GI Section 1: Luminal (Colon/Rectal CA/Colon Misc Masses))

Question 1

Answer 1

Applecore appearance in colon CA

Question 2

Cancers on the right tend to a. ___.

Cancers on the left tend to b. ___.

Answer 2

Cancers on the right tend to bleed (present with bloody stools, anemia).

Cancers on the left tend to OBSTRUCT

Question 3

Large bowel intussusception in adult =

Answer 3

Mallignancy

Question 4

Colon CA likes to Met to the?

Answer 4

Liver

Question 5

Liver METS on MRI

Answer 5

Liver Mets will classically be T 1 Dark, T2 Mildly Bright (“evil grey”), heterogenous non-progressive in enhancement, sometimes target.

Question 6

Occasionally arises in the anus (think HPV).

Answer 6

Squamous Cell Carcinoma

Question 7

Most rectal CA are what type?

Answer 7

AdenoCA (98%)

Question 8

Low rectal cancer definition

Answer 8

0-5 cm from the anorectal angle

Question 9

What type of rectal CA has the highest recurrence rate?

Answer 9

Low rectal CA

Question 10

How do you stage rectal CA?

Answer 10

MRI - you only need T2WI (contrast doesn’t matter)

Question 11

You call stage 3 rectal CA when?

Answer 11

tumor breaks out of the rectum and into the perirectal fat.

Question 12

This is the critical stage that
changes management in Rectal CA (they will get chemo/rads prior to surgery).

Answer 12

Stage 3

Question 13

High Rectal CA treatement

Answer 13

Low anterior Resection (LAR

• Will maintain fecal continence post op

Question 14

Low Rectal CA treatment

Answer 14

Abdomino Perineal resection (APR)

• WIll end up with colonostomies

Question 15

Surgical Treatment is classically determined by?

Answer 15

the position of the tumor relative to the butthole.

Question 16

Both surgical approaches in rectal CA are performed with?

Answer 16

a total mesorectal excision (tumor, nodes, and blood supply).

Question 17

The second most common tumor in the colon.

Answer 17

Lipomas

Question 18

The most common benign tumor of the colon and rectum.

Answer 18

Adenoma

Question 19

What type of colonic adenoma has the largest risk of malignancy?

Answer 19

Villous adenoma

Question 20

villous adenoma classically causes what symtpom?

Answer 20

Mucous diarhhea = severe fluid and electrolyte depletion

Question 21

old + diarhhea + electrolyte imbalance + bowel mass =

Answer 21

Villous adenoma

McKittrick-Wheelock Syndrome

Question 22

Answer 22

VIllous adenoma

Question 23

sigmoid colon sheds its oppressive mesentery and becomes the rectum at this level

Answer 23

S3

Question 24

When does rectum become the anus?

Answer 24

15 cm after S3.

Question 25

What part of teh rectium is retroperitoneal?

Answer 25

Proximal 1/3

Question 26

What are the retroperitoneal structures?

Answer 26

Duodenum (2nd and 3rd)
Pancrease (head and body)
Colon (ascending and descending)
rectum (proximal 1/3)

Question 27

The distal 1/3 of teh rectum is entirely….

Answer 27

Extraperitoneal