MCQ Esophagus - Esophageal carcinoma

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  1. What is Barrett’s Esophagus?
    Metaplasia of esophageal squamous epithelium into columnar in distalQ esophagus
  2. Risk factors for adenocarcinoma esophagus?
    • • GERD (leading to Barrett’s esophagusQ)
    • • ObesityQ
    • • SclerodermaQ
  3. Risk factors for squamous cell carcinoma esophagus?
    • • AlcoholQ
    • • SmokingQ
    • • Ingested carcinogens
    • • Plummer vinson syndrome
  4. H. Pylori and carcinoma esophagus?
    CAG-A positive strain is protective for adenocarcinoma esophagus but can lead to SCC of esophagusQ
  5. MC esophageal cancer worldwide?
    Squamous cell carcinomaQ
  6. MC esophageal cancer in United States (Western countries)?
    AdenocarcinomaQ
  7. MC site of CA esophagus?
    • Middle 1/3rd (Overall)Q
    • SCC – Middle one third
    • Adenocarcinoma – lower one third
  8. Treatment of squamous and adenocarcinoma?
    • Squamous cell - Treated aggressively with nonsurgical therapyQ
    • Adenocarcinoma - Treated by a more aggressive surgical approachQ.
  9. MC symptom of carcinoma esophagus?
    Dysphagia >Weight lossQ
  10. Diagnosis of carcinoma esophagus?
    • • Barium swallow: First investigation doneQ in suspected case of CA esophagus (classic finding of an apple core lesionQ)
    • • Endoscopy with biopsy: Investigation of choice for diagnosis of CA esophagusQ.
    • • Endoscopic Ultrasound: Investigation of choice for staging of CA esophagus, best for T staging and LN metastasisQ.
    • • CECT (abdomen and chest): metastasis to liver and lungsQ
  11. SiewertQ classification GE junction tumors?
    • Type I – within 1-5 cm above from GE junction
    • Type II – from 1 cm above, 2 cm below GE junction
    • Type III – From 2-5 cm caudal to GE junction
  12. Features of Malignant Lymph Nodes on EUS?
    • • Echo-poor (hypoechoic)Q structure
    • • Sharply demarcated bordersQ
    • • Rounded contourQ
    • • Size >1 cmQ
  13. Palliation Therapy in Carcinoma Esophagus?
    • • Laser TherapyQ
    • • Photodynamic TherapyQ
    • • Radiation TherapyQ
    • • SEMSQ (Self expandable metallic stent)
  14. Features of CA Esophagus on Barium Swallow?
    • • Mucosal irregularity and shoulderingQ
    • • NarrowingQ of the lumen
    • • Irregular “rat-tail” filling defectQ of the distal esophagus with shouldered edgeQ
    • • Annular strictureQ
    • • Sharp and clear cut edge of filling defectQ
    • • Proximal dilatationQ of the esophagus
  15. Best conduit after esophagectomy (overall)?
    StomachQ
  16. Conduit of choice after esophagectomy in CA esophagus?
    StomachQ
  17. Conduit of choice after esophagectomy in benign disorders (caustic injuries, acid-peptic disease), unhealthy stomach?
    ColonQ
  18. Conduit of choice for short segment replacement?
    JejunumQ
  19. Gastric conduit is based on which vessel?
    Right gastric and right gastroepiploic vesselsQ
  20. Left colon is based on which vessel?
    Left colic artery (Branch of IMA), placed in isoperistaltic direction.
  21. What is Orringer Transhiatal Esophagectomy?
    • • Double incision: Midline laparotomy followed by cervical incisionQ
    • • Cervical anastomosis is doneQ
    • • MC procedure done for carcinoma esophagusQ
  22. What is Ivor-Lewis procedure?
    • • Transthoracic esophagectomyQ
    • • Double incision: Midline laparotomy followed by right sided thoracotomyQ
    • • Done for tumors of middle 1/3rd of esophagusQ
  23. What is McKeon procedure?
    • • En-bloc esophagectomyQ
    • • Three incisions: Right sided thoracotomy, followed by midlineQ laparotomy, followed by cervical incisionQ
    • • Associated with maximum morbidity and mortalityQ
  24. Tumor Margin for Curative Excision?
    • In GI malignancies (stomachQ, small intestineQ, colonQ and proximal rectumQ), tumor margin for curative excision is 5cmQ except:
    • − Esophagus: 10 cmQ
    • − Distal rectum: 2 cmQ
  25. Complications of Esophagectomy?
    • • Anastomotic Leak (MC)Q
    • • Anastomotic stricture
    • • Pulmonary complications
    • • Recurrent laryngeal nerve palsy
    • • Chylothorax
  26. MC benign esophageal tumorQ?
    Leiomyoma

Card Set Information

Author:
surgerymaster
ID:
334727
Filename:
MCQ Esophagus - Esophageal carcinoma
Updated:
2017-10-02 11:52:58
Tags:
Esophageal carcinoma
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Description:
Esophageal carcinoma
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