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Med Surg II > Exam 1: Cancers of the GI System > Flashcards

Exam 1: Cancers of the GI System Flashcards

1
Q

Oral cancer generally involves the _______ or _______ ?

A

mouth or throat

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2
Q

Oral cancer is generally a ___________ cell cancer ?

A

“Squamous” cell cancer

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3
Q

What are the risk factors for Oral cancer ?

A
  • Tobacco use
  • ETOH
  • Sunlight (lips, external area)
  • Smoking a pipe
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4
Q

What are the Manifestation(s) of Oral cancer ?

A

The oral tissue can look white (Leukoplakia) from smoking

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5
Q

How is testing for Oral cancer done ?

A

Through Biopsy

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6
Q

What is the Tx for Oral cancer ?

A
  • Surgery (lesions need to be removed)
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7
Q

What is main concern after after oral cancer surgery ?

A

Nutrition

  • Want to make sure the patient is able to consume liquids (ex: boost) to get the necessary nutrients
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8
Q

What are Risks/complications of Oral Cancer ?

A
  • watch for bleeding
  • pain
  • dysphagia
  • difficulty swallowing
  • etc,.
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9
Q

True or False: Esophageal cancer is often advanced at the time of diagnosis ?

A

True

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10
Q

Esophageal cancers tend to be what ?

A

Adenocarcinomas

  • arise from the glandular tissue lining the esophagus
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11
Q

What are risk factors for Esophageal Cancer ?

A
  • Barrett’s Esophagus
  • ETOH consumption
  • Smoking
  • Occupational exposure to asbestos
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12
Q

What are Manifestations of Esophageal cancer ?

A

Early sign

  • Difficulty swallowing (feels like a lump in the throat)
  • Have a hard time eating things like meat, b/c its hard to get them down

Late sign
- Pain

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13
Q

How do they test for Esophageal cancer ?

A

Biopsy

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14
Q

Stomach Cancers tend to be what ?

A

Adenocarcinomas

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15
Q

What are the Risk factors for stomach cancer ?

A
  • Asain population
  • Smoking
  • Obesity
  • Exposure to irritants (ex: Tobacco)
  • Reflux of bile into the stomach
  • Anti-inflammatory drugs over time causing injury
  • Smoked foods
  • Salted fish & meat
  • Pickled vegetables
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16
Q

Manifestations such as………. are seen with what type cancer ?

  • Unexplained weight loss
  • Early satiety (being full)
  • Fatigue (d/t anemia that isn’t being picked up from a very small GI bleed)
  • Hemorrhaging (which may not be noticeable in th stool)
A

Stomach Cancer

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17
Q

What type of Testing is used for Stomach cancer ?

A

EGD w/ biopsies

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18
Q

What is the Tx for Stomach Cancer ?

A 
- Billroth I or II
        OR 
- A total Gastrectomy (depending on size & location of tumor)
- Combination chemotherapy/radiation
- Targeted therapy (If applicable)
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19
Q

What are the Risks/complications of Stomach cancer ?

A

If a pt. had a total gastrectomy
- would be worried about a leak at the anastomosis site

After a gastrectomy

  • worried about dumping syndrome
  • worried about vitamins that have not been absorbed
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20
Q

True or False: If a pt. has an NG tube after a total gastrectomy , we DO NOT irrigate the NG tube ?

A

TRUE !

B/c were always concerned about the suture lline

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21
Q

True or False: With Stomach cancer, immediately post-op the pt’s will be having IV fluids ?

A

True

  • Will need lots of fluids !
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22
Q

What is the Tx for Esophageal cancer ?

A

A combination of surgery and then depending on the stage of cancer, chemotherapy or radiation

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23
Q

What are Risks/complications of Esophageal cancer ?

A
  • Airway !!!
  • after surgery if we have resected something and there is inflammation, etc, we WANT TO MAKE SURE THE AIRWAY STAYS PATENT !!!
24
Q

What are other complications of Esophageal cancer ?

A
  • Communication: can be difficult
  • Nutrition!!!
    • B/c these pt’s are not going to be able to eat through their mouth for a while.
    • They will have a temporary gastrotomy tube, so we can feed into the stomach until the esophagus heals
25
Q

What is the second leading cause of death from cancer ?

A

Colorectal cancer

26
Q

Colorectal cancer is more common in what sex ?

A

Males

27
Q

Colorectal cancer is the leading cause of death seen in what race ?

A

African Americans

  • possibly d/t poor diet, poor screenings, decreased access to health care, etc.
28
Q

Colorectal cancer, is typically what type of cancer ?

A

Adenocarcinoma

29
Q

What are Risk factors for Colorectal Cancer ?

A
  • Family Hx (1st degree relative: mom, dad,sibling)
  • IBD (ex: Crohn’s, UC, Polyps)
  • Obesity (BMI > - 30)
  • Red meat (>- 7 servings per week)
  • Smoking
  • ETOH (> 4 drinks per week)
  • DM
30
Q

True or False: Physical exercise, a diet high in fruits, vegetables, and grains decreases the risk for colon cancer ?

