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Alimentary > Upper GI surgery > Flashcards

Upper GI surgery Flashcards

1
Q

What oesophageal cancer is more common distally

A

adenocarcinoma (Barret’s oesophagus)

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2
Q

What oesophageal cancer is more common proximally

A

squamous cell carcinoma

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3
Q

Risk factors in adenocarcinoma of oesophagus

A

obesity

acid- reflux

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4
Q

Risk factors of squamous carcinoma of oesophagus

A

smoking
alcohol
low socio-economic status

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5
Q

Warning signs of oesophageal cancer

A 
Frequent hiccups 
acid reflux 
pain between shoulder blades 
frequent burps 
weight loss
difficulty swallowing
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6
Q

Investigations for oesophageal cancer

A

endoscope- most common/best

barium swallow

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7
Q

What is first line investigation to stage oesophageal cancers

A

CT

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8
Q

What are second stage investigations for oesophageal cancer stage

A

EUS (oesophageal ultrasound) for T and N

PET CT for metastasis

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9
Q

What patients get second stage oesophageal cancer staging investigations

A

Patients fit for surgery

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10
Q

What is treatment for patients unfit for surgery

A

palliative/supportive

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11
Q

Treatment options for unfit patients to improve quality or length of life with oesophageal cancer

A

stent (dysphagia)
palliative radiotherapy
palliative chemotherapy

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12
Q

What immediately makes patient not fit for surgery who has oesophageal cancer

A

metastasis

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13
Q

What treatment is offered to patients with oesophageal cancer who are fit for surgery

A

Oesophagectomy + Chemotherapy

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14
Q

What treatment is offered to patients with oesophageal cancer who are not fit for surgery but have no metastases

A

Chemotherapy or radiotherapy

This comes with reduced survival expectancy

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15
Q

What is used as the conduit in Oesophagectomy

A

stomach

rarely colon

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16
Q

Risk factors of stomach cancer

A

Alcohol
H. pylori infections
smoking
excessive cured meats, salted fish and picked vegetables

17
Q

ALARM symptoms of upper GI cancer

A 
Anaemia
Loss of weight 
Anorexia 
Rapid onset of symptoms 
Masses, Melaena and haematemesis (masses and bleeding)
18
Q

Investigations for stomach cancer

A

endoscopy

barium swallow- rare

19
Q

What investigations are used to stage cancer

A

CT

Investitive laparoscopy

20
Q

What is being looked for in an investitive laparoscopy

A

Cancer in the greater omentum which is undetectable on CT

21
Q

Investigations for acid reflux

A

Endoscope
pH study
manometry study

22
Q

What surgery can be offered to those with a hiatus hernia

A

laparoscopic hiatus hernia repair and fundoplication

23
Q

What is fundoplication

A

fundus of stomach wrapped around oesophagus and stitched there. Creates a sphincter

Alimentary (14 decks)

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