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GI > Week 10 - GI cancer > Flashcards

Week 10 - GI cancer Flashcards

1
Q

Demographics of oesophageal carcinomas

A

Affects males more

China and around the Caspian Sea

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2
Q

Causes of oesophageal carcinomas

A

HPV

Vitamin A deficiency

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3
Q

Clinical features of oesophageal carcinomas

A

Progressive dysphagia

Weight loss

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4
Q

Investigations for oesophageal carcinomas

A

Upper GI endoscopy
Biopsy
Barium

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5
Q

Types and location of oesophageal carcinomas

A

Squamous cell carcinoma most common - anywhere in oesophagus
Adenocarcinoma - lower 1/3

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6
Q

Prognosis of oesophageal carcinomas

A

5% 5 year survival rate

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7
Q

Spread of oesophageal carcinoma

A

Directly through oesophageal wall and distally (towards Z line)

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8
Q

Demographics of gastric cancer

A

More common in males
Japan, Columbia and Finland
Blood group A

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9
Q

Prognosis of gastric cancer

A

Poor as asymptomatic until advanced
Advanced - 10% 5 year survival
Early - good prognosis

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10
Q

Clinical features of gastric cancer

A

Vomiting
Weight loss
Epigastric pain
Malena

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11
Q

Investigations of gastric cancer

A

Upper GI endoscopy
Biopsy
Barium

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12
Q

Macroscopic appearance of gastric cancer

A

Fungating
Ulcerating
Infiltrative (linitis plastica)

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13
Q

Microscopic appearance of gastric cancer

A

Intestinal type - degree of gland formation

Diffuse type - signet ring cells

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14
Q

Difference between early and advanced gastric cancer

A

Early is confined to mucosa and submucosa

Advanced has invaded into the muscularis externa

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15
Q

Spread of gastric cancer

A

Direct
Lymph nodes (Virchow’s nodes)
Liver
Transcoelomic to peritoneum or ovaries

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16
Q

Treatment of gastric cancer

A

Surgery
Chemotherapy
Herceptin

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17
Q

Risk factors for gastric cancer

A

Male
Smoking
H pylori infection

18
Q

Describe gastric lymphoma

A

Strongly associated with H pylori
Eradication of H pylori may lead to tumour regression
Better prognosis than gastric cancer

19
Q

Describe GI stromal cancers

A

Uncommon

Derived from interstitial cells of Cajal (pacemaker cells)

20
Q

Behaviour of GI stromal cancers

A

Unpredictable:
Pleomorphism
Mitoses
Necrosis

21
Q

Treatment for GI stromal cancers

A

Imatinib

Have C-kit mutation

22
Q

What are tumours of the large intestine

A 
Adenomas 
Adenocarcinomas
Polyps
Anal carcinoma 
Carcinoid (neuro-endocrine tumour)
Lymphoma - usually spread from somewhere else
Stromal (smooth muscle tumour)
23
Q

What are large intestine adenomas

A

Benign neoplastic lesions with malignant potential (adeno-carcinoma sequence)

24
Q

Macroscopic appearance of large intestine adenomas

A

Sessile - no stalk
Or
Pedunculated - stalk

25
Q

Describe genetic conditions associated with adenomas

A

Familial adenomatous polyposis - autosomal dominant mutation on chromosome 5, high risk of cancer
Gardner’s syndrome - similar to FAP with bone and soft tissue tumours

26
Q

Macroscopic appearance of colorectal adenocarcinomas

A

Fungating - in the right side

Stenotic - in the left side

27
Q

Microscopic appearance of colorectal adenocarcinomas

A

Mucinous types

Signet ring cell types

28
Q

Spread of colorectal adenocarcinomas

A

Directly through bowel wall to adjacent structure e.g bladder
Lymphatics to mesenteric LNs
Portal venous system to liver

29
Q

Staging methods of colorectal adenocarcinomas

A

TNM

Dukes staging

30
Q

Describe Dukes staging

A

A - confined to bowel wall
B - through bowel wall
C1 - LN involvement but not highest lymph node
C2 - highest LN involvement

31
Q

Risk factors for FAP

A

ras mutation

p53 inactivation

32
Q

Causes of colorectal adenocarcinomas

A

FAP
High dietary fat
Slow transit time - longer contact time for carcinogens
UC or Chron’s disease

33
Q

Treatment for colorectal adenocarcinomas

A

Surgery
Chemo
Resect liver metastases
Local radiation for rectal cancer

34
Q

Describe pancreatic cancer

A 
Most are ductal adenocarcinomas 
2/3 in head
Firm pale masses with a necrotic centre 
May be haemorrhagic or cystic 
Poor prognosis
35
Q

Spread of pancreatic cancer

A

Direct to adjacent structures e.g spleen

36
Q

Symptoms of pancreatic cancer

A

Weight loss
Jaundice if in head
Trousseau’s sign - carpal spasm after cuffing upper arm

37
Q

Describe acinar pancreatic cancers

A

Contain zymogen granules

38
Q

Describe ampulla of Vater carcinomas

A

Good prognosis - detected early

Bile duct is blocked leading to jaundice and steatorrhoea

39
Q

Types of islet cell tumours

A

Insulinoma - hypoglycaemia
Glucogonoma - characteristic skin rash
Vasoactive intestinal peptideoma (VIPoma) /Verner Morrison syndrome - watery diarrhoea, hypokalaemia, achlorydria
Gastrinoma/Zollinger Ellison syndrome

40
Q

Malignant liver tumours

A

Hepatocellular carcinoma
Cholangiocarcinoma
Hepatoblastoma

41
Q

Benign liver tumours

A

Hepatic adenoma
Hamartoma - bile duct adenoma
Haemangioma

GI (19 decks)

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