Intestinal Carcinoma

Question 1

what is the most positive risk factor for colon cancer?

Answer 1

family history

Question 2

what are four complications of GI polyps?
what are the two type?
what are the two gross appearances?

Answer 2

hemorrhage
obstruction
intussusception
malignant transformation

types: nonneoplastic/neoplastic
gross: pedunculated/sessile

Question 3

greater than what size increases the change of carcinoma of a adenomatous polyp?

Answer 3

> 2cm

Question 4

penetration through which layer will give malignant cells access to submucosal lymphatic channels?

Answer 4

Muscularis mucosa

Question 5

What level are all sessile polyps with invasive carcinoma according to Haggitts criteria? how should it be managed?

Answer 5

level 4

Tx: colectomy

Question 6

what is the “T” grading of the TNM scaling for GI carcinomas?

Answer 6

Tis - Carcinoma in situ (through lamina propria)
T1 - submucosa
T2 - Muscularis propria
T3 - Subserosa
T4 - other organs perforated

Question 7

Where in the colon are colorectal cancers most common?

Answer 7

Sigmoid

Question 8

What is the perforation a/w in the context of colorectal cancer?

Answer 8

high rate of local recurrence

low survival

Question 9

What is the most common cause of large bowel obstruction?

Answer 9

colorectal cancer

Question 10

What are the three types of Familial Adenomatous Polyposis (FAP)

Answer 10

1. Gardner’s - osteomas, desmoid tumors
2. Turcot’s - CNS tumors
3. Attenuated FAP - mutations on 5’ end = short proteins = alot less polyps

Question 11

What genes are involved with HNPCC/Lynch Syndrome?

Answer 11

Mismatch repair genes (MMR)