gastric cancer

Question 1

intestinal gastric cancer

Answer 1

assoc with H.pylori

commonly on lesser curvature of stomach

Question 2

diffuse gastric cancer

Answer 2

not asoc with h.pylori

assoc with signet cells

Question 3

Menetrier’s disease

Answer 3

pre-cancerous
hyperpplasia of gastric mucosa
assoc with parietal cell atrophy

reduced stomach acid - achlorydria

Question 4

Krukenberg tumour

Answer 4

‘signet ring tumour’

secrete mucin, readily metastasise to ovaries

abdo bloating, ascites, dyspareunia

Question 5

Sister Mary Joseph nodule

Answer 5

S/c peri-umbilical metastasis assoc with intestinal type gastric cancer

Question 6

Linitis Plastica

Answer 6

muscles of stomach become thicker –> stomach holds less food

assoc with diffuse stomach cancer

Question 7

risk factors

Answer 7

smoking 
pernicious anaemia 
H.pylori 
alcohol
dierty nitrosamines
atrophic gastritis
adenomatous polyps 
achloryhdria

Question 8

features

Answer 8

iron def anaemia 
loss weight
anorexia
malaena
haematemesis
dysphagia

Question 9

indiciations for 2wk wait OGD

Answer 9

dysphagia (any age)

age ≥55 + weight loss +

• upper abdo pain/reflux/dyspepsia
• upper abdo mass

Question 10

indications for 6wk wait OGD

Answer 10

haematemesis (any age)

≥55yrs +

• Rx resistent dyspepsia
• upper abdo pain and low Hb
• raised platelets + other things

Question 11

Rx - invasive gastirc cancer

Answer 11

partial or total gastrectomy + neoadjuvant chemotherapy

Question 12

Rx - not surgical

Answer 12

fluourouracil (chemo) + radiotherapy