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JL Gastrointestinal > Colo-rectal Cancer > Flashcards

Colo-rectal Cancer Flashcards

1
Q

What is a benign colorectal neoplasia called and what is a maligant colorectal neoplasia called?

A

Adenoma - benign

Adenocarcinoma - malignant

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2
Q

What can be inflammatory, hamartomatous, metaplastic and neoplastic?

A

Colorectal polyps

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3
Q

What genes, when normal promote cell growth and division however, when mutated cause excess cell growth and division?

A

Oncogenes

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4
Q

What genes when normal suppress cell growth and division and when mutated allow cell growth and division?

A

Tumour suppressor genes

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5
Q

What 4 genes are involved in colo-rectal cancer?

A
  1. APC
  2. Kras
  3. p53
  4. 18qloss
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6
Q

What three macroscopic appearances does colorectal cancer have?

A

Polypoidal, ulcerative and annular

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7
Q

What colorectal neoplasm is tubular and villous?

A

Adenomas

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8
Q

What kind of colorectal neoplasm can be well or poorly differentiated?

A

Adenocarcinoma

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9
Q

What two staging methods are there for colorectal cancer?

A

Dukes and TNM

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10
Q

What does the D mean in Dukes staging?

A

Distant metastases

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11
Q

What do T1, T2, T3 and T4 mean in TNM staging?

A

T1 - submucosa only
T2 - into muscle
T3 - through muscle
T4 - adjacent structures (including peritoneum)

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12
Q

What do NO, N1 and N2 mean in TNM staging?

A

N0 - no lymph node involvement

N1 - 3 nodes involved

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13
Q

What two nodes can colorectal cancer spread to?

A
  1. Periocolic nodes

2. Perivascular nodes

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14
Q

What kind of gene is LKB1?

A

Tumour suppressor

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15
Q

What is the inheritance like in colorectal cancer?

A

Autosomal dominant

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16
Q

What is FAP?

A

A mutation in APC gene

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17
Q

What is HNPCC?

A

Mutation in DNA mismatch repair gene

18
Q

What two mutations give autosomal dominant inheritance in colorectal cancer?

A

FAP and HNPCC

19
Q

Name two predisposing conditions for colorectal cancer?

A

Adenomatous polyps

IBD

20
Q

Give 5 symptoms of colorectal cancer?

A

Anaemia, tenesmus, rectal bleeding, change of bowel habit and pain

21
Q

What are three general clinical findings of colorectal cancer?

A

Anaemia
Chachexia
Lymphadenopathy

22
Q

What are three abdomen clinical findings with colorectal cancer?

A

Mass
Hepatomegaly
Distension

23
Q

What are two rectum clinical findings with colorectal cancer?

A

Mass and Blood

24
Q

What are 4 methods of diagnosing colorectal primary disease?

A
  1. Barium enema
  2. CT colography
  3. Sigmoidoscopy
  4. Colonoscopy
25
Q

What technique used in screening can detect 70% of cancers?

A

FOBT

26
Q

Name two staging investigations for colorectal cancer regarding the lungs?

A

CXR or CT

27
Q

Name 2 staging investigations for colorectal cancer regarding the liver?

A

US or CT

28
Q

What two investigations can be done to stage primary rectal cancer?

A

CT or MRI

29
Q

What are obstruction, bleeding, perforation, vomiting, pain, constipation and distension all signs of?

A

Emergency presentation of colorectal cacner

30
Q

What three ways are there to treat obstruction in colorectal cancer?

A

Colostomy alone
Resection and colostomy
Stenting

31
Q

What are right hemicolectomy, extended right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy and subtotal colectomy all used for?

A

Colonic cancer

32
Q

Name three surgical methods for rectal cancer?

A
  1. Abdomino-perineal excision
  2. Anterior resection
  3. Local excision
33
Q

What agent is used for chemotherapy for colorectal cancer?

A

5-fluorouracil (5-FU)

34
Q

What is an adjuvant for stage C colorectal cancer?

A

Chemotherapy

35
Q

What are two new drugs for advanced colorectal cancer?

A

Oxaliplatin

Irinotecan

36
Q

What are 2 biological agents used for advanced colorectal cancer?

A

Cetuximab

Bemab

37
Q

What is Dukes class A?

A

Tumour confined to bowel wall (97% 5 year survival)

38
Q

What is Dukes class B?

A

Tumour extends across bowel wall (80% 5 year survival)

39
Q

What is Dukes class C?

A

Involvement of regional lymph nodes (48% 5 year survival)

40
Q

How often are people screened?

A

Every 2 years for 60-75 using Faecal Occult Blood

JL Gastrointestinal (33 decks)

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