Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Session 8: GI Cancer > Flashcards

Session 8: GI Cancer Flashcards

1
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give examples of GI cancers (broad)

A

Oesophageal cancer Gastric cancer Pancreatobiliary cancers Hepatocellular carcinoma Colorectal cancers Anal cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the red flags of upper GI malignancy?

A

Dysphagia Epigastric pain Jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the red flags of lower GI malignancy?

A

Bowel obstruction PR bleeding Change in bowel habits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the differentials of dysphagia? (Where is the mass found?)

A

Extraluminal Luminal Intraluminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Red flags of dysphagia

A

ALARM Anaemia Loss of weight (unintentional) Anorexia Recent onset of progressive symptoms Masses/Malaena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Subtypes of oesophageal cancer

A

Oesophageal squamous cell carcinoma Oesophageal adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common oesophageal cancer?

A

Oesophageal squamous cell carcinoma even though there is a decreasing incidence of it and an increasing incidence of oesophageal adenocarcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Location of oesophageal squamous cell carcinoma.

A

Upper oesophagus of stratified squamous epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Location of oesophageal adenocarcinoma.

A

Distal oesophagus and gastroesophageal junction in columnar epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk factors of oesophageal squamous cell carcinoma.

A

Tobacco smoking and alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Risk factors of oesophageal adenocarcinoma.

A

Obesity Reflux disease Metabolic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pathophysiology of oesophageal squamous cell carcinoma.

A

Chronic mucosal injury caused by tobacco or alcohol.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pathophysiology of oesophageal adenocarcinoma

A

Chronic acid reflux leading to Barrett’s oesophagus. Epithelial metaplasia from squamous to columnar epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical presentation of oesophageal cancer.

A

Dysphagia Chronic reflux Unintentional weight loss Anorexia Malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diagnosis of oesophageal cancer.

A

Endoscopy Biopsy Endoscopic US Assessment of T&S CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment of oesophageal cancer.

A

Surgery resection Chemoradiation Improve QOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Prognosis of oesophageal cancer.

A

5% at 5 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Subtypes of gastric cancer.

A

Diffuse gastric cancer Intestinal gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Demography of diffuse gastric cancer.

A

Young age Signet ring cells Increasing incidence Worse prognosis Can be hereditary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Demography of intestinal gastric cancer.

A

Older patients History of intestinal metaplasia Decreasing incidence Better prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where will gastric adenocarcinomas most commonly be found?

A

In the cardia or antrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Risk factors of gastric cancer.

A

Poor food hygiene and most importantly Helicobacter pylori. Food preservatives Smoking High salt diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is there a bad prognosis of gastric cancers?

A

Because most present late and are often far advanced by then.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Red flags of gastric cancer.

A

Haematemesis Malaena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Other common symptoms in gastric cancer.

A

Triad of symptoms: anorexia, anaemia and asthenia. Dysphagia Satiety Epigastric pain Nausea Vomiting GI bleeds Can have a very similar presentation to peptic ulcers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Diagnosis of gastric cancer.

A

Oesophagogastroduodenoscopy. Biopsy CT for metastatic disease Screening is common in Japan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Treatment of gastric cancer.

A

Surgery if it is non-metastatic. This involves removal of stomach, lymph nodes and spleen which can be common in Japan and SK. Chemoradiation if metastatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Prognosis of gastric cancer.

A

10% 5y survival 50% after curative surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Give examples of other cancers that can occur in the stomach.

A

Gastric lymphoma Gastrointestial stromal tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Red flags of jaundice.

A

Hepatomegaly Unintentional weight loss Painless Ascites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Give subtypes of pancreatobiliary cancers.

A

Pancreatic ductal carcinoma Cholangiocarcinoma Pancreatic neuroendocrine tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Location of pancreatic ductal carcinoma.

A

Pancreatic head is most commonly affected. If the body or tail are affected then the symptoms tend to be more vague.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Risk factors of pancreatic ductal carcinoma.

A

Smoking Chronic pancreatitis BRCA1/2 and PALB2 mutations Peutz-Jeghers Lynch syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pathophysiology of pancreatic ductal carcinoma.

A

Accumulation of mutations in the pancreatic duct epithelium. Pancreatic intraepithelial neoplasia leading to invasive adenocarcinoma and fibrotic stroma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Red flags of pancreatic ductal carcinoma.

A

Painless jaundice Epigastric pain Unintentional weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Clinical presentation of pancreatic ductal carcinoma.

A

Painless jaundice Epigastric pain Unintentional weight loss Anorexia Malaise Steatorrhoea Venous thromboembolism

38
Q

Diagnosis of pancreatic ductal carcinoma.

A

CT/US/MRI Endoscopic US Biopsy

39
Q

Treatment of pancreatic ductal carcinoma.

A

Surgery (very risky) Chemoradiation Improve QOL

40
Q

Prognosis of pancreatic ductal carcinoma.

A

<5%

41
Q

What are cholangiocarcinomas?

A

Defined as arising from biliary epithelium. They are either intrahepatic or extra hepatic or gallbladder cancers. They are often found incidentally.

42
Q

Why might cholangiocarcinomas be found on accident?

A

Because their similar presentation to cholelithiasis and cholecystitis.

43
Q

Location of cholangiocarcinomas.

A

Biliary system

44
Q

Risk factors of cholangiocarcinoma.

A

Chronic inflammation of biliary system. PSC Cholelithiasis Infection

45
Q

Clinical presentation of cholangiocarcinomas.

A

Painless/painful jaundice Epigastric pain Anorexia Unintentional weight loss Malaise Symptoms of cholelithiasis or cholecystitis.

46
Q

Diagnosis of cholangiocarcinoma.

A

CT/US/MRI Endoscopic US Biopsy

47
Q

Treatment of cholangiocarcinoma.

A

Surgery (very risky) Chemoradiation Improve QOL

48
Q

Prognosis of cholangiocarcinoma.

A

<10%

49
Q

What are pancreatic neuroendocrine tumours?

A

Tumours of pancreatic parenchyma. They can be non-functional or functional. If they are functional they might affect insulin, glucagon, gastrin or vasoactive intestinal peptide.

50
Q

Location of pancreatic neuroendocrine tumours.

A

Pancreas

51
Q

Pathophysiology of pancreatic neuroendocrine tumours.

A

Originate from endocrine cells in pancreas

52
Q

Clinical presentation of pancreatic neuroendocrine tumours.

A

Symptoms related to its functionality. Hypoglycaemia Hyperglycaemia Zollinger-Ellison syndrome Diarrhoea with electrolyte imbalance

53
Q

Diagnosis of pancreatic neuroendocrine tumours.

A

CT/MRI/US Endoscopic US Biopsy Scintigraphy

54
Q

Treatment of pancreatic neuroendocrine tumours.

A

Surgery Somatostatin Improve QOL

55
Q

Prognosis of pancreatic neuroendocrine tumours.

A

<10%

56
Q

What is hepatocellular carcinoma?

A

The most common primary liver cancer.

57
Q

Are primary liver cancers common?

A

No

58
Q

What liver cancers are more common?

A

Secondary malignancy

59
Q

How can cancer spread to the liver?

A

Blood via the portal system Lymphatics Ovaries (transcoelomic) Lungs Breast

60
Q

Risk factors of hepatocellular carcinoma

A

Cirrhosis Alcohol Hep B Hep C

61
Q

Clinical presentation of liver cancer.

A

Abdominal distention Ascites Fatigue Muscle wasting Anorexia Encephalopathy RUQ pain

62
Q

Diagnosis of hepatocellular carcinoma.

A

Can be done without histological confirmation. Cirrhosis Elevated alpha-fetoprotein CT/MRI

63
Q

Treatment of hepatocellular carcinoma.

A

Surgery Liver transplant Ablation Chemoradiation

64
Q

What types of colorectal cancers are most common?

