ColoRectal Flashcards Preview

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Flashcards in ColoRectal Deck (39):
1

Colon actively secretes ___ and ___

K and HCO3

2

Superior rectal artery origin: ____
Middle origin: ____
Inferior origin: ____

Superior off IMA; middle off internal iliac; inferior off internal pudendal (off internal iliac)

3

External sphincter innervated by ___ and ___.

inferior rectal branch of internal pudendal nerve and perineal branch S4

4

Rx for squamous cell CA of anal canal _____
Rx for recurrent disease ____

Nigro protocol (chemo and XRT), not surgery;
APR for recurrent disease

5

Transformation of polyp to cancer takes ___ (time)

~8 years

6

T1 colon cancer: limited to ___
T1 Rectal adeno cancer excision method: ___

submucosa; transanally

7

T2 colon cancer; ___% are node positive
Recommended rx: ____

20% node positive; recommend APR

8

Do not do transanal resection of T2 colon cancer if:
___, ___

poor differentiation, neuro/vasc invasion

9

Stage III colon cancer (node +) rx:
___ (yes/no) chemo?
___ (yes/no) XRT?

gets chemo, no XRT

10

Stage II, and III rectal cancer rx:
___ (yes/no) chemo?
___ (yes/no) XRT?

gets chemo and XRT

11

Colon cancer mutations:
___% ras mutation
p53 absent in ___%
___% DCC

50% ras
p53 absent in 85%
70% DCC

12

Familial adenomatous polyposis:
____ inheritancy
Cancer by age ___
___ gene

autosomaal dominant; cancer by age 40; APC gene

13

Familial adenomatous polyposis inheritant Rx:
__________________

need total colectomy prophylactically

14

Familial adenomatous polyposis:
Have ____ as well and need to survey ___ for cancer

UGI polyps, survey duodenum

15

Familial adenomatous polyposis:
Also have ___ tumors, benign but very difficult to manage

desmoids

16

For FAP; ____ makes polyps recede

Sulindac

17

Hereditary non-polyposis colon cancer:
Lynch I: Right or left? Multiple or solitary ca? Young or old?

Lynch I: R sided; multiple Ca's; young

18

Hereditary non-polyposis colon cancer:
Lynch II: associated with cancer of ___, ___, ___

ovary, bladder and stomach (and colon obvi)

19

___ associated with DNA mismatch repair gene mutations

Hereditary non-polyposis colon cancer; lynch I and II

20

Hereditary non-polyposis colon cancer:
Amsterdam Criteria: ______________

3 1st degree relatives, over 2 generations

21

Gardner's syndrome:
________ and ________

colon cancer and desmoid tumors

22

Turcot's syndrome:
______ and _________

colon cancer and brain tumors

23

Peutz Jeghers:
______ ( not ________) and __________

polyposis (not colon cancer) and mucocutaneous pigmentation

24

Sigmoid Volvulus Rx strategy:
____________, _________, ___________

decompress with scope, prep bowel, do sigmoid colectomy that admission

25

Cecal volvulus rx strategy:
________, _____, ______________, _________

likely will not decompress, take to OR, most recommend R hemicolectomy with ileo-transverse anastomosis, cecopexy is alternative

26

Carcinoid of appendix:
_________ or ______ = do Right hemicolectomy, otherwise appendectomy only

>2cm or involving base

27

If operating for appy and find normal appy and chrons disease.... unless...

Take appendix (unless cecum involved in inflammation); does not increase fistula rate (Every year)

28

HLA B27 associated with ____.

sacroiliitis

29

Pouchitis Rx:
___ or ___

flagyl or short chain fatty acid enemas

30

Pyoderma gangrenosum Rx:
____ and/or ___

Dapson and/or steroids (topical or systemic)

31

Fissue in Ano:
___% anterior in ___ (men/women). nearly all others ___.

10% anterior; posterior midline

32

Fissure in Ano INITIAL Rx:
___ and ___ for ___.

sitz baths, regular loose BM (water/fiber)

33

PERSISTENT fissure in ano rx:
_____________________

lateral internal sphincterotomy

34

Alternative Rx for fissure in ano:
___ or ____.

nitroglycerine creams (increase O2 for ischemia) or botox (relax sphincter)

35

Fissure not in midline, think:
___, ____, ____

IBD, TB, syphilis

36

Bowen's diesease: ___________
___% invasisve
Rx: _______

intraepidermal squamous cell carcinoma;
5% invasive;
rx is wide local excision

37

______: rare intraepidermal neoplasm of apocrine glands.
_____ (long/short) pre-invasive phase?
____ (+/-) PAS stain

Perianal paget's; long pre-invasive phase; +PAS stain

38

___% of patients with AVM also have ___.
___% have ___.

25% have aortic stenosis;
50% have CAD

39

___ (disease): may see aphthous ulcers on colonoscopy

campylobacter infectious colitis