Colorectal Surgery Flashcards

Question

Bowel cancer screening

Answer 1

FIT based screening is every 2 years. In studies comparting annual with 2 yearly screening, there was no mortality difference between the groups.

Answer 2

Congenital hypertrophy of the retinal pigment epithelium is strongly associated with FAP. As such, a colonoscopy is the usual investigation of choice. Improve

Answer 3

Urgency is the commonest side effect of stapled haemorroidectomy

Answer 4

Suitable for minor haemorrhoidal symptoms and disease Low risk

Answer 5

Bands are applied to the base of the haemorrhoidal cushion above the dentate line Mucosal necrosis and subsequent fibrosis will tend to result in elevation of the haemorroids to their normal locatio Only likely to succeed if the underlying cause is addressed

Answer 6

Injection of 5% phenol in almond oil at the base of the haemorroid Deep or ineffective injection may result in pelvic sepsis or prostatitis

Answer 7

Involves excision of the haemorrhoidal tissue Good for large volume prolapsed haemorrhoids Excessive tissue excision may result in anal stenosis Pain may be reduced by post operative oral metronidazole

Answer 8

Use of circular stapler to excise the haemorrhoidal base and surrounding mucosa Will elevate the cushions into the anorectum and reduce symptoms Urgency occurs in up to 20% (though usually resolves in the first 6 months) Large skin tags may be less effectively addressed with this technique Urgency is a comman side effect

Answer 9

Uses doppler device to identify the haemorrhoidal vessel that is then underrun Additional sutures placed to hitch up the haemorrhoidal complex Low morbidity technique. However, equipment is expensive

Answer 10

Oak. Early in Hx is more likely to be infective

Answer 11

More than 100 adenomatous polyps affecting the colon and rectum. Duodenal and fundic glandular polyps APC (over 90%)

Answer 12

As FAP but with desmoid tumours and mandibular osteomas APC

Answer 13

Polyposis and colonic tumours and CNS tumours APC +MLH1 and PMS2

Answer 14

Colorectal cancer without extensive polyposis. Endometrial cancer, renal and CNS MSH2, MLH1, PMS2 and GTBP Mnemonic 3-2-1 for HNPCC. 3 individuals, 2 generations and one must be younger than 50 yrs.

Answer 15

Hamartomatous polyps in GI tract and increased risk of GI malignancy LKB1 andSTK11 (in up to 70%

Answer 16

Also known as multiple hamartoma syndrome. Rare autosomal dominant condition with incidence of 1 in 200,000.. It is characterised by multiple mucocutaneous lesions, trichilemmomas, oral papillomas and acral keratosis. Most often diagnosed in third decade of life. Breast carcinoma may occur in up to 50% of patients and conditions such as fibrocystic disease of the breast may occur in 75% of women. Thyroid disease occurs in 75% and may include malignancy. Endoscopic screening will identify disease in up to 85% although the small bowel is rarely involved. There is a 15-20% risk of developing colorectal cancer and regular colonoscopic screening from age 45 is recommended. PTEN (85%)

Answer 17

Autosomal recessive, multiple adenomatous polyps in GI tract, those in colon having somatic KRAS mutations MYH

Answer 18

Activity related polyarthropathy is seen in up to 20% of patients with ulcerative colitis

Colorectal Surgery Flashcards

(43 cards)