colorectal cancer Flashcards

1
Q

where are the common locations for colorectal cancer from most –> least common (5)

A

rectal // sigmoid // ascending colon + caecum // transverse // descending

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2
Q

what are the 3 types of colorectal cancer

A

sporadic // HNPCC (lynch syndrome) // FAP

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3
Q

what is the most common form of inherited colon cancer

A

HNPCC - lynch syndrome

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4
Q

what cancer are patients with HNPCC also at risk for

A

endometrial

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5
Q

what criteria can aid diagnosis of HNPCC + what is in it (3)

A

amsterdam: 3 family with colon cancer // 2 generations // 1 case before 50

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6
Q

what inheritence is FAP + HNPCC

A

autosomal dominance

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7
Q

what is FAP

A

lots of polyps aged 30-40 –> carcinoma

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8
Q

what other cancer are FAP patients at risk of

A

duodenal

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9
Q

what symptoms does a 40year need for urgent colorectal referral

A

unexplained weight loss + abdo pain

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10
Q

what symptoms does a 50year need for urgent colorectal referral

A

unexplained rectal bleeding

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11
Q

what symptoms does a 60year need for urgent colorectal referral

A

iron deficiency anaemia OR change in bowel habit

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12
Q

what test at any age would warrant urgent colorectal referall

A

occulut blood in faeces (from screening)

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13
Q

when should urgent colorectal referalls be considered (3)

A

rectal or abdo mass// anal mass or ulcer // 50+ with PR bleed + abdo pain OR change bowels OR weight loss OR anaemia

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14
Q

what test is used to screen for colorectal cancer

A

faecal immunochemical test (FIT)

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15
Q

who is screened for colorectal cancer

A

every 2 years from 50-74 // 74+ can rquest screening

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16
Q

if patients do not meet 2 week criteria what test can be done

A

FIT stool test

17
Q

what is the most common anal cancer

A

SCC

18
Q

what node do tumours closer to the anal margin spread (distal anus)

A

inguinal nodes

19
Q

where do more proximal anal tumours spread

A

pelvic lymph node

20
Q

what is the cause RF for anal cancer

A

HPV

21
Q

what are other RF for anal cancer (5)

A

anal intercourse // MSM // HIV // cervical cancer // smoking

22
Q

presentation anal cancer

A

perianal pain // PR bleed // legion // faecal incontinence // rectovesical fistula

23
Q

initial invx anal cancer

A

PR + biopsy // virus tests eg HPV + HIV

24
Q

imaging for anal cancer

A

CT // MRI // USS

25
Q

what is a T1 anal canccer

A

tumour <2cm

26
Q

what is a T2 anal canccer

A

<2 but >5

27
Q

what is a T3 anal canccer

A

5cm+

28
Q

what is a T4 anal canccer

A

invades adjacent organs

29
Q

what are villous adenomas

A

colonic polyps that can be malignant –> secrete lots of mucous

30
Q

surgery caecal, ascending, proximal transverse colon cancer

A

right hemi-coloectomy

31
Q

surgery distal transverse or descending colon cancer

A

left hemicolectomy

32
Q

surgery sigmoid colon cancer

A

high anterior resection

33
Q

surgery rectum cancer

A

anterior resection

34
Q

surgery anal verge

A

Abdomino-perineal excision of rectum

35
Q

what risk is increased with perforated bowel cancer and what surgery is performed

A

high risk anastomosis –> end colostomy

36
Q

what is a Hartmanns

A

sigmoid colostomy + end stoma