A

Adenomas They are commonly demonstration by familial adenomatous polyposis

65
Q

What subtypes of colorectal cancers are there? (anatomical)

A

Right sided and left sided.

66
Q

Risk factors of colorectal cancers.

A

High dietary fat Red meat Low fibre diet Obesity Alcohol IBD Polyposis syndromes such as FAP and HNPCC

67
Q

Pathophysiology of colorectal cancer.

A

Arise in polyps. 3 major pathways which may occur - Adenomacarcinoma sequence DNA mismatch repair pathway - Promoter methylation

68
Q

Red flags of colorectal cancer.

A

Altered bowel habits Obstructive symptoms Rectal bleeding

69
Q

Clinical presentation of right-sided colorectal cancer.

A

Weight loss Anaemia Not common to have bowel obstruction Mass in right iliac fossa Late change in bowel habits Fungating

70
Q

Clinical presentation of left-sided colorectal cancer.

A

Weight loss Rectal bleeding Bowel obstruction Mass in left iliac fossa Early change in bowel habits Stenosing Tenesmus

71
Q

What is usually more advanced upon discovery, L or R.

A

Right sided.

72
Q

Why is right sided usually more advanced?

A

Because symptoms show up later. Caecum and ascending colon is also more distensible.

73
Q

DXR of bowel obstruction.

A

Volvulus Diverticular disease Hernias Strictures Pyloric stenosis

74
Q

DXR of PR bleed

A

Haemorrhoids Anal fissures Infective gastroenteritis IBD Diverticular disease

75
Q

DXR of altered bowel habits

A

Thyroid disease IBD Meds IBS Coeliac disease

76
Q

General clinical presentation of colorectal cancer.

A

Altered bowel habits Obstructive symptoms PR bleeding Abdo distention Abdo pain Haematochezia Ascites Anorexia, malaise and unintentional weight loss Tenesmus

77
Q

Diagnosis of colorectal cancer.

A

Screening Colonoscopy is golden standard. Sigmoidscopy Barium enema CT/MRI

78
Q

Treatment of colorectal cancer.

A

Surgery Laparoscopy Chemoradiation

79
Q

Prognosis of colorectal cancer.

A

50-95%

80
Q

Location of anal cancer.

A

Anal canal

81
Q

Risk factors of anal cancer.

A

HPV infection HIV Anal receptive intercourse Condyloma acuminate

82
Q

Pathophysiology of anal cancer.

A

Squamous cell carcinoma. HPV 16&18 inactivation of TSGs TP53 and RB1 by viral proteins E6 and E7 Chronic inflammation by IBD Recurrent anal fissures and fistulas

83
Q

Clinical presentation of anal cancer.

A

Perianal pruritus and pain Bleeding Discharge Mass-like sensation Non-healing anal or perianal lesions Anorexia, unintentional weight loss and malaise

84
Q

Diagnosis of anal cancer

A

Physical examination CT of chest, abdo and pelvis Inguinal lymph node inspection as it is a common site of early spread.

85
Q

Treatment of anal cancer

A

Preventive by vaccination Curable without surgical resection Chemoradiation Permanent colostomy

86
Q

Prognosis of anal cancer.

A

70% by chemoradiation

87
Q

Give examples of changes in bowel habits.

A

Frequency Consistency Any other associated symptoms

88
Q

How is large bowel cancer screened for?

A

Faecal occult Blood sample

89
Q

Explain how malignancy can arise from a polyp.

A

Hyperproliferation of the epithelium occurs. This leads to formation of a polyp. The polyp will then undergo dysplasia to form an adenocarcinoma. The adenocarcinoma will then usually start by growing out into the lumen of the bowel. However they can become invasive, this is when they are more prone to metastasise.

90
Q

Give examples of small bowel cancers.

A

Stromal Lymphoma Adenocarcinoma Sarcoma Carcinoid tumours

91
Q

How is staging assessed in GI malignancy?

A

By Duke’s staging (A-D)

92
Q

What is the most common site for a gastrointestinal lymphoma?

A

The stomach

GI (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions