GI Epidemiology Westra

Question 1

What is recommended for colorectal screening?

Answer 1

Flex sig + FOBT q 5 years
or
Colonoscopy q 10 years

*Both need a rectal exam

Question 2

where does colorectal cancer rank in cancer death?

Answer 2

2nd

Question 3

lifetime risk of colorectal cancer for americans?

Answer 3

5 %

Question 4

After age 40, male or female greater incidence of CRC?

Answer 4

Male

Question 5

What group has highest mortality rate and highest incidence except for AI?

Answer 5

African Americans

Question 6

Primary prevention for CRC?

Answer 6

change the environment: diet, excersise, NSAIDS, calcium/vit D, hormone replacement, statins

Question 7

secondary prevention for CRC?

Answer 7

Attack the precursor of the dz (benign colonic polyp etc.)

Question 8

what age do you begin screening for CRC in average risk pop? in african americans?

Answer 8

50

45

Question 9

What age do you stop CRC screening?

Answer 9

75

Question 10

What is Cologuard?

Answer 10

stool DNA test + blood

Covered by medicaid/medicare

Question 11

Blood screening test for CRC?

Answer 11

Circulating methylated septin 9 DNA

Question 12

How does pillCam stack up compared to colonoscopy?

Answer 12

Inferior for deteciton of polyps

Question 13

Less than what percent of americans over age 50 undergo screening?

Answer 13

40 %

Question 14

Do most people who develop colorectal ca have identifiable risk factors?

Answer 14

NOO! Most do not have identifiable risk factors

Question 15

Location for Lynch polyps?

Answer 15

Right colon

Question 16

HNPCC CRC screening?

Answer 16

colonoscopy every 2 years starting at 20-25 and annual colonoscopy after age 40

Question 17

FAP screening?

Answer 17

Flexible sigmoidoscopy or colonoscopy every 1-2 years starting at age 10-12

Question 18

UC screening?

Answer 18

Colonoscopy with biopsies for dysplasia q 1 to 2 years beginning 7-8 years after diagnosis or 12-15 years after diagnosis of left-sided colitis

Question 19

Symptoms of CRC?

Answer 19

Change in bowel movements
rectal bleeding
stool testing +
Abdominal pain
Anemia
Weight loss

Question 20

Male smoker with recurrent GERD, on Nexium, has Barrett’s esophagus, how often would you screen him for cancer?

Answer 20

Yearly

Question 21

Squamous cell esophageal cancer location?

Answer 21

upper and middle third

Question 22

Adenocarcinoma of esophagus location?

Answer 22

Lower 1/3

Question 23

Risk factors for esophageal cancer squamous cell carcinoma?

Answer 23

Tobacco
Alcohol
African american
Male
Mucosal irritants (hot tea, radiation, achalasia)
Carcinogen 
Poor diet

Question 24

Risk factors for adenocarcinoma of esophagus?

Answer 24

GERD
Barrett's
Caucasian
Male
Obese
Diet

Question 25

4th most common cancer in world?

Answer 25

hepatocellular cacrinoma

Question 26

What are common causes of HCC ?

Answer 26

Hep C Alcohol Hep B Hemochromatosis

Question 27

Environmental causes of HCC?

Answer 27

Aflatoxin B: mycotoxin in inappropriately stored grain and nuts Viny chloride: industrial carcinogen Anabolic steroids Estrogens & androgens-oral contraceptives

Question 28

Sx of HCC?

Answer 28

``` abd pain abd swelling weight loss weakness feeling full vomiting jaundice ```

Question 29

PE findings for HCC?

Answer 29

``` hepatosplenomegaly Ascites jaundice fever hepatic bruit ```

Question 30

Screening for high-risk for HCC?

Answer 30

Alpha-fetoprotein Abdominal helical CT (ultrasound if CT unavailable) Screen every 6 months? Liver bx for dx

Question 31

What does the USPSTF recommend offering screening for 1 time to adults born between 1945 and 1965?

Answer 31

Hep C