Uiuc M2 2010 Fcp Upper Gi & Colon Cancer

Front 1

Esophageal CA: change with fundus involvement?

Change going higher up in esophagus?

Radiation, chemo + radiation remission?

Back 1

Can't remove fundus; excludes surgery.

Higher in esophagus = poorer prognosis (can’t replace esophagus).

Rads: 80%; both: 85%

Front 2

Postop followup procedures for esophageal surgery (2)?

Gastric side effects (3)?

Back 2

Followup: EGD / CT

Side effects: achlorhydria, B₁₂ deficiency, early satiety

Front 3

Esophageal cancer risk factors:

which for adenocarcinoma, which for squamous carcinoma?

Barrett’s esophagus, drinking, GERD, obesity, smoking

Back 3

Adenocarcinoma: Barrett’s esophagus, GERD, obesity

Squamous carcinoma: drinking, smoking

Front 4

N1 excludes treatment?

Back 4

Excludes radiation: lymph nodes are too far for a local radiation dose.

Front 5

Iron deficiency anemia from perimenopause

If gastric adenocarcinoma found on biopsy, next diagnostic step?

Followup? Supplementation?

Back 5

(Do MMA as substitute for Schilling test.)

After gastric scope, do a CT to find other lymph node involvement.

Followup: PET/CT fusion (radio F attached to glucose) @ 5 years, consider 10

Provide iv iron, B₁₂ supplementation.

Front 6

HER2neu link to GI cancer?

Back 6

Gastric adenocarcinoma. (Also breast CA, of course.)

Front 7

Tumor of head of pancreas: best evaluation by?

Tx: Whipple procedure? outcome?

Another option?

Back 7

ERCP, image-guided needle biopsy (issues: miss area of interest; may not get enough tissue; core biopsy may induce pancreatitis)

Whipple: resect head of pancreas, duodenum/jejunum into stomach, reroute bile duct

Best option: gemcitabine (nucleoside analog)/erlotinib (EGFR inhibitor)