gi cancer

Question 1

what type of cancer can squamous cells become?

Answer 1

scc and adenoma

Question 2

what are enteroendocrine cell cancers called?

Answer 2

neuroendocrine tumours

Question 3

what are cancers of the interstitial cells of cajal called?

Answer 3

gastrointestinal stromal tumours (gists)

Question 4

what is an adipose cancer called?

Answer 4

liposarcoma

Question 5

what type of cell becomes squamous cell carcimoma in the oesophagus?

Answer 5

stratified squamous epithelium

Question 6

what is scc (oesophagus) associated with?

Answer 6

alcoholism

Question 7

what type of cells form adenocarcimona of the oesophagus?

Answer 7

metaplastic columnar epithelium

Question 8

3 stages of progression from reflux to oesophageal cancer?

Answer 8

oesophagitis, barrett’s, adenocarcinoma

Question 9

how is barrett’s survaillance?
no dysplasia
mild dysplasia
high dysplasia

Answer 9

2-3 years
6 months
intervention

Question 10

2 key symptoms of oesophageal adenocarcinoma?

Answer 10

dysphagia and weight loss

Question 11

how is oesophageal cancer diagnosed?

Answer 11

endoscopy and biopsy

Question 12

how is it staged?

Answer 12

ct
laparoscopy
eus
pet scan

Question 13

treatment plan for curative oes. cancer?

Answer 13

neoadjuvant cx and oesophagectomy

Question 14

3 aspects of palliative oesophageal treatment?

Answer 14

chemo, radiotherapy, stent

Question 15

what approach is taken for the oesophagectomy?

Answer 15

ivor lewis approach

Question 16

3 forms of colorectal cancer?

Answer 16

sporadic, familial, hereditary

Question 17

2 heredetroy synromes that increase risk of crc?

Answer 17

FAP, HNPCC (lynch syndrome)

Question 18

what do prophylactic endoscopies look for

Answer 18

polyps

Question 19

what can prevent progression of polyps?

Answer 19

asprin, nsaids, folate, calcium

Question 20

4 past history rfs for crc?

Answer 20

colorectal cancer, polyps, ulcerative colitis, radiotherapy

Question 21

4 lifestype factors that can increase crc risk>

Answer 21

carcinogenic foods, smoking, obesity, socioeconomic status

Question 22

how does caecal/right sided cancer present?

Answer 22

iron deficiency anaemia
change in bowel habits
palpable mass
ileal obstruction

Question 23

how does left sided/sigmoid carcinoma present?

Answer 23

PR bleeding
mucus in stool
thin stool

Question 24

how does rectal cancer present

Answer 24

PR bleeding, mucus, tenesmus, anal pain

Question 25

what other symptoms may crc present with?

Answer 25

liver mets - jaundice, hepatic pain | lung mets - cough

Question 26

what is the sister mary joseph nodule indicative of?

Answer 26

peritoneal mets

Question 27

4 aspects of physical exam for crc?

Answer 27

pr exam palpable mass tenderness rigid sigmoidoscopy

Question 28

2 faecal occult blood tests to do?

Answer 28

guaiac test | FIT

Question 29

what advice to give before suaiac test?

Answer 29

avoid red meat, melons, horse radish, vit c and nsaids for 3 days before

Question 30

what is looked for in a blood test for crc

Answer 30

anaemia, low ferratin | CEA tumour marker

Question 31

imaging for crc?

Answer 31

``` colonoscopy ct colonoscopy (elderly, unfit) ```

Question 32

when is an MRI pelvis done?

Answer 32

rectal cancer shows mesorectal lymph node involvement decides if chemo first or surgery

Question 33

how is a right/transverse carcinoma surgically treated?

Answer 33

resection (hemicolectomy/extended hemicolectomy) and primary anastoomosis to ileum

Question 34

how is a left sided obstruction treated?

Answer 34

1. hartmann's procedure - proximal end colostomy then anastamose in 6 months 2. resect and anastomose directly 3. ileostomy

Question 35

risk factors for pancreatic cancer?

Answer 35

``` chronic pancreatitis t2dm gallstones diet cigarettes family history ```

Question 36

risk factors for pancreatic cancer?

Answer 36

``` chronic pancreatitis t2dm gallstones diet cigarettes family history ```

Question 37

which inherited syndromes increase risk for pancreartic cnacer?

Answer 37

hereditoray pancreatitis family atypical multiple mole melanoma lynch syndrome fap

Question 38

what are PanINs? how are they visable?

Answer 38

pancreatic intraepithelial neoplasias (like polyps for bowel). only visable microscopically. acquire genecic alterations along way

Question 39

clincial presentation for cancer in head of pancreas?

Answer 39

jaundice, weight loss, epigastric pain, acute pancreatitis, vomiting, gi bleeding

Question 40

what pain is a bad sign in pancreatic cancer?

Answer 40

epigastric pain that radiates to back - shows capsule invasion and irresectability

Question 41

why is cancer of the tail of the pancreas worse?

Answer 41

develops insidiously and presents late

Question 42

most common symptoms of pancreas tail cancer? what is not seen?

Answer 42

weight loss and back pain | no jaundice

Question 43

what tumour marker is there for pancreatic cancer? what can falsely raise it?

Answer 43

CA19-9 | PANCREATITIS, obstructive jaundice

Question 44

investigations for pancreatic cancer?

Answer 44

1. dual phase CT ercp (double duct sign, theraputic) eus (small tumours) pretty much all

Question 45

what must be taken out in a top resection?

Answer 45

spleen due to splenic artery

Question 46

what is hepatocellular cancer associated with?

Answer 46

cirrhosis

Question 47

treatment for hepatocellular cancer?

Answer 47

surgical excision liver transplant radiofrequency ablation transarterial chemo embolisayion

Question 48

3 causes of gallbladder cancer?

Answer 48

gallstones, porcelain gallbladder, chronic typhoid infection

Question 49

3 causes of cholaniocarcimoma?

Answer 49

primary sclerosing cholangitis liver fluke choledochal cyst

Question 50

optimal treatments for all liver cancers?

Answer 50

surgical excision with curative intent