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3 - GI > deck_1672085 > Flashcards

deck_1672085 Flashcards

(61 cards)

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1
Q

Name five common GI malignancies

A

• Oesophagus • Stomach • Large intestine • Pancreas • Liver

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2
Q

Outline the epidemiology of oesophageal carcinoma

A

• Wide geographical variation ○ Incidence low in USA and high around caspian sea and parts of china • 2% of malignancies in the UKMales > Females

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3
Q

Give the two main features of oesophageal carcinoma

A

• Progressively worsening DysphagiaWeight loss

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4
Q

Give three investigations for oesophageal carcinoma

A

• Endoscopy • Biopsy • Barium

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5
Q

Give the two main types of oesophageal cancer

A

• Squamous cell carcinoma • Adenocarcinoma

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6
Q

Which is the most common type of oesophageal cancer

A

Squamous cell

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7
Q

Where is oesophageal adenocarcinoma found

A

• Lower third of the oesophagus • Association with Barrett’s oesophagusProgresses through dysplasia

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8
Q

What is the prognosis of oesophageal cancer?

A

• Advance disease presentation in most cases • 40% resectable • 5% five year survival

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9
Q

What causes oesophageal carcinoma

A

• HPV • Tannins • Vitamin A deficiency

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10
Q

How common is gastric cancer?

A

• Second most common GI malignancy • 15% of cancer deaths worldwideMen >women

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11
Q

What countries is the incidence of gastric cancer highest?

A

• Japan • Columbia • Finland

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12
Q

What condition is gastric cancer associated with?

A

Gastritis

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13
Q

What blood group is gastric cancer most commonly associated with?

A

• Blood group A

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14
Q

Give three symptoms of gastric cancer

A

• Epigastric pain • Vomiting Weight loss

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15
Q

Give three investigations for gastric cancer

A

• Endoscopy • BiopsyBarium

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16
Q

Give three macroscopic features of gastric cancer

A

• Fungating • Ulcerating • Infiltrative ○ Linitis plastica

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17
Q

What is linitis plastica?

A

• A rare type of stomach adenocacrinoma • Tumour spreads to muscles of stomach making it thicker and more rigid

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18
Q

Give two microscopic features of gastric cancer

A

• Intestinal ○ Variable degree of gland formation • Digguse ○ Single cells and small groups, signet ring cells

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19
Q

What is early gastric cancer?

A

• Confined to sub-mucosa • Good prognosis

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20
Q

Describe advanced gastric cancer?

A

• Far spread of cancer10% 5 year survival

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21
Q

Give four methods of spread of gastric cancer?

A

• Direct • Lymph nodes • Liver • Trans-coelomic ○ Periotneum Ovaries

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22
Q

Outline direct spread of gastric cancer

A

• Through gastric wall into duodenum, transverse colon, pancreas

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23
Q

Outline the development of gastric cancer

A

• Normal gastric mucosa • H pylori infection • Acute gastritis • Chronic active gastritis • Atrophic gastritis • Intestinal metaplasia • Dysplasia • Advanced gastric cancer

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24
Q

What is intestinal metaplasia in gastric cancer?

