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ON13 Colorectal cancer

Deleted user 16 questions Updated 9 Oct 2019

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Questions in this quiz (16)

  1. 1Choose the incorrect epidemiology statement about colorectal cancer.
    1. A3rd most common cancer in the world​
    2. BHighest rates in undeveloped/third world nations​
    3. C95% of colorectal cancers are adenocarcinomas​
    4. D91% and 88% 5 year survival rate for early stages of colon and rectal cancer, respectively​
    5. E70% 5 year survival rate after tumor spreads to adjacent lymph nodes
    6. F12% 5 year survival rate after metastasis​
  2. 2NZ stats:
    - Eight New Zealander’s diagnosed each day​
    - [blank_start]Three[blank_end] New Zealander’s die from bowel cancer each day​
    - [blank_start]2nd highest[blank_end] cause of cancer death in New Zealand​
    - One of the highest rates in the [blank_start]world[blank_end] ​
    - Rates for [blank_start]women[blank_end] are highest in world ​
    - Less frequent in [blank_start]Maori[blank_end] vs. non-Maori
    1. AThree
    2. B2nd highest
    3. Cworld
    4. Dwomen
    5. EMaori
  3. 3Risk factors for colorectal cancer:
    [blank_start]Male[blank_end] sex​
    Age​ (older)
    History of colorectal cancer, [blank_start]polyps, T2DM, IBD​[blank_end]
    Inherited factors (e.g. familial adenomatous polyposis, [blank_start]family history[blank_end])​
    Lifestyle factors​
    Diet ([blank_start]red[blank_end] meat, processed food, high fat, low fibre)​
    Physical [blank_start]inactivity[blank_end]​
    Long term [blank_start]smoking[blank_end]​
    Excessive [blank_start]alcohol[blank_end]​
    Obesity
    1. AMale
    2. Bpolyps, T2DM, IBD​
    3. Cfamily history
    4. Dred
    5. Einactivity
    6. Fsmoking
    7. Galcohol
  4. 4Protective Factors​:
    Some evidence [blank_start]NSAIDs / Aspirin[blank_end] use (13-28% RRR)​
    [blank_start]Postmenopausal[blank_end] hormone use (RRR 35%)​
    Healthy BMI, physical [blank_start]activity[blank_end], smoking [blank_start]cessation[blank_end]​
    Fibre, fruits, vegetables, reduced meat consumption​
    [blank_start]Calcium and vitamin D[blank_end] supplementation​
    1. ANSAIDs / Aspirin
    2. BPostmenopausal
    3. Cactivity
    4. Dcessation
    5. ECalcium and vitamin D
  5. 5Screening usually starts at age 50​. Decreases mortality through early detection​.
    Methods:​
    [blank_start]Colonoscopy[blank_end] (every 10 years post-50)​
    Flexible [blank_start]sigmoidoscopy[blank_end] (every 5 years)​
    CT scan (every 5 years)​
    Double contrast [blank_start]barium enema[blank_end] (every 5 years)​
    Fecal occult blood tests ([blank_start]annually[blank_end])​
    1. AColonoscopy
    2. Bsigmoidoscopy
    3. Cbarium enema
    4. Dannually
  6. 6Which of these is not a symptom of bowel cancer?
    1. ATenesmus​ (continual or recurrent inclination to evacuate the bowels)
    2. BAdvanced: unintentional weight loss, iron-deficiency anemia, weakness​
    3. CBloating​
    4. DRectal bleeding​
    5. EAbdominal pain​
    6. FChanges in bowel habits ​
    7. GMucositis
  7. 7Diagnosis:
    History and physical exam​
    Colonoscopy [blank_start]or[blank_end] sigmoidoscopy​
    [blank_start]Biopsy[blank_end] (to confirm presence of cancer)​
    [blank_start]CT[blank_end] scanning (search for metastases)​
    Baseline [blank_start]labs[blank_end] (CBC, platelet, liver panel, renal panel, CEA, iron studies)​
    Pathological staging after tumor resection ([blank_start]TNM[blank_end])​
    Gene mutation testing (?)​
    1. Aor
    2. BBiopsy
    3. CCT
    4. Dlabs
    5. ETNM
  8. 8Staging:
    Stage 1 - tumour size T1 (no deeper than [blank_start]submucosa[blank_end]) and T2 ([blank_start]not all the way through muscularis[blank_end])
    Stage 2 - T3 ([blank_start]through[blank_end] muscularis)
    Stage 3 - N1 ([blank_start]1-3[blank_end] lymph nodes involved), N2 ([blank_start]>4[blank_end] lymph nodes involved)
    Stage 4 - M - [blank_start]distant[blank_end] metastases.
    1. Asubmucosa
    2. Bnot all the way through muscularis
    3. Cthrough
    4. D1-3
    5. E>4
    6. Fdistant
  9. 9Clinical factors associated with poor prognosis:​
    Bowel [blank_start]obstruction or perforation​[blank_end]
    High preoperative [blank_start]CEA​[blank_end]
    Distant [blank_start]metastases[blank_end]​
    Location of tumor in [blank_start]rectal or rectosigmoid[blank_end] area​
    Molecular markers (KRAS mutations MSI, BRAF mutations)​
    1. Aobstruction or perforation​
    2. BCEA​ (carcinoembryonic antigen)
    3. Cmetastases
    4. Drectal or rectosigmoid
  10. 10Treatment:
    Need to consider stage, performance status, patient preferences, comorbidities, age. Curability depends on tumor stage​.
    General approach:​
    [blank_start]Surgical resection[blank_end] of primary tumor is 1st line therapy (Stage 1, 2, 3)​
    Removal of tumor plus [blank_start]5cm[blank_end] of tumor free bowel and regional [blank_start]lymph nodes[blank_end] for cure​
    Adjuvant [blank_start]chemotherapy and/or radiation[blank_end] can be given to eliminate residual micrometastases ​

    if it's metastases (Stage 4)​?
    Classified as resectable, potentially resectable, or unresectable​
    [blank_start]Systemic chemotherapy[blank_end] is mainstay, radiation may be used for palliative purposes​
    1. ASurgical resection
    2. B5cm
    3. Clymph nodes
    4. Dchemotherapy and/or radiation
    5. ESystemic chemotherapy

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Description
User has deleted their subject information Quiz on ON13 Colorectal cancer, created by Deleted user on 09/10/2019.
Author
Deleted user
Language
English
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67
History
Created on 9 Oct 2019 · updated on 9 Oct 2019

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