S11) Gastrointestinal Cancers Flashcards Preview

Y2 SEM 3: Gastro-intestinal System > S11) Gastrointestinal Cancers > Flashcards

Flashcards in S11) Gastrointestinal Cancers Deck (41)
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1

What are the differentials for a patient presenting with dysphagia?

- Extraluminal

- Luminal

- Intraluminal 

2

In terms of upper GI cancers, what are the possible causes of a patient present with dysphagia?

- Benign causes

- Malignant causes – squamous cell carcinoma, adenocarcinoma 

3

What are the red flags for dysphagia?

- Anaemia

- Loss of weight (unintentional)

- Anorexia

- Recent onset of progressive symptoms

- Masses/Malaena 

4

What types of carcinomas are found in the GI tract?

- Stratified squamous epithelium in the oesophagus → squamous cell carcinomas

- Columnar epithelium in rest of GI tract → adenocarcinomas 

5

Describe the clinical features of oesophageal carcinoma

- Typically present with progressive dysphagia

- Spread is common if presenting with symptoms 

6

What are the risk factors for oesophageal carcinoma?

- Smoking

- Obesity

- Barrett’s oesophagus

7

What are the red flags for epigastric pain?

- Malaena

- Haematemesis 

8

What is the differential diagnosis for a patient presenting with epigastric pain?

- Oesophageal varices

- Gastric ulcer

- Duodenal ulcer

- Acute gastritis

9

What are the clinical factors for gastric cancer?

Adenocarcinomas typically in the cardia or antrum

- Present with similar pain to peptic ulcer

- 50% have a palpable mass

10

What are the risk factors for gastric cancer?

- Smoking

- High salt diet

- Family history

11

As a general note, which inflammatory response puts one at a higher risk of malignancy?

Chronic inflammation

12

What are some other forms of cancer which occur in the stomach?

- Gastric lymphoma

- Gastrointestinal stromal tumours (GISTs)

13

What are the clinical features of gastric lymphoma?

- Involves MALT tissue

- Similar presentation to gastric carcinoma

- Most associated with H. pylori

14

What are the clinical features of gastrointestinal stromal tumours?

- Sarcomas (not epithelial)

- Tend to be an incidental finding on endoscopy 

15

What are the differentials for a patient presenting with jaundice?

- Pre-hepatic – too much haem

- Hepatic – reduced liver function

- Post-hepatic – obstructive causes

16

What are the red flags for jaundice?

- Hepatomegaly

- Ascites

- Painless

- Unintentional weight loss 

17

What are the clinical features of liver cancer?

- Primary malignancy very rare

- Hepatocellular carcinoma typically links to underlying disease 

18

Why do malignancies commonly metastasise to the liver? 

⇒ The liver drains the entirety of the GI tract

⇒ Any malignant cells go through the liver

⇒ Therefore it is a common site for metastases

19

What malignancies commonly metastasise to the liver? 

- Breast

- Colon 

- Prostate

- Gastric

- Oesophageal

20

How do pancreatic cancers present?

- Head of pancreas: painless jaundice (Courvoisier’s law)

- Body/tail of pancreas: symptoms more vague

- 80% ductal adenocarcinomas 

21

What does Courvoisier's law dictate?

If a patient has large, palpable non-tender gallbladder, then the cause is not gall stones i.e. malignancy

22

What are the risk factors of pancreatic cancers?

- Family history

- Smoking

- Gender (men)

- Age (typically >60yrs)

- Chronic pancreatitis 

23

What are the four symptoms of obstruction?

- Abdominal distension

- Abdominal pain

- Constipation

- Nausea and vomiting 

24

What are the red flags for obstruction?

- Unexplained abdominal pain

- Unintentional weight loss 

25

In terms of lower GI cancers, what are the differentials for a patient presenting with obstruction?

Benign:

I. Diverticular disease

II. Volvulus

III. Hernias

- Malignancy:

I. Adenocarcinoma large colon

II. Small bowel cancer 

26

What are the symptoms of per rectum bleeding?

- Fresh bright red bleeding

- Melaena

- Anal pain

- Tenesmus 

27

What are the red flags for per rectum bleeding?

- Iron deficient anaemia

- Unexplained weight loss

- Age dependant

- Change in bowel habit 

28

In terms of lower GI cancers, what is the differential diagnosis for a patient presenting with per rectum bleeding?

Benign:

I. Haemorrhoids

II. Anal fissures

III. Infective gastroenteritis

IV. Inflammatory bowel disease

V. Diverticular disease

- Malignancy:

I. Adenocarcinoma large colon

II. Small bowel cancer 

29

What are the symptoms of a change in bowel habit?

- Change in frequency

- Change in consistency

- Bloating

- Abdominal discomfort 

30

What are the red flags for a change in bowel habit?

- Iron deficient anaemia

- Unexplained weight loss

- Age dependant

- PR blood loss