Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oncology > Upper GI > Flashcards

Upper GI Flashcards

1
Q

Distance from incisors

A

Cervical: 18cm
Upper 1/3: 24cm
Middle 1/3: 32 cm
Lower 1/3 : 40cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the histology of a tumour at the cervical esophagus

A

Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Out of all the upper GI tumours, which location has the best prognosis

A

Cervical esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the histology of a tumour at the thoracic esophagus

A

Combination of squamous and adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the histology of the esophageal junction

A

Adenocarcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the main histologies of the upper GI

A

Adenocarcinoma
Squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the other lesser histologies of the upper GI

A

Muceoepidermoid
Adenoid cystic carcinoma
Melanoma
Small cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some risk factors that contribute to upper GI tumours

A
  • smoking alcohol
  • Barrett’s esophagus
  • tylosis
  • Plummer Vinson / Patterson Kelly syndrome
  • caustic injury
  • achalasia
  • heliobacter infection
  • Previous aerodigestive tract malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Name the countries have the most occurrences of upper GI cancer to the lowest

A
  • Iran / northern china
  • Sri Lanka / India / South Africa / France / Switzerland
  • japan / Great Britain / Canada
  • USA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What age is upper GI most likely diagnosed

A

Age 60-80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the local / regional symptoms of a tumour in the esophagus

A
  • dysphagia
  • odynophagia
  • Melena, hematochezia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the local / regional symptoms of a tumour in the airway

A
  • cough
  • shortness of breath
  • pneumonia (TE fistula)
  • stridor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the local / regional symptoms of a tumour in the mediastinum

A
  • retrosternal pain
  • hoarseness of voice
  • SVC obstruction
  • hemorrhage (erosion into aorta)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are systemic symptoms caused by metastatic involvement in the esophagus

A

Cough
Shortness of breath
Bone pain
Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where are systemic constitutional symptoms of upper GI

A
  • weight loss
  • anorexia
  • fatigue
  • fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some tools for diagnosis for esophageal cancer

A
  • barium swallow
  • upper endoscopy / esophagogastroscopy (EGD) + biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some staging procedures for esophagus

A
  • CT chest / abdo
  • OGD / EGD
  • EUS
  • PET
  • Bronchoscopy
  • Nasolaryngoscopy
  • Bone scan
  • CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the layers of the lumen

A
  • mucosa
  • submucosa
  • muscularis propia
  • adventia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If a tumour’s epicenter is within 2 cm of the esophagogastric junction and extends into the esophagus, what is it classified and staged as

A

Esophageal scheme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If a tumours epicenter involves the esophagogastric junction and is within the proximal 2cm of the cardiac what is it staged as

A

Esophageal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If a cancer’s epicenter is more than 2cm distal from the EGJ, what will they be staged as

A

Stomach cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are forms of esophagus surgery

A
  • transhiatal esophagectomy
  • transthoracic esophagetcomy
  • en bloc esophagectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the fractionations of esophageal cancer with chemotherapy

A

Cervical : 70/35
Resectable: 41.4 / 23
Unresectable concurrent: 50 / 25 , 50.4 / 28
XRT alone : 50/20 , 60/30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the fractionations of esophageal cancer with RT alone

A

50 / 20
60 / 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What radiation therapy techniques are used in esophageal cancer

A

IMRT / VMAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Inhaling and exhaling will move the gtv in which direction

A

Exhale (sup)
Inhale (inf)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are some acute side effects of treatment for esophageal cancer

A
  • esophagitis
  • skin erythema/ dry desquamation
  • tracheotomy
  • pneumonitis
  • gastritis
  • fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are some late side effects of treatment for esophageal cancer

A
  • stricture, fistula
  • pulmonary fibrosis
  • ischemic heart disease, pericarditis
  • spinal cord myelopathy
  • gastric ulcer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are fractionations for palliative care of esophagus cancer

A

30/10
20/5
8/1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are some predisposing conditions of gastric cancer

