GI Malignancies, Colorectal Cancer Screening

Question 1

T/F: GI malignancies can be detected early due to the early presentation of symptoms (diarrhea/constipation).

Answer 1

False. Frequently asymptomatic until late stages

Question 2

Biggest risk factor to GI malignancies

Answer 2

Smoking

Question 3

Treatment for head and neck cancers (3)

Answer 3

Radiation
Surgery
Percutaneous Endoscopy Gastrostomy (PEG) for nutrition

Question 4

T/F: Dysphagia in head and neck cancer is due to the tumor.

Answer 4

False. Due to tumor AND therapy

Question 5

The initial step for evaluating esophageal cancer

Answer 5

Endoscopy w/ biopsy

Question 6

Staging of esophageal cancer
Distal metastasis:
Local staging:

Answer 6

Distal: CT/PET
Local: endoscopic US

Question 7

Which of the following is NOT a symptom of esophageal cancer?
A. Progressive dysphagia
B. Diarrhea
C. Vomiting
D. Fatigue
E. Anemia
F. Weight loss

Answer 7

B

Question 8

Most common type of esophageal cancer in US

Answer 8

Adenocarcinoma

Question 9

Which of the following treatment options is NOT part of curing esophageal cancer?
A. Esophagectomy w/ gastric pull up
B. Chemo and radiation
C. PEG tube placement
D. Nasogastric tube

Answer 9

C. Don’t place PEG b/c can scar b/w stomach and abdominal wall → makes sx more tricky

D. Nasogastric tube for nutritional support PRN

Question 10

Which of the following treatment options is NOT part of palliative therapy for metastatic esophageal cancer?
A. Esophageal stent
B. Tumor debulking
C. PEG tube
D. Chemo and radiation

Answer 10

ALL are correct

D. shrinks tumor

Question 11

Jaundice, malabsorption, pruritis and abdominal pain are symptoms of ____

Answer 11

pancreatic cancer

Question 12

T/F: CEA is useful in evaluating pancreatic cancer.

Answer 12

False. CA19-9 for pancreatic cancer but not specific. CEA used to monitor recurrence in colorectal cancer

Question 13

T/F: Patients with stage 4 colorectal cancer should receive palliative treatment only.

Answer 13

False. Some stage 4 patients can be cured with surgery and chemo.

Question 14

Curative treatment for rectal cancer

Answer 14

Surgery + chemo + RADIATION

Other colorectal cancer treated with only surgery + chemo

Question 15

T/F: Surgery can be used to debulk tumors as a palliative treatment in colorectal cancer.

Answer 15

False. NO surgery in palliative management.

Question 16

Which of the following is NOT an evaluation method for all colorectal cancer?
A. Colonoscopy w/ biopsy
B. Universal testing for HNPCC
C. CT
D. EUS, MRI

Answer 16

D. Only for rectal cancer

Question 17

Surveillance techniques of colorectal cancer (3)

Answer 17

CT
CEA
Colonoscopy

Question 18

T/F: Flexible sigmoidoscopy for colorectal screening does not require bowel prep.

Answer 18

False. All invasive screening methods require bowel prep

Other methods:
Colonoscopy
Barium enema
CT colonography

Question 19

T/F: CT colonography can remove precancerous polyps.

Answer 19

False. Only endoscopies can

Question 20

MOST important question in screening colorectal cancer

Answer 20

Has anyone in your family had ANY kind of cancer? (What kind? How old?)

Question 21

When to screen for colorectal cancer?

Average risk population

Answer 21

50 y/o

Question 22

When to screen for colorectal cancer?

1st degree relative w/ CRC

Answer 22

40 y/o OR 10 years younger than relative’s diagnosis

Question 23

When to screen for colorectal cancer?

Grandparent w/ CRC

Answer 23

50 y/o. Average risk b/c NOT 1st degree relative.

Question 24

When to screen for colorectal cancer?

Ulcerative colitis

Answer 24

8 years after dx, every 1-2 years

Question 25

When to screen for colorectal cancer?

Primary sclerosing cholangitis AND Ulcerative colitis

Answer 25

Startwhen diagnosis made

Question 26

When to screen for colorectal cancer?

Familial Adenomatous Polyposis

Answer 26

10 y/o Prophylactic colectomy

Question 27

When to screen for colorectal cancer?

FHx of Hereditary Non-Polyposis Colorectal Cancer

Answer 27

20 y/o OR 10 years younger than relative diagosis