GI Epidemiology Westra Flashcards

1
Q

What is recommended for colorectal screening?

A

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

*Both need a rectal exam

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2
Q

where does colorectal cancer rank in cancer death?

A

2nd

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3
Q

lifetime risk of colorectal cancer for americans?

A

5 %

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4
Q

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

A

Male

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5
Q

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

A

African Americans

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6
Q

Primary prevention for CRC?

A

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

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7
Q

secondary prevention for CRC?

A

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

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8
Q

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

A

50

45

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9
Q

What age do you stop CRC screening?

A

75

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10
Q

What is Cologuard?

A

stool DNA test + blood

Covered by medicaid/medicare

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11
Q

Blood screening test for CRC?

A

Circulating methylated septin 9 DNA

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12
Q

How does pillCam stack up compared to colonoscopy?

A

Inferior for deteciton of polyps

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13
Q

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

A

40 %

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14
Q

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

A

NOO! Most do not have identifiable risk factors

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15
Q

Location for Lynch polyps?

A

Right colon

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16
Q

HNPCC CRC screening?

A

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

17
Q

FAP screening?

A

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

18
Q

UC screening?

A

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

19
Q

Symptoms of CRC?

A
Change in bowel movements
rectal bleeding
stool testing +
Abdominal pain
Anemia
Weight loss
20
Q

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

A

Yearly

21
Q

Squamous cell esophageal cancer location?

A

upper and middle third

22
Q

Adenocarcinoma of esophagus location?

A

Lower 1/3

23
Q

Risk factors for esophageal cancer squamous cell carcinoma?

A
Tobacco
Alcohol
African american
Male
Mucosal irritants (hot tea, radiation, achalasia)
Carcinogen 
Poor diet
24
Q

Risk factors for adenocarcinoma of esophagus?

A
GERD
Barrett's
Caucasian
Male
Obese
Diet
25
Q

4th most common cancer in world?

A

hepatocellular cacrinoma

26
Q

What are common causes of HCC ?

A

Hep C
Alcohol
Hep B
Hemochromatosis

27
Q

Environmental causes of HCC?

A

Aflatoxin B: mycotoxin in inappropriately stored grain and nuts

Viny chloride: industrial carcinogen

Anabolic steroids

Estrogens & androgens-oral contraceptives

28
Q

Sx of HCC?

A
abd pain
abd swelling
weight loss
weakness
feeling full
vomiting
jaundice
29
Q

PE findings for HCC?

A
hepatosplenomegaly
Ascites
jaundice
fever
hepatic bruit
30
Q

Screening for high-risk for HCC?

A

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

Liver bx for dx

31
Q

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

A

Hep C