GI Tract Board Study

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  1. What is part of the GI tract/Alimentary canal
    • esophagus
    • stomach
    • small bowel
    • colon
    • anus
  2. What is the most common alimentary canal cancer
  3. Name the layers of the intestinal wall from inner to outer most
    mucosa, submucosa, muscularis, serosa
  4. What % of polyps are cancerous
  5. What pathology is the bowel
  6. what pathology is the stomach
  7. What pathology is the esophagus
    • upper 1/3 is squamous cell
    • Lower third is adenocarcinoma
  8. What is the tx of choice for the esophagus
    surgery in the lower portion and radiation in the upper
  9. What is an acute reaction of the esophagus to radiation
    dysphagia at about 20GY
  10. What is Tylosis
    a rare genetic disorder that is assoc with squamous cell.  Esophagus cancers seen in familial clusters
  11. What is the TD 5/5 for the esophagus
    50-55 GY
  12. Esophagitis occurs at what dose
  13. Gastritis occurs at what dose
  14. Proctitis occurs at what dose
  15. Diarrhea occurs at what dose
  16. Where are esophagus tumors most common
    middle or lower third of the esophagus
  17. What are 2 syndromes associated with esophageal cancer
    • Barrett's esophagus (assoc with reflux as the chronic stomach acids change the cells to cancer)
    • Plummer Vinson-iron deficiency
  18. What is the #1 clinical presentation of esophageal cancer
    • dysphagia
    • a few others are
    • chest pain (like heart burn)
    • weight loss
    • odynophagia
    • hematemesis
    • coughing
    • hemoptysis
    • hoarseness
  19. Staging for esophageal cancer is
    TNM and based on outward extension (how many layers it penetrates)
  20. #1 distant site for esophageal cancer is
    • liver
    • others are
    • lung
    • bone
    • adrenals
    • brain
  21. What are the chemodrugs for esophageal cancer
    5 FU and cisplatin
  22. What are the tx margins for esophagus
    ALL lesions have a 5 cm superior and inferior margin and a 2-3 cm lateral margin
  23. TD 5/5 for the esophagus is
    5000 cGy
  24. What is the # 1 side effect when treating the esophagus and list a few more
    • esophagitis
    • ulceration
    • decreased blood counts
    • radiation pneumonitis
    • pericarditis
    • strictures
    • transverse myelitis
  25. What are the main structures around the esophagus that are at risk
    • heart
    • lungs
    • cord
  26. What is the tx of choice for stomach
  27. what are the dose limiting structures around the stomach
    • kidneys
    • liver
    • bowel
    • cord
  28. Where does stomach cancer met to 1st
  29. Where do we get most of our nutrients
    small intestine
  30. Why do we not usually treat small bowel with radiation
    • because it is a moving target
    • surgery is tx of choice
  31. What pathology is the small bowel
    50% is adenocarcinoma
  32. What is the # 1 symptom for rectal cancer
    blood in stool
  33. Name the route of the colon
    cecum, ascending colon, transverse colon, descending colon, sigmoid, rectum
  34. What is the pathology for colorectal
  35. Where does the colorectal cancer met to
    • lung
    • liver
    • bone
    • ovaries
    • adrenal
  36. What is an APR
    • abdominal perineal resection
    • resects the rectum and anus and installs a colostomy. No sphincter salvage
  37. What is tenesmus
    rectal spasms
  38. what is a tumor marker for rectal cancer
    • CEA
    • carcinoembryonic antigen
  39. How dose rectal carcinoma spread
    directly. It will penetrate bowel wall unlike esophageal which will skip met
  40. What is the # 1 route of spread for colorectal cancer
  41. What is peritoneal seeding
    It is very bad. It is when the tumor breaks through all the rectal layers and goes into the abdominal cavity
  42. what is the tx of choice for colorectal cancer
  43. What are the chemo drugs for colorectal
    • 5 FU and gemcitabine or
    • 5 FU and leucovorin
  44. What is the field design for the colorectal tx
    • AP/PA
    • Top L4-L5 interspace
    • Bottom- Bottom of obturator foramina or 3-5 cm below gross tumor and
    • Lateral- 2cm lateral to pelvic brim and inlet
    • Top and bottom of the lateral field is same as AP/PA
    • Anterior- anterior edge of femoral head
    • Posterior- 2cm behind the bony sacrum
  45. To treat colorectal ca do we want a full or empty bladder
  46. What are some common sim procedures for colorectal cancer
    • Supine or prone
    • Prone allows for gluteal fold decrease
    • Full bladder
    • Women have vaginal marker
    • Contrast for bowels
    • Wire scar and anal verge so we can try to spare the sphincter
  47. Anal cancers occur mostly in
  48. What is the pathology for anal ca
    squamous cell  80%
  49. Tx for early stage anal cancer is
  50. What do we have to treat along with treating the anus
    inguinal nodes
  51. Most pancreatic cancers occur in the
  52. What is the tx of choice for pancreatic cancer
    • Surgery
    • Whipple Procedure
    • Pancraticoduodenectomy
  53. What is the pathology for pancreas
  54. What is the most common site of met from pancreas
    Easily goes to the liver but most likely to the lung
  55. What is the most common pathology for liver cancer
    hepatocellular carcinoma HCC
  56. What is the tx of choice for liver and gallbladder
  57. What is the # 1 pathology for gallbladder
  58. Liver cancer spreads to the
    lung and brain
  59. HCC is rising due to the increase of
    Hepatitis C
  60. What is a tumor marker for the liver and gall bladder cancers
    AFP and CEA
  61. What is a cholangiography
    When you inject dye into bile ducts to see if clogged
  62. What is the critical structures for treating liver and gall bladder cancer
    • bowel
    • kidney
    • cord
  63. Who does liver cancer affect more
    men 2:1
  64. What is the porta hepatis
    where the blood supply enters
  65. What does the gall bladder do
    stores and concentrates bile
  66. What is the treatment of choice for gall bladder cancer
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GI Tract Board Study
GI Tract Board Study
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