Colorectal cancer

Question 1

Where are most colon Ca found?

Answer 1

Rectum (45%) and sigmoid colon (25%)

Question 2

Histological subtype of most colon Ca?

Answer 2

Adenocarcinoma

Question 3

Presentation of colon Ca? (6)

Answer 3

Anorexia and weight loss
Anaemia
PR bleeding
Altered bowel habit
Tenesmus
Abdominal mass

Question 4

Investigation of suspected colon ca? (4)

Answer 4

Colonscopy/flexible sigmoidscopy + biopsy
CT colongraphy
FBC, LFT
CEA

Question 5

Staging investigation for confirmed colon Ca?

Answer 5

Contrast enhanced CT of the chest, abdo, pelvis

Question 6

Surgery for:

Caecal, ascending or proximal transverse tumour

Answer 6

Right hemicolectomy

Question 7

Surgery for:

distal transverse or descending colon tumours

Answer 7

Left hemicolectomy

Question 8

Surgery for:

sigmoid tumours

Answer 8

Sigmoid colectomy

Question 9

Surgery for:

low sigmoid or high rectal tumours

Answer 9

Anterior resection

Question 10

Surgery for:

tumours low in the rectum

Answer 10

adominoperineal resection + permanent colostomy

Question 11

When is a Hartmann’s procedure usually considered?

Answer 11

When there is an obstruction requiring emergency relief

Question 12

Problems with faecal occult blood testing?

Answer 12

Low patient acceptability and high false positive rate (around 10%)

Question 13

Autosomal dominant condition characterized by numerous hamartamous polyps in the GI tract, and pigmented lesions on lips, oral mucosa, face palm and soles?

Answer 13

Peutz-Jeugher syndrome