Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 Lower GI Surgery > Colorectal cancer > Flashcards

Colorectal cancer Flashcards

1
Q

Colorectal carcinoma

A

95% adenocarcinomas

Most commonly rectal or sigmoidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for colorectal carcinoma

A
  • Diet: ↓ fibre
  • IBD
  • Familial: FAP, HNPCC - FHx
  • Smoking and alcohol
  • Male
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation of colorectal carcinoma

A 
Left:
• Altered bowel habit
• PR mass 
• Obstruction 
• Bleeding / mucus PR
• Tenesmus

Right (late presentation)
• Anaemia and Wt. loss
• Abdominal pain

Both:
• Abdominal mass
• Perforation
• Haemorrhage
• Fistula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Examination of colorectal carcinoma

A
  • Palpable mass: per abdomen or PR
  • Perianal fistulae
  • Hepatomegaly
  • Anaemia
  • Signs of obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Investigations of colorectal carcinoma

A

• Bloods

  • FBC: Hb
  • LFTs: mets
  • Tumour Marker: CEA

• Imaging
- CXR: lung mets
- USS liver: mets
- CT CAP - staging
- MRI (depth) - rectal cancers only
- Endoanal USS: staging early rectal tumours
§ Ba / gastrograffin enema: apple-core lesion

• Endoscopy + Biopsy - gold standard

  • Flexi sigmoid
  • Colonoscopy (right side)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MRI imaging in CRC

A

Best for rectal Ca and liver mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What score is used to stage CRC

A

Dukes staging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Surgery for rectal carcinoma

A

• Neo-adjuvant radiotherapy - shrink size

• Anterior resection: tumour 4-5cm from anal verge
- Defunction with loop ileostomy

• Abdominal Perineal resection: <4cm from anal verge

• Total mesorectal excision for tumours of the
middle and lower third

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Surgery of other tumours

A
  • Sigmoid: high anterior resection or sigmoid colectomy
  • Left: left hemicolectomy
  • Transverse: extended right hemicolectomy
  • Caecal / right: right hemicolectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CRC screening

A
  • FIT Testing for 60-75yrs
  • every 2yrs
  • Colonoscopy if +ve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Familial Adenomatous Polyposis

A
  • Autosomal dominant
  • APC gene
  • 100-1000s of adenomas which leads to CRC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hereditary Non-Polyposis Colorectal Cancer

A
  • Autosomal dominant

* Mutation of mismatch repair enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Referral

A
  • ≥40yrs with unexplained weight loss and abdominal pain
  • ≥50yrs with unexplained rectal bleeding
  • ≥60yrs with iron‑deficiency anaemia or change in bowel habit
  • Positive occult blood screening test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is a Endo-anal ultrasound done

A

Assess suitability for trans-anal resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Right Hemicolectomy

A

Surgical approach for caecal to ascending colon tumours

Ileocolic, right colic, and right branch of the middle colic vessels (branches of the SMA) are divided and removed with their mesenteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Extended Right Hemicolectomy

A

Performed for distal colon tumours

17
Q

Left Hemicolectomy

A

Descending colon tumours

Left branch of the middle colic vessels (branch of SMA/SMV), the inferior mesenteric vein, and the left colic vessels (branches of the IMA/IMV) are divided and removed with their mesenteries

18
Q

Sigmoidcolectomy

A

Sigmoid colon tumours

IMA is fully dissected out

19
Q

Anterior Resection

A

High rectal tumours typically >5cm from anus

  • renal sphincter intact

Defunctioning loop ileostomy is performed

20
Q

Abdominoperineal (AP) Resection

A

Low rectal tumours, typically <5cm from the anus

Excision of the distal colon, rectum and anal sphincters, resulting in a permanent colostomy

21
Q

Hartmann’s Procedure

A

Emergency bowel surgery

  • bowel obstruction
  • perforation

Involves a complete resection of the recto-sigmoid colon

Formation of an end colostomy and the closure of the rectal stump

22
Q

Colorectal cancer presenting with bowel obstruction

A

Can be relieved by either a decompressing colostomy or endoscopic stenting

Staging and mx after

23
Q

Radiotherapy

A

Used in rectal cancer

Not given in colon cancer due to the risk of damage to the small bowel

Neo-adjuvant treatment

Can be given alongside chemotherapy.

24
Q

In a pt with rectal bleeding what Hb level needs a transfusion of packed red blood cells

A

< 70

25
Q

When is surgery indicated

A

Intestinal ischaemia
Obstruction
No improvement with conservative mx

26
Q

Mx of large bowel obstruction initially

A

Drip and suck

  • NG tube + NBM
  • IV fluids

Year 3 Lower GI Surgery (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions