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Flashcards in Colon Cancer Questions Deck (27):
1

Which of these genes puts a patient at a high risk for developing colon cancer? (Select all)

A. Familial Adenomatosis Polyposis (FAP)

B. OncoGene TSA

C. Hereditary Nonpolyposis Colon Cancer (HNPCC)/ Lynch Syndrome

D. Familial Buricks Ulcerative Translocation Telomere (FBUTT)

A. Familial Adenomatosis Polyposis (FAP)

C. Hereditary Nonpolyposis Colon Cancer (HNPCC)/ Lynch Syndrome

...but D was funny right?

2

Diets that are ___ in fat and ___ in fiber or ___ caloric intake can increase the development of colon cancer.

A. High, low, decreased

B. Low, high , decreased

C. High, low, excessive

D. Low, high, excessive

C. High, low, excessive 

3

Which of the following are the MOST common locations of colon cancer? (Select All)

A. Transverse colon

B. Ascending colon

C. Descending colon

D. Sigmoid colon

E. Rectum 

B. Ascending colon

D. Sigmoid colon

E. Rectum 

4

T/F

Diets high in calcium intake and antioxidant intake such as Vitamin E showed better outcomes in the prevention of colon cancer

False

Results did not show any benefit and actually showed increased incidence of colon cancer in patients that took vitamin E. 

5

Colectomy is shown to be beneficial and should be Considered in patients with:

A. Familial Adenomatous Polyposis (FAP)

B. Average risk for colon cancer

C. Hereditary Nonpolyposis Colorectal Cancer (HNPCC)

D. All patients

A. Familial Adenomatous Polyposis (FAP)

C. Hereditary Nonpolyposis Colorectal Cancer (HNPCC)

6

ASA NSAIDs and COX-2 inhibitors are shwon to prevent __ in patients with FAP

A. Colon cancer

B. Bone mets

C. Polyp formation

D. Liver mets

C. polyp formation

these do nothing to prevent colon cancer directly and ASA should NOT be recommended in the average risk person due to increased risk of GI and Cardiovascular toxicity

7

Average risk individuals over the age of 50 should receive a colonoscopy every __ years or a CT colonography or Flex Sig every __ years

A. 10, 10

B. 5, 10

C. 5, 5

D. 10, 5

D. 10, 5

8

All of the following statements regarding the comparison of Colonoscopy to Double contrast barium enema are treu EXCEPT:

A. Colonoscopy observes the entire bowel 

B. Colonoscopy is more risky and inconvenient for patient compared to double-contrast barium enema

C. Double-contrast barium enema is inferior to colonoscopy for detecting polyps and colorectal cancer

D. Double-contrast is reserved when colonoscopy is not feasable for the patient

E. Colonoscopy was recently shown to be inferior to double-contrast in detection of colon cancer

E. Colonoscopy was recently shown to be inferior to double-contrast in detection of colon cancer

9

CT colonography can show a detailed evaluation of the entire colon liek a colonoscopy can. However it comes with some drawbacks that include:

A. CT colonography is more invasive in comparison to colonoscopy 

B. Increased cost of sedation is associated with CT colonography

C. if abnormality is found it cannot be removed and a colonoscopy must be performed to remove the abnormality

D. A number of studies have demonstrated varying levels of sensitivity for cancer and large polyp detection

C. if abnormality is found it cannot be removed and a colonoscopy must be performed to remove the abnormality

10

YW is a high-risk patient for colon cancer and has one family member who currently has colon cancer. When should he begin screening?

A. Screening at age 30

B. Screening at age 35-40

C. Screening at age 10-12

B. Screening at age 35-40

11

High risk patients that present with HNPCC should be screened for colon cancer at:

A. Screening at age 35-40

B. Screening at age 30

C. Screening at age 10-12

B. Screening at age 30

12

High risk patients that present with FAP should begin screening at:

A 35-40

B. 10-12

C. 30

B. 10-12

13

Which of these patients that presented with IBD should be screened for colon cancer?

A. YW, ulcerative colitis 4 years ago

B. CC, ulcerative colitis 9 years ago

C. TT, ulcerative colitis 7 years ago

D. IT, ulcerative colitis 2 years ago

B. CC, ulcerative colitis 9 years ago

14

Mainstay of treatment for Stages 1-3 curable colon cancer is:

A. FOLFOX

B. FOLFIRI

C. CAPEOX

D. Surgery

D. Surgery 

15

(Short Answer) 

How does Leucovorin work with 5-FU? 

–Leukovorin will keep the 5-FU around longer in the body and work more effectively

–Leukovorin will increase the stability of the 5-FU with the enzyme complex and prevent it from being metabolized easily.

–HOWEVER, also increases toxicity of the 5-FU because it keeps the 5-FU in the body longer

We do not use with capcitabine

16

Most common site of Mets in Colon cancer is___

A. Brain

B. Bone

C. Liver

D. Spine

C. Liver

17

CR presents with Stage II Colon Cancer. In general, which of the following is NOT a possible treatment for this patient?

A. Observation

B. Clinical Trial

C. FOLFOX/ FLOX/ CapeOX

D. 5-FU/ Leucovorin or Capecitabine

E. FOLFIRI

E. FOLFIRI

Stage don't forget that even though surgery is not listed here it is still a mainstay of treatment in stages 1-3 colon cancer

18

Patient YT presents with stage I colon cancer. Which of the following are possible treatment options for this patient? (Select All)

A. Surgery 

B. FOLFOX

C. CapeOX

D. Capecitabine or 5-FU/Leucovorin

E. Observation

A. Surgery 

E. Observation

19

CL presents with Stage III colon cancer and requires treatment. Which of the following are possible treatment options for this patient? (Select All)

A. FOLFOX or FLOX

B. Observation

C. Surgery

D. CapeOx

E. Capecitabine or 5-FU/Leucovorin

A. FOLFOX or FLOX

C. Surgery

D. CapeOx

E. Capecitabine or 5-FU/Leucovorin 

20

Patient TT presents with metastatic stage IV colon cancer and is a candidate for Intensive chemotherapy. Patient has been evaluated as FIT and can initiate treatment. Which of the following is an acceptable treatment for this patient? (Select All)

A. FOLFOX + Bevacizumab

B. CAