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23 Cards in this Set
- Front
- Back
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1. Known risk factors for squamous cell esophageal cancer?
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a. Caustic burns
b. Alcohol consumption c. Smoking d. Nitrites and nitrates containing food |
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2. Risk factors for esophageal adenocarcinoma?
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a. GERD
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3. What Should think of in a patient who describes dysphagia to solid foods that developed over a fairly short period of time and with a hx of self-medicating w/PPIs.?
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a. He may have had a history of GERD and has now developed adenocarcinoma of the distal esophagus.
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4. If the patient were to describe a more protracted course (months to years) of dysphagia what would the differential diagnosis include?
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1. Benign strictures
2. Congenital malformations 3. Achalasia |
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5. What is the most accurate imaging modality for identifying the depth of esophageal tumor invasion and for identifying regional nodal disease?
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a. Endoscopic ultrasonography (EUS)
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6. Endoscopic ultrasonography (EUS)?
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a. Patients in whom lymphadenopathy is visualized, EUS – directed fine needle aspiration of the nodes can help confirm regional nodal mets.
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7. Type I tumours w/Siewert classification of GE junction adenocarcinomas (Type I-III)?
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a. Type one tumors are located more than 1 cm above the GE junction
b. Surgical treatment would generally consist of esophagectomy. |
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8. Type II tumours w/Siewert classification of GE junction adenocarcinomas (Type I-III)?
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a. Located within 1 cm proximal and 2 cm distal to the GE junction.
b. Surgical treatment would consist of esophagectomy with partial resection of the proximal stomach. |
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9. Type III tumours w/Siewert classification of GE junction adenocarcinomas (Type I-III)?
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a. Located more than 2 cm distal to the GE junction
b. Surgical treatment would consist of total gastrectomy |
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10. Transthoracic esophagectomy (TTE)?
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a. This resection is traditionally done through an incision in the abdomen (or laparoscopic approach) and a separate incision through the right chest.
b. The stomach is brought into mediastinum and anastomosed to the proximal esophagus. c. It is associated with a high rate of pulmonary complications due to pain from incisions in both the chest and upper abdomen. |
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11. Transhiatal esophagectomy?
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a. This resection is done through an abdominal incision (or laparoscopic) and a cervical incision.
b. The gastric conduit is brought up through the posterior mediastinum and anastomosed to the cervical esophagus in the neck. c. The major advantages of this approach a reduction in pulmonary complications compared to TTE and reduce mortality and morbidity associated with cervical anastomotic leaks. |
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12. Most predominant esophageal tumor type in the US?
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a. Adenocarcinoma
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13. Advantages of endoscopic stent placement for esophageal carcinoma?
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a. Rapid relief of dysphagia
b. Treatment of choice for tracheoesophageal fistula c. short procedural time/outpatient procedure |
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14. Disadvantages of endoscopic stent placement for esophageal cancer?
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a. Recurrence due to stent migration
b. Tumor overgrowth c. Food impaction d. Transient pain following placement e. Gastroesophageal reflux f. Increased risk of late hemorrhage |
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15. Advantages of photodynamic therapy and laser for esophageal carcinoma-Endoluminal destruction of obstructing lesions for esophageal cancer?
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a. Works well with exophytic lesions
b. Generally low complication rates |
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16. Disadvantages of photodynamic therapy and laser for esophageal carcinoma-Endoluminal destruction of obstructing lesions for esophageal cancer?
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a. Often available only in specialized centres
b. Repeat treatment every 4 to 8 weeks is needed. |
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17. Advantages of single-dose brachytherapy-intraluminal radiotherapy for esophageal cancer?
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a. Long-term dysphagia improvement is better than stent placement.
b. Long-term quality-of-life score was better compared with stent placement c. Lower rate of hemorrhage and stent placement |
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18. Disadvantages of single-dose brachytherapy-intraluminal radiotherapy for esophageal cancer?
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a. Dysphagia relief is delayed in comparison to stent placement.
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19. Optimal palliative chemotherapy combination for esophageal cancer?
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a. epirubicin, cisplatin, and 5-FU
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20. Advantages of palliative chemotherapy for esophageal cancer (epirubicin, cisplatin, and 5-FU)?
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a. Treatment improves median survival
b. Responders may have improved quality of life due to release of obstruction. |
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21. Disadvantages of palliative chemotherapy for esophageal cancer (epirubicin, cisplatin, and 5-FU)?
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a. Response to obstruction is variable
b. Therefore, additional treatment for obstruction may be needed c. Relief from obstruction may be delayed |
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22. In whom is esophagectomy primarily performed?
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a. Patients with potentially curable esophageal cancers.
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23. Complete
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23. Complete
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