Colorectal Cancer Flashcards

1
Q

Types of colorectal polyps

A

Inflammatory, hamartomatous (benign, focal malformation that resembles a neoplasm in tissue of origin), metaplastic, neoplastic

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2
Q

Genes associated with cancer

A

Oncogenes - Promote normal growth and division, cause excess cell growth and division when mutated
Tumour suppressor genes - Suppress cell growth and division, allow cell growth and division when mutated

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3
Q

Staging of cancer

A

TNM or Dukes

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4
Q

Explain Dukes staging system

A
Dukes A - Mucosa
B1 - Into muscularis propria
B2 - Through muscularis propria
C1 - Tumour spread to <4 lymph nodes
C2 - Tumour spread to > 4 lymph nodes
D - Distant metastases
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5
Q

Example of autosomal dominant inheritance of colorectal cancer

A

Familial adenomatous polyposis -
Mutation in APC gene
Hereditary nonpolyposis colorectal cancer -
Mutation in DNA mismatch repair gene

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6
Q

Symptoms of colorectal cancer in caecum

A

Anaemia

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7
Q

Symptoms of colorectal cancer in descending colon

A

Pain, change in bowel habit, rectal bleeding

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8
Q

Symptoms of colorectal cancer in rectum

A

Rectal bleeding, tenesmus

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9
Q

Clinical findings on examination

A

Anaemia, cachexia, lymphadenpathy
Hepatomegaly, distensions
Rectal bleeding, mass
6 weeks on unexplained change in bowel movement

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10
Q

Iron deficiency anaemia

A

Iron-deficiency tablet but carry out OGD and endoscopy, possible caecal cancer

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11
Q

Sigmoidoscopy vs colonoscopy

A

Sigmoidoscopy - If rectal bleed is bright red

Colonoscopy - If iron deficiency anaemia, to see where problem is

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12
Q

Why do we prefer endoscopy > CT colography

A

Endoscopy has diagnostic and therapeutic use

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13
Q

Toblerone sign on endoscopy

A

Endoscope is in transverse colon

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14
Q

What can be used to check for blood hidden/not seen in stool

A

Faecal Occult Blood Test (FOBT)

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15
Q

What is the Scottish Bowel Screening Programme

A

50-75-year-olds invited every 2 years for a bowel scan

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16
Q

How can primary rectal cancers be staged

A

MRI unlike staging lung and liver cancer - CT scan

17
Q

Emergency presentation of cancer

A
Obstruction -
Distension
Constipation
Pain
Vomiting
Bleeding and perforation
18
Q

Treatment of obstruction

A

Colostomy
Resection + colostomy
Resection + anastomosis
Stenting

19
Q

Radiotherapy in rectal cancer

A

Pre or postoperative - Reduces local recurrence after rectal excision
Palliative - Inoperable primary rectal cancer
Recurrent rectal cancer

20
Q

Chemotherapy for colorectal cancer

A

5-fluorouracil or Capecitabine
Adjuvant for stage C - Improve survival
Median survival advantage of 5 months for advanced