A
  • nutritional (salt, nitrate, low vitamin A/C, smoked foods
  • occupational (rubber coals)
  • smoking
  • HPV, EBV
  • radiation exposure
  • prior gastric surgery for ulcers
  • genetic : type A blood, pernicious anemia, HNCC, Li fraumeni,
  • precursor : adenomatous polyps, chronic gastritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What counties is gastric cancer most common

A

Japan, South America, Eastern Europe, Middle East

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are stomach local/regional symptoms of gastric cancer

A
  • dysphagia
  • vomiting
  • early satiety
  • melena, hematochezia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are abdominal local/regional symptoms of gastric cancer

A
  • bowel obstruction
  • malignant fistula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are metastatic (systemic) symptoms that occur in gastric cancer AND esophageal cancer

A
  • cough
  • shortness of breath
  • bone ache
  • headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are constitutional (systemic) symptoms that occur in gastric cancer

A
  • weight loss
  • anorexia
  • fatigue
  • fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are some classic signs of stomach cancer (types of spread)

A

Peritoneal
Nodal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are some examples of peritoneal spread

A

Krukenberg’s tumoru
Blumer’s shelf
Melena, hematochezia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are some examples of nodal spread in stomach cancer

A

Left supraclavicular node
Left axilla
Periumbilical nodal deposit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the histologies of stomach cancer

A

Adenocarcinoma carcinoma
SCC
Adenocanthoma
Carcinoid
Lymphoma
Leiomyosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

TNM staging for stomach cancer : T

A

1a: invade lamina propia, muscularis mucosae
1b: submucosa
2: muscularis propria
3: subserosal connective tissue without invasion of the visceral peritoneum or adjacent structures
4a: serous (visceral peritoneum)
4b: adjacent structures/organs

41
Q

TNM staging for stomach cancer : N

A

1: 1-2
2: 3-6
3a: 7-15 nodes
3b: 16 or more nodes

42
Q

What are the regional nodes of the stomach

A
  • perigastric
  • nodes along lesser and greater curvature
  • left gastric
  • common hepatic
  • splenic
  • cardiac arteries
  • hepatodeodenal nodes
43
Q

Regional nodes of the GE junction

A
  • pericardial, left gastric, celiac, diaphragmatic, lower esophageal
44
Q

What its the 5 year survival for node negative and positive

A
  • : 40-60%
    + : 10-30%
45
Q

What is the chance of local regional failure after resected gastric cancer

A

70-90%

46
Q

What is the dose constraint of the spinal cord

A

< 5% receives > 45gy
0% receives > 50gy

47
Q

What lymphnodes are included in the CTV post surgery

A
  • gastric
  • gastroepiploic
    -celiac
  • porta hepatis
  • subpyloric
  • paraaortic
  • gastroduodenal
  • suprapancreatic
48
Q

What part of the stomach is included in the CTV (what sites)

A
  • proximal 1/3
49
Q

For proximal T3/4 lesions a what part of the hemidiaphragm is included in the CTV

A

The medial 2/3 - 3/4 left hemidiaphragm

50
Q

What part of the CTV is included for tumours invading the GE junction with positive lymphnodes

A

Distal 4cm of esophagus and periesophageal lymph nodes will be included

51
Q

What part of the CTV is included for tumours in the distal 2/3 of the stomach

A

Retropancreaticduodenal lymphnodes (inferior boarder of L3/4)

52
Q

What are some risk factors of pancreatic cancer

A
  • smoking
  • diet
  • prior radiation
  • genetic (10%) - BRCA2
  • occupational exposure (chlorinated hydrocarbons, formaldehyde, pesticides)
  • predisposing illnesses (chronic pancreatitis, diabetes)
53
Q

Which races have the highest prevalence of pancreatic factors

A

US, black 12 / 100, 000
Japan, Europe, USA 9 / 100, 000
Hong Kong, Spain, Singapore 4 / 100, 000

