Colorectal Carcinoma

Question 1

What are the main causes of colorectal cancer?

Answer 1

Pre-existing polyps 
Inflammatory conditions 
Genetics
Diet
Smoking and alcohol

Question 2

What inflammatory conditions can cause colorectal cancer?

Answer 2

Ulcerative colitis
Crohn’s disease
Lymphoid hyperplasia

Question 3

Which genetics can increase the risk of developing colorectal cancer?

Answer 3

FAP

HNPCC

Question 4

Which aspects of the diet can increase the risk of developing colorectal cancer?

Answer 4

Low fibre

High red meat

Question 5

What are the main symptoms of colorectal cancer?

Answer 5

Change in bowel habits 
Weight loss
PR bleeding 
Iron deficiency anaemia 
Tenesmus

Question 6

What type of anaemia is associated with colorectal cancer?

Answer 6

Iron deficiency anaemia

Question 7

What are red flags in someone who is 40-60?

Answer 7

Rectal bleeding
Change in bowel habits
–For more than 6 weeks

Question 8

What are red flags in someone who is more than 60?

Answer 8

Rectal bleeding
OR
Change in bowel habits
–For more than 6 weeks

Question 9

What are 2 general red flag symptoms?

Answer 9

Palpable abdominal or rectal mass

Question 10

What is the gold standard investigation for colorectal cancer?

Answer 10

Endoscopy- to visualise the colon

Question 11

What would you do if a colonoscopy can’t be preformed?

Answer 11

CT colonoscopy

Question 12

What would you use to stage colon cancer?

Answer 12

CT of chest, abdomen and pelvis

Question 13

What would you use to monitor response to intervention of colorectal cancer?

Answer 13

Carcinoembryonic antigen (CEA)

Question 14

What would you carry out before a colonoscopy?

Answer 14

Faecal occult blood test

Question 15

Why would you carry out a FOB in someone over 50?

Answer 15

Unexplained abdominal pain
Or
Unexplained weight loss

Question 16

Why would you carry out a FOB in someone younger than 60?

Answer 16

Changes in bowel habits
OR
Iron deficiency anaemia

Question 17

Why would you carry out a FOB in someone over 60?

Answer 17

Iron deficiency anaemia

Question 18

What is used to classify colorectal cancer?

Answer 18

Dukes criteria

Question 19

What is Dukes A?

Answer 19

Confined to mucosa and part of the muscle of the bowel wall

Question 20

What is Dukes B?

Answer 20

Extending through the muscle of the bowel wall

Question 21

What is Dukes C?

Answer 21

Lymph node involvement

Question 22

What is Dukes D?

Answer 22

Metastatic disease

Question 23

What does the TNM classification stand for?

Answer 23

Tumour
Node
Metastasis

Question 24

What does Tx mean?

Answer 24

Unable to assess size

Question 25

What does T1 mean?

Answer 25

Submucosa involvement

Question 26

What does T2 mean?

Answer 26

Involvement of muscularis propria (muscle layer)

Question 27

What does T3 mean?

Answer 27

Involvement of the subserosa and serosa (outer layer), but not through the serosa

Question 28

What does T4 mean?

Answer 28

A)spread through the serosa | B) reaching other tissues or organs

Question 29

What does Nx mean?

Answer 29

Unable to assess nodes

Question 30

What does N0 mean?

Answer 30

No nodal spread

Question 31

What does N1 mean?

Answer 31

Spread to 1-3 nodes

Question 32

What does N2 mean?

Answer 32

Spread to more than 3 nodes

Question 33

What does M0 mean?

Answer 33

No metastasis

Question 34

What does M1 mean?

Answer 34

Metastasis

Question 35

What is the management of colorectal cancer?

Answer 35

Colectomy

Question 36

What can a colectomy be?

Answer 36

Curative or Palliative

Question 37

What does a colectomy involve?

Answer 37

Removal of tumour and create end to end anastomosis

Question 38

Tumours in which areas are treated with a right hemicolectomy?

Answer 38

Caecum Ascending colon Transverse colon

Question 39

Tumours in which areas are treated with a left hemicolectomy?

Answer 39

Distal transverse colon | Descending colon

Question 40

Tumours in which areas are treated with a sigmoid colectomy?

Answer 40

Sigmoid colon

Question 41

Tumours in which areas are treated with an anterior resection?

Answer 41

Low sigmoid colon | High rectum

Question 42

Tumours in which areas are treated with an abdominoperineal resection?

Answer 42

Lower rectum