Flashcards in 53. Colorectal cancer Deck (18):
epidimiology ( age, persentage of family histolry )
- more patients are over 50
25% have family historu
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
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