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GIR Test 3 > B5-028 GI Cancers, Non-Tubular > Flashcards

B5-028 GI Cancers, Non-Tubular Flashcards

1
Q

a tumor in the head of the pancreas is likely to involve the […]

A

biliary duct

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2
Q

normal pancreas

A
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3
Q

pancreatic adenocarcinomas arise from

A

ductal cells

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4
Q

pacreatic NETs arise from

A

islets of Langerhans

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5
Q
  • most common cancer of the pancreas
  • third leading cause of cancer deaths
A

pancreatic ductal adenocarcinoma

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6
Q

risk factors for pancreatic ductal carcinoma

A
  • smoking
  • chronic pancreatitis
  • diabetes
  • BRCA2 and CDKN2A mutations
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7
Q
  • older individuals
  • back pain, unexplained weight loss, fatigue
  • jaundice
  • new onset diabetes
A

pancreatic ductal carcinoma

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8
Q

pancreatic ductal carcinoma in the […] of the pancreas tend to present at a more advanced stage

A

tail/body

most are in head

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9
Q

mutations seen in pathogenesis of pancreatic ductal carcinoma

A

early: **KRAS **
later: SMAD4

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10
Q
A

pancreatic ductal carcinoma

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11
Q

proliferation of malignant glands with or without mucin production

A

pancreatic ductal carcinoma

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12
Q
A

fine needle biopsy of pancreatic ductal carcinoma

intital diagnosis by fine needle biopsy

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13
Q
  • precursor lesion
  • telomere shortening, KRAS mutation (low grade)
  • later, CDKN2A mutation (high grade)
A

pancreatic intraepithelial neoplasia

PanIN

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14
Q
A

high grade PanIN

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15
Q

2 types of cystic precursor lesions to pancreatic ductal carcinoma

A
  • intraductal papillary mucinous neoplasm
  • mucinous cystic neoplasm

always always curable early on

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16
Q

main pancreatic duct dilated and filled with mucin

A

intraductal papillary mucinous neoplasm

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17
Q

papillary structures lined by mucinous epithelium

A

intraductal papillary mucinous neoplasm

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18
Q
  • majority occur in pancreatic head
  • KRAS and GNAS mutations
  • more common in men
  • can be multifocal
A

intraductal papillay mucinous neoplasms

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19
Q
A

mucinous cystic neoplasm

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20
Q
A

mucinous cystic neoplasm

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21
Q
  • more common in females
  • occurs in body/tail
  • KRAS mutations
  • no connection to ductal system
A

mucinous cystic neoplasm

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22
Q

tumors associated with clinical syndromes caused by abnormal secretion of hormones by the tumor

A

functional PanNETs

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23
Q

insulinomas, gastrinomas, glucagonomas, somatostatinomas, VIPomas

A

functional PanNETs

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24
Q

may secrete peptide or biogenic substance at levels insufficient to cause symptoms or do not give rise to a clinical syndrome

A

non-functional PanNETs

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25
incidentally discovered or become clinically apparent due to size, invasion or metastasis
non-functional PanNETs
26
tumors not associated with a clinical hormone hypersecretion syndrome
non-functional PanNETs
27
cause hyperinsulinemia and hypoglycemia
insulinoma | functional PanNETs
28
* palpitations, tremor * sweating, hunger, paraesthesia * severe weakness, psychiatric, and neurological manifestations
insulinoma | functional PanNETs
29
deposits of **amyloid** in between stroma
insulinoma | functional PanNETs
30
**whipple triad**: hypoglycemia low plasma glucose symptom relief after glucose administration
insulinoma | functional PanNETs
31
best diagnostic test for insulinoma
prolonged fasting measurement of blood glucose, insulin, C-peptide, and pro insulin
32
gastrinomas are more common in the [...] than the pancreas
duodenum
33
* leads to peptic ulceration, ZE * typical medical management of high gastrin levels does not work
gastrinoma | functional PanNETs
34
* usually asymptomatic unless blocking bile ducts * 55-75% behave in a malignant manner
non-functional PanNETs
35
non-functional PanNETs
36
MEN1 mutations increase the risk of
NETs
37
pancreatic polypeptide secreting NETs are more commonly associated with a mutation in
MEN1
38
solid, tan-red nodules
pancreatic NETs
39
"salt and pepper" granular chromatin in uniform cells
NETs
40
treatment for NETs
octreotide resection
41
* common in women of childbearing age * linked to OCPs and anabolic steroids * often asymptomatic, may cause abdominal pain
hepatocellular adenoma
42
hepatocellular adenoma are [...] and arise in non-cirrhotic livers
benign
43
* strong female predilection * LOF mutation in trancription factor that regulates many genes in hepatocytes and pancreatic islets * low risk of transformation to HCC
HNF1a-inactivated hepatocellular adenoma
44
* commonly associated with obesity and metabolic syndrome * leads to constitutive JAK/STAT signaling * low risk of HCC
inflammatory hepatocellular adenoma
45
* activating mutation in gene * up to 40% in men * high risk for malignant transformation * type of hepatocellular adenoma
b-catenin activated hepatocellular adenoma | positive on B-catenin IHC
46
most common subtype of hepatocellular adenoma
inflammatory
47
least common subtype of hepatocellular adenoma
B-catenin
48
hepatocellular adenoma
49
hepatocellular adenoma
50
if hepatocellular adenoma is larger than 5 cm...
risk for hemorrhage consider resection | if smaller, watchful waiting
51
treatment for B-catenin hepatocellular adenoma
resect
52
* young adult women * associated with Bud-Chiari syndrome, hemangiomas * usually asymptomatic, cause abdominal pain * non-neoplastic
Focal Nodular Hyperplasia
53
focal nodular hyperplasia
54
focal nodular hyperplasia
55
central stellate scar thick walled arteries
focal nodular hyperplasia
56
most common benign tumor of the liver
cavernous hemangioma
57
* discrete nodule <5 cm * dilated, thin vessel walls
cavernous hemangioma
58
cavernous hemangioma
59
cavernous hemangioma
60
most common cause of liver tumors
metastasis
61
most common cancers that metastasize to liver | 6
* colorectal * stomach * breast * pancreas * lung * melanoma
62
shows GNAS and KRAS mutations
intraductal papillary mucinous neoplasm
63
localized vascular malformation leading to mass forming hyperplastic response of hepatocytes
focal nodular neoplasia
64
are primary liver tumors common?
no metastases to the liver are more common
65
most common primary tumor to spread to the liver | 6
* colon * rectum * breast * stomach * pancreas * melanoma
66
[...] occurs early in all pancreatic cancer and is thought to lead to multiple chromosomal abnormalities
telomere shortening

GIR Test 3 (16 decks)

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