Colorectal neoplasms and non-neoplasms

Question 1

How can sessile polyps be removed?

Answer 1

Endoscopic mucosal resection

Question 2

What is the surgical procedure for removing most polyps?

Answer 2

Colonoscopic polypectomy

Question 3

What is the surgical treatment for FAP?

Answer 3

Total proctocolectomy with ileal pouch-anal anastomosis

Question 4

How is Peutz-Jeghers syndrome diagnosed?

Answer 4

1. Genetic testing
2. Small bowel and pancreatic imaging
3. Colonoscopy
4. Testicular examination in males
5. Cervical smear test, mammography, pelvic examination in females

Question 5

What is the criteria for classifying risk of HNPCRC and what does it entail?

Answer 5

Amsterdam criteria

1. FAP excluded
2. 1/more relatives with CRC below age of 50
3. 3 relatives with colorectal cancer (at least 1 direct)
4. 2 or more generations with CRC

Question 6

What is the gold standard investigation for diagnosing colorectal cancer?

Answer 6

Colonoscopy

Question 7

How is CRC staged?

Answer 7

CT of chest, abdomen and pelvis

For rectal: Pelvic MRI or endoanal ultrasound

Question 8

What is the treatment for rectal cancer?

Answer 8

Neoadjuvent radiotherapy and chemotherapy

Question 9

What is the treatment for colorectal cancer?

Answer 9

1. Adjuvant chemotherapy OR
2. Neoadjuvent chemotherapy and radiotherapy prior to surgery
3. Radiotherapy in rectal cancer ONLY

Question 10

What are the possible surgeries for CRC?

Answer 10

1. Endoscopic or local resection (DUKE A)
2. Stoma formation
3. Removal of lymph nodes
4. Partial hepatectomy for liver mets

Question 11

What are the preventative screening methods for CRC?

Answer 11

1. FOBT
2. FIBT
3. Colonoscopy
4. Flexible sigmoidoscopy
5. CT colonography (if risk for colonoscopy complications high)