Colon Cancer

Question 1

Name 5 signs and symptoms

Answer 1

• Rectal bleeding, blood in stool
• Weakness, weight loss, fatigue, anorexia, vomiting
• Change in bowel habits: diarrhea / constipation / change in caliber / urgency / incontinence /tenesmus
• Absence of perianal symptoms
• Persistent bloating, feeling of fullness, cramps, steady abdo pain

Question 2

Name 5 risk factors

Answer 2

• Age (90%>50)
• PMHx: IBD, polyps, obesity
• FHx: risk increases with number of 1st degree relatives and young age
• SoHx: Excessive caloric intake / EtOH intake, high fat diet, sedentary life, smoking

Question 3

Name two initial serum measurements

Answer 3

• HgB

* Ferritin

Question 4

Criterial and screening frequency for average risk patients

Answer 4

• 50-74
• No s/sx of CRC
• PMHx: NO polyps, NO IBD
• FHx 2nd degree relative w/ CRC, 1st degree with non-advanced adenoma
• gFOBT / FIT q 2 yrs
• Sigmoidoscopy q10yrs

Question 5

First and second line screening for >/ 1st degree relative w/ colon CA:

Answer 5

• Frist line: screen q5-10 yrs w/ colonoscopy age 40-50 OR 10 yrs younger than the age the relative was dx, whichever is earlier.
• 2nd line: screen q 1-2 yrs w/ FIT age 40-50 OR 10 yrs younger than the age the relative was dx, whichever is earlier.

Question 6

Screening for >/ 1st degree relative w/ advanced adenoma:

Answer 6

• screen w/ colonoscopy q5-10 yrs or FIT q 1-2 yrs starting age 40-50 or 10 yrs younger than the FDR

Question 7

Screening for inflammatory bowel disease

Answer 7

• colonoscopy 8-10 years after pancolitis OR 12-15 yrs after left sided colitis done q1-2 yrs

Question 8

Screening for Familial Adenomatous Polyposis

Answer 8

• Genetic counselling, flexible sigmoidoscopy q1 yrs starting 10-12 yrs

Question 9

Screening for HNPCC (Lynch Syndrome):

Answer 9

• Genetic counselling, colonoscopy q1-2 yrs starting 20 yrs or 10 yrs earlier than family case

Question 10

Complications of surgery

Answer 10

anastomosis breakdown, infection, bleeding, adhesions

Question 11

Treatment complications of chemotherapy

Answer 11

POF, dilated cardiomyopathy, secondary CA, cognitive dyscfunction

Question 12

Treatment complications of radiation

Answer 12

weakness, paresthesisa, CAD, valvular dx

Question 13

Treatment complications of immunotherapy

Answer 13

bond pain, fatigue, fever, rash, bleeding, clots