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GS > Colorectal > Flashcards

Colorectal Flashcards

1
Q

Most common site of metastasis of Colon Cancer

A

Liver

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2
Q

Symptoms of Colorectal cancer

A

Melena/Hematochezia
Alternating constipation and diarrhea
Pencil thin stools
Tenesmus
Loss of weight
Anemia Sx

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3
Q

Causes of pyoderma gangrenosum

A
  1. IBD
  2. Haem malignancy
  3. Granulomatosis with polyangiitis
  4. IgA?
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4
Q

What investigation after strep bovis endocarditis

A

Colonoscopy as it’s a/w colon cancer

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5
Q

Modified and original Amsterdam criteria

A

3 2 1 rule

3 relatives with Colon(OG) or non colon(modified) Ca
2 successive generations
1 diagnosed before age 50

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6
Q

Risk factors for anal SCC

A
  1. HIV and HPV infection
  2. Immunocompromise
  3. Receptive anal intercourse
  4. Smoking
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7
Q

T staging of Colon and Rectal ancer

A

Tis: Carcinoma in situ, intramucosal
T1: Invades submucosa
T2: Invades muscularis propria
T3: Invades into pericolorectal tissues
T4a: Invades through parietal peritoneum
T4b: Invades or adheres to surrounding organs

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8
Q

Type of IBD that causes lead pipe appearance

A

UC

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9
Q

Hinchey classification

A

1a: pericolonic phlegmon
1b: abscess
2: retroperitoneal abscess
3: Purulent peritonitis
4: Feculent peritonitis

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10
Q

Main features of Crohn’s disease

A
  1. Transmural with skip lesions,cobblestone
  2. Mouth to anus
  3. Strictures, fistulation and malabsorption
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11
Q

Type of IBD a/w rose thorn appearance and string of pearls(Sign of Cantor) on barium enema

A

Crohns
-deep linear ulcerations

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12
Q

Dx of short gut syndrome

A
  1. Malnutrition
  2. <100cm
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13
Q

diagnosis of Gardner’s syndrome

A

FAP + Extraintestinal manifestations

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14
Q

Definition of high output stoma

A

> 1litre

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15
Q

FAP vs attenuated FAP vs Gardners

A

Gardner’s : FAP + extraintestinal
FAP: CRC before 40yo
Attenuated FAP: CRC after 40yo

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16
Q

What is Chilaiditi syndrome

A

Transposition of bowel between liver and diaphragm
- May mimic pneumoperitoneum

17
Q

Options for treatment for obstructed Colorectal Ca

A

3S
-stent
-stoma
-surgical excision

18
Q

Spigelman classification is for

A

Familial adenomatous polyposis

19
Q

What to look for in a DRE for rectal tumor

A
  1. Location of tumor
  2. Distance of tumor from anal verge
  3. Mobility
  4. Ability to get over tumor
  5. Whether tumor can be cannulated
  6. Anal tone for sphincter involvement
20
Q

Invx for newly diagnosed Rectal Ca

A
  1. MRI Rectum
  2. TransRectal US
  3. CT AP
21
Q

Most common site of mets for low rectal tumor

A

Lung: Venous return in via inferior rectal artery which goes to IVC then lung

22
Q

Colorectal cancer T staging

A

Tis: Carcinoma in situ, intramucosal
T1: Invades submucosa
T2: Invades muscularis propria
T3: Invades through muscularis propria into subserosa/ pericolorectal tissues
T4a: Invasion through parietal peritoneum
T4b: Invasion/ Adherence to adjacent structures/organs

23
Q

Mx for anal fistula

A
  1. Cutting seton placed
  2. After fistula migrates to external sphincter, fistolotomy
24
Q

Mx for anal fistula

A
  1. Cutting seton placed
  2. After fistula migrates to external sphincter, fistolotomy
25
Q

Reason for spouting ileostomy

A

Contents are liquid, will swirl around and cause dermatitis

26
Q

Spot recognition of operation creating an end colostomy with midline laparotomy

A

Hartmann’s procedure

27
Q

Spot recognition of operation creating an ileal conduit and an end colostomy

A

Pelvic exenteration

28
Q

Principles of treating enterocutaneous fistula

A
  1. Sepsis
  2. Nutrition
  3. Rule out distal obstruction
  4. Reduce fistula output( Loperamide, fybogel)
29
Q

What is a subtotal colectomy

A

Total colectomy sparing the sigmoid colon

30
Q

Classification systems for perianal fistulas

A
  1. Park
  2. Goodsall rule
31
Q

Key numbers for fecal calprotectin test

A

<100: IBD unlikely —> normal FC has a high negative predictive value
100-250: refer gastro
>250: urgent referral to gastro

32
Q

Sites of biopsy for suspected IBD

A

Terminal ileum
Ascending Colon
Transverse Colon
Descending Colon
Rectum

33
Q
A

GS (11 decks)

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