Colorectal Cancer

Question 1

4 layers

Answer 1

Outer - serous (int) / Adventita (ret)

Muscularis

Submuscularis

Mucosa

Question 2

Most carcinomas are

Answer 2

AdenoCarcinomas : from layer lining the glands

Question 3

Come from which mutation

Answer 3

Sporadic

But sometimes APC

Question 4

Uncontrollable division leads to

Answer 4

Polyps

Question 5

Polyps do what

Answer 5

Can accumulate mutations in other genes and become a malignant tumour

Question 6

Types of premalignant/ neoplastic polyps

Answer 6

Adenomatous or serrated depending on appearance

Question 7

Adenomatous polyp?

Answer 7

Normal appearance

(APC) mutation

Question 8

Serrated polyp

Answer 8

Saw tooth appearance

Mutation in DNA repair

Question 9

Stages

Answer 9

0- not passed mucosa 
1-beyond mucosa 
2-entire wall
3- lymph 
4- metastasised

Question 10

Risk factors

Answer 10

Elderly
Inflamm bowel disease
Cig smoke

Red meat
Lack of fibre
Obesity
Familial adenomas

Question 11

Symptoms

Answer 11

Ascending :
Pain and weight loss
No bowel obstruction so grows large= late diagnosis
Can ulcerated and bleed = anaemia

Descending/left :

Lumen narrowing
Pain
Blood stained stool

Question 12

Diagnosis

Answer 12

Colonoscopy
Fecal occult blood

Testing fro GI bleeding

Barium enema: inject fluid and look for abnormality - apple core sign shows constriction of lumen in descending colon

Question 13

Treatment

Answer 13

Early- surgical

To lymph - chemotherapy