Colorectal cancer/large bowel conditions Flashcards
Medications associated with a reduced risk of CRC? (4)
HRT
COCP
Statins
Aspirin
Frequencies of distribution of CRC (colon vs rectum)
2/3rds in colon, 1/3rd in rectum
Urgent two week referral: any age (2)
Rectal or abdominal mass
Rectal bleeding AND abdo pain/change in bowel habit/weight loss/IDA
Urgent two week referral: >40 years of age
Unexplained weight loss and abdo pain
Urgent two week referral: >50 years of age
Unexplained rectal bleeding
Urgent two week referral: >60 years of age (3)
Iron deficiency anaemia
Changes in bowel habit
Positive q-FIT
Current colorectal screening programme?
qFIT sent every 2 years to patients 60-74
Circumstances where patients with family history should be referred for colonoscopy? (2)
2x first degree relatives with a history of CRC
1x first degree relative with a history of CRC < 45 years of age
At what age should patients with a positive family history be referred for colonoscopy? (2)
At presentation or aged 35-40 (whichever is later)
Repeat at age 55
Familial CRC syndromes (4)
Familial adenomatous polyposis
Juvenile polyposis
Peutz-Jegher’s syndrome
HNPCC (Lynch syndrome)
Autosomal dominant condition causing benign intestinal (usually small) polyps in association with dark freckles on lips, oral mucosa, face, palm and soles
Petz-Jegheurs syndrome
When should q-FIT be offered to symptomatic patients? (3)
Patients without rectal bleeding
>50- unexplained abdo pain or weight loss
<60 change in bowel habit or weight loss
> 60 anaemia without iron deficiency
Management of diverticular disease?
High fibre diet +/- antispasmodics e.g. mebeverine
Delay in passing meconium + abdominal distension + vomiting + poor feeding in a neonate
Hirchsprung’s disease
Pathophysiology of Hirchsprung’s?
Absence of ganglion cells in the myenteric plexus, supplying a segment of bowel
