Colorectal Cancer

Question 1

What is the most common type of benign colorectal tumours

Answer 1

Adenomas

Question 2

What is the most common type of malignant colorectal tumours

Answer 2

Adenocarcinomas

Question 3

What do normal oncogenes do?

Answer 3

Promote cell growth and division

Question 4

What do abnormal oncogenes do?

Answer 4

Cause excess cell growth and division (gain of function)

Question 5

What do normal tumour suppressor genes do?

Answer 5

Suppress cell growth and division

Question 6

What do mutated tumour suppressor genes do?

Answer 6

Allow cell growth and division (loss of function)

Question 7

What are 3 macrocopic appearances of colorectal cancer

Answer 7

Polypoidal
Ulcerative
Annular (ring shaped)

Question 8

Where is the most common site of cancer in the large bowel?

Answer 8

Rectum or sigmoid colon

Question 9

Where is the least common site of cancer in the large bowel?

Answer 9

Descending colon

Question 10

What are two different appearances of adenomas

Answer 10

Tubular and villous

Question 11

What are the three different appearances of adenocarcinomas

Answer 11

Well differentiated
Moderately differentiated and
Poorly differentiated

Question 12

What appearance of an adenoma is more likely to develop into an adenocarcinoma?

Answer 12

Villous

Question 13

Describe the appearance of a well differentiated adneocarcinoma

Answer 13

Still looks like colonocytes

Question 14

What are the two different methods of pathological staging

Answer 14

Dukes and TNM

Question 15

Describe Duke’s stage C

Answer 15

A growth which has invaded throught hte muscle wall nad has metastasised to the lymph nodes

Question 16

Where is colorectal cancer most likely to metastasise to?

Answer 16

Liver or lungs

Question 17

What is a typical symptom of ascites

Answer 17

An everted umbilicus

Question 18

What are the main two causes of colorectal cancer

Answer 18

Environemnt

Genetic factors

Question 19

What are 3 protective lifestyle factors for colorectal cancer?

Answer 19

Vegetables
Gibre
Exercise

Question 20

What are 4 causative lifestyle factors for colorectal cancer

Answer 20

Red and processed meat
Smoking
Alcohol
Obesity

Question 21

What is the only treatment for FAP polyps?

Answer 21

Removing the colon

Question 22

What are 3 predisposing conditions for Colorectal cancer

Answer 22

Adenomatous polyps
Ulcerative colitis
Crohn’s disease

Question 23

What are the symptoms for ascending colon cancer and why

Answer 23

Anaemia - early blood loss

Often asymptomatic

Question 24

What are the symptoms for descending colon cancer

Answer 24

Pain
change in bowel habit
rectal bleeding

Question 25

What are symtpoms for colorectal cancer

Answer 25

Significant rectal bleeding | Tenesmus

Question 26

What are 4 ways of diagnosing primary disease

Answer 26

Barium enema CT colography Sigmoidoscopy Colonoscopy

Question 27

What is a method of removing colonic cancer via colonoscopy

Answer 27

Snare

Question 28

What does FOBT stand for

Answer 28

Faecal Occult Blood Testin

Question 29

When is FOBT used?

Answer 29

Screening device in the healthy population | It detects around 70% of cancers

Question 30

What are the emergency presentations of colorectal cancer?

Answer 30

``` Distension Constipation Pain Vomiting Bleeding ```

Question 31

What can be the diagnosis of an emergency presentaiotn

Answer 31

Obstruction Bleeding Perforation

Question 32

What are 3 ways in which we can treat an obstruction

Answer 32

Colostomy Resection and colostomy Stenting

Question 33

What are the prognosis rates for differentiated cells

Answer 33

Good for well differentiated Moderate for moderately differentiated Poor for poorly differentiated

Question 34

What are the treatments for colorectal cancer

Answer 34

Surgery Radiotherapy Chemotherapy

Question 35

When would radiotherapy be used

Answer 35

After Surgery (not alone)

Question 36

What are the 3 different surgical prcedures for rectal cancer?

Answer 36

Abdominal-perineal excision Anterior resection Local excision

Question 37

What is the difference between abdominal-perineal excision and anterior resection

Answer 37

More of the colon is removed in abdominal-perineal excision. The sphincter is saved in anterior resection

Question 38

How can we prevent colorectal cancer

Answer 38

Diet and lifestyle

Question 39

How can we improve early detection of colorectal cancer

Answer 39

Heightened awareness | Screening

Question 40

What other ways can we improve the survival rates of colorectal cancer

Answer 40

High quality surgery Appropriate use of RT and Chemo New agents for advanced disease