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large intestine tumours Flashcards

1
Q

what is a colonic polyp

A

an abnormal growth of tissue projecting from the colonic mucosa

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2
Q

what is the precursor lesion in most colon cancer

A

adenomas

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3
Q

what type of inheritance is colon cancer

A

autosomal dominant

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4
Q

what is an adenoma

A

benign, dysplastic tumour of columnar cells or glandular tissue

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5
Q

what do polyps in the rectum and sigmoid present with

A

rectal bleeding

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6
Q

diagnosing polyps

A
  • barium enema
  • CT colonography
  • colonoscopy
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7
Q

what do large villous adenomas present with

A

profuse diarrhoea with mucus and hypokalaemia

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8
Q

what happens when polyps are found

A

remove them with endoscopically

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9
Q

what are sessile adenomas characterised by

A

saw-tooth appearance of the crypt epithelium

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10
Q

what do right sided colorectal cancers originate from

A

sessile serrated adenomas

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11
Q

what kind of inheritance is FAP

A

autosomal dominant

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12
Q

what mutations causes FAP

A

APC gene

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13
Q

how many polyps is there in FAP

A

hundreds to thousands of colorectal and duodenal adenomas

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14
Q

treatment of FAP

A
  • colectomy

- olirectal anastomosis

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15
Q

which side of the colon do FAP polyps reside

A

right side

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16
Q

another name for Lynch syndrome

A

HNPCC

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17
Q

what mutation causes HNPCC

A

DNA mismatch repair genes

MLH1

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18
Q

what are DNA mismatch repair genes responsible for

A

maintaining the stability of DNA during replication

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19
Q

what is the inheritance for HNPCC

A

autosomal dominant

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20
Q

where are the polyps in HNPCC

A

right side

21
Q

where else can HNPCC occur

A
  • stomach
  • small intestine
  • bladder
  • skin
  • brain
22
Q

what are female patents at risk for in HNPCC

A

endometrial and ovarian cancer

23
Q

how is diagnosis of HNPCC made

A

from family history of colon cancer at a young age

24
Q

what is Turcot syndrome

A

FAP or lynch with brain tumour

25
Q

what is Gardner syndrome

A

FAP + desmoid tumours, osteomas of the skull and other lesions

26
Q

risk factors of colorectal cancer

A
  • increased age
  • red meats
  • polyps
  • family history
  • IBD
  • smoking
  • obesity
  • acromegaly
27
Q

what decreases risk of colorectal cancer

A
  • garlic
  • milk
  • exercise
  • aspirin
28
Q

pathology of colorectal carcinoma

A
  • polypoid mass with ulceration

- spreads by direct infiltration through the bowel wall

29
Q

what type of caner is colorectal cancer

A

adenocarcinoma

30
Q

what type of prognosis does signet ring cells have

A

poor

31
Q

symptoms of colorectal carcinoma

A
  • change in bowel habit
  • looser and more frequent stools
  • rectal bleeding
  • tenesmus
  • anaemia symptoms
32
Q

investigations for colorectal carcinoma

A
  • colonoscopy
  • double contrast barium enema
  • MRI
  • CT
  • PET
  • FOB
33
Q

what is the gold standard investigation for colorectal carcinoma

A

colonoscopy

34
Q

what does colonoscopy allow for in colorectal carcinoma

A

biopsy

35
Q

is biopsy mandatory

A

yes

36
Q

what is pet scanning useful for in colorectal carcinoma

A

detecting occult metastases

37
Q

what is MRI useful for in colorectal carcinoma

A

evaluating suspicious lesions found on CT

38
Q

treatment for colorectal carcinoma

A

surgery

39
Q

what is gold standard for examination of colon and rectum

A

colonoscopy

40
Q

where do most arise from

A

glandular crypts

41
Q

what does the cancer usually start as

A

polyps

42
Q

what mutation do polyps usually have

A

APC

43
Q

symptoms

A
  • change in bowel habit
  • weight loss
  • PR bleeding
  • tenesmus
  • iron deficiency anaemia
  • bowel obstruction
44
Q

what is tenesmus

A

feeling of full rectum even after opening bowels

45
Q

what side is most commonly affected

A

left

46
Q

how is the tumours classified

A

TNM staging
or
Dukes staging

47
Q

what is dukes staging

A

A - tumour confined to mucosa
B- tumour invading bowel wall
C - lymph node metastases
D - distant metastases

48
Q

what is main curative treatment

A

surgery

GI (50 decks)

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