Flashcards in 04a: Esophagus, Gastric Deck (36)
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1
T/F: Squamous cell carcinoma is the most common esophageal cancer worldwide.
True - but incidence gradually decreasing
2
In high-incidence areas, how might diet be increasing Squamous cell carcinoma of esophagus?
Nutritional deficiency; high level nitrosamines or aromatic hydrocarbons; drinking hot tea
3
SCC of esophagus: Two most important risk factors in low-incidence areas.
EtOH and smoking
4
(X) cancer is associated with high risk of esophageal SCC.
X = SCC of head and neck
5
Pt with Barretts has (X)% yearly risk of cancer, which is (Y)x that of general population
X = 0.1-0.5
Y = 30-60
6
(Hyper/hypo)-calcemia occurs in up to 30% of patients with esophageal cancer. Why?
Hypercalcemia; PTHrP secretion
7
(SCC/AdenoCa) of esophagus is very locally invasive and may affect which structures?
SCC;
Recurrent laryngeal n (hoarseness) or cause tracheoesophageal fistula
8
List two key reasons why esophageal cancer is advanced at time of diagnosis in most cases.
1. Absence of serosa in esophagus
2. Rich lymphovascular network in LP and submucosa
9
Preferred method of esophageal and gastric cancer diagnosis.
EGD (esophagogastroduodenoscopy) with biopsy
10
T/F: Screening for esophageal cancer has not proven useful for low-risk populations.
True - but benefit in screening high-risk pop
11
T/F: T1 stage of esophageal cancer has nearly 100% 5-year survival
False - only 46%!!
12
T/F: Metastasized esophageal cancer has under 5% 5-year survival
True
13
Esophageal and gastric cancer: (X) is the most accurate modality for staging.
X = endoscopic ultrasound
14
T/F: Surgery can be curative for esophageal cancer.
True - in early lesions (rarely seen in US)
15
#2 cause of cancer death worldwide
Gastric cancer (used to be #1 until 1930s)
16
(X) cancer was the most common cancer in US in 1930s, but is not no longer in top 10 US cancers.
X = gastric
17
Most common histological type of gastric cancer:
Intestinal type adenocarcinoma
18
Diffuse type gastric cancer is (more/less) common than intestinal type adenocarcinoma, associated with (better/worse) prognosis, and has "(X) cell" pathology.
Less; worse
X = signet
19
(Diffuse/intestinal) type gastric cancer is associated with cancer family syndrome.
Diffuse
20
H. pylori strains that are cagA (pos/neg) are associated with higher risk of atrophy and cancer.
Pos
21
T/F: Smoking is independent risk factor for gastric cancer, but alcohol is not.
True - 2-fold increased risk for smoking
22
T/F: Diet rich in fruits and veggies is protective against gastric cancer.
True - 30-50% risk reduction
23
T/F: Regular aspirin use increases risk of gastric cancer by about 1.5.
False - protective (relative risk is 0.5)
24
Patient's father died of gastric cancer. He's worried about his risk of also developing gastric cancer. What do you tell him about his risk?
2-3x increased risk
25
Which genetic syndromes/mutations are associated with high risk of gastric cancer?
1. FAP (10-fold increased risk; screen via EGD every 3-5y)
2. HNPCC (11% risk)
3. E-cadherin gene mutation (diffuse type with high penetrance)
26
List causes of chronic atrophic gastritis, which carries (X)x risk of gastric cancer. Star the cause that carries highest risk.
X = 6
1. H. pylori*
2. Pernicious anemia (anti-parietal cell Ab)
27
Gastric polyps: (common/uncommon), most (rarely/always) undergo malignant transformation, except for the 10% of them that are (X).
Uncommon;
Rarely
X = Adenomas (excision recommended for these due to high risk of malignant transformation)
28
T/F: Gastrectomy is protective against gastric cancer.
False - premalignant group of patients (maybe due to decreased acid production, bac, atrophy, etc)
29
List the most common physical signs of gastric cancer
1. Cachexia
2. Abdominal tenderness (and maybe a mass)
30
