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GI System > Session 8- Upper and Lower GI malignancies > Flashcards

Session 8- Upper and Lower GI malignancies Flashcards

1
Q

what are some benign causes of dysphagia

A

strictures
foreign bodies
nerve palsies

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2
Q

what are some malignant causes of dysphagis

A

squamous cell carcinoma

adenocarcinoma

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3
Q

what carcinoma arises from stratified squamous epithelium

A

squamous cell carcinoma

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4
Q

what type of epithelia does a adenocarcinoma arise from

A

simple columnar epithelium

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5
Q

how can we diagnose barretts oesophagus

A

endoscopy - can take biospy

barium swallow - cant take biopsy

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6
Q

what is the prognosis of barretts

A

5 years

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7
Q

red flags of upper GI malignancy

ALARM

A 
a- anaemia
l- loss of weight
a- anorexia
r- recent onset of progressive symtoms
m-masses- maleana
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8
Q

what three ways can a oesophagel malignancy be

A

intra-luminal
extra-luminal
luminal

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9
Q

red flags of epigastric pain

A

maleana

haemtemesis

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10
Q

what causes haematemesis

A

varices
ulcers
mallory-weiss- tears in oesophagus

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11
Q

benign causes of epigastric pain

A

gastritis
peptic ulcers
pancreatitis

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12
Q

where can an adenocarcinoma present in stomach

A

antrum

cardia

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13
Q

risk factors for gastric cancer

A 
high salt diet
smoking
FHx
H. pylori 
old age ]men
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14
Q

how can you get malignancy in the liver

A

hepatocellular carcinoma- cirrhosis

metastises - portal circulation

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15
Q

what are common metasis to the liver

A 
breast
colon
lung 
skin 
ovaries
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16
Q

how can metastise to the liver

A

haemtogenous
transcoelemic
lymph

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17
Q

what are the majorty of pancreatic cancers

A

exocrine- 90%

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18
Q

what is an exocrine pancreatic cancer

A

ductal adenocarcinoma

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19
Q

how does a ductal adenocarcinoma affect the pancreas

A

head- jaundice as it interfers with billary flow into duodenum
tail/body- malabsorption

20
Q

risk factors for pancreatic cancer

A 
FHx
smoking
male
old age 
chronic pancreatitis
21
Q

what is a malignancy of the bie dicts called

A

cholangiocarcinoma

22
Q

what are the 2 forms of oesophageal cancer

A

adenocarcinoma

squamous cell carcinoma

23
Q

what are adenocarcinomas linked to

A

barretts oesophagus

24
Q

what are the most common form of pancreatic malignacies

A

ductal adenocarcinomas`

25
Q

what are most colerectal cancers

A

adenomas

26
Q

what is familial adenomatous polyposis

A

autosomal dominant condition caused by a mutation in the APC gene( tumour suppressor gene) where invariably the
numerous polyps arise which can undergo dysplasia and become a cancer

27
Q

what are colorectal cancers linked to

A

several genetic events such as the
activation of oncogenes, ineffective DNA repair and the loss of tumour
suppressor genes

28
Q

where do most colorectal cancers occur

A

sigmoid colon -30%

rectum - 50%

29
Q

how do small bowel obstructions present compared with large

A

vomiting in small bowel wheres constipation in large bowel

30
Q

benign causes of PR bleeding

A 
haemorrhoids 
anal fissures
IBS
diverticular disease 
infective gastroenteritis
31
Q

what is tenesmus

A

feeling the need to pass stools even though bowel is empty

32
Q

how do right sided malignancies grow

A

fungating, gow out into lumen

33
Q

where is obstruction more likely on the right or left side

A

left -descending colon

34
Q

how do malignanies grow in left side

A

stenosing- obstruct lumen

lumen is narrower

35
Q

how do we investigate large bowel cancer

A

colonoscopy

endoscopy

36
Q

blood tests for large bowel cancer

A

FBC
Tumour marker
CEA
CA19-9

37
Q

risk factors of small nowel cancer

A

FAP
IBD
coeliac

anything that causes the growth of polyps/inflammation

38
Q

what is common cause of chronic gastritis

A

infection with H pylori

39
Q

How does autoimmune gastritis result in Vit B12 deficiency?

A

Antibodies to the parietal cells not only affect the acid production, but also the release of intrinsic factor.
Intrinsic factor is required for the binding of B12 and its subsequent absorption.

40
Q

State one way that H-pylori can interfere with the mucus layer lining the stomach epithelium

A

It releases mucinases (enzymes that breakup mucus)

41
Q

Colonisation of which region of the stomach, by H-pylori, can increase the likelihood of duodenal
ulceration?

A

antrum

42
Q

To qualify as a peptic ulceration, what layer of the gastric or duodenal wall must the erosion pass
through?

A

muscularis mucosae

43
Q

In basic terms, what causes Malaena?

A

Slow upper gastrointestinal bleed. Blood is oxidised as it passes through gut turning stool black

44
Q

where are meckels diverticuli commonly situated

A

middle to distal ileum

45
Q

where in the oesophagus do you get adenocarcinomas

A

lower third

GI System (16 decks)

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