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F3E3 > Colon > Flashcards

Colon Flashcards

1
Q

a growth on the inner surface of the colon is referred to as

A

a polyp

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2
Q

some polyps undergo what type of transformation?

A

malignant transformation, others do not

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3
Q

types of colon polyps

A

pedunculated which are attached by stem or stalk

sessile which are flat

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4
Q

three type of colon adenomas? which of these is most common

A

tubular adenoma, the most common
tubulovillous adenoma
villous adenoma

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5
Q

which types of colon polyps are neoplastic (precancerous)

A

adenomas (2/3 of all colon polyps), and sessile serrated adenomas

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6
Q

which types of colon polyps are non-neoplastic

A

hyperplastic and pseudopolyps (associated with inflammation/ IBD)

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7
Q

large polyps may

A

bleed

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8
Q

70% of ________ arise from adenomas

A

colorectal carcinomas (CRC), this takes about 10 years therefore early detection and removal is key

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9
Q

what is considered an advanced adenoma (3 criteria)

A

greater than 10 mm, villous component, high grade dysplasia

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10
Q

what increases the risk of colorectal cancer

A

the number of adenomas, the size, and the histology

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11
Q

malignant growth on the inner wall of the colon and/or rectum is called

A

colorectal cancer

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12
Q

over 95% of colorectal cancers are

A

adenocarcinomas

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13
Q

what is the non screen rate

A

1/4 of adults aged 50-75

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14
Q

pertaining to colorectal cancer, what are the left side and right side differences

A

left side is most common, but right side is on the rise

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15
Q

risk factors for colorectal cancers (9)

A 
age
personal or family history 
IBD after 8 to 10 years 
African American 
Smoking 
ETOH 
diet 
obesity 
diabetes
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16
Q

diet factors for colorectal cancers risk

A

high fat low fiber

increased amounts of red and processed meats

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17
Q

colorectal cancer red flags (5)

A 
changes in bowel habits 
hemattochezia 
IDA (iron deficiency anemia)
anorexia or weight loss
abdominal pain
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18
Q

colorectal cancers patients are often?

A

asymptomatic, why screening is important

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19
Q

when presenting with symptoms what are the common colorectal cancers presentations

A

cachectic, pallor of the skin, lymphadenopathy, abdominal distention, ascites, mass, oragnomegaly, positive hemocult, rectal mass

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20
Q

colorectal cancer- why are we performing a CBC?

A

used to check for IDA due to chronic blood loss

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21
Q

colorectal cancer- what abnormalities may be seen on a liver function test?

A

Alk phos may be elevated with liver metastasis

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22
Q

what is CEA used for and what is it not used for?

A

can be a helpful prognostic indicator and allow for monitoring for recurrence, it is not used for screening

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23
Q

what test. allows for both biopsy and pathologic confirmation?

A

colonoscopy

24
Q

why would you order a chest/abdominal/ pelvic CT when assessing for colorectal cancer?

A

to asses for tumor extension or complication, regional lymphatic metastases and distant metastases

25
what type of lesion is classic on colonoscopy for colorectal cancers
a classic apple core lesion
26
what is the colectomy management of colorectal cancers
Partial colectomy with wide margins and adjacent lymph node removal
27
when is chemotherapy used for CRC treatment
use when metastasis are present
28
when is radiation therapy commonly used for CRC
rectal adenocarcinomas
29
CRC surveillance consist of what 3 things
serial CEA levels annual surveillance CT periodic colonscopy
30
gold standard for CRC screening
colonoscopy, it is both diagnostic and therapeutic
31
In what way is a colonoscopy therapeutic?
Able to detect and remove polyps to PREVENT them from turning into cancer Post polypectomy surveillance interval depends on endoscopist recommendations, size number, histologic features
32
complications of colonoscopy
perforation/bleeding
33
what can influence results of a colonscopy
bowel prep and operator skill
34
flex sigmoidoscopy reaches, this causes limited detection of what area?
the distal 1/3 of the colon, lower benefit in protection again right sided colon cancer
35
if a polyp is found on a flex sig, what is the next step?
They will then need a colonoscopy to rule out proximal lesions
36
Which less invasive test can miss flat or smaller polyps (less than 6 mm)?
CT colonography
37
gFOBT sensitivity and use
sensitivity for one time screening is not ideal, annual use is recommended which can influence compliance
38
diet modifications of gFOBT (what food must be avoided)
avoidance of red meat, iron supplements, Vitamin C and NSAIDS
39
what are the 3 stool based screenings
gFOBY, FIT, abd FIT DBA
40
When do we start CRC screening in IBD patients
8 to 10 years after onset of symptoms
41
when to start CRC screening in patients with Single 1st degree relative w/ CRC or documented advanced adenoma dx > 60 y/o
age 40 and if it is normal screen as average risk
42
when to start CRC screening in patients with Single 1st degree relative w/ CRC or documented advanced adenoma dx < 60 y/o or ≥ two 1st degree relatives dx at any age
Colonoscopy every 5 years beginning at age 40 or 10 years younger than the age at which the youngest 1st degree relative was diagnosed whichever comes first
43
Which colorectal cancer screening test is used in individuals with increased risk?
colonoscopy
44
which condition is autosomal dominant with a mutation in the APC gene? what does this put them at an increased risk for?
Familial Adenomatous Polyposis, Increased risk of extracolonic malignancies
45
how many adenomatous polyps are common in Familial Adenomatous Polyposis? What age do these polyps being to form?
over 100, they typically begin at age 16
46
with Familial Adenomatous Polyposis, nearly all of them will develop what by age 39? How do we manage this risk?
CRC, therefore a prophylactic colectomy is typically recommend
47
4 examples of increased risk of extracolonic malignancies which Familial Adenomatous Polyposis
Gastric/Duodenal/Ampullary carcinoma Follicular or Papillary thyroid cancer Hepatoblastoma CNS tumors screen for these with FAP Screening
48
FAP screening
Sigmoidoscopy/Colonoscopy starting at age 10-12 and repeating every 1-2 years Routine EGD recommended
49
what is "Lynch syndrome"
Hereditary NonPolyposis Colon Cancer (HNPCC), multiple family members will be affected
50
Hereditary NonPolyposis Colon Cancer patients have an increased risk for what? and at what age?
for CRC (usually right-sided); aged 45-60 years and other cancers
51
what is the most common additional cancer for Hereditary NonPolyposis Colon Cancer
Endometrial cancer
52
Hereditary NonPolyposis Colon Cancer 321 rule (Amsterdam criteria)
3 relatives associated with Lynch syndrome associated cancer, 2 successive generations affected and 1 should be diagnosed before age 50
53
Hereditary NonPolyposis Colon Cancer screening
Annual colonoscopy beginning between the ages of 20-25 | or 2-5 years prior to the earliest age of CRC diagnosis in the family (whichever comes first)
54
other exams for patents diagnosed with HNPCC
pelvic exam with endometrial bx and transvaginal US
55
any screening regime is better than _________?
nothing, but advised patients that colonoscopy is required for further evaluation if anything is found on the less invasive test
56
diet modifications to decrease CRC risk (6)
``` encourage fiber rich foods limit red and processed meats limit ETOH (1-2 savings a day) exercise maintain healthy body weight stop smoking ```
57
pseudopolyps are associated with what condition?
IBD

F3E3 (11 decks)

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