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SURGICAL DISEASES > TH7 GASTROINTESTINAL CANCERS > Flashcards

TH7 GASTROINTESTINAL CANCERS Flashcards

1
Q

WORLDWIDE, MOST COMMON CANCER?

A

GASTRIC CANCER 4TH MOST COMMON

2ND LEADING CAUSE OF CANCER DEATH

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2
Q

IN WHICH GENDER IS STOMACH CANCER MORE COMMON

A

MEN (2:1) WOMEN

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3
Q

WHICH STOMACH CANCER HAS WORSE PROGNOSIS BASED ON THEIR LOCATION?

A

PROXIMALLY PLACED TUMOURS WORSE THAN SITE DISTALLY

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4
Q

DEFINE EARLY GASTRIC CANCER?

A

TUMOUR CONFINED TO GASTRIC MUCOSA + SUBMUCOSA

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5
Q

DEFINE ADVANCED GASTRIC CANCER?

A

DEEPER INVASION OF TUMOUR OTHER THAN GASTRIC MUCOSA + SUBMUCOSA

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6
Q

WHICH ARE THE VARIATION IN THE GROSS APPEARANCE OF ADVANCED GASTRIC CANCER?

A
  1. POLYPOID FUNGATING TUMOUR
    - nodular polypoid surface with superficial ulceration
  2. ULCERATING CANCER
    - may look like benign gastric ulcer
  3. SUPERFICIAL SPREADING CARCINOMA
    - diffusely infiltrative over wide area
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7
Q

DEFINE LINITIS PLASTIC CARCINOMA?

A

SUB GROUP OF DIFFUSELY INFILTRATIVE GASTRIC CANCER

> extensive infiltration of submucosa + muscular layer w/ marked fibroblastic/desmoplastic reaction around columns of malignant cells

> spreads to muscles of stomach + makes it more thicker + rigid

> stomach can’t stretch as much + hold much

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8
Q

MOST DEFINITIVE DIAGNOSIS OF GASTRIC NEOPLASM?

A

FIBROPTIC ENDOSCOPY

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9
Q

HOW IS BENING DIFFERENTIATED FROM MALIGNANT GASTRIC ULCERS?

A

ONLY WITH GASTRIC BIOPSY

ACCURACY CAN EXCEED 95% WITH MULTIPLE BIOPSY SPECIMEN

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10
Q

WHICH FORM OF THERAPY IS CURATIVE FOR GASTRIC CANCER?

A

RADICAL SURGERY

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11
Q

WHICH IS MOST COMMON MALIGNANT TUMOUR OF SMALL BOWEL?

A

CARCINOID TUMOURS

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12
Q

WHAT IS THE ORIGIN OF CARCINOID TUMOURS?

A

ORIGINATE > ENTEROCHROMAFFIC CELLS
> form part of a system of neuroendocrine cells scattered throughout body

> these cells found in mucus membrane of gut near base of crypts

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13
Q

WHAT IS THE MOST COMMON LOCALISATION OF CARCINOID TUMOURS?

A

MOST COMMON > APPENDIX

FOLLOWED BY JEJENUM, RECTUM + DUODENUM

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14
Q

CLINICAL PRESENTATION OF CARCINOID SYNDROME?

A

FLUSHING
DIARRHOA
WHEEZING

> occurs when carcinoid metabolites secreted directly into circulation from hepatic metastasis

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15
Q

WITH WHICH OTHER DISEASE IS ADENOCARCINOMAS OF TERMINAL ILEUM MOSTLY ASSOCIATED WITH?

A

CROHNS DISEASE

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16
Q

WHAT IS THE ANATOMICAL DISTRIBUTION OF COLORECTAL CANCER?

A 
RECTUM 57%
SIGMOID COLON 21%
DESCENDING COLON 3%
SPLENIC FLEXURE 3%
TRANSVERSE COLON 5%
HEPATIC FLEXURE 2%
ASCENDING COLON 3%
CECUM 6%
17
Q

GROSS PATHOLOGY FORMS OF COLORECTAL CANCER?

A 
MACROSCOPICALLY COLORECTAL CX CLASSIFIED:
> POLYPOID
> ULCERATIVE 
> ANNULAR 
> COMBINATION OF ALL 3
18
Q

WHICH METHOD IS USEFUL IN DX + PREOPERATIVE STAGING OF TUMOURS OF RECTUM?

A

ENDORECTAL ULTRASONOGRAPHY

19
Q

MOST COMMON SITE FOR METASTASIS OF COLORECTAL CARCINOMA?

A 
LIVER 
followed by LUNG
RETROPERITONEUM
OVARY 
PERITONEAL CAVITY 
RARELEY ADRENAL GLANDS
20
Q

MOST COMMON COMPLICATION OF LEFT SIDED COLON CANCER?

A

COMPLETE OBSTRUCTION OF LARGE BOWEL (ILEUS)

21
Q

MOST COMMON COMPLICATION OF RIGHT SIDED COLON CANCER?

A

IRON DEFIEINCY ANAEMIA > due to protracted occult blood loss

22
Q

HOW MOST COMMONLY ARE PRESENTED ADVANCED RECTAL CANCER?

A

TENESMUS - continues urge to defecate
> can give continuous sacral pain + sometimes radiating down to perineal + thighs > as tumour invades sacrum + sacral nerve plexus

23
Q

WHAT SHOULD BE THE COMPLETION OF PHYSICAL EXAMINATION IN SUSPICION OF RECTAL CANCER?

A

DIGITAL RECTAL EXAMINTION TO FEEL FOR MASS
ASSESS MOBILITY + POSITION
DETECT ENLARGED, EXTRARECTAL LYMPH NODES

24
Q

WHY SHOULD ALL PX WITH COLORECTAL CX SHOULD HAVE PREOPERATIVE COLONOSCOPY OR AT LEAST AN AIR CONTRAST BARIUM ENEMA?

A

EVEN IF IT CLINICALLY OBVIOUS OF COLORECTAL TUMOUR

> radiography/ colonoscopy considered to exclude synchronous neoplasm + polyps

25
Q

STANDARD TX FOR PX WITH LOCALISED COLON CANCER (WITHOUT DISTANT METASTASIS)?

A

OPEN SURGICAL RESECTION OF PRIMARY TUMOUR + REGIONAL LYMPH NODES

TYPE OF LARGE BOWEL RESECTION DEPENDS ON ANATOMICAL LOCALISATION OF CANCER

26
Q

MAJOR RISK FACTORS FOR GASTRIC CANCER?

A

H. PYLORI

SALTY FOODS

27
Q

ACCORDING TO LAURENS CLASSIFICATION GASTRIC ADENOCARCINOMA IS DIVIDED INTO?

A

TWO TYPES

28
Q

WHAT IS TYPICAL FOR DIFFUSE TYPE OF GASTRIC ADENOCARCINOMA?

A

POORLY DIFFERENTIATED

SIGNET RING CELLS

29
Q

HOW MANY LYMPH NODES MUST BE EVALUATED FOR ACURATE STAGING OF CARCINOMA OF STOMACH?

A

15

30
Q

WHICH PART OF COLON IS MOST COMMONLY AFFECTED BY MALIGNANCY?

A

RECTUM

31
Q

WHICH IS MOST COMMON HISTOLOGICAL TYPE OF COLORECTAL CANCER?

A

ADENOCARCINOMA

32
Q

MOST COMMON SYMPTOMS OF RECTAL CANCER?

A

HEMATOCHEZIA

33
Q

WHICH DISEASE IS NOT INCLUDED IN DDX FOR RECTAL CANCER?

A

RECTOCELE
- type of prolapse where supportive tissue between women rectum + vaginal wall weakens

  • weakened tissue - front wall of rectum will bulge + sag into vagina + can protrude into vaginal opening

SURGICAL DISEASES (13 decks)

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