Surgical Tut - colorectal tut

Question 1

APC controls what?

Answer 1

B-catenin production

Question 2

FAP is? why does it happen?

Answer 2

familial adenomatous polyposis
>100 polyps
has two hits already

Question 3

HNPCC

Hereditary non polyposis colon cancer is what?

Answer 3

lynch syndrome

Question 4

HNPCC caused by what?

Answer 4

microsatellite instability

DNA mismatch repair

Question 5

HNPCC, lynch can cause what cancers?

Answer 5

small bowel
gall bladder
colon
endometrial

Question 6

gardener syndrome is?

Answer 6

subtype of FAP: skin tags all over

Question 7

different polyps?

Answer 7

pedunculated

sessile

Question 8

FAP vs. HNPCC polyps different?

Answer 8

FAP - clear polyp

HNPCC - subtle, not as obvious

Question 9

symptoms of bowel cancer?

Answer 9

PR bleeding
iron deficiency
constipation/diarrhoea
abdo pain, obstipated (no farts)

Question 10

how much iron in a litre of blood?

Answer 10

500mg of iron

Question 11

how much iron do you absorb a day?

Answer 11

10mg per day

Question 12

what is obstipated?

Answer 12

not passing wind

Question 13

obstruction symptom

Answer 13

stop passing wind
distension
empty PR

Question 14

what causes gasses in large bowel

Answer 14

Nitrogen
swallowing air
bacteria gas production

Question 15

why does caecum perforate?

Answer 15

thinner wall
open and close loop
more tension on wall: ischaemia

Question 16

how can bowel perforate re: cancer?

Answer 16

gas distention

ulcerated cancer

Question 17

how to investigate bowel cancer?

Answer 17

colonoscopy

Question 18

when does adenoma become adeno-carcinoma?

Answer 18

invasion past lamina propria

Question 19

3 places colon cancer spreads

Answer 19

liver
lungs
nodes

Question 20

ways to scan for colon

Answer 20

CT c/a/p

MRI

Question 21

difference in rectal and colon cancer rx?

Answer 21

rectal are fixed
radiotherapy has better chance to
neoadjuvant

Question 22

what does neo-adjuvant mean?

Answer 22

chemo and radio before a surgery to decrease size

Question 23

TMN staging for colon cancer?

Answer 23

T- depth stage
T1 -  not through muscularis
T2- low rate
T3 - 20% mets
T4 - almost definitely mets
M - metastasis
N - Nodes

Question 24

what chemo for bowel cancer?

Answer 24

Folfox

Question 25

colorectal cancer risks?

Answer 25

APC gene

Adenomatous polyposis coli