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15 Cards in this Set
- Front
- Back
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Gastric cancer:
- gender predom? |
- 2:1 male:female
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Order the following steps in the adenoma-carcinoma sequence:
loss of p53 loss of APC mut of KRAS deletion of 18q |
APC, KRAS, 18q, p53
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In gastric cancer, there are "early" and "late" events. To which category does chronic inflammation belong/characterize?
What is a common cause of this inflammation in cases that go on to gastric cancer? |
early.
Esophageal h. pylori infection. |
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How does HP live in the acid environment in the stomach?
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UreI – proton-gated urea channel
Cytoplasmic urease – generates ammonia buffered periplasm survival pH 2-9; growth pH 6-8 |
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When is someone typically infected w/ h.pylori? What is the biggest risk factor?
- racial prevalence? - most common/most efficient route of transmission? |
in childhood.
child/sibling w/ infection - whites are less infected than blacks and latinos. - vomit |
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Is H.pylori associated w/ the following:
- chronic gastritis - gastric adenocarcinoma - gastric MALToma (low grade, b-cell, non-hodgkin's lymphoma) |
It's associated with them all, but in decreasing order of frequency.
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What is the gold standard of HP dx?
- What is the utility of a rapid urease test? Does it require a biopsy? - less invasive methods? (3) + which are useful for documenting eradication? Why? - I |
histolgy;
- show ACTIVE infection, yes; + can help show eradication, same as the gold standard. - IgG, Urea breath test (UBT), Stool antigen test (HpSA) + UBT and HpSA, b/c they document active infection. |
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How do we tx H. pylori infections?
Resistance to which antibiotic is increasingly becoming an issue? |
PPT + 2 antibiotics
Clarithromycin |
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What are the three sides of the "gastric cancer" pathogenesis triangle?
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Genetics, H.pylori, Environmental factors (tobacco, burnt meat, insults, etc.)
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What are the virulence factors of h. pylori that contribute to gastric cancer pathogenesis? (3)
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cagA, vacA, BabA2
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Describe the clinical presentation of Gastric cancer - give some insidious/nonspecific sx as well as some from more advanced dz
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Insidious / non-specific
Dyspepsia Nausea Early satiety Weight loss Advanced Emesis (gastric obstruction) GI bleeding (anemia; melena; hematemesis) Palpable mass Lymphadenopathy (Virchow’s; Sister Mary Joseph |
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What is the procedure of choice to dx gastric cancer? Staging? Prognosis?
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Endoscopy
- CT, EUS, PET, laparoscopy - v. poor |
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What is MALToma?
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Gastric B-cell lymphoma
- Mucosal-associated lymphoid tumor |
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What is the clinical presentation of MALToma?
- can it also show with lymphoma "B" sx? - can this dz be tx'ed and cured sometimes? |
Clinical presentation can be similar to gastric cancer
- yes - yes! tx the h.pylori infection! |
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What can be used to tx and manage Gastrointestinal stromal tumors?
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imatinib --> targets c-kit
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