Flashcards in EXAM #3: REVIEW Deck (62)
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1
List 7x risk factors for colon cancer.
1) Family history
2) IBD
3) Smoking
4) Alcohol
5) Obesity
6) Inactivity
7) Poor diet
2
What is the inheritance pattern of the APC mutation seen in FAP?
Autosomal dominant
3
Name the three scenarios that will give a patient a positive family history for colon cancer.
1) Colon ca in 1st degree relative under 60 y/o
2) 2+ first degree relatives with colon ca at ANY age
3) 2nd degree relative under 50 y/o with colon ca
4
What is the biopsy protocol for a patient with IBD undergoing colonoscopy?
Collect 4x random samples every 10cm of bowel for a total of 30+ samples
5
What are the surveillance recommendations following resection of a colon or rectal cancer?
1) H/P + CEA Q3-6 months
2) CT Q1 year for 5x years
6
List seven diseases that are associated with pancreatic cancer.
1) FAP
2) Peutz-Jegher's Syndrome
3) Von Hippel-Lindau
4) MEN1
5) HNPCC
6) BRCA
7) FAMMM
7
List five signs/ symptoms typically seen in the presentation of pancreatic cancer.
1) Abdominal pain
2) Weight loss
3) Jaundice
4) Steatorrhea
5) Pruritus
8
What should you be concerned about in an elderly, non-obese patient that develops glucose intolerance?
Pancreatic cancer
9
How is pancreatic cancer diagnosed i.e. what studies are needed for the diagnosis?
1) Spiral CT with IV contrast
2) Biopsy
10
What are the characteristics of resectable pancreatic cancer?
1) No extrapancreatic disease
2) No tumor extension into:
- Celiac axis
- SMA
11
What is a non-opiate approach to pain management in pancreatic cancer?
Celiac plexus neurolysis
12
What are the three hallmarks of a cystic neoplasm?
1) Bloating
2) Obstructive jaundice
3) Weight loss
13
What are the most common types of cystic neoplasms?
- Mucinous cystadenomas
- Cystadenocarcinoma
14
Where are mucinous cystadenomas or cystadenocarcinomas located?
Body or tail of the pancreas
15
What is an intraductal papillary mucinous neoplasm referred to as?
Pancreatic precursor tumor
16
What studies should be ordered to work up a cystic neoplasm?
1) Abdominal CT
2) EUS
3) Biopsy
17
What confirms the diagnosis of an insulinoma with a 72 hour fast?
Elevated c-peptide and insulin
18
What lab is diagnostic for a Gastrinoma?
Elevated serum gastrin
19
List the four benign liver lesions. Which is the most common?
1) Hemangioma*
2) Focal Nodular Hyperplasia
3) Adenoma
4) Simple cyst
20
Where is HCC common geographically?
Worldwide except US and Europe
*This is b/c of endemic viral hepatitis*
21
What is the tumor marker for HCC?
Alpha-fetoprotein
22
List four surgical methods for treating HCC.
1) Wedge resection
2) Lobectomy
3) Trisegmentectomy
4) Liver transplant
23
What are the three major obstacles to liver surgery?
1) Dual blood supply
2) Liver reserve
3) Coagulopathy
24
List four characteristics of a good surgical candidate for HCC resection.
1) Class A Child Pugh Score
2) Solitary tumor
3) No vascular invasion
4) Tumor less than 3 cm
25
What drug is specifically used for HCC chemotherapy?
Sorafenib
*Note that this drug block angiogensis and targets HCC surface proteins*
26
List three risk factors for cholangiocarcinoma.
1) Primary Sclerosing Cholangitis
2) Liver flukes
3) Choledochal cyst
27
How does cholangiocarcinoma typically present?
1) Constitutional sx. of cancer
2) Painless jaundice
3) Biliary Tract Obstruction
28
How is cholangiocarcinoma diagnosed?
1) ERCP
2) CT or MRI with cholangiography
3) US
29
What surgery is used to treat perihilar cholangiocarcinoma i.e. the most common type of cholangiocarcioma?
Roux-en-Y Hepaticojejunostomy
30
