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Med Prep > onco - esophagus, stomach, colon, rectum > Flashcards

onco - esophagus, stomach, colon, rectum Flashcards

0
Q

Esophageal Ca is most common in what sex? Age?

A

M

>50

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1
Q

Lining of esophagus

A

Stratified squamous

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2
Q

Most common benign tumor of esophagus?

A

Leiomyoma

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3
Q

Presenting symptoms of esophageal Ca

A

Dysphagia - most common
Weight loss
Regurgitation

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4
Q

Diagnosis for esophageal Ca

A

Barium swallow

Esophagoscopy

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5
Q

Seen in barium swallow in esophageal Ca

A

Filling defect

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6
Q

Confirmatory procedure for esophageal Ca after barium swallow

A

Esophagoscopy

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7
Q

Why is biopsy contraindicated in diagnosis of esophageal Ca?

A

Destroys mucosa, can affect the result. Violates the mucosa making subsequent surgery (otherwise lesion will be disturbed)

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8
Q

Treatment for esophageal Ca

A

Esophagectomy

Percutaneous endoscopic gastrostomy (PEG)

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9
Q

Treatment of choice for esophageal Ca if upper 3rd is affected

A

Surgery, esophagectomy

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10
Q

Treatment of choice for esophageal Ca if lower 3rd is affected

A

RT

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11
Q

Why is endoscopy contraindicated during surgery?

A

Could perforate esophagus

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12
Q

Etiology of esophageal Ca

A

Alcohol ingestion
Cigarette smoking, opiates
Food additives (Nitrate,Fungal toxins in pickled veggie)
Poor dental hygiene
Hot drinks, lye ingestion
Esophageal disorders (Esophagitis, achalasia, Mallory-Weiss, gerd, Plummer-Vinson)

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13
Q

Esophagitis is an infection caused by..

A

Herpes simplex
CMV
Candidiasis, aspergillosis

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14
Q

Motor disorder characterized by aperistalsis, failure of relaxation of LES and increased basal tone of LES

A

Achalasia

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15
Q

Gross appearance of achalasia

A

Proximal dilatation (Bird’s beak)

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16
Q

Complication of long standing reflux esophagitis or gerd where in squamous cell becomes columnar

A

Barrett’s esophagus

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17
Q

Barrett’s esophagus has increased risk for what type of esophageal Ca?

A

Adenocarcinoma

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18
Q

Most common esophageal Ca

A

SCC

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19
Q

Rare esophageal Ca

A

Mucoepidermoid Ca

Adenoid cystic

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20
Q

Most commonly affected site of Ca of SCC of esophagus

A

Middle 1/3

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21
Q

Most commonly affected site of adenocarcinoma of esophagus

A

Distal. 1/3

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22
Q

Metastatic site of esophageal

A

Liver
Bone
Brain

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23
Q

Earliest metastasis of esophageal Ca

A

Liver, due to chronic drinking

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24
Q

T/F: if esophageal Ca is accompanied with pneumonia, it has poor prognosis

A

True

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25
Q

Size of esophagus

A

25cm

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26
Q

3 areas of narrowing in esophagus

A
  1. Beginning of esophagus (cricopharyngeus m)
  2. Where l mainstream bronchus and aortic arch cross
  3. At hiatus of diaphragm
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27
Q

Cricopharyngeus muscle

Prevents passage of excess air into the stomach during breathing

A

Upper esophageal sphincter UES

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28
Q

Physiologic sphincter
Relaxes with the initiation of pharyngeal swallow and prevents reflux of gastric content when swallowing is not occurring

A

Lower esophageal sphincter LES

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29
Q

I ate 10 eggs at noon

A

IVC - T8
Esophagus - T10
Aorta - T12

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30
Q

Contraindication for surgery of esophageal mass

A 
Poor performance status
Severe malnutrition
Vocal cord palsy
Broncho-esophageal fistula
Invasion of great vessels 
Cervical/celiac node involvement
Distant metastasis
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31
Q

Mechanical injury of esophagus with laceration with a clinical seething of chronic alcoholics after bout of severe vomiting

A

Mallory-Weiss syndrome

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32
Q

Syndrome characterized with dysphagia, iron def anemia and esophageal web

A

Plummer-Vinson syndrome

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33
Q

Most common gastric Ca

A

Adenocarcinoma

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34
Q

2nd most common gastric Ca

A

Lymphoma -GIST, leiomyosarcoma

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35
Q

Gastric Ca is commonly seen in what age?

A

50-70

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36
Q

Etiologic factors for gastric Ca

A 
Nitrosamines
Atrophic gastritis
Achlorhydria
Pernicious anemia (folic acid def)
Blood type a
Cdh1
37
Q

Presenting symptoms of gastric Ca

A

Anorexia, weight loss, epigastric pain

38
Q

Diagnosis for gastric Ca

A 
GI series (upper gi series>
Barium swallow 
Biopsy - guided by endoscopy
39
Q

Classification of gastric Ca

A

Ulcerating - diffuse type

Fungating - intestinal type

40
Q

Among classif go gastric Ca, which is the most common? Least common.

