Colon Cancer Flashcards
Which from ths following consider as risk factor
A) alcohol B) obesity C) high procced meat D) smoking E) all of the above
E : all
First organs colon cancer metastae to?
1st: Liver
2ed: lung
The presentage of FAP related colon cancer account for?
1) 5%
2) 10%
3) 25%
4) 50%
Pathologically colon cancer can be divided into ?
1- annular
2- ulcer
3- tubular
4- cauliflower
TNM classfication of colon cancer ?
T T1: submucosa T2: muscular putpura T3: reach serosa pericolic fat or dubserosa but has not breach wall T4: breach wall , surrounded structure
N
N0: none
N1: 1-3 LM
N2: 4 or more LM
M
M0: no
M1: yes
Most common affected age group ?
1) 60
2) 40
3) 70
4) 80
4)80
lesion of left collon will present as? A) itin deficency annemia B) mass C) lower Gi bleeding D) aysmptomatic
C)
They present with gl bleeeding with alter bowel habits
ذا كلام الكتاب بس عيسى قال اللي يجيب بليدنق الركنم مو الكولون
فنقول افضل جواب التر بارل هابتز
lesion of righ ( proximal) collon will present as? A) iron deficency annemia B) mass C) lower Gi bleeding D) alter bowl habits
A.B
Investigation of choice to screen patient with Colon cancer?
Colonscopy
Simplest way to screen patient by? What will be your next step if positive
Fecal icclut blood
Colonoscopy
Apple core is radiological sign of barrium enema associated with? A) colon cancer B) polyps C) volvlys D) diverticulitis
A colon cancer
CT rule in colon cancer?
- diagnosis
- staging
- thruueptic
- radiolgical gaudince drainge
Staging
MRI best test to stage rectal cancer , true or false
Other alterntive?
True
Endoscopic US
Intial screening test in patient susbected to have colon cancer? A- fecal occlut blood B- sigmoidoscopy C- NG tube - bairiek red cell matking
B sigmodisvopg
…..% of collon cancer located in ….?
70% Left colon( sigmoid)
Pc presenting with ascending colon CC what your suregey choice? 1- right hemicolecyomy 2- extended tight hemicoloctomy 3- left hemi colectomy 4- resection and iliocecal anastomasis
Artery you will ligate?
1- Ilicolic artery with right colic artery
2- Left colic artery
3- sigmoid artery
A) Right hemi colecyticomy
1) iliocolic and right colic srtery
Pc presenting with rectal cancer what your suregey choice? 1- right hemicolecyomy 2- extended tight hemicoloctomy 3- left hemi colectomy 4- low anterior resection
Liw anterior resection
Pc presenting with sigmoid CC what your suregey choice? 1- right hemicolecyomy 2- sigmoidecty 3- left hemi colectomy 4- resection and iliocecal anastomasis
Artery you will ligate?
1- Ilicolic artery with right colic artery
2- Left colic artery
3- sigmoid artery
Sigmoidectomy
Sigmoid artery
Pc presenting with splenic flexure what your suregey choice? 1- right hemicolecyomy 2- extended left hemicoloctomy 3- left hemi colectomy 4- extended right hemicolocectomy
Artery you will ligate?
1- Ilicolic artery with right colic artery
2- left colic artery
3- sigmoid artery
2
2
شوفي بقيه الاماكن بالسرجري باخر صفحه بالملخص
Post opertive colonscopy survellance used to detect …., the chance in peressntage?
Synchronized, meta synchronized
3-5%
Post opertive complication include?
DVT
Ansatmosis leakagd
Pertonitis
Colon cancer if left untreated complucation
Ibstructuon Hemorrhage Perforation Pertonitis anemia
Patient with obstructed left colon due to CC what will you do? Hartman Or Resection and anastomasis Or Radiological stent
Both can be done
But hartman best to rdfuce rodk of infection
If onstruction due to right CC? In healthy fit patient
Right hemicolectomy snd anastomasis
If rightobstruction of CC with unstable oatient or contimated?
Ileocolostomy
No anastomasis
Types of adenomitic polyos according to gross patholgy?
Villous ( sesile) __ higher risk of ca
Tubular( oenducuksted , not milgnancy )
Adenomatous( premalgnan)
Viliotubular mixed
Viloius polyps might present with?
Bleeding Diarrhia Mucuse dischargs Hypokelmia Hypoalbumindmua
Adenoma of polys larger than ….. require resection انتبعي للوخده 1-2cm 2- 4mm 3- 5mm 4- 5cm
5mm
Managment if polyos ? M
Snall
Colonscopuc snare polypectomy
Large
— Superfical : endiscopic mucosal resection
— Deep: endoscopic submucosal disecetionwith saline injected
If reaced the base : colon resection???
ماهو سوال بس معلومه ذا
Familia adenomus polypodis Number of polyps ? Common age? Risk of milgnency ? Presenting conllain? Gene related? Type of inhertience ? Treatment? Why do we jeep the recum Do you need to screen the family? Assosiated tumors syndrome?
> 100
15 years old
100% in 30 years they develop cancer so at17 do prophlyctic iliocecal resection
Lowe gi bleeding
APC
Autosomial dominant
Treatment: prophlyctic colectomy iliorecral anastomasis, keep rectum to avoid sexual dysfunction in young male
Yes screen blood relative
Doudenoum adenoma
Gardner( dermoid tumor, polyps congeital hypertrophy of retina?
Lynch syndrome
Heredietry non polypodus colerectal cancer Ingertience? Age : Risk if mailgnency? Gene: Coomon part: Assosiated condition:
Autosomal dominant 45 80% rosk of mailgnancy MSH1-2 gene Comon site rigt CEOربطه ( colon, endometriak, ovarian)
Lynch is diagnosed by amsterdam criteria , what is it?
- 3 relative with coloretal cancer
- 2 generation
- 1 first degree relative
- 1 diagnosed kess than 50 y
- FAP excluded
- tumor verify by oathlogical examination
شوفي ملاحظلت دكتور عيسى بالملاحظات هم حق الانفلامتوري بارل
ومخطط اللور جي اي بليدنق
شيكي على علاج كرون الدوائي من ملخص ريما
الدايفراتكلولز راحعيها من الملخص مو موجوده هنا وتراها مهمه
