bowel Flashcards
(22 cards)
what is the screening programme for bowel cancer
FIT test every 2 years from 60-74
RF for bowel cancer
HNPCC, FAP, processed meat, male, alcohol, smoking, IBD, low fibre diet
what other cancers is HNPCC associated with
gastric, endometrial and ovarian
is colonoscopy with biopsy is contraindicated in bowel cancer investigation, what can be done
CT colonography
staging investigations for bowel cancer
if cancer is in the colon do a CT CAP, if cancer is in the rectum do a MRI
what prophylactic Abx are people given before a bowel op
gentamicin and metronidazole
apart from antibiotic prophylaxis, what else is given as prophylaxis in bowel op
28 days of LMWH
how long do you leave an anastomosis to heal if you have done a defunctioning loop ileostomy
6 weeks
what is the T1-T4 staging for bowel cancer
T1 - invades submucosa
T2 - invades MP
T3 - invaded –> serosa
T4 - invades visceral peritoneum
when is it appropriate to do an anterior resection
for high rectal tumours if they are >5cm from anus
when is is appropriate to do a APR
for low rectal tumours <5cm from anus , removes the anal sphincter so patient has a permanent colostomy
what’s the most common bacteria to cause a problem after a bowel operation
E coli - gram negative (can use vacuum assisted closure to treat this)
what kind of metaplasia is Barretts oesophagus
intestinal metaplasia
what is the most common type of oesophogeal cancer and what is its biggest RF
squamous and smoking
apart from progressive dysphagia, how else does oesophageal cancer present
weight loss, hoarse voice, odynophagia
which kind of oesophageal cancer is normally operated on
adenocarcinoma (effecting the bottom 1/3 of the oeosphogus)
patients who present with red flags at GP should have what done first, before determining 2WW for colonoscopy (eg for abdominal mass, change in bowel habit, unexplained iron deficiency anaemia)
FIT
what is gastric dumping syndrome
after gastrectomy
early post prandial symptoms –> hypertonic/hyperosmolar contents move quickly to the small intestine which causes large fluid shifts and diarrhoea
then later symptoms due to insulin spike –> hypoglycaemia
how is gastric dumping syndrome prevented
-eat little and often
-avoid carbs
-refer to dietician
-avoid having food and drink together to prevent heavy loads on stomach
Dx of hepatocellular carcinoma
CT and AFP (not biopsy as this causes seeding)
how are unilateral inguinal hernias normally Tx
OPEN mesh repair
how are bilateral or recurrent inguinal hernias normally treated
laparoscopically
