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Absite Killer colorectal + some Fiser
self explanatory
47
Medical
Professional
01/22/2014

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Cards

Term
Blood supply to rectum
Definition
# superior rectal artery off IMA
# middle rectal artery off internal iliac
# inferior rectal off pudendal off internal iliac
Term
Electrolytes actively secreted by the colon
Definition
K and HCO3
Term
Innervation of external anal sphincter
Definition
# inferior rectal branch of internal pudendal nerve and perineal branch of S4
Term
Managemet of SCC of the anal canal
Definition
# Nigro protocol (Chemo and XRT)
# must check for inguinal adenopathy and FNA anything suspicious; if positive- extend radiation field
# APR for recurrent disease
Term
Avg length of time for malignant transformation of a polyp
Definition
8 years
Term
Definition of T1 rectal CA and management
Definition
# Confined to submucosa
# can be excised transanally
Term
Definition of T2 rectal CA and management
Definition
#
# APR; do not resect transanally if poor differentiation or neurovasc invasion
Term
Definition of stage III colon CA and management
Definition
# has + node
# chemo, no RT
Term
Management of Stage II rectal CA
Definition
chemo and RT
Term
Management of stage III rectal CA
Definition
chemo and RT
Term
Genetic alterations a/w with colon CA
Definition
# 50% have ras mutation
# 85% have absent p53
# 70% have DCC (deleted in colon CA)
Term
Mode of inheritance of FAP
Definition
# auto-dominant
Term
Genetics involved with FAP
Definition
# APC gene on chrom 5
Term
Presentation of FAP
Definition
# polyps present at puberty
# colon CA by age 40
Term
Surveillance in FAP
Definition
# start at 10-12 yo; stop at 40 if no CA
# flex-sig looking for polyps and EGD looking for duodenal polyps,
# sulindac to makes polyps recede
Term
Management of FAP
Definition
# Prophylactic total proctocolectomy, mucosectomy and ileoanal pouch followed by lifetime surveillance of remaining rectal mucosa
Term
Presentation of Lynch
Definition
# lynch I: Right sided colon cancer, young
# Lynch II: colon CA + increased risk of ovary, bladder, endometrial and stomach CA
Term
Mode of inheritance of Lynch
Definition
Auto-dominant
Term
Genetics of Lynch
Definition
DNA mismatch repair gene mutation
Term
Diagnostic criteria of Lynch
Definition
# Amsterdam criteria (3-2-1)
* 3 primary relatives
* over 2 generations
* 1 with cancer < 50 yo
Term
Surveillance in HNPCC
Definition
# start at 20-25 yo or 10 yrs younger than earliest family member
# Colonoscopy every 2 years until age 40, then annual
Term
Gardner's syndrom
Definition
Colon CA and desmoid tumors
Term
Turcot's Syndrome
Definition
Colon CA and breain tumors
Term
Peutz Jeghers
Definition
Polyposis (not CA) and mucocutaneous pigmentation
Term
Best approach if operating for a suspected appy but find Crohn's dz
Definition
# do appendectomy unless cecum is involved in Crohn's
Term
Management of peri-rectal abscess in Crohns
Definition
I&D
Term
Effect of total colectomy on extra-intestinal manifestations of UC
Definition
# PSC and arthritis do not improve
# skin and anemia may get better
Term
Genetic association of sacroiliitis
Definition
HLA-B27
Term
Management of pouchitis
Definition
Flagyl and/or short chain fatty acid enemas
Term
Management of pyoderma gangrenosum
Definition
# dapson and/or steriod (topical or systemic)
Term
Location of anal fissures
Definition
# 10% anterior in women
# nearly all others posterior midline
Term
Management of anal fissures
Definition
# sitz baths
# water and fiber
# can try topic nitroglycerine or botox
# lateral internal sphincterotomy if persists
Term
# Ddx for fissures that are not in midline
Definition
# IBD
# TB
# syphillis
Term
Definition of Bowen's dz and manaement
Definition
# intraepidermal SCC (only 5% invasive)
# tx with widel local incision
Term
Definition and diagnosis of perianal Paget's dz
Definition
# rare intra-epidermal neoplasms of apocrine glands with a long pre-invasive phase
# +PAS stain
Term
Diff b/w CD and UC: location
Definition
# CD: small bowel involved
# UC: confined to colon (+backwash ileitis)
Term
Diff b/w CD and UC: anatomic distribution
Definition
# CD: asymetric (skip lesions)
# US: contiguous involvemed started distally and moving proximally
Term
Diff b/w CD and UC: rectal involvement
Definition
# CD: rectal sparing
# UC: most of the time
Term
Diff b/w CD and UC: Gross bleeding
Definition
# CD: no
# UC: universal
Term
Diff b/w CD and UC: peri-anal dz
Definition
# CD: yes
# UC: no
Term
Diff b/w CD and UC: Fistulas
Definition
# CD: yes
# UC: no
Term
Diff b/w CD and UC: Granulomas
Definition
# CD: yes
# UC: no
Term
Diff b/w CD and UC: layers of bowel involved
Definition
# CD: transmural
# UC: mucosa and submucosa
Term
Granulomas: UC or CD
Definition
CD
Term
Cobblestoning: UC or CD
Definition
CD
Term
Diff b/w CD and UC: location of perforation
Definition
# CD: distal ileum
# UC: transverse colon
Term
Most common post-op morbidity
Definition
# anastamotic leak
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