Flashcards in EXAM #3: REVIEW Deck (62)
List 7x risk factors for colon cancer.
1) Family history
7) Poor diet
What is the inheritance pattern of the APC mutation seen in FAP?
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
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
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
List seven diseases that are associated with pancreatic cancer.
2) Peutz-Jegher's Syndrome
3) Von Hippel-Lindau
List five signs/ symptoms typically seen in the presentation of pancreatic cancer.
1) Abdominal pain
2) Weight loss
What should you be concerned about in an elderly, non-obese patient that develops glucose intolerance?
How is pancreatic cancer diagnosed i.e. what studies are needed for the diagnosis?
1) Spiral CT with IV contrast
What are the characteristics of resectable pancreatic cancer?
1) No extrapancreatic disease
2) No tumor extension into:
- Celiac axis
What is a non-opiate approach to pain management in pancreatic cancer?
Celiac plexus neurolysis
What are the three hallmarks of a cystic neoplasm?
2) Obstructive jaundice
3) Weight loss
What are the most common types of cystic neoplasms?
- Mucinous cystadenomas
Where are mucinous cystadenomas or cystadenocarcinomas located?
Body or tail of the pancreas
What is an intraductal papillary mucinous neoplasm referred to as?
Pancreatic precursor tumor
What studies should be ordered to work up a cystic neoplasm?
1) Abdominal CT
What confirms the diagnosis of an insulinoma with a 72 hour fast?
Elevated c-peptide and insulin
What lab is diagnostic for a Gastrinoma?
Elevated serum gastrin
List the four benign liver lesions. Which is the most common?
2) Focal Nodular Hyperplasia
4) Simple cyst
Where is HCC common geographically?
Worldwide except US and Europe
*This is b/c of endemic viral hepatitis*
What is the tumor marker for HCC?
List four surgical methods for treating HCC.
1) Wedge resection
4) Liver transplant
What are the three major obstacles to liver surgery?
1) Dual blood supply
2) Liver reserve
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
What drug is specifically used for HCC chemotherapy?
*Note that this drug block angiogensis and targets HCC surface proteins*
List three risk factors for cholangiocarcinoma.
1) Primary Sclerosing Cholangitis
2) Liver flukes
3) Choledochal cyst
How does cholangiocarcinoma typically present?
1) Constitutional sx. of cancer
2) Painless jaundice
3) Biliary Tract Obstruction
How is cholangiocarcinoma diagnosed?
2) CT or MRI with cholangiography
What surgery is used to treat perihilar cholangiocarcinoma i.e. the most common type of cholangiocarcioma?