54
Q

What is the common histology of pancreatic cancer

A

Ductal adenocarcinoma

55
Q

What are the other histologies of pancreatic cancer

A

Acinar cell
Adenosquamous carcinoma
Cystasquamous carcinoma
Cystadenocarcinoma
Papillary mucinous carcinoma
Signet ring carcinoma
Undifferentiated carcinoma
Giant cell carcinoma
Mixed type
Small cell type carcinoma
Unclassified
Pancreatoblastoma

56
Q

What are some clinical manifestations of pancreatic cancer . And what percentage of these are present in patients

A
  • pain jaundice
  • weight loss
  • epigastric pain
  • diabetes
    70-95%
57
Q

How is pancreatic cancer staged

A
  • CBC, lytes, CA19-9
  • CT chest/abdomen/pelvis
  • MRI pancreas
  • ERCP/MRCP with biopsy
  • endoscopic ultrasound with biopsy
58
Q

What is the TNM staging for pancreatic cancer : T

A

T1: tumour is <2cm
T1a: tumour is < 0.5 cm in greatest dimension
T1b: tumour is between 0.5 and 1cm
T1c: tumour is 1-2cm
T2: tumour is between 2 and 4 cm
T3: tumour is greater than 4 cm
T4: tumour involves celiac axis, superior mesenteric artery, and or common hepatic artery regardless of size

59
Q

What is the 5 year survival rate for PDAC

A

Pancreatic ductal adenocarcinoma <10%

60
Q

What are the clinical challenges of PDAC

A

Few symptoms / late diagnosis
Early locoregional invasion and distant metastasis
Post operative recurrence
Resistant to chemotherapy and radiotherapy

61
Q

What is the percentage of are patients resectable at diagnosis

A

Less than 20%

62
Q

What are the major advances of PDAX

A

FOLFIRINOX
Gemcitabine/abraxane
SBRT

63
Q

What is the treatment process of an SBRT pancreas

A
  • EUS guided fiducial placement
  • 33-40 in 5 fractions every other day
  • need to be off chemo for 2 weeks then resume 2 weeks after SBRT
64
Q

What is the 5th most common solid organ and 3rd most common cause of cancer death globally

A

Hepatocellular carcinoma

65
Q

What is the gender ratio for hepatocellular carcinoma

A

Male to female 3:1

66
Q

What is the percentage of hepatocellular carcinoma in less developed regions of the world

A

> 80%

67
Q

What are the most common regions to have hepatocellular carcinoma

A

East Asia, Africa (middle, east, then west)

68
Q

What age is hepatocellular carcinoma most common

A

6th decade of life

69
Q

What is the 5 year survival rate for HCC

A

<12%

70
Q

What are the screening tools for HCC for high risk patients

A
  • liver U/S 6-12 months
  • AFP 6-12 months (high false positive)
71
Q

What are diagnostic tools for HCC

A

CBC, LFTs, Cr, coagulation profile, hepatitis profile, AFP
Triphasic CT or MRI
Calculate child Pugh score
Staging CT chest/abdomen/pelvis to rule out distant metastasis Post
Biopsy

72
Q

What are curative options of HCC

A
  • partial hepatectomy
  • liver transplant
73
Q

What are the Milan criteria

A
  1. Single tumour less than 5 cm
  2. Not more than three foci of tumour each one not exceeding 3cm
  3. No Angiovasion
  4. No extrahepatic involvement
74
Q

What are some locoregional therapies of HCC

A

Tumour ablation (RFA)
TACE
SBRT

75
Q

What RT modality is good for locally advanced HCC

A
  • SBRT
76
Q

What are some side effects to SBRT

A

Fatigue
RUQ pain
Nausea
Decline in liver function
Liver disease

77
Q

What is the percentage of patients that have a recurrence in 5 years after partial hepatectomy

A

75%

78
Q

What is the histology of liver cancer

A

Well differentiated or poorly differentiated

79
Q

What is the treatment for cervical esophagus (and chemo and dosage pls!)

