21 - bowel cancer

Question 1

Diffential for bleed rectum or anal canal?

Answer 1

Colorectal cancer

haemarrhoids

Anal fistula

Acute proctatis

IBD

Question 2

What are the features of a stoma colostomy?

Answer 2

Lower left quadrant

Not sprouted

Can be end or loop

excreations are solid and poo looking like

Question 3

What are the features of a stoma ileuostomy?

Answer 3

Usually lower right quadrant

contineous effluent - liquid

Protrudes from the surface of the skin

Question 4

What indicaitons are there for a RIght hemicolectomy?

Answer 4

ceacal, right ascending and transverse tumour

Question 5

What indication are there for left hemicolectomy?

Answer 5

Transverse and descending colon tumours

Question 6

What indication would there be for an anterior resection?

Answer 6

low or high rectal tumour

This results in a loop ileostomy and is rectified when the anastomis is sufficient

Question 7

What are the indications for a abdominal perineal resection?

Answer 7

For rectal pathology.

Results in colostomy and closure of the anus

Question 8

What is Hartmanns procedure?

Answer 8

For emergencies

results in rectal stump and end colostomy

Question 9

What is FAP in relation to the bowel?

Answer 9

Familial Adematous Polyposis

mutation of the APC-1 allele

autosomal dominant

Many polyps with minority developing into carcinoma

Question 10

What is Lynch syndrome?

Answer 10

Also know as hereditary non-polyposis colorectal cancer (HNPCC)

Micro satalite instability

Few polyps with high chance of colon carcinoma

Related to development of other cancers.

Question 11

What does colicky pain describe?

Answer 11

Pain that starts and stops abruptly

Question 12

What are the 6 F of abdominal dystension?

Answer 12

Fat

Flatus

Featus

Feaces

Fuids

Fecking huge mass

Question 13

What screening is there for colorectal cancer?

Answer 13

60-69 year olds

Fecal ocult blood test

Question 14

What are the methods of staging for colorectal cancer?

Answer 14

Dukes criteria

TNM staging

Question 15

What is diverticular disease?

Answer 15

“wear and tear of the bowel”

Out puchings of the bowel wall. Diverticulitis is when they become infected

Question 16

Risk factors for diverticular disease?

Answer 16

Age

Chronic constipation

Posotiev family history

High intake of meat and red meat

Question 17

Complications of diverticular disease?

Answer 17

Diverticulosis

Blood in stools

Performation => peritonitis

Abscess formation

Question 18

Patient has generalised abdominal pain with a metabolic acidosis and is known AF. What is the most likely diagnosis?

Answer 18

Bowel infarcation/ ischeamia

Question 19

How Big does the transverse colon have to be on abdominal X-ray inorder for it to be classified as toxic megacolon?

Answer 19

> 6 cm

Question 20

What features let you identifiy small bowel on abdominal x-ray?

Answer 20

Vulvular extend across the whole intestine

Centrally located

2-3 has pockets

Question 21

What features would let you identify large bowel on adbominal x-ray?

Answer 21

Haustra do not go across whole intestine

More peripharlly located

Question 22

What is coffee bean sign on abdominal X-ray?

Answer 22

Sigmiod volvulus: twisting of the sigmoid colon leading to obstruction