Colorectal ca

Question 1

Histological type?

Answer 1

Adenocarcinoma 95%

Question 2

CRC develops from what

Answer 2

polyps

Question 3

Name a genetic syndrome that predisposes to polyps

Answer 3

FAP

Question 4

What antigen is increased in CRC

Answer 4

carcinoembryonic antigen

Question 5

What changes in bowel habit are especially worrying

Answer 5

At night

incontinent of faeces

adjusting lifestyle as a result

Question 6

If a patient is fit with red flags what happens (from GP)

Answer 6

Colonoscopy/flex sig

Question 7

If a patient is unfit with red flags what happens

Answer 7

Seen by CR surgeon/gastro within 14 days

Question 8

What is the screening test for CRC

Answer 8

Foecal occult blood

60-74yrs

every 2 yrs

+ve = treat as urgent susp ca

Question 9

How might CRC present emergency?

Answer 9

Obstruction

Perforation

Bleeding

Abdo pain

Question 10

What type of cancer is anal normally?

Answer 10

squamous cell

Question 11

Imaging for rectal cancer?

Answer 11

MRI (better visualisation of pelvis)

Question 12

Imaging for colon cancer?

Answer 12

CT

Question 13

How is CRC split along the bowel in terms of location?

Answer 13

1/3 rectum

1/3 L side

1/3 rest

Question 14

Is local recurrence more common in colon or rectal?

Answer 14

Rectal

Question 15

Management colon cancer

Answer 15

?neoadjuvants- still experimental

Surgery- anterior resection or hemicolectomy

Question 16

Management rectal cancer

Answer 16

Low risk- surgery

Moderate risk- RT and surgery

High risk- RT, CT, surgery

The surgery is anterior resection, hartmans or APER

Question 17

When is the carcinoembryonic antigen blood test useful?

Answer 17

In metastatic disease it is raised. Not useful in initial dx .

Is produced by GI tract normally

Normal is <5

Can be raised in drinkers and smokers