A

Ulcerating - most common

Fungating - least common

41
Q 
Ulcerating/fungating: 
No cell cohesion
Ca develops throughout stomach 
Poor prognosis
No asso risk factor
Younger pts
A

Diffuse, ulcerating

42
Q 
Ulcerating/fungating: 
Cohesive neoplastic cells
Ca appears in atrium and lesser curvature 
Good prognosis
Asso risk factor: h.pylori
Older pts
A

Fungating, intestinal

43
Q

A loss of distensibility of gastric wall resulting to a leather bottle appearance called

A

Linitis plastica

44
Q

Linitis plastica is seen in what type of gastric Ca?

A

Diffuse, ulcerating

45
Q

Treatment of choice for gastric Ca if distal part is affected

A

Subtotal gastrectomy

46
Q

Treatment of choice for gastric Ca if proximal part is affected

A

Total gastrectomy

47
Q

T/f: Gastric Ca is radioresistant

A

True. RT is for palliation of pain

48
Q

Closely asso with gastric Ca, where Ca starts.

A

Adenomatous polyps

49
Q

T/f: duodenal Ca is not asso with gastric Ca

A

True

50
Q

Gastric Ca that metastasize to ovaries

A

Krukenberg tumor

Signet ring appearance

51
Q

Gastric Ca that metastasize to Periumbilical region

A

St Mary Joseph node

52
Q

Gastric Ca that metastasize to peritoneal cul de sac

A

Blumer’s tumor

53
Q

Most common site of hematogenous spread of gastric Ca

A

Liver

54
Q

Post gastrectomy complication

A

Dumping syndrome
Postvagotomy diarrhea
Gastritis

55
Q

Dumping syndrome

A 
Symptoms:
Epigastric pain
Diarrhea
Nausea and vomiting
Palpitations
Dizziness 
Flushing, sweating
Signs: 
Tachycardia, elev.bp
56
Q

Prevention for dumping syndrome

A

Eat Small quantity of food
Avoid carbs
Decrees fluid intake

57
Q

Postvagotomy diarrhea resolves after

A

1yr

58
Q

Most commonly affected by gastrectomy which makes it more difficult to perform

A

Pancreas

59
Q

If pancreas and duodenum is affected and performed after gastrectomy, what do you call the procedure

A

Whipple’s procedure - pancreaticoduodenectomy

60
Q

Prognosis or staging of gastric Ca depends on

A

Depth of invasion to gastric wall

Extent of mets and lymph node involvement

61
Q

Most common small bowel Ca

A

Adenocarcinoma > carcinoid > lymphoma

62
Q

Presenting signs of small bowel or colon Ca

A 
Abdominal distention
Obstruction 
Intussusception
Diarrhea 
Melina
63
Q

Asso disease with adenocarcinoma of small bowel or colon Ca

A 
Celiac disease
Crohn's disease
Celiac disease
FAP
PJ syndrome
64
Q

Small intestine enters large intestine due to persistent peristalsis without intake

A

Intussusception

65
Q

Intussusception is more common in what age?

A

Children

66
Q

Treatment for Intussusception

A

Surgery, reduction

67
Q

If in Intussusception there is cyanosis what procedure will you do?

A

Segmental resection, colostomy

68
Q

Most common site of adenocarcinoma of small bowel Ca

A

Distal duodenum > jejunum > ileum

69
Q

SR of small bowel Ca

A

25% 5 year survival

70
Q

Most common site if carcinoid tumor of small bowel Ca

A

Appendix > ileum > rectum

71
Q

An inflammatory bowel disease which forms granulomatous ileitis with bloody diarrhea and pain

A

Crohn’s disease

72
Q

Most common site of crohn’s disease

A

Ileum

73
Q

What can you see in barium enema in person with Crohn’s disease?

A

Skip lesions of Cobblestone appearance

74
Q

Treatment for crohn’s disease

A

Metronidazole

75
Q

Which is most common.. L or R colon Ca.

A

R colon Ca

76
Q

Colon Ca is most common in what sex?

A

Female

77
Q

Rectal Ca is most common in what sex?

A

Male

78
Q

Left sided colon Ca presenting signs

A

Change in bowel habit
Small caliber stool
Obstruction

79
Q

R sided colon Ca presenting signs

A 
Anemia
Fatigue
Melena
Less solid stools
Occult bleeding
Weakness
80
Q

What can yours see in barium enema of left sided Colon ca?

A

Apple core

81
Q

Risk factors for colon Ca

A 
>50 y/o
Personal history of Resected colon
Family history
Low fiber, high fat diet
FAP, HNPCC
Long standing UC or crohn's disease
82
Q

Colon Ca diagnosis

A 
Barium enema
Endoscopy
Proctosigmoidoscoy
Colonoscopy
CT scan
Intravenous pyelography (IVP)
83
Q

Mutated gene in APC.

A

C5

84
Q

FAP + osteomas

A

Gardner’s syndrome

85
Q

FAP + Gliomas

A

Turcot’s syndrome

86
Q

Most common site of rectal Ca

A

Lower 3rd

87
Q

S&s of rectal Ca

A 
Change in bowel habits
Alternating constipation and diarrhea
Tenesmus
Anal bleeding 
Lump
Itching
88
Q

Risk factors for rectal Ca

A 
HPV 
HIV
Smoking
Multiple sexual parter
Anal inter ours 
Immunosuppressed state
89
Q

2 unique in situ tumors of perianal skin

A
  1. Paget’s disease - adenoca in situ

2. Bowen’s disease - SCC in situ

90
Q

Diagnosis of rectal Ca

A

Direct rectal examination

Med Prep (52 decks)

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