19. Constipation

Question 1

Answer 1

Question 2

Answer 2

Question 3

6 RED FLAGS?

Answer 3

Question 4

The GP has referred Mrs Crabbe because of persistent constipation that has been refractory to primary care management with increased dietary fibre and two laxatives (macrogol and senna). You take a fresh history from Mrs Crabbe about her constipation. What key clues will you look for in her history?
- About the constipation? (2)
- Associated symptoms? (8)
- Risk factors for constipation? (4)

Answer 4

Question 5

List 7 differentials to consider.

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Question 8

Answer 8

Question 9

What will you tell Mrs Crabbe? What is the next step?

Answer 9

SPIKES for Colon Cancer

Question 10

6 Treatment options for constipation?

Answer 10

Question 11

Answer 11

Question 12

Answer 12

Question 13

What are the causes of Hypercalcaemia?

Answer 13

Question 14

Answer 14

Question 15

What is the most likely diagnosis? How will Mr Nikolaidis be managed?

Answer 15

Question 16

What is the pathology?

Answer 16

Question 17

What are the main advantages and disadvantages of the following methods for visualising colon masses?
1. Rigid sigmoidoscopy?
2. Flexible sigmoidoscopy?
3. Colonoscopy?
4. CT colon?
5. CT colonography?
6. DCBE?

Answer 17

Question 18

Why is constipation common after surgery?

Answer 18

Question 19

What staging classifications do you know for colon cancer?

Answer 19

Question 20

How is the Dukes staging system used for guiding management and prognosis?

Answer 20

Question 21

Patients often ask what can be done to reduce the risk of colon cancer when one of their family members has been diagnosed with this condition. Do you know of any key studies that have investigated modifiable risk factors for colorectal cancer?

Answer 21

Question 22

Answer 22

Question 23

Answer 23