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GI CA@ Flashcards

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1
Q

Esoph CA T1-2 tx

A

Esophagectomy

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2
Q

Esoph CA T3-4 tx if resectable

A

Chemo then surg

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3
Q

T staging levels for esoph CA

A 
T0 = HGD
T1 = LP, submucosa
T2 = MP
T3 = adventitia
T4 = adjacent structures
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4
Q

Which pts require gastric CA screening program?

A

None - not IM, not atrophic gastritis, not FAP or Lynch, not partial gastrectomy

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5
Q

What is a Spindle cell neoplasm?

A

A type of GIST

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6
Q

High risk GIST tx?

A

Surg + 36 mon of imatinib if resectable

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7
Q

Which gene is affected earliest in transition to CRC?

A

APC gene

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8
Q

Which Lynch screening starts at age 20?

A

Colonoscopy every 1-2 years

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9
Q

Which 4 tests to get for Lynch starting at age 30?

A
  1. TVUS Q1yr
  2. EGD with antral bx
    Q2-3yrs
  3. UA Q1yr
  4. Pelvic with PAP Q1yr
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10
Q

Hereditary diffuse gastric CA with mutation in which gene?

A

CDH1

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11
Q

What else AW CDH1 mut?

A

Lobular breast CA

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12
Q

Rt sided CRC with mucinous features and tumor infiltrating LCs classic for what?

A

MMR gene mut in Lynch pts

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13
Q

If polyp removed with AC within it - which features would req surg?

A
  • G3 histo (poorly diff)
  • <1mm margins
  • Piecemeal resection
  • Lymph/vasc invasion
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14
Q

T1 Gastric NET AW which condition?

A

Atrophic gastritis

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15
Q

T2 gastric NET (carcinoid) AW which conditions?

A

ZES and MEN1

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16
Q

T3 gastric NET AW which condition?

A

None

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17
Q

Which type of gastric NET Is worst and needs surg?

A

T3

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18
Q

Asian M&F age for HCC screening in HBV?

Study These Flashcards
A 
M = 40
F = 50
19
Q

Nodule <1 cm mgmt in cirrhotic?

Study These Flashcards
A

Repeat US in 3 months

20
Q

BRCA2 gene causes which CAs?

Study These Flashcards
A

Breast
Ovarian
Panc

21
Q

List MC to LC GI CA.

Study These Flashcards
A

CRC > Panc > Liver > Stomach > Esophagus > SI

22
Q

Best tx for T3N0 AC of esophagus?

Study These Flashcards
A

Chemotherapy followed by surgery

23
Q

What are sxs of plummer vinson and what is it associated with?

Study These Flashcards
A

IDA, Dysphagia due to webs, angular chelitis, glossitis - AW esophageal SCC so get annual screening

24
Q

Associated conditions wt PVS?

Study These Flashcards
A

celiac, RA, thyroiditis, pernicious anemia

25
If early MALToma, what is rate of cure with HP tx?
75%
26
If pt dx with MALT, what should be done for workup?
CT CAP, EGD with mapping, BM bx, EUS
27
What is the best mgmt of gastric GIST with high risk features?
Surgery followed by 36 months of imatinib
28
What are GIST high risk features?
Size > 10 cm, Size > 5 cm with mitotic rate of > 5/50 hpf, mitotic rate > 10/50 hpf
29
Risk of panc AC in the following: 1. Hereditary Panc 2. PJS 3. Familia atypical mole melanoma syndrome 4. Lynch 5. FAP
1. HP - 40% 2. PJS - 36% 3. FAMMS - 17% 4. Lynch - 3.6% 5. FAP - 3x risk c/t gen pop
30
What is the earliest mutation on the road to CRC?1
APC - leads to adenomatous changes
31
List Lynch screening recs.
1. CRC every 1-2 years starting age 20 2. EM sampling starting age 30 3. Annual TVUS at age 30 4. EGD with antral biopsies every 2-3 yrs starting age 30 5. UA annually beginning age 30
32
CDH1 mutation inc risk of what?
Gastric and lobular breast CA
33
When you do a polypectomy and there is surgery within the polyp, what factors increase risk of recurrent CRC and indicate a need for surgery?
Grade 3 histo (poorly differentiated) < 1 mm disease free margin Piecemeal resection Lymphatic or vascular invasion
34
Which tumors stain + for CD117?
GIST
35
What is size cut off for surgery in GISTs?
> 2 cm
36
Mass with "nests of endocrine cells"
NET
37
Three types of Carcinoids.
Type 1 - well differentiated, AW chronic gastritis - can do EMR Type 2 - AW ZES and MEN1 Type 3 - NOT AW hypergastrinemia, poor prognosis
38
Difference between carcinoid and NET?
Carcinoid is a type of NET
39
When choosing enteral stenting vs GJ tube for gastric cancer, at what point is GJ better than stenting?
If pt expected to live > 2 months.
40
Enteropathy associated T cell lymphoma is AW which dz?
Celiac dz
41
T/F: All pts with HBV who have a FH of HCC should be screened for HCC, even without cirrhosis.
True
42
Name the 3 HR features of PCLs.
Size > 3 cm, solid component, dilated PD - EUS if 2/3
43
BRCA2 cancers
Breast, ovarian, pancreas (BRCA2 BOP)

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