile duct

Tail and body - vague symptoms- steatorrhoea due to decreased lipase release

Rapidly invasive - poor prognosis

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15
Q

RF for pancreatic cancer

A 
Family history
Male
Smoker
Age 
Chronic pancreatitis
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16
Q

Obstruction of lower GI tract

A

Abdominal distention - air Abdominal pain

17
Q

Size of Intestines

A

Small bowel - 3cm
Large bowel - 6cm
Caecum - 9cm

18
Q

Benign causes of lower GI obstruction

A 
Hernia
Diverticulum 
Volvulus
Strictures
Intussusception 
Pyloric stenosis
19
Q

Intussusception

A

One part of bowel slides into another

20
Q

Benign differentials for PR bleeding

A 
Haemorrhoids
Anal fissure
Ulcerative cystitis 
Infective gastroenteritis 
Diverticula disease
21
Q

PR bleeding types

A

Brigh red - sigmoid colon, rectum and anal canal

If dark and looks like maleana - colon

22
Q

Red flags for PR bleeding

A 
Age dependent - 50 + yrs
Change in bowel habit
Unexplained weight loss
Tenesmus
Iron deficient anaemia
23
Q

Benign differentials for change in bowel habit

A 
Thyroid disorder
IBD
Medication
Infection
IBS
Coeliac disease
24
Q

Red flags for change in bowel habit

A

PR bleeding
Age dependent
Unexplained weight loss
Iron deficient anaemia

25
Q

Large bowel cancer

A

3rd most common cancer in UK
Adenocarcinoma

RF:
Family history
Polyposis - FAP
Low fibre diet 
Inactive
26
Q

Right sided large bowel cancer

A
  • Weight loss
  • Anaemia - occult bleeding
  • Less likely for obstruction
  • Right iliac fossa mass
  • More advanced when presented
  • Late change in bowel habit
  • Fungating
27
Q

Left sided large bowel cancer

A
  • Weight loss
  • Rectal bleeding
  • Obstruction
  • Left iliac fossa mass
  • Less advanced when presents as narrower
  • Early change in bowel habits
  • Stenosing
28
Q

Small bowel cancer types

A 
Carcinoid
Lymphoma
Adenocarcinom
Sarcoma
Stromal
29
Q

RF for small bowel cancer

A

Inflammatory bowel disease
FAP
coeliac disease

30
Q

Symptoms of small intestine cancer

A

Weight loss
Abdominal pain
Haematochezia

31
Q

Management of bowel cancer

A

Bloods - FBC and markers
CT/MRI
Endoscopy
TNM staging

32
Q

Treatment of bowel cancer

A

Chemotherapy
Radio therapy
Surgical resection

GI (18 decks)

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