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GI > Upper GI Pathology > Flashcards

Upper GI Pathology Flashcards

1
Q

Prevalence increases with age?

A

True but not uncommon now to get it in 20’s

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2
Q

More prone gender for mouth cancer

A

Males and least deprived part of society

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3
Q

Cause of oral cancer

A

Tobacco, alcohol, diet and nutrition, HPV, candida

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4
Q

Are hand made cigarrettes less harmful?

A

No as there are no filters, more harmful

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5
Q

Risks of e-cigarettes

A

Exploding batteries, children getting hold of juice and drinking it, also has low levels of carcinogens

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6
Q

Risks with hookah or shisha

A

Water doesn’t filter toxic chemicals and infectious diseases can be passed on when sharing hookah

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7
Q

Why do people chew tobacco

A

Suppress appetite (especially when working long tiring hours), cultural norm

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8
Q

Upper alcohol limit in men and women

A

14 units per week

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9
Q

What is binge drinking for me

A

> 8 units in one sitting

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10
Q

Oral cancer and smoking

A

More you smoke, higher your chances of oral cancer

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11
Q

Deficiency of what makes you more susceptible to oral cancer

A

Vitamin A, C and iron. Atrophy of oral mucosa makes more susceptible to carcinogens

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12
Q

Usual signs of oral cancer

A

Erythroleukoplakia. It can be infection but if antibiotic have been given for a few weeks with no change in the white and red patches, send to screen for oral cancer. Numb feeling, change in voice, dysphagia, unexplained pain, ulcers

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13
Q

One side of tongue seems fine, should the other side be checked for

A

Yes as subtle changes can occur on either side

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14
Q

High risk sites for oral cancer

A

Soft, non-keratinizing sites such as ventral/floor of mouth and lateral tongue

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15
Q

Rare sites of oral cancer

A

Dorsal tongue and hard palate

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16
Q

What is erythroplakia

A

Red patch on oral mucosa that can’t be accounted for by any specific disease

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17
Q

What is leukoplakia

A

Thick, white patches that form on your tongue and lining of mouth

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18
Q

What is a mixture of erythroplakia and leukoplakia called

A

Erythroleukoplakia

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19
Q

What is common in India due to tobacco chewing

A

Oral submucous fibrosis - Chronic, premalignant condition of oral cavity. Inflammation and progressive fibrosis of submucosal tissue which eventually causes the jaw to become rigid and not open

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20
Q

What can dyskeratosis congenita cause

A

Leukoplakia, nail dystrophy and increased skin pigmentation

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21
Q

Oral cancer can lead to

A

Facial palsy (drooping of eye lids), fracture of mandible, double vision, blocked or bleeding nose, facial sweling

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22
Q

Questions to ask patient who presents with lesion in oral cavity

A

How long has the lesion been present
Is it painful
What colour
Smoke or drink

23
Q

Why do we ask how long patient’s had lesion

A

A lesion usually takes 1-14 days to heal after trauma. Any longer might be a malignant sign

24
Q

Oesophageal vs gastric cancer prognosis

A

Oesophageal cancer has a better outcome than gastric cancer

25
Q

Cancerous growth at pylorus of stomach can lead to a feeling of

A

Fullness causing a loss in apetite

26
Q

Boerhaave syndrome and Mallory-Weiss syndrome are both associated with haematemesis. How can they be distinguished?

A

Boehaave syndrome is transmural perforation with vomiting whereas Mallory-Weiss is a non-transmural
mucosal oesophageal tear with vomiting

27
Q

5 year survival of oesophageal cancer

A

12 %

28
Q

Most common type of oesophageal cancer in the east vs west

A

Squamous cell carcinoma is more common in the east whereas adenocarcinoma is the most common in west

29
Q

Male vs female for oesophageal cancer

A

More common in males

30
Q

Risk factors for oesophageal cancer

A

Smoking, alcohol, obesity, gastric reflux, low fibre diet

31
Q

Risk factor for squamous cell carcinoma of oesophagus but not adenocarcinoma

A

Hot beverages

32
Q

Z line in oesophagus is also known as

A

Squamocolumnar junction

33
Q

> 55 year old presents with new onset dyaphagia

A

Offer endscopy to check for oesophageal cancer

34
Q

Mucosal abnormalities mandates how many biopsies

A
  1. CT staging once carcinoma has been diagnosed
35
Q

What CT scan is asked for to stage

A

CT chest, abdomen and pelvis

36
Q

Staging method for distal vs local nodal disease (metastases)

A

Distal - PET CT scan

Local/regional - Endoscopic ultrasound

37
Q

Most common cause of dysphagia

A

Stroke

38
Q

Treatment for squamous cell carcinoma

A

Chemotherapy, no surgery

39
Q

Treatment for adenocarcinoma

A

Endoscopic resection if < T1a

If no metastases and comorbidities, consider oesophagectomy +/- neoadjuvant chemotherapy

40
Q

What is neoadjuvant chemotherapy

A

First step treatment to shrink a tumour before main treatment, usually surgery. Ex: Chemotherapy

41
Q

Most common cause of gastric cancer

A

Helicobacter pylori

42
Q

Symptoms of gastric cancer

A

Early symptoms are non-specific. Associated with indigestion, fatigue, bloating, abdominal pain, weight loss

43
Q

How can gastric cancer be staged

A

Endoscopy, >6 biopsies if mucosal abnormalities found
CT scan – Abdomen, chest, pelvic region
PET scan – Distal metastases
Endoscopic ultrasound – Local/regional nodal metastases

44
Q

Treatment for gastric cancer if no metastases

A

Surgery with curative intent

45
Q

Treatment for gastric cancer if metastases present

A

Palliative care

46
Q

Squamous cell vs adenocarcinoma senstitive to chemotherapy

A

Squamous cell carcinoma

47
Q

Red flags for oesophageal cancer

A 
Loss of appetite
Weight loss
Odynophagia
Progressive dysphagia
Iron deficiency anaemia
48
Q

What type of anaemia can iron deficiency cause

A

Microcytic anaemia, low MCV

49
Q

TIPSS involves shunting between which vessels

A

Portal veins to inferior vena cava

50
Q

Investigation for suspected upper GI cancer

A

Oesophago-Gastro-Duodenoscopy (OGD)

51
Q

What is used to predict whether a patient with an acute upper GI bleed will need blood transfusion or endoscopic intervention

A

Glasgow-Blatchford score

52
Q

Common signs of hypovolaemic shock

A

Tachycardia, hypotension, pallor, cool peripheries, reduced JVP, confusion

53
Q

Treatment for oesphageal variceal bleeding

A

Terlipressin > emergency sclerotherapy

GI (32 decks)

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