Gastroenterology
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| Colon cancer risk: | doubles each decade after 40 yo; M>F; 90% occur after 50; sig higher risk if 1st-degree relative with colon ca
🗑
|
||||
| Colon cancer Genl RFs | Age; Personal hx colon polyps or ca; FH; inherited syndromes; T2DM; IBD
🗑
|
||||
| Colon cancer lifestyle RFs | Diet (red meat); physical inactivity; obesity; smoking; heavy alcohol use
🗑
|
||||
| 2 types of dx criteria for HNPCC | Amsterdam; Bethesda
🗑
|
||||
| S/S colon cancer | Rectal bleeding; Fe def anemia; Fatigue / wt loss; obstruction (left sided tumors); change in stool quality/caliber; abdominal mass or abd pain
🗑
|
||||
| Colon cancer: most common metastases are to: | liver, then lung (colon); liver or lung (rectal ca)
🗑
|
||||
| Colon cancer: gold standard of dx eval: | colonoscopy
🗑
|
||||
| Colon cancer: other dx eval | CT with contrast abd/pelvis (for staging). CXR. Needle bx of suspected mets. PET scan only for suspected mets dz
🗑
|
||||
| Colon cancer: labs | CBC, chemistry; may check CEA, but not for dx (help w/staging)
🗑
|
||||
| Cancer stage is determined from: | PE, biopsy, imaging, lymph node dissection
🗑
|
||||
| Layers of colon wall | Mucosa; muscularis mucosa; submucosa; muscularis propia; subserosa/serosa
🗑
|
||||
| Types of ablation of mets | Radiofrequency Ablation; Ethanol ablation; Cryosurgery; Hepatic artery embolization
🗑
|
||||
| Goal of chemo: | Eradicate micrometastasis to increase likelihood of cure; none for stage 0 or I; resected stage II: poss modest survival benefit but not routinely recommended
🗑
|
||||
| Indications for radiation tx in colorectal cancer | not typically used for colon cancer. Used for rectal cancer
🗑
|
||||
| Screening: stool Tests: | primarily detect cancer; Guaiac FOBT & immunochemical-based FIT; Stool DNA (sDNA)
🗑
|
||||
| Screening: Structural Exams: | Detect cancer and polyps; Colonoscopy; CT colonography; Flexible Sigmoidoscopy; Double-contrast barium enema (uncommon)
🗑
|
||||
| Best mortality data for CRC screening: | Guiac FOBT
🗑
|
||||
| Never screen for colon ca with: | DRE
🗑
|
||||
| Positive FOBT should always be followed by: | colonoscopy (and no more FOBTs needed)
🗑
|
||||
| Negative FOBT tests should be: | repeated annually
🗑
|
||||
| Flexible Sigmoidoscopy procedure description | Examines left colon; some bowel prep needed; can be performed w/o sedation in Dr’s office. 5-year interval between exams
🗑
|
||||
| Patients w/ adenomas found on flex sig should: | have a colonoscopy
🗑
|
||||
| Colonoscopy: procedure description | Direct inspection of entire colon with sedation (usu conscious); thorough bowel prep required
🗑
|
||||
| Colonoscopy false negative rates | 6-12% miss rates for large adenomas; 5% miss rates for cancer
🗑
|
||||
| Most common serious complication of colonoscopy | bleeding post-polypectomy; Perforation = 1/1000 and increases with age and diverticular disease
🗑
|
||||
| Colon cancer screening | FOBT at age 50-75 yrs (alt: colonoscopy or sigmoidoscopy). USPSTF: no screen for >75 y.o.
🗑
|
||||
| Colon cancer surveillance | once ca/adenomatous polyps are detected, occurs at shorter intervals (usually repeat colonoscopy in 3-5 years); If FH CRC: every 5 yr; IBD: yearly once disease present for more than 15 yr
🗑
|
||||
| Colon polyps (types) | adenomatous (poss pre-malig: req shorter surveillance colonoscopy interval); hyperplastic (not considered pre-malig)
🗑
|
||||
| CT colonography | No sedation; req bowel prep; pos result req f/u colonoscopy
🗑
|
||||
| Colon polyps: more likely to be malignant if: | sessile, >1cm, villous
🗑
|
||||
| Colon polyps: less likely to be malignant if: | pedunculated, <1cm, tubular
🗑
|
||||
| If 2 first-degree relatives have CRC or 1 relative with colon ca or adenomatous polyps: | Screen at 40 y.o. (or 10 yrs <earliest family dx)
🗑
|
||||
| Colon ca: most common metastases are to: | liver, then lung (colon); liver or lung (rectal ca)
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Abarnard
Popular Medical sets