Shared Flashcard Set

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First Aid Step 3 Oncology 5
GI Cancers
27
Medical
Professional
12/25/2013

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Cards

Term
60 yo woman presents with painless obstructive jaundice and weight loss. What is the most likely location of the obstructing mass?
Definition
Pancreatic head
Term
What are the risk factors for ductal adenocarinoma of the pancreas?
Definition
>50yo; smoking, chronic pancreatitis, DM
Term
What is Trousseau's syndrome?
Definition
A hypercoagulable state seen with adenocarcinoma.
Term
What are the signs and symptoms of pancreatic cancer?
Definition
Nausea, anorexia, lumbar back pain, new-onset DM, venous thromboembolism, and painless obstructive jaundice.
Term
What lab changes indicate pancreatic cancer?
Definition
Increased bilirubin; increased aminotransferases, and normocytic, normochromic anemia.
Term
How do you establish diagnosis of pancreatic cancer?
Definition
Labs: Bilirubin, LFT, CBC
ultrasound initially, then abd/pelvic CT; endoscopic ultrasound (can determine if resectable)
Term
What are the treatment options for pancreatic cancer?
Definition
Whipple for resectable tumors.
Chemotherapy or Radiation for palliative care when not resectable.
Term
What are the risk factors for Hepatocellular cancer?
Definition
Viral hepatitis, alcoholic cirrhosis, aflatoxin, hemochromatosis, and alpha-1-antritrypsin deficiency.
Term
What labs will you see with HCC?
Definition
increased bilirubin, increased LFT, coagulopathy
Term
What is the treatment for HCC?
Definition
Surgical resection and liver transplantation can give long-term survival.
For unresectable tumors; percutaneous alcohol inections, arterial chemoembolization, radiofrequency ablation, and chemotherapy (sorafenib)
Term
A 60yo man with known colon cancer in remission is found to have a CEA level that is increased from baseline. What does this indicate?
Definition
Cancer is back.
Term
What are the symptoms of colorectal cancer?
Definition
Change in bowel habits, melena, BRBPR, wt loss, fatigue, vomiting, and abdominal discomfort, iron-deficiency anemia, increased transaminases.
Term
What treatments are available for colon cancer?
Definition
Resection with regional lymph nodes and adjacent mesentery.
Term
What can be done for solitary liver or lung mets when present with colorectal cancer?
Definition
may be resected
Term
What adjuvent therapy is available for colorectal cancer stage III and above?
Definition
5-FU based chemotherapy
Term
A 65 yo man with a history of GERD presents with a 10lb weight loss, dysphagia, and epigastric pain. What will biopsy results from EGD most likely reveal?
Definition
Esophageal adenocarcinoma.
Term
What are the symptoms/Exam of someone with an esophageal tumor?
Definition
Dysphagia, smokers and alcoholics; confirm with EGD and biopsy.
Term
How do you treat esophageal cancer?
Definition
Resection for localized disease and radiation therapy with chemo for advanced disease.
Term
What are the characteristics of Gastric cancer?
Definition
more common among asian ethnicity; presents with iron-dificiency anemia with vague abdominal pain in the elderly
Term
How do you diagnose and treat gastric cancer?
Definition
EGD with biopsy for Ex.
Resection for localized disease and radiation therapy with chemo for advanced disease.
Term
How does a carcinoid tumor present?
Definition
Generally found in the appendix of small bowel. Clinically presents with flushing, abdominal pain, diarrhea and tricuspid regurgitation (syndrome)
Term
How does an insulinoma present?
Definition
Elevated proinsulin, C-peptide, and insulin levels. Hypoglycemia, fasting blood glucose <40 and immediate relief with glucose administration.
Term
How does a VIPoma present?
Definition
Elevated VIP levels, suspect in setting of profuse watery diarrhea that causes hypokalemia.
Term
How does a glucogonoma present?
Definition
Elevated glucagon levels. Characterized by persistent hyperglycemia with necrolytic erythema (intertriginous and perioral rash)
Term
What are the three islet cell tumors?
Definition
Insulinoma, VIPoma, and Glucogonoma
Term
How do you diagnose islet cell tumors?
Definition
Somatostatin receptor scintigraphy for localization. Mets are most commonly found in the liver.
Term
What are the treatment options for islet cell tumors?
Definition
Surgical resection, debulking, chemotherapy, and somatostatin analogs with glucagonomas and VIPomas.
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