Wk5 Colon Cancer

Question 1

Determinant of staging CRC:

Answer 1

depth of penetration

Question 2

What to know about T4 tumors:

Answer 2

Behave BADLY

obstruction/perforation

lymph/vascular invasion

undifferentiated histology

need at least 10-12 nodes for biopsy

Question 3

Genetic necessity for use of cetuximab or panitumab:

Answer 3

k-ras wild-type

Question 4

adenoma prevention in FAP

Answer 4

COX-2 inhibitors

Question 5

**Test

Tx for stage 1:

Answer 5

surgery only

Question 6

**Test

Tx for stage IIA/B:

Answer 6

consider chemo, esp for IIB

Question 7

**Test

Tx for stage III:

Answer 7

chemo

same for stage IV

Question 8

When to do predictive testing:

Answer 8

If effective prevention, screening, and treatment exist

Info reduces morbidity/mortality

Predictive power of the test

Question 9

When recommended predictive testing?

Answer 9

1st degree relative with known gene mutation

Question 10

Right sided CRC more likely:

Answer 10

HNPCC

“Lynch Syndrome”

MMR gene mutation inherited and second is lot via “second hit”

Question 11

Microsatellite instability

Answer 11

HNPCC

Question 12

Left sided CRC:

Answer 12

FAP

Question 13

Loss of APC –> ?

Answer 13

buildup of B-catenin –> cell proliferation

Question 14

Gatekeeper for FAP CRC:

Answer 14

APC gene

follows “two hit” hypothesis

a tumor suppressor gene

Question 15

~85% of all CRC

Answer 15

APC/CIN

**CIN= chromosomal instability

FAP

Question 16

~15% of all CRC

Answer 16

MMR/MIN

**MIN= microsatellite instability

Lynch syndrome (HNPCC)