A
  • primary treatment: XRT
  • concurrent CRT
    70/35 with cisplatin
  • advanced is palliation
80
Q

What is the treatment for upper,middle, and lower esophagus (and chemo and dosage pls!) for resectable

A

Primary : surgery
Standard: resectable
- Neoadjuvant CRT (carboplatin and paclitaxel with 41.4/23)

81
Q

What is the treatment for upper,middle, and lower esophagus (and chemo and dosage pls!) for unresectable

A

Primary: surgery
- concurrent CRT (50/25 or 50.4/28 with cisplatin and 5FU)
XRT alone = 50g/20 or 60/30

82
Q

What is the diagnostic procedure for gastric cancer

A
  • OGD/EGD + biopsy
83
Q

What is the staging procedure for gastric cancer

A
  • upper GI series (barium meal)
  • OGD/EGD
  • CT chest / abdomen
  • laparoscopy
  • bone scan
  • CXR
84
Q

What is the primary treatment for gastric cancer

A

Surgery

85
Q

What is the treatment procedure for gastric cancer ? Doses pls

A
  • surgery
  • concurrent CRT
  • chemo on 1st and last 3 days of XRT
  • XRT dose: 45/25
  • 1 month rest
  • 2 more cycles of chemotherapy
  • sometimes preoperative chemo to shrink tumour before surgery
86
Q

Diagnostic procedures for pancreatic cancer

A
  • CT abdo
  • upper endoscopy
  • biopsy
87
Q

What is the staging procedures for gastric cancer

A
  • ERCP
  • MRI
    CT chest/ abdo
  • bone scan
  • CXR
88
Q

How is M category defined in pancreatic cancer

A
  • NCCN
    Findings on imaging
    Resectable, boarderline resectable, locally advanced unresectable, metastatic
89
Q

What is the primary treatment for pancreatic cancer

A
  • surgery
90
Q

What is the primary treatment for pancreatic cancer

A
  • surgery
91
Q

What is the treatment procedure for resectable pancreatic cancer (chemo and doses included)

A
  • adjuvant chemo
  • adjuvant CRT if positive margins
  • XRT : 45-54gy/25-30 with gemcitabine or 5FU)
92
Q

What is the treatment procedure for resectable pancreatic cancer (chemo and doses included)

A
  • adjuvant chemo
  • adjuvant CRT if positive margins
  • XRT : 45-54gy/25-30 with gemcitabine or 5FU)
93
Q

What is the treatment procedure for boarder line resectable pancreatic cancer (chemo and doses included)

A
  • Neoadjuvant (4-6 cycles of FOLFIRINOX)
  • restage during chemo if no response : CRT (45-54/25/30 + gemcitabine)
  • then surgery
94
Q

What is the treatment procedure for boarder line resectable pancreatic cancer (chemo and doses included)

A
  • Neoadjuvant (4-6 cycles of FOLFIRINOX)
  • restage during chemo if no response : CRT (45-54/25/30 + gemcitabine)
  • then surgery
95
Q

What is the treatment procedure for locally advanced unresectable pancreatic cancer (chemo and doses included)

A
  • indication chemo (4-6 months)
  • concurrent CRT 50.4/28 + capecitabine
  • SBRT 33-40gy/5

Primary: surgery

96
Q

What are the diagnostic procedure for liver cancer

A
  • triphasic CT
97
Q

What are the staging procedures for liver

A
  • triquad phasic CT
  • MRI
  • CT chest abdo pelvis
  • Child Pugh score
  • bloodwork
98
Q

What is the treatment procedure for liver cancer

A
  • primary : surgery Standard
  • radiotherapy for bridging treatment before transplant or local control or if not suitable for surgery
  • palliative : 8gy /1
99
Q

What is the treatment procedure for liver cancer

A
  • primary : surgery Standard
  • radiotherapy for bridging treatment before transplant or local control or if not suitable for surgery
  • palliative : 8gy /1

Oncology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions