53. Colorectal cancer Flashcards Preview

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Flashcards in 53. Colorectal cancer Deck (18)

epidimiology ( age, persentage of family histolry )

- more patients are over 50
25% have family historu


risk factors

1. adenomatous polys
2. serrated polys
3. familiar cancer syndromes
4. inflammantory bowel disease
5. tobacco use
6. diet of processed meat with low fiber


location ( in order)

rectosigmoid> ascending > descending


presentantion ( according to location

right side bleeds, left side obstruct
Ascending --> exophitic mass, iron deficiency anemia, weight loss
Descending --> infiltrating mass ( napkin ring) , partial obstruction , colicky pain, hematochezia


microbe associated with colorectal cancer

rarely, bactermia with S. bovis


whent os uspect colorectal CA

iron deficiency anemia in males over 50 and postmenopausal females


clorectal cancer - screening

screen patients over 50 with
1. colonoscopy
2. flexible sigmoidoscopy
3. fecal blood test
4. fecal DNA test


the stool DNA test is a noninvasive laboratory test that identidies

DNA changes in the cells of a stool sample --> specifically looks for DNA alterations associated with colon polyps and colon cancer


barium enema x-ray

: apple core" lesion


markers / characteristcis

CEA tumor marker --> food for monitoring recurrence, should not used for screening


• A patient is diagnosed with right-sided colon cancer. What type of symptoms would you observe in this patient to reach your diagnosis?

An exophytic mass, iron deficiency anemia, weight loss


• Name at least three risk factors for colorectal cancer.

Adenomatous and serrated polyps, familial cancer syndromes, IBD, tobacco use, diet of processed meat with low fiber


• How do you screen for colorectal cancer?

Colonoscopy, flexible sigmoidoscopy, or stool occult blood testing


• A patient with past history of colorectal cancer is constantly monitored for recurrence. What nonspecific serum tumor marker is used?

Carcinoembryonic antigen (CEA)


• A man has fevers, hypotension, and a new murmur. Blood cultures grow a streptococcal species. Why might you want to perform a colonoscopy?

Although rare, colorectal cancer can be associated with Streptococcus bovis bacteremia (this patient may need a colonoscopy once stabilized)


• A male patient with iron deficiency anemia is concerned about colon cancer risk. Should he be concerned? Who else should be concerned?

Yes, as iron deficiency anemia can be a presenting sign of colorectal cancer, from occult GI bleeding; postmenopausal females


• Put in order (from most to least common) where colorectal cancer presents: descending colon, ascending colon, rectosigmoid junction.

Rectosigmoid junction, ascending colon, descending colon


• A man is worried about colon cancer. He wants a screening CEA level drawn, because he is "scared of colonoscopies." What do you tell him?

CEA levels cannot be used for screening—they can be used only to monitor for recurrence in previously diagnosed patients

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