Colorectal Cancer

Question 1

Is an adenoma benign or malignant?

Answer 1

Benign with the potential to become malignant

Question 2

Is an adenocarcinoma benign or malignant?

Answer 2

Malignant

Question 3

What are the 4 main types of polyps?

Answer 3

Inflammatory
Hamartomaous
Metaplastic
Neoplastic

Question 4

What is the first gene to be mutated in the development of colorectal cancer?

Answer 4

APC gene

Question 5

Name the 3 genes mutated in colorectal cancer

Answer 5

APC gene
Kras gene
p53 gene

Question 6

If an adenoma is tubular is it likely to be benign or malignant?

Answer 6

benign

Question 7

Describe the criteria for Duke’s staging A

Answer 7

Not invaded through the muscle layer

Question 8

Describe the criteria for Duke’ staging B

Answer 8

Has invaded through the muscular layer

Question 9

Describe the criteria for Duke’ staging C

Answer 9

Regional lymph nodes have become affected

Question 10

Describe the criteria for Duke’ staging D

Answer 10

Distant metastases

Question 11

Name three protective factors to reduce the risk of colorectal cancer

Answer 11

Vegetables
Fibre
Exercise

Question 12

Name four causative factors of colorectal cancer

Answer 12

Red meat
Smoking
Alcohol
Obesity

Question 13

What does the enzyme AMPK do?

Answer 13

Increases glucose uptake by muscle

Decreases cell turnover

Question 14

If someone is autosomal dominant - FAP, where does the mutation occur?

Answer 14

APC gene

Question 15

If someone is autosomal dominant - HNPCC, where does the mutation occur?

Answer 15

In DNA mismatch repair gene

Question 16

If the cancer is in the caecum what are the likely symptoms?

Answer 16

Anaemia

Question 17

If the cancer is in the descending colon what are the likely symptoms?

Answer 17

Pain
Change in bowel habit
Rectal bleeding (occasionally)

Question 18

If the cancer is in the rectum what are the likely symptoms?

Answer 18

Rectal bleeding

Tenesmus

Question 19

What investigations would be used if the history and examination was suggestive of colorectal cancer? (4)

Answer 19

Barium enema
CT colography
Sigmoidoscope
Colonoscopy

Question 20

Why might a barium enema not be a good investigation?

Answer 20

Picture is not clear as bowel is overlapping and often indistinguishable

Question 21

What does faecal occult blood testing do?

Answer 21

Looks for small amounts of blood in stool

Question 22

To stage a primary rectal cancer which scan is used?

Answer 22

MRI

Question 23

What are emergency cases of colorectal cancer?

Answer 23

Obstruction
Perforation
Bleeding

Question 24

What is the curative option for treatment in colorectal cancer?

Answer 24

Surgery

Question 25

Which surgeries can be offered to a person with colonic cancer?

Answer 25

right hemicolectomy
extended right hemicolectomy
transverse colectomy
left hemicolectomy
sigmoid colectomy
subtotal colectomy

Question 26

which surgical procedures are offered to a patient with rectal cancer?

Answer 26

abdomino-perianal excision

Anterior resection

Question 27

which agent is used in chemotherapy for colorectal cancer?

Answer 27

5-fluorouracil (5-FU)