Colorectal surgery

Question 1

_nd most deadly cancer
_ most ocmmon common

Answer 1

2nd most deadly cancer, 3rd most common cancer

Question 2

men or women more likely?

Answer 2

Men

Question 3

Colorectal cancer factors that increase risk based on diet

Answer 3

Red meat and alcohol

low fibre, low fruit/veg, low calcium

Question 4

Other crc risk factors

Answer 4

Obesit, lack of exercise, smoking, diabetes, age, prev. adenoma, family history/genetics

Question 5

What do colorectal cancers usually develop from?

Answer 5

colorectal polyps

Question 6

Onco gene malfunctions causing crc

Answer 6

k-ras, c-myc

Question 7

Tumour supressor genes eg

Answer 7

P-53, APC, DCC

Question 8

CRC presentation

Answer 8

Altered bowel movements (>4 wks)
blood in stool
Iron deficiency anaemia
Palpable mass
Weight loss, anorexia,
Colonic obstruction

Question 9

CRC investigation of choice

Answer 9

Colonoscopy!! Can take biopsies and even treat too :)))

Question 10

Radiological choice

Answer 10

CT Colonography

Question 11

CRC typical appearance with barium enema

Answer 11

“Apple core”

Question 12

Liver metastases, can you still undergo surgery?

Answer 12

Yes, sometimes as can chop off part of liver :)

Question 13

radio vs chemo adjuvant/neoadvuvant

Answer 13

Radio is neoaduvant
Chemo can be adjuvant and can be neoadjuvant with radiotherapy

Question 14

Scotland screening

Answer 14

FIT test, testing human haemoglobin in stools

Question 15

High risk groups (genetically) [3]

Answer 15

FAP
MAP
HNPCC

Question 16

FAP due to

Answer 16

Autisomal dominant APC mutation

Question 17

FAP screening / protocolectomy

Answer 17

Annual colonoscpopy from age 10-12

Prophylactic protocolectomy around ages 16-25

Question 18

What if FAP and dont have surgery?

Answer 18

Sulindac - reduces polyp no. and lower cases of cancers

Question 19

MAP what gene? Where? Screening

Answer 19

MUTYH base-excision repair gene. Autosomal recessive

Right sided

Annual colorectal surveillance from 18-20

Question 20

MHPCC polyps where?

Answer 20

JOKES they don’t have any

Question 21

MHPCC Screening and genetic type

Answer 21

2 yearly colonoscopy from 25y/o.

Autosomal dominant

Question 22

IBD CRC creening

Answer 22

Every 10 years