Gastric cancer Rx question

[Enzymes]

I just did a question from USMLE Rx on gastric cancer, diffuse type. It clearly showed signet rings on histology and metastasis to the left supraclavicular node. The question asked what predisposed to the cancer.

Answer was nitrosamines...I am confused about this because Pathoma said that diffuse type was NOT associated with the usual risk factors (H. pylori, nitrosamines) of the intestinal type of gastric carcinoma. Does this question make sense to anyone?

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[BlueJay25]

I was under the same impression as you.

As far as I know, the only risk factors for Diffuse Gastric cancer are Blood Group A, and mutations in the E-Cadherin (CDH1) gene which is a hereditary risk. I haven't heard of nitrosamines causing the increased risk of diffuse gastric cancer.

 

[wonderbread12]

I just did a question from USMLE Rx on gastric cancer, diffuse type. It clearly showed signet rings on histology and metastasis to the left supraclavicular node. The question asked what predisposed to the cancer.

Answer was nitrosamines...I am confused about this because Pathoma said that diffuse type was NOT associated with the usual risk factors (H. pylori, nitrosamines) of the intestinal type of gastric carcinoma. Does this question make sense to anyone?

was the person Japanese?

 

[dingohopper]

yea it seems like Rx is wrong. in robbins, intestinal-type stomach cancer rates are decreasing, while diffuse-type has remained the same. it would seem that you can tackle intestinal-type risk factors (i.e. nitrosamines), but not diffuse-type (hereditary)

 

[syoung]

Our lecture slides say Diffuse type has no known risk factors, that it arises w/out dysplastic precursors; more common in young Mean age 48, M=F. Agree w/ you on the rest about intestinal type, it has alllll of the risk factors

 

[MD22412]

Rx has mistakes throughout the qbank so just take it and move on as a reflection of you knowing FA. Recall that FA updates each yr whereas Rx less so. UW is the qbank you'll be doing last to sharpen your knowledge