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Phase 2a GI > Oesophageal, Gastric & SI carcinomas/cancer > Flashcards

Oesophageal, Gastric & SI carcinomas/cancer Flashcards

1
Q

What are 2 types of oesophageal cancers? mc?

A

Squamous cell carcinoma - MC
Adenocarcinoma

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2
Q

Squamous cell carcinoma
Where is it found?
Derived from?
RF?

A

Upper 2/3 oesophagus
derived from squamous epithelium
RF = Smoking, alcohol, hot fluids (causes damage + divide)

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3
Q

Adenocarcinoma
Where is it found?
Derived from?
RF? associated with?

A

Lower 1/3 oesophagus
derived from columnar glandular epithelium
Parrets oesophagus (due to GORD)
ssnke –> simple columnar (metaplasia)

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4
Q

Sx of oesophageal cancer?

A

Presents when advanced = poor prognosis
ALARMS

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5
Q

What does ALARMS stand for?

A

Anemia
Loss of weight
Anorexia
Recent sudden Sx worsening
Melena
Swallowing progressive difficulty (dysphagia)
(First it was hard to swallow steak, then potatoes, now heard to swallow soup) - non progressive would be Achalasia (DDX)

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6
Q

Dx of oesophageal cancer?

A

OGD (oesophageal gastroduodenoscopy) + biopsy with barium swallow

PET/CT for staging

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7
Q

Tx for oesophageal cancer?

A

Medically fit = chemo/radio + surgery
Unfit = palliative

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8
Q

What are some red flag signs to look out for and what would you do?

A

ALARMS + >55y/o
do endoscopy/colonoscopy

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9
Q

What is gastric cancer?

A

Malignant/cancerous cells in stomach

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10
Q

What type of cells are they mostly?
T1 & T2?
typically at?

A

Mostly adenocarcinoma (from columnar epithelium)

T1 (Intestinal) - well differentiated - better prognosis MC

T2 (Diffuse) - undifferentiated ‘signet ring’ carcinomas - worse prognosis

Proximal stomach

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11
Q

Causes of gastric cancer?

A

H.Pylori (intestinal)
Smoking
CDH-1 Mutation (mutated cadherin gene); 80% risk + fHx - diffuse
Pernicious anemia (autoimmune chronic gastritis)

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12
Q

Sx of gastric cancer?

A

severe epigastric pain (same as gastritis but worse)

Anemia (Fe def, occult loss), weight loss, tired all the time, Progressive dysphagia

Metastasis signs =
Jaundice - liver mets
Krukenberg tumour - ovarian mets from gastric cancer

+ lymph node spread
-Virchows node = supraclavicular
-sister Mary Joseph node - umbilical

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13
Q

Dx of gastric cancer?

A

Gastroscopy + biopsy
CT/MRI for staging, PET to ID mets
staging = TNM

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14
Q

Tx for gastric cancer?

A

Surgery and ‘ECF’ chemo regime, if resectable

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15
Q

SI carcinomas
chance of tumour there?
Most are?

A

Pretty tumour resistant
low chance of tumour here (1% all GI tumours)
Most are adenocarcinomas

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16
Q

RF for SI carcinomas?
DX and TX?

A

Chronic SI disease eg, crohns, coeliacs
same Dx and Tx as gastric

Phase 2a GI (14 decks)

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