A

True :)

31
Q

True or False: Colorectal cancer can very much be asymptomatic until the disease is advanced ?

A

True :(

32
Q

True or False: We need to do A LOT of teaching w/ patients in regards to colorectal cancer ?

A

True

33
Q

True or False: Screenings for colorectal cancer are very important !?

A

True

34
Q

True to False: Not everybody with colon cancer ends up with an ostomy ?

A

True

35
Q

Manifestations such as…. are seen with what type of cancer ?

  • Insidious onset may be vague and nonspecific
  • Abdominal discomfort
  • Fatigue (may be d/t some loss of blood- visible or not)
  • Rectal bleeding (if low enough in the colon)
  • Sensations of incomplete evacuation
  • Weight loss
  • Change in stools (color, shape, consistency, pattern)
A

Colon cancer

36
Q

What is the Management for colon cancer include ?

A
  • Surgery* - only curative Tx
    • depends on location & involvement, regarding type of surgery
  • Prognosis coorelates with staging
  • Procedures
    • Right hemicolectomy (if thats the side its on)
    • Left hemicolectomy (If thats the side its on)
    • Abdominal-Perineal resection
37
Q

What type of procedure for colon cancer involves, 1 incision in the abdominal area, and 1 incision in the perineal/rectal area ?

A

Abdominal - Perineal resection

  • in this case an ostomy is formed
38
Q

The symptoms below, correlate to colon cancer in which area of the Large intestine (colon) ?

  • Pain
  • Mass
  • Change in bowel habits
  • Anemia
A

Ascending colon

39
Q

The symptoms below, correlate to colon cancer in which area of the Large intestine (colon) ?

  • Pain
  • Obstruction
  • Change In bowel habits
  • Anemia
A

Transverse colon

40
Q

The symptoms below, correlate to colon cancer in which area of the Large intestine (colon) ?

  • Pain
  • Change in bowel habits
  • bright red blood in stool
  • Obstruction
A

Descending colon

41
Q

The symptoms below, correlate to colon cancer in which area of the Large intestine (colon) ?

  • Blood in stool
  • Change in bowel habits
  • Rectal discomfort
A

Rectum

42
Q

True or False: Pt’s with cancer in either the ascending or transverse colon, may or may not have pain ?

A

True

43
Q

Stools are more liquidly in what area of the Large intestine (aka: colon) ?

A

Ascending colon

44
Q

Stools are more formed, in what part of the large intestine (aka: colon) ?

A

Descending colon

45
Q

What are Diagnostics used for Colon cancer ?

A
  • Rectal exam
  • Testing stool for occult blood
  • Sigmoidoscopy
  • COLONOSCOPY - Gold Standard !
  • CEA (Carcinoembryonic Antigen)
  • DNA test
  • CT scan
46
Q

True or False: Sometimes with a digital rectal exam, with a gloved finger, polyps can be palpated ?

A

True

47
Q

What type of diagnostic test for colon cancer involves, a scope that goes up through the rectum and visualizes the sigmoid colon ?

A

Sigmoidoscopy

48
Q

What type of diagnostic test involves bowel prep and inserting a scope through the anal area, and the scope can go up and all the way around & look at the intentional tissue ?

A

Colonoscopy ! (Gold Standard)

49
Q

True or False: the diagnostic test (blood test) CEA = a tumor marker ?

A

True

-CEA shouldn’t normally be secreted by us
an embryo would make this substance…??

50
Q

An example of a DNA diagnostic test for colon cancer is what ?

A

Cologuard

51
Q

True or False: If a pt. does a DNA diagnostic test (ex: Cologuard) and DNA changes are seen in the stool, that will most likely lead a physical to order a colonoscopy where they can actually look at the intestinal mucosa through their scope ?

A

True

52
Q

True or False:

  • Cologuard is intended for people who are not high risk for colon cancer
  • More providers are starting to offer it because its much less expensive & doesn’t involve a bowel prep ?
A

True

53
Q

For individuals at average risk for colon cancer, they should have one of the following procedures starting at age 50 for prevention and screening ?

A
  • Sigmoidoscopy (every 5yrs)
  • Colonoscopy (every 10yrs)
  • Virtual colonoscopy (every 5yrs)*
  • Double-contrast barium enema (every 5yrs)*
  • if positive –> do colonoscopy
  • If polyps removed, colonoscopy moved up to every 5yrs
54
Q

If your at increased or high risk for colon cancer, prevention & screening usually start between what ages ?

A

40 to 50yrs

- Sometimes even earlier than that

55
Q

If you are at increased or high risk for colon cancer, how often should you have a colonoscopy ?

A

Every 5yrs

56
Q

If there is a family hx of colon cancer, what age should screening begin at ?

A

Begin at 40 or 10yrs before the age of the youngest family member diagnosis

Ex: if you had a parent you had colon cancer at age 45, then you would probably start screening at age 35

Med Surg II (13 decks)

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