A

• Metaplasia of gastric cells to intestinal

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25
What is the association of gastric cancer with H.pylori?
H.pylori causes chronic inflammation which is strongly associated with gastric cancer
26
Give three treatments for gastric cancer
• Surgery • ChemotherapyHerceptin
27
What is gastric lymphoma?
• Commonest GI lymphoma • Starts as a low-grade lesion, strong association with H.pylori • Eradication of H.pylori may lead to regression of tumour
28
How does the prognosis of gastric lymphoma compare to gastric carcinoma?
Much better
29
What is a gastrointestinal stromal tumour?
• Derived from interstitial cells of cajalCaused by C-kit mutation which makes it vulnerable to targeted treatment
30
What is the behaviour of gastrointestinal stromal tumours?
• Pleomorphism • MitosesNecrosis
31
What is a key feature of gastric lymphoma
• Gastro-intestinal haemorrhage
32
Give four types of tumours of the large intestine
• Adenomas • Adenocarcinomas • Polyps • Anal carcinoma
33
Give three types of adenomas in the large intestine
• Benign, neoplastic lesions in the large bowel • Familial adenomatous polyposis • Gardner's syndrome
34
Give two macroscopic features of adenoma of the large intestine
• Sessile (immobile)OR pedunculated (small growth on stalk)
35
Give two microscopic features of adenoma of the large intestine
• Variable degree of dyplasiaMalignant potential
36
What is the most common risk factor for large intestinal adenoma?
• Advancing age
37
What is familial adenomatous polyposis?
• An autosomal dominant condition on chromosome 5 • Large number of adenomas form giving high risk of cancer
38
What is gardner's syndrome?
• Similar to familial adenomatous polyposis • Bone and soft tissue tumours also
39
What is the most common type of GI malignancy?
• Colorectal adenocarcinoma
40
Give two macroscopic features of colorectal adenocarcinoma
• Rectosigmoid fungating/stenotic
41
Give two microscopic features of colorectal adenocarcinoma
• Mucinous Signet ring cell types
42
Give three ways in which colorectal adenocarcinoma spreads
• Direct through bowel wall to adjacent organs • Via lymphatics to mesenteric lymph nodesVia portal venous system to liver
43
Give two ways in which colorectal adenocarcinoma is staged
• Dukes staging • TMN
44
Outline duke's staging of colorectal adenocarcinoma
• A - Confined to bowel wall • B - Through wall, lymph nodes clear • C - Lymph node involvement • C1/C2 - Highest node clear/ involved
45
Give three main mutations in colorectal adenocarcinoma
• FAP - Chromosome 5 • Ras mutations • P53 loss/inactivation • K-ras - Guides treatment with cetuximab
46
At what age is colorectal adeno carcinoma?
• Peak at 60-70 • High in UK/USA, low in Japan
47
Give two diseases which predispose a patient to colorectal adenocarcinoma
• Ulcerative carcninoma • Crohn's disease
48
Give four predisposing aeitological factors to colorectal adenocarcinoma
• Low residue diet • Slow transit time • High fat intake • Genetic predisposition
49
Give three carcinomas of the large intestine of the colorectal adenocarcinoma
• Carinoid tumoure ○ Rare and unpredictabel neuro-endocrine tumour • Lymphoma ○ Rare, may be primary • Smooth muscle/stromal tumours ○ Rare and unpredictable
50
Outline the morphology of pancreatic carcinoma
• 2/3 in the head • Firm pale mass with a necrotic centreMay infiltrate adjacent structures
51
What is the histology of a pancreatic carcinoma
• 80% are ductal adenocarcinomas • Well formed glands • Some may contain zymogen granulesAll have poor prognosis
52
Give three symptoms of pancreatic cancer
• Weight loss • JaundiceTrousseau's signDARK RED PATCH
53
Describe a carcinoma of the ampulla of vater
• Bile duct blocked with a small tumour, leading to jaundice and early presentation when the tumour is still treatable
54
Give four islet cell tumours
• Insulinoma • Glycagonoma • Vasoactive intestinal peptideoma • Gastrinoma
55
What does insulinoma cause?
• Hypoglycaemia
56
What is a characteristic sign of glycagonoma
• Characteristic skin rash - Thrombophlebitis migrans
57
What syndrome is associated with gastrinoma
Zollinger - Ellison syndrome (Ectopic gastrin production)
58
Give three types of benign liver tumour
• Hepatic adenoma • Bile duct adenoma • Haemangioma
59
Give three types of malignant liver tumours
• Hepatoceullarcarcinoma • Cholaniocarcinoma - liver flukes • Hepatoblastoma
60
What are the four most common GI malignancies in order
• Colorectal • Stomach • Pancreas • Oesophagus
61
What are two types of malignant tumour
• Primary • Malignant

3 - GI (36 decks)

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