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Gastric Cancer Flashcards

(47 cards)

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1
Q

Those That Increase the Risk of Gastric Cancer:

A

**Hypoacidity (85% of all gastric cancers)
** H. Pylori

• Atrophic gastritis (95% of all gastric cancers)

• Adenomatous polyp (especially > 2cm)

• Genetics

• Pernicious anemia

• A blood group

• Environmental factors

• Nitrites and Smoked
fish(3,4 benzopyrene)

• Aflatoxin

• Duodenal ulcer surgery

• Residual stomach after resection (especially Billroth II operation)

• Presence of gastric ulcer

• Presence of intestinal metaplasia

• Epstein Barr Virus (EBV)

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2
Q

Those that Reduce the Risk of Gastric Cancer:

A

Aspirin(salicylates)
Diet(fresh fruits, vegies)
Vitamin C

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3
Q

Which condition has highest risk for premalignancy in gastric ca?

A

Atrophic gastritis

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4
Q

Which condition has lowest risk for premalignancy in gastric ca?

A

Hyperplastic polyp

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5
Q

Early stage of gastric cancer is most common in ……?

A

Corpus/body of stomach

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6
Q

In which layer of the stomach is the early stage of gastric ca confined in?

A

Mucosa and submucosa of stomach

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7
Q

Tx of early stage gastric ca?

A

EMR (no need for surgery)
Or ESD

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8
Q

**Which is the most common subtype of type 2 early gastric ca classification?

A

Depressed-corpus

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9
Q

What is the classification of type 3 EARLY gastric ca ?

A

Excavated -corpus

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10
Q

Which type of gastric carcinoma is associated with H.pylori?

A

Intestinal type gastric carcinoma

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11
Q

Which type of gastric carcinoma is associated with poorly differentiated signet ring cells?

A

Diffuse type gastric carcinoma

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12
Q

Which type of metastasis is in intestinal vs. diffuse type gastric carcinoma?

A

In intestinal type —>hematogenous metastasis
(Lymphatic met is lower)
In diffuse type—> lymphatic metastasis (is more)

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13
Q

Which type of Lauren classification is more in female and which is more in male?

A

In female Diffuse
While
In males it is intestinal type gastric ca

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14
Q

Which cancer is treated with antibiotic?

A

Low-grade MALT Lymphoma (MALTOMA) ;caused by H pylori

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15
Q

Is a 10 cm submucosal gastric cancer early or late?

A

It is early bcz it is sill in submucosa

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16
Q

Tumor size is imp in GIST(intestinal);

A

Lesion 1cm> may behave as malignant

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17
Q

Gastric tumor size is

A

Not imp; only the layer in which the tumor invades is imp

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18
Q

Tx for gastric carcinoid?

A

Resection

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19
Q

Which type of gastric carcinoma is familial vs environmental?

Study These Flashcards
A

Diffuse type is familial
Intestinal type is environmental

20
Q

** what is the mutations that occur in diffuse vs intestinal types of gastric carcinoma?

Study These Flashcards
A

Intestinal type—>APC gene mutation
Diffuse type—> E-cadherin (CDH1) expression decreased

21
Q

Which type of gastric carcinoma is endemic vs epidemic?

Study These Flashcards
A

Intestinal type—>epidemic
Diffuse type—>endemic

22
Q

Which type of gastric carcinoma secretes mucin and is infiltrative

Study These Flashcards
A

Diffuse type gastric carcinoma

23
Q

Which type of gastric carcinoma looks like a polypoid?

Study These Flashcards
A

Intestinal type gastric carcinoma

24
Q

Which type of gastric carcinoma has better vs poor prognosis and differentiation ?

Study These Flashcards
A

Intestinal type—> better prognosis &better differentiation
Diffuse type—>poor prognosis /worse differentiation

25
What are the most common symptoms of gastric carcinoma?
Anorexia(restriction of food) Weight loss
26
Diagnosis for gastric cancer?
Endoscopy+golden standart: Biopsy
27
How many lymph nodes must be resected for adequate staging of gastric ca?
15
28
Tx for gastric ca?
Surgical+15 lymph nodes resected
29
When is neoadjuvant tx of gastric adenocarcinoma being evaluated?
In cases with clinical T3 or N1 disaese
30
When is Endoscopic submucosal dissection (ESD) performed for gastric ca?
In mucosal and SUBMUCOSAL metastasis and in EARLY lymph node metastasis
31
When is Endoscopic mucosal resection (EMR) performed for gastric ca?
In differentiated MUCOSAL gastric cancer less than 2cm and have no risk for lymph node metastasis and no sign for ulcereation (If larger than 2cm there’s a risk for perforation)
32
When is TNM staging used for in gastric cancer
For prognosis depends on invasion depth of layers for DIFFUSE type of gastric cancer
33
what is the definition of krukenberg tumor?
implantation in the ovary
34
def of Blummer's shelf
implantation into the rectouterine fascia
35
sister joseph nodule def?
umbilicus metastasis
36
virchow nodule def?
left supraclavicular LN metastasis
37
Irish nodule def?
left axilla LN metastasis
38
peritonitis carcinomatosis and M1
39
Which protein is responsible for the pathogenesis of Menetrier’s disease (hypertrophic gastritis)?
TNF-α is responsible for the pathogenesis. (The disease is thought to be of autoimmune origin.)
40
Which disease is an inflammatory disease of the gastric epithelium
Menetrier’s disease
41
Which disease is characterized by hypochlorhydria, hypoproteinemia, anemia, pain
MENETRIER'S DISEASE (HYPERTROPHIC GASTRITIS)
42
What is the scan used for gastric carcinoid?
Octreotide scan
43
Definitive diagnosis of menetrier’s disease (hypertrophic gastritis) is made by biopsy that shows……?
Loss of oxyntic gland/parietal cell and detection of foveolar hyperplasia
44
Imatinib and Sunitinib are usually drugs given for which neoplastic tumor?
Gastrointestinal stromal tumors (GIST)
45
If KIT rec is not expressed in GIST then which other protein is?
TNF-alpha
46
Where is tumor size important?
It is imp in small intestines, while it is not imp in colon
47
GIST tumors are mainly in which layer?
Submucosa

General Surgery (28 decks)

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