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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
What technique used in screening can detect 70% of cancers?
FOBT
26
Name two staging investigations for colorectal cancer regarding the lungs?
CXR or CT
27
Name 2 staging investigations for colorectal cancer regarding the liver?
US or CT
28
What two investigations can be done to stage primary rectal cancer?
CT or MRI
29
What are obstruction, bleeding, perforation, vomiting, pain, constipation and distension all signs of?
Emergency presentation of colorectal cacner
30
What three ways are there to treat obstruction in colorectal cancer?
Colostomy alone Resection and colostomy Stenting
31
What are right hemicolectomy, extended right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy and subtotal colectomy all used for?
Colonic cancer
32
Name three surgical methods for rectal cancer?
1. Abdomino-perineal excision 2. Anterior resection 3. Local excision
33
What agent is used for chemotherapy for colorectal cancer?
5-fluorouracil (5-FU)
34
What is an adjuvant for stage C colorectal cancer?
Chemotherapy
35
What are two new drugs for advanced colorectal cancer?
Oxaliplatin | Irinotecan
36
What are 2 biological agents used for advanced colorectal cancer?
Cetuximab | Bemab
37
What is Dukes class A?
Tumour confined to bowel wall (97% 5 year survival)
38
What is Dukes class B?
Tumour extends across bowel wall (80% 5 year survival)
39
What is Dukes class C?
Involvement of regional lymph nodes (48% 5 year survival)
40
How often are people screened?
Every 2 years for 60-75 using Faecal Occult Blood

JL Gastrointestinal (33 decks)

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