Doctor Exam 2 Flashcards Preview

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Flashcards in Doctor Exam 2 Deck (34):
1

How many esophageal cases per year?

about 12,000

2

M:F ratio for esophageal cancer

3:1

3

What country has the highest incidence of esophageal cancer?

China, more smokers

4

Risk factors for squamous cell esophageal cancer

smoking, alcohol abuse, low socioeconomic status, diet

5

Risk factors for adenocarcinoma esophageal cancer

Obesity, recurrent reflux, Barrett's (stratified squamous replaced by columnar)

6

Signs and symptoms of esophageal cancer

dysphagia, weight loss, odynophagia, hemoptysis

7

Diagnosis of Esophageal cancer?

H&P, PET, endoscopic ultrasound, x-ray with barium swallow, chest XT

8

Distant metastasis locations esophageal cancer

Lung and liver are most common but can also go to bone, kidney and adrenal

9

Chemotherapy for esophageal

Cisplatin for squamous cell and 5FU for adenocarcinoma

10

Radiation treatment planning for esophageal cancer

4 cm proximal/distal and 2 cm laterally, 4140-5040 Gy

11

Acute toxicities for esophageal cancer

fatigue, esophagitis, nausea and weight loss

12

Late toxicities for esophageal cancer

Stricture, pneumonitis, heart disease

13

Prognosis for esophageal cancer

24-48 months depending on treatment modality

14

TD 5/5 esophagus

55 Gy

15

Liver cancer incidence

about 35,000 cases in the US, 4th most common cancer in the world

16

Histology of liver cancer?

Hepatocellular carcinoma

17

Risk factors for liver cancer

Hep B and C, chemical carcinogens, alcohol, liver cirrhosis, genetic

18

Treatment for liver cancer

Surgery if possible, radiofrequency ablation, SBRT

19

Radiation treatment for liver cancer

SBRT: 60 Gy / 5 fractions

20

gallbladder cancer facts

Slightly more common in females, disease of the elderly, poor prognosis, typically diagnosed after a cholecystectomy

21

Treatment for gallbladder cancer

Surgery, chemo +/- radiation

22

Epidemiology of colorectal cancer

Most common GI malignancy, 2nd leading cause of death, 2 colon: 1 rectal, more right sided tumors

23

Risk factors for colorectal cancers

Family history, IBS, familial adenomatous polypsis, chronic ulcerative colitis, obesity, diet high in fat and low in fiber, smoking and alcohol

24

Lymph drainage for left colon and sigmoid

follows inferior mesenteric arteries

25

Lymph drainage for right colon

Follows superior mesenteric arteries

26

Lymph nodes to be concerned about if colorectal cancer spreads

Iliac and periaortic LN

27

Histology of colorectal cancer

adenocarcinoma, 50% of patients have positive LN at dx

28

Distant mets of colorectal cancer

Liver: all of colon and upper third of rectum (portal system)
Lung: distal 2/3 of the rectum (IVC)

29

Signs and symptoms f colorectal cancer

hematochezia, change in bowel habits, tenesmus (Urge) abdominal pain, nausea and vomitting

30

detection and diagnosis of colorectal cancer

H and P, Labs (stool test, LFT), colonoscopy with bx

31

treatment for early stage colorectal

Surgery, requires strict criteria

32

LAR surgery

tumors high in the rectum, ideal, temporary colostomy while tissues heal

33

APR Surgery

not good margins, perm. colostomy

34

Concurrent chemo radiation treatment for colorectal cancer

5FU, 45-50.4, up to 54 if T4, surgery post more likely to be LAR