Wrong Questions Flashcards
What is the type of hereditary gastric cancer? What is the gene? What is the inheritance? What other cancers are associated
Hereditary diffuse gastric cancer
CDH1
Autosomal recessive - colon, rectal, breast, prostatw
When do you screen for CDH1? Do you offer anything routinely
18 years
Prophylactic surgery - 20-25 years
Clinical criteria for CDH1
2+ family members
Diffuse gastric cancer <40, no FH
How is colorectal cancer staged
A - limited mucosa or muscularis propria
B1 - to the level of muscularis, but not beyond
B2 - penetrates through muscularis into surrounding tissue
C1 - limited to bowel wall BUT with lymph node involvement
C2 - beyond the bowel with lymph node involvement
D - distant mets
What is the pathophysiology of atherosclerosis
Endothelial injury and dysfunction
Lipoprotein infiltration
platelet adhesion > monocyte infiltration > differentiation into macrophages and formation of foam cells
Free radical damage
What are the types of germ cell tumours
Seminomatous
- seminoma
- spermatocytic seminoma
Non seminomatous tumours
- embryonal carcinoma
- yolk sac tumour
- choriocarcinoma
Sex cord stromal tumours
- leydig cell tumour
- sertoli cell tumour
Teratoma
Common ages for seminoma vs teratoma
Seminoma 30+
Teratoma 20-30
What are the boundaries of the mediastinum
Superior - thoractic inlet
Inferior - continous with inferior mediastinum at the level of the sternal angles
Anterior - manubrium
Posterior - vertebral bodies of T1-4
lateral - pleurae of lung
What are the contents of the superior mediastinum
Great vessels
- arch of aotra and it’s three branches
- SVC AND:
1. Brachiocephalic veins
2. Left superior intercostal vein
3. Supreme intercostal vein
4. Azygous vein
Nerves
- vagus
- phrenic
- cardaic nerves - from suprerior/middle/inferior cardiac ganglia, which form cardiac plexuses
- sympathetic trunk
Thymus
Traches
Oesphagus
Thoracic duct
Muscles
- sternohyoid
-sternothyroid
What are the borders of the posterior mediastinum
Lateral - mediastinal pleura
Anterior - pericardium
Posterior - T5-T12 vertebrae
Roof - imaginary line between sternal angle and T4
Floor - diaphragm
What are the contents of the posterior mediastinum
Thoractic Aorta
-Posterior intercostal arteries
-Bronchial arteries
-oesophageal arteries
- superior phrenic arteries
Oesophagus
Thoracic duct
Ayzgous system
- azygous vein - right lumbar + right subcostal
- hemiazygous vein - left lumbar and left subcostal - drains into azygous at T8
- accessory hemiazygous - 4th to 8th intercostal vein, drains into azygous at T7
Sympathetic trunk
- arising from these trunks are
Describe the structure of the sympathetic trunk
Pre-ganglionic fibres - originate in T and L divisions of spinal cord, end by synapsing with post ganglionnic fibres at peripheral ganglia
Post ganglionic fibres - begin at peripheral ganglia and carry sympathetic fibres to target organs
Where do the pre-ganglionic fibres of the sympathetic chain arise
Myelinated fibres arising from lateral horns of T1-L2
What is the course of the pre-ganglionic fibres
ventral root > ventral ramus > white ramus communicans > sympathetic chain
What is the surface anatomy of the abdominal aorta
?just below xiphisternum to line bisecting iliac crests
Surface anatomy of transpyloric plane
Halfway between jugular notch and pubic symphysis
Definition of aneurysm
Abnormal dilatation of an artery more than 1.5x original diameter
Tributeries of IVC
Common iliac veins
renal veins
Median sacral
Lumbar veins
Right gonadal
