Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Alimentary System > Lecture 24 Colorectal Cancer > Flashcards

Lecture 24 Colorectal Cancer Flashcards

1
Q

Risk factors for CRC

A

Sporadic
Familial
HNPCC, FAP
IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for sporadic cases

A 
•	Age 
•	Male gender
•	Previous adenoma/CRC
•	Environmental influences:
–	Diet (fibre, fruit & veg,
 calcium, red meat, alcohol,)
–	Obesity
–	Lack of exercise
–	Smoking
–	Diabetes Mellitus
•	Colorectal Polyps:
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 main histological types of adenomas

A

Tubular
Villous
Intermediate tubulovillous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Morphologically how can adenomas present

A

Pedunculated

Sessile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What changes lead to the transition of normal epithelium to small sdenoma

A 
APC mutation
MCC mutation
5q deletion
c-myc activation
bel-2 mutation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What changes lead to the transition from small adenoma to are adenoma

A

KRAS mutation

c-yes mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes the transition from large adenoma to invasive adenocarcinoma

A

Chromosome 17p, 18q deletions

p53 mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes the change from invasive adenocarcinoma to metastases

A

nm23 deletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Presentation of CRC

A
  • Rectal bleeding (especially if mixed in with stool)
  • Altered bowel opening to loose stools >4 weeks
  • Iron Deficiency Anaemia men of any age and non-menstruating women (more likely to have right sided colonic malignancy)
  • Palpable rectal or right lower abdominal mass
  • Acute colonic obstruction if stenosing tumour
  • Systemic symptoms of malignancy: Weight loss, Anorexia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Investigation for CRC

A

Colonoscopy

Tissue bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Radiological imaging for CRC

A

• Barium enema
• CT colonography
o 3D virtual colonoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dukes A

A

Confined to mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dukes B

A

Invasion through muscularis without LN involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dukes C

A

Invasion through muscularis with regional LN involvement (1-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dukes D

A

Presence of distant metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T1
T2
T3
T4

A

Confined to submucosa
Confined to muscularis
Confined to serosa
Branched serosa, invading other structures

17
Q

N0
N1
N2

A

No tumour involvement in regional LN
Tumour seen in up to 3 regional L
Tumour seen in 4+ regional LN

18
Q

M0

M1

A

No metastases to distant organs

Metastases to distant organ

19
Q

What type of surgery would Dukes A and cancer polyps require

A

Endoscopic or local resection

20
Q

Screening methods for CRC

A

FOBT
FIT
Flexible sigmoidoscopy
CT colonography

21
Q

Describe the Scottish Bowel Screening Programme

A

 Age 50-74 years
 FOBT every 2 years
 If FOBT positive  colonoscopy

22
Q

FOBT has low positivity is what gender

A

Women

23
Q

Describe the Faecal Immunochemical test

A

– Specific for human haemoglobin
– Automated
– Quantitative
– User friendly format that increases uptake

24
Q

What type of disease is– FAP (familial adenomatous polyposis)

A

 Autosomal dominant condition

25
Q

What is the cause of FAB

A

 Mutation of the APC gene on chromosome 5

26
Q

How is FAP prevented from becoming malignant

A

 Screening – annual colonoscopy from age 10-12 yrs
 Prophylactic proctocolectomy (surgical removal of the rectum and all or part of the colon) usually age 16 - 25 yrs
• NSAIDs chemoprevention
 Sulindac reduces polyp number and prevents recurrence of higher-grade adenomas in the retained rectal segment

27
Q

What type of disease is HNPCC (hereditary non-polyposis colorectal cancer)

A

Autosomal dominant

28
Q

What mutation causes HNPCC

A

 Mutation in DNA mismatch repair (MMR) genes

- e.g MLH1 and MSH2

29
Q

Diagnosis of HNPCC

A

 Tumours typically have a molecular characteristic called microsatellite instability (MSI) - frequent mutations in short repeated DNA sequences (microsatellites).
 Diagnosis – clinical criteria (Amsterdam / Bethesda), genetic testing
2 yearly colonoscopy

30
Q

Other high risk groups of CRC

A

Family history
IBD
Previous CRC
Previous adenomas

Alimentary System (39 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions