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Flashcards in Colon Deck (46)
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1

What are the 2 types of colonic polyps?

Neoplastic and non-neoplastic

2

What is the main neoplastic polyp

Adeno

3

What are the 3 types of non-neoplastic polyps

Hamartoma
Metaplastic
Inflammatory

4

Where do all colonic adenocarcinomas originate from

Colonic adenomas

5

How long does it take for an adenoma to progress into a carcinoma

10years (average)

6

What is the gold standard for polyps

Colonoscopy and removal of polyps

7

What is Familial adenomatous polyposis (FAP) characterised by

Multiple colonic adenomas which invariably progress to colorectal cancer unless colectomy is performed in the second or third decade of life

8

What type of disorder is Hereditary non-polyposis colorectal cancer

Autosomal dominant

9

In what 3 syndromes do hamartomas occur

Peutz-Jeghers syndrome
Cowden's disease
Cronkhite-Canada syndrome

10

Where are metaplastic polyps usually found

In the rectum

11

What is another term for inflammatory polyps

Pseudo-polyps

12

What type of cancer is the second most common cancer in the UK

Colorectal adenocarcinoma

13

What are the main risk factors for developing colorectal cancer

Genetic
Dietary - red meat, saturated animal fats
Protective - dietary fibre
Cbronic inflammaiton - IBD
Medical conditions (primary sclerosing cholangitis, acromegaly, obesity)
Smoking

14

Where in the colon are most adenocarcinomas located

Rectosigmoid
Right colon
Left and transverse colon

15

How does spread of colonic adenocarcinoma

Through the bowel wall into lymphatics
Portal and systemic circulations later

16

What are the clinical features of colorectal adenocarcinoma

Rectal bleeding
Altered bowel habit
Anorexia
weight loss
abdominal mass
intestinal obstruction or perforation is rare
Tenesmus
Abdominal pain

17

What are the investigations carried out in suspected colorectal adenocarcinoma

Rigid sigmoid
Flexible sigmoid (for fresh bleeding)
Colonoscopy (altered bowel habit, polyps seen in sigmoidoscopy, FHx, surveillance of IBD or polyps

18

What is typically seen in a barium enema for colorectal carcinoma

Apple core stricture

19

What staging system is used for staging colorectal adenocarcinoma

Duke's

20

At what stage is surgery suitable in colorectal adenocarcnoma

Dukes stage A and B

21

What is colonic diverticular disease

symptomatic diverticula

22

What is diverticulitis

Refers to diverticula causing complications (bleeding, inflammation, stricturing and perforation

23

Where in the GI tract is diverticula most common in the Western Wordl

In the sigmoid and the left colon

24

Where in the GI tract is diverticula most common in Oriental populations and rare under 40

right sided disease is more common

25

What explains the geographical variability of the diverticulosis problem

A diet, especially in early life

26

What does a lack of fibre mean for the GI tract

More pressure for propulsion is required
Inflammation from impacted faeces

27

What are the symptoms of uncomplicated diverticulosis

Symptoms of colicky left iliac fossa pain eased by defecation
passage of pellet stools
abdominal bloating

28

What is the treatment for uncomplicated diverticulosis

Increase in dietary fibre and dietary fluids

29

What is the treatment for Diverticular bleeding

Most settle with simple observation

30

What side of the colon does bleeding come from in diverticular bleeding

The right side