Gastric Cancer Quiz

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Gastric Cancer Quiz

Created by Chris Galbraith and Connor Bohlken
Edited by Dr. Paris Ingledew

Today you are doing a gross dissection of the stomach and small intestines on Mrs. Dige Stron. Prior to the dissection your favourite anatomy instructor gives a brief overview and asks a few questions. Whoever gets the questions right gets a free chocolate bar, and the smell of formaldehyde is making you hungry. Today the question is “Which of the following is NOT one of the four main anatomical regions of the stomach”? You answer:

1 point

Cardia

Isthmus

Fundus

Pylorus

Body

Clear selection

You are a R2 Family Practice resident and one rainy Friday afternoon while the clinic is slow, you are reviewing the file of a patient with Gastric cancer and you harken back to your days in medical school. You opt to quiz yourself and try to see if you can remember the 5 layers of the wall of the stomach from deep to superficial?

1 point

Submucosa, Mucosa, Muscularis Propria, Serosa, Subserosa

Submucosa, Mucosa, Muscularis Propria, Subserosa, Serosa

Subserosa, Serosa, Submucosa, Mucosa, Muscularis Propria

Mucosa, Submucosa, Muscularis Propria, Subserosa, Serosa

Muscularis Propria, Mucosa, Submucosa, Serosa, Subserosa

Clear selection

Today you are working with Dr. Gut, an Oncologist who treats Gastric cancers. It just so happens that his interests include: the superbowl, air-force history, and cancer subtypes, in that order. Seeing as he already asked you who won the 1993 Superbowl, to which you unfortunately disappointed him with your answer, he asks you: If you received a pathology report that stated: “This tissue sample, taken from the patient’s stomach who was found to have a suspicious lesion on gastroscopy appears to have glandular tissue resembling that found in the colon”, what type of gastric cancer specifically would you suspect the patient has?

1 point

Diffuse Type Gastric Adenocarcinoma

Intestinal Type Gastric Adenocarcinoma

Colon Type Gastric Adenocarcinoma

Carcinoid Tumor

Gastric Lymphoma

Clear selection

Mr. Gus Trick has just walked into your clinic today. He is a 67 year old male of East Asian descent, who is presenting with a 6mth history of abdominal pain and weight loss. In addition he endorses some new onset difficulty swallowing and some dark stools. Throughout your appointment Mr. Trick believes he has been told he has an h.pylori infection, but he had to move before he got it treated. Additionally, he endorses a lifestyle of smoking, alcohol consumption, and salt consumption. Which of his risk factors for gastric cancer is non-modifiable?

1 point

East Asian Ethnicity

H. Pylori Infection

Smoking

Alcohol Use

Salt Consumption

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In Western populations there is a low incidence of gastric cancer, and therefore screening in average risk patients is not endorsed. That being said, there are some screening programs in areas where gastric cancer is more endemic, or for patients with hereditary cancer syndromes. Which of the following is a potential screening modality for gastric cancer?

1 point

Barium Enema

Manometry

Upper Endoscopy

Urea Breath Test

CT Imaging

Clear selection

You are on an oncology elective and have just been tasked to go and see Mrs. Hanna Pylorus, a 63 year old female who had a gastric biopsy showing intestinal gastric adenocarcinoma. On history she endorses long standing abdominal pain, as well as dysphagia, early satiety, melena stools, and weight loss. Physical exam is largely non-contributory except for the presence of melena stool on your glove following the digital rectal exam. Laboratory findings show a microcytic anemia. Which of the following is the most common symptom of gastric cancer at diagnosis:

1 point

Abdominal Pain

Dysphagia

Early Satiety

Melena Stools

Weight Loss

Clear selection

You are a 4th year medical student just starting an elective in rural family medicine. Your preceptor, Dr. Tummy, is a huge proponent of the early identification of cancer, which he believes can be achieved in part through conscious effort during your history, physical, and differential diagnoses. He gives you the following 5 hypothetical patients, and asks, which of the following patients would you consider for for further workup for suspected Gastric Cancer:

1 point

13 year old female, began menses 3 months ago, diet is low in iron, presenting to a family medicine clinic with iron deficiency anemia.

22 year old male, persistent vomiting following heavy drinking, presenting to the emergency department, was previously fine.

33 year old female, predominant epigastric pain for 3 months, is now losing weight without trying to, presenting to family medicine clinic.

54 year old male, having odynophagia and the sensation that something is stuck in his throat, on history you learn that he was eating chips and swallowed one whole, presenting to the emergency room.

28 year old primip female who reports a burning sensation in her stomach every time she lays down or has spicy foods, presenting to a family medicine clinic.

Clear selection

You are working in an oncology clinic and just about to see your patient Mr. Gus Trick. He is a 67 year old male who was recently diagnosed with gastric cancer. Mr. Trick was found to have metastatic disease, and he is presenting today to discuss treatment options. Other than the sequela of his gastric cancer, he is fairly healthy, and is willing to do whatever it takes. What is a good treatment regimen for him?

1 point

Endoscopic Mucosal Resection

Gastrectomy with Lymph Node Dissection

Radiation Therapy

Combination Chemotherapy

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You are a third year medical student who has just started their third year clinical rotation in Oncology. Today you will be working with Dr. Rumbly, who primarily treats Gastric cancers. You begin the day with a quick review of TNM staging. To gauge your knowledge she asks the following: If you have a patient with a known gastric cancer that has the following characteristics: The cancer invades the serosa, there are 24 positive regional lymph nodes, and metastasis to the pancreas. What TNM stage would it be?

1 point

T3a,N3b,M1

T3a,N2,M0

T4a, N1a, M0

T4b, N3b, M1

T4a,N3b,M1

Clear selection

Approximately how many patients who had gastric cancer treated surgically with curative intent will experience recurrence of their disease?

1 point

10%

20%

30%

40%

50%

Clear selection

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