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GI System > Upper GI Malignancy > Flashcards

Upper GI Malignancy Flashcards

1
Q

List 3 key symptoms associated with Upper GI Malignancy

A
  • Epigastric pain
  • Jaundice
  • Dysphagia
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2
Q

What are 3 types of obstruction leading to Dysphagia?

A
  • Extraluminal (compression from outside)
  • Intraluminal (in lumen)
  • Luminal (in wall)
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3
Q

List the Red Flags of Dysphagia

A

ALARM

  • Anaemia
  • Loss of Weight
  • Anorexia
  • Recent onset of progressive symptoms
  • Masses/ Malaena
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4
Q

List 3 Benign causes of Dysphagia

A
  • Fibrous strictures
  • Foreign bodies
  • Nervous disorders
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5
Q

List 2 Malignant causes of Dysphagia

A

Oesophageal Carcinoma;

  • Squamous cell carcinomas (Strat Squamous epithelia)
  • Adenocarcinomas (Columnar epithelia)
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6
Q

Which Oesophgeal Carcinoma is more common

A
  • Oesophageal Carcinoma (as mostly Strat squamous)

- Lower 1/3 can develop Adenocarcinoma (Barret’s oesophagus)

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7
Q

What are 2 risk factors for Oesophageal carcinoma?

How does it present?

A
  • Smoking
  • Barret’s Oesophagus
  • Progressive Dysphagia (Solids-> Liquids)
  • Spread is common if presenting with symptoms
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8
Q

What are 2 methods if investigating for Oesophageal carcinoma?

How good is the prognosis?

A
  • Endoscopy
  • Barium swallow

Poor prognosis (5% survival at 5 years)

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9
Q

List 4 BENIGN conditions that can cause Epigastric pain

A
  • Oesophagitis
  • Gastritis
  • Peptic Ulcer Disease PUD
  • Pancreatitis
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10
Q

What are 2 Red Flags for Epigastric Pain?

A
  • Malaena

- Haematemesis

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11
Q

List 3 non-malignant causes of Haematemesis

A
  • Ulcers
  • Varices
  • ‘Mallory-Weiss Syndrome’ (Repeated vomiting-> Oesophgeal tears)
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12
Q

Suggest 1 malignant cause of Haematemesis with Epigastric pain

A

Gastric Cancer

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13
Q

Describe Gastric Cancer in 4 ways

A
  • Typically in Cardia or Antrum (Can cause Dysphagia and outflow obstruction)
  • Typically Adenocarcinomas
  • 50% have a palpable mass
  • Pain similar to Peptic Ulcer (Epigastric)
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14
Q

List 6 risk factors of Gastric Cancer

A
  • Age
  • More common in Males
  • Smoking
  • High salt diet
  • Family history
  • H. pylori (Chronic inflammation anywhere can-> cancer)
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15
Q

Describe the Prognosis for Gastric Cancer

A
  • 10% survival after 5 years

- 50% survival after surgery (removing part of stomach + reconstructive surgery

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16
Q

Name 2 types of Gastric Cancer other than Adenocarcinomas (most common)

A
  • Gastric Lymphoma

- Gastrointestinal Stromal tumours (GISTs)

17
Q

Describe Gastric Lymphoma

A
  • In MALT tissue
  • Presents similarly to Gastric Carcinoma
  • Mostly associated with H. pylori
  • Prognosis much better than Gastric Carcinoma
18
Q

Describe GISTs

A
  • Sarcomas
  • Usually asymptomatic
  • Typically Benign, can be Malignant
  • Tend to be incidental findings on Endoscopy
19
Q

List the Red Flags for Jaundice

A
  • Hepatomegaly (especially with an irregular border)
  • Weight loss
  • Ascites
  • Painless
20
Q

Describe Primary Malignancy of the Liver

A
  • Very rare
  • Hepatocellular Carcinomas
  • Typically linked to underlying disease (chronic inflammation)
  • Common site for metastases (Any malignant cells in body enter liver)
21
Q

What are 3 routes via which malignancies can metastasise to the liver

A
  • Haematogenous (portal circulation)
  • Via lymphatics (common in carcinomas)
  • Transcoelomic spread (through body cavities, e.g ovarian, breast lung)
22
Q

What percentage of Pancreatic Cancers are exocrine?

What’s the most common Pancreatic Cancer?

A

80-90%

Ductal Adenocarcinomas

(Neuroendocrine cancers are rare, and produce insulin)

23
Q

Compare the presentation of Pancreatic Cancers originating in the Head and Body/Tail

A

Head: Jaundice

Body/ Tail: Symptoms more vague (Malabsorption, Steatorrhea)

24
Q

List 5 risk factors for Pancreatic Cancer

A
  • Family history
  • Smoking
  • Age (>60)
  • More common in males
  • Chronic Pancreatitis
25
Q

Describe the Prognosis of Pancreatic Cancer

A

Extremely poor, survival often measured in months rather than years

GI System (26 decks)

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