GI: Colon Polyps & Colon CA Flashcards
What class of polyp?
Hyperplastic Pseudopolyp (inflammatory)
non-neoplastic
What class of polyp?
tubular adenoma
tubulovillous adenoma
villous adenoma
sessile serrated
neoplastic (pre-cancer)
MC type of polyp
tubular adenoma
3 factors that increase risk of colon CA…
of adenomas
size
histology
pt. p/w:
- cachexia
- pallor
- LAD
- Distension, abd. mass
- organomegaly
- Ascites
- Hemoccult POS
- rectal mass
colon CA
3 lab tests for colon CA…
CBC (IDA)
LFTs (alk phos = liver mets)
Carcinoembryonic Antigen (CEA)
tx for rectal adenocarcinoma…
radiation
3 surveillance mechanisms for colon CA?
serial CEA
annual CT Chest/AP
Periodic Colonoscopy
Gold Standard colon cancer screen
colonoscopy
frequency for colonoscopy
10 years
frequency for flex sig
5 years
this screen can miss flat or small polyps…should be done 5 years
CT colonography
which stool test?
Fit + DNA Mutation biomarkers
High risk pts
Positive warrants timely colonoscopy
3 years
cologuard
Which stool test?
Tests for human hemoglobin
Preferred CRC detection test
Annual
FIT
Which stool test?
one-time screening sensitivity low
gFOBT
Do most polyps bleed? what effect does this have on stool tests?
don’t bleed
low sensitivity for stool tests
Colorectal CA Screening if dx < 60 yo or 2 1st degree relatives
Colonoscopy q 5 years beginning age 40 or 10 years younger than age of family member
Colorectal CA Screening if dx > 60 yo
Colonoscopy at 40
Colorectal CA Screening if IBD
8-10 years after sxs onset
Which hereditary colon CA syndrome?
> 100 polyps
Onset in teenage years
FAP
Screening if FAP?
Early and routine scopes necessary; including EGD
Which hereditary colon CA syndrome?
Risk of duodenal, ampullary CA plus extracolonic malignancy
FAP
Which hereditary colon CA syndrome?
Early onset, right sided colon CA
Increased risk of endometrial CA, extracolonic malignancy
Hereditary Nonpolyposis Colorectal CA
Dx of Hereditary Nonpolyposis Colorectal CA
Amsterdam Criteria
Amsterdam Criteria…
3 family members
2 generations
1 under 50 yo
colon CA screening for Hereditary Nonpolyposis Colorectal CA
annual colonoscopy beginning at 20-25 or 2-5 years before earliest FHx
