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GI > Colorectal/Anal Disease > Flashcards

Colorectal/Anal Disease Flashcards

1
Q

Types of colorectal tumour?

A

Adenoma

Adenocarcinoma

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2
Q

How do you differentiate/stage colorectal cancer?

A

Duke’s staging (5 year survival)
- based on depth of tumour formation

TNM staging

NEED BIOPSY

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3
Q

What is the highest risk factor for colorectal cancer?

A

Smoking

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4
Q

Specific symptoms of colorectal cancer? (4)

A

Anaemia (due to bleeding/malabsorption)
Change in bowel habits
Tenesmus
Abdo mass

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5
Q

Investigation of colorectal cancer?

A

Colonoscopy
Pill endoscopy
CT colongraphy

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6
Q

Treatment of colorectal cancer?

A

Colectomy (removal of affected area and anatomise the two regions)

Radiotherapy - adjuvant or neoadjuvant

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7
Q

What is the only big difference between anorectal and colorectal cancer?

A

Anorectal cancers can be adenocarcinoma or SCC (from adjacent skin)
Colorectal - just adenocarcinoma

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8
Q

Who gets bowel cancer screening (FOB test)?

A

Pts 50-75 yo with risk factors every 2 yrs

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9
Q

What is diverticular disease? What is diverticulitis?

A

Diverticula which are symtpomatic

Diverticulitis - inflammation of diverticulum

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10
Q

What causes diverticulum to form

A

Low fibre diet

Colon has to work harder to move faeces … ADD

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11
Q

Signs and symptoms of diverticulitis

A

Symptoms like appendicits but on other side

Severe LIF pain
Fever
Tachycardia
Tenderness and guarding (muscle tenses around area of disease) of left side

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12
Q

Symptoms and signs of diverticular disease

A

Similar to IBD

LIF pain - colic (coming and going)
Altered bowel habit

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13
Q

Invx of diverticular disease

A

Colonscopy

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14
Q

Invx of diverticulitis?

A

-CT (gold)
-Increased ESR and CRP
DO NOT SCOPE -> perforation

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15
Q

Complications of diverticulitis (4)

A

Complications of diverticulitis = complicated diverticultis

Perforation
Haemorrhage
Fistula
Stricture

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16
Q

When would you use hinchey classification?

A

For acute diverticulitis (based on CT findings - used to find best treatment in diverticulitis complicated with abscess formation/peritonitis)

17
Q

Treatment of diverticular disease

A

Balanced diet
Analgesia
Bulking laxative

18
Q

Treatment of Uncomplicated diverticulitis

A

Analgesia if necessary

Antibiotics if suspected infection

19
Q

Treatment of complicated diverticultis?

A

Precutatneous drainage of large abscess

Hartmann’s procedure (removal of sigmoid coloon)

20
Q

Where is diverticulum most likely to occur?

A

Sigmoid colon - due to narrowing

21
Q

What is a colonic polyp?

A

Abdnormal growth of tissue projecting from colonic mucosa

22
Q

What is the most important polyp to know about?

A

Adenoma - all dysplastic (potential to become cancerous)

23
Q

What inherited conditions put you at an increased risk of polyp formation?

A

Familial adenomatous polyposis (FAP)
- loads and loads of adenomas - very very high risk of cancer

Lynch syndrome - lots of adenomas on right side

Peutz-jeghers syndrome - Multiple benign intestinal hamartomas

24
Q

What gene is their a mutuation in FAP and Lynch syndrome?

A

FAP - APC gene (tumour suppressor disease)

Lynch - MSH2 gene (DNA mismatch repair))

25
Q

Signs and symtpoms of colonic polyps?

A 
Asymptomatic mostly
Rectal bleeding (often not frank) -> anaemia
Mucus in stool
Abdo pain 
Bowel change
26
Q

Invx of colonic polyps?

A
  • Fam history (inhertited conditions and cancers)
  • Genetic testing
  • Colonscopy
27
Q

What is a haemorrhoid?

A

Enlargement of the vascular cushions in the wall of the anus and rectum due to increased pressure

28
Q

Treatment of haemorrohoid?

A

Increase fibre and fluid

ADD

29
Q

Where is the first site of metastasises of colorectal cancer?

A

Liver

Due to haematological spread via portal system

30
Q

What is the difference between a true diverticulum and psudeo diverticulum?

A

Pseudo is missing muscularis externa

31
Q

Difference between hyperplastic polyp and adenoma

A

Hyperplastic polyp - v. v. low risk of becoming malignant

Adenoma - high risk of malignancy (found in FAP)

32
Q

Most commonly used tumour marker in colorectal cancer?

A

CEA

33
Q

Pseudomembranous colitis (yellow plaques that are easily dislodged) is associated with what condition?

A

C.diff

GI (26 decks)

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