Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MBChB Surgery > Colorectal cancer > Flashcards

Colorectal cancer Flashcards

1
Q

Define colorectal cancer

A

Cancer involving the large intestine (colon and rectum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where does the colon begin?

A

Ileo-caecal junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 5 parts of the colon?

A 
Caecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the function of the colon?

A

Receives digested food
Absorbs water and electrolytes
Forms faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What vessel supplies midgut-derived structures?

A

SMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What vessel supplies hindgut-derived structures?

A

IMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the blood supply of the ascending colon?

A

SMA

  • ileocolic aa
  • right colic aa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the branches of the ileocolic artery?

A

Colic aa
Anterior caecal aa
Posterior caecal aa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the blood supply of the transverse colon?

A

SMA

- middle colic aa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the blood supply of the descending colon?

A

IMA

- left colic aa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the blood supply of the sigmoid colon?

A

IMA

- sigmoid arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Marginal Artery of Drummond?

A

Anastomoses between SMA and IMA that provides collateral supply to the colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the lymphatic drainage of the colon?

A

SMN and IMN -> cisterna chyli -> thoracic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 2 major flexures of the rectum?

A

Sacral

Anorectal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give the blood supply of the rectum

A 
IMA
- superior rectal
Internal iliac 
- middle rectal
Internal pudendal
- inferior rectal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Discuss the epidemiology of colorectal cancer

A

> 65yo
W>B
M>F

17
Q

Name risk factors for colorectal cancer

A 
>65yo
Smoking
Obesity
Diet (red meat, processed, alcohol)
IBD
Personal history of polyps of cancer
18
Q

Name screening modalities for colorectal cancer

A

Faecal occult blood test
Sigmoidoscopy
Colonoscopy

19
Q

What is the pathogenesis of colorectal cancer?

A

Sporadic

Inherited

20
Q

What are the 3 genetic pathways implicated in the pathogenesis of colorectal cancer?

A
  1. Chromosomal instability
  2. Microsomal instability
  3. Serrated pathway
21
Q

Explain the chromosomal instability pathway

A

Inactivating tumour suppressor genes (APC)

Activating proto-oncogenes (KRAS)

22
Q

Explain the microsomal instability pathway

A

Inactivation of MMR genes (MLH1) due to epigenetic silencing via promoter hypermethylation

23
Q

Explain the serrated pathway

A

Proto-oncogene BRAF mutation

24
Q

How is colorectal cancer staged?

A

AJCC TNM staging

Modified Duke’s = old system

25
Q

Discuss the AJCC TNM staging of colorectal cancer

A

T1 - invades submucosa
T2 - invades muscularis propria
T3 - invades subserosa or non-peritonealized pericolic/perirectal tissue
T4 - directly invades other structures or visceral peritoneum

N1 = 1-3 LN
N2 = >3 LN
26
Q

Name suspicious symptoms that clinically suggest colorectal cancer

A 
Significant weight loss
Constipation
Change in bowel habits
PR bleeding
Rectal mass
Tenesmus
Rectal pain
27
Q

How can complications of colorectal cancer present clinically?

A 
Intestinal obstruction
Perforation
Peritonitis
Abdominal pain
Iron deficiency anemia 
Acute GI bleed
28
Q

How can colorectal cancer spread?

A

Lymphatic
Hematogenous
Contiguous
Transperitoneal

29
Q

Name the most common sites of colorectal cancer metastases

A

LN
Liver
Lungs
Peritoneum

30
Q

Where can tumours in the distal rectum metastasize to initially and why?

A

Lungs

Inferior rectal vv drains into IVC

31
Q

Name atypical symptoms of colorectal cancer

A

Pneumaturia

Fever of unknown origin

32
Q

Name investigations in colorectal cancer

A 
Bloods
- FBC, U+E, LFT, CEA, HIV 
Imaging
- CXR
- AXR 
Colonoscopy 
Staging CT
33
Q

Name treatment options for colorectal cancer

A

Chemotherapy
Radiotherapy
Surgical

34
Q

Name indications for adjuvant chemotherapy in colorectal cancer

A

Metastatic
T3, T4 tumours
Positive lymph nodes
High risk features

35
Q

Discuss palliation in colorectal cancer

A 
Analgesia 
Bowel obstruction surgery 
ERCP (obstructive jaundice)
Psychologist 
Radiotherapy
Chemotherapy
36
Q

How long is surveillance in colorectal cancer carried out for?

A

Minimum 5 years

37
Q

How do you perform surveillance in post-colorectal cancer patients?

A

Clinical
Bloods
CT scan
Colonoscopy

MBChB Surgery (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions