Fiser- Ch 36&37: Colon, Rectum, Anus Flashcards Preview

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Flashcards in Fiser- Ch 36&37: Colon, Rectum, Anus Deck (52)
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1

what marks the transition between anal canal and rectum?

levator ani muscle

2

main nutrient of colonocytes?

short chain fatty acids

3

layers of the colon: from lumen to exterior

1. mucosa
2. muscularis mucosa
3. lymphatics
4. submucosa
5. muscularis propria
6. subserosal connective tissue

4

what margin do you need for polypectomy of invasive cancer?

2mm

5

what can give a false positive guaiac stool test? 4

1. beef
2. iron
3. vit c
4. cimetidine

6

which organism infection is associated with colon cancer?

clostridium septicum

7

when do you perform an APR vs LAR in colon cancer?

you need at least 2cm margins, so if the cancer is within 2cm of the levator ani muscles, do an APR. otherwise LAR

8

T staging of colorectal cancer

T1 = submucosa
T2 = muscularis propria
T3 = into subserosa or through muscularis propria
T4 = through the serosa

9

management of stage III colon cancer?

- nodes + or distant disease
- postop chemo, NO XRT

10

management of stage II and III rectal cancer

- NEOADJUVANT chemo and XRT

11

management of stage IV rectal cancer?

chemo and xrt, maybe not surgery unless just colostomy

12

what chemo is used in colorectal cancers?

FOLFOX
- 5FU
- Leucovorin
- Oxaliplatin

13

gene associated with FAP

APC, chromosome 5
autosomal dominant

14

management of patients with FAP?

total proctocolectomy, rectal mucosectomy, ileoanal pouch by age 20

15

what are the amsterdam criteria for lynch syndrome?

3,2,1:
at least 3 first degree relatives, over 2 generations, 1 cancer before age 50

16

treatment of sigmoid volvulus?

decompress with colonoscopy, give bowel prep then plan for sigmoid colectomy during that admission

17

treatment of cecal volvulus?

OR for right hemicolectomy, decompression w colonoscopy only works in 20% of pts

18

buzzword: creeping fat

crohns

19

buzzword: crypt abscesses

ulcerative colitis

20

buzzword: skip lesions

crohns

21

perforation with ulcerative colitis is most commonly where?

transverse colon

22

perforation with crohns disease is most commonly where?

distal ileum

23

management of low rectal carcinoids?

<2cm = wide local excision w negative margins
>2cm or invasion into muscularis propria: APR

24

management of colon or high rectal carcinoids?

<1cm = polypectomy
>1cm = formal resection

25

treatment of ogilvie's syndrome

initial: neostigmine, NGT, IVF
if colon >10cm, then decompression w colonoscopy and neostigmine

26

tagged RBC scan can pick up bleeding at what rate?

>0.1cc/min

27

management of thrombosed hemorrhoids

Within 72 hours: elliptical excision
After 72 hours: lance open

28

difference between internal and external hemorrhoids?

above and below the dentate line

29

Management of rectal prolapse?

Altemeier: transanal perineal rectosigmoid resection if old and frail
LAR and pexy if in good condition

30

where are most anal fissures located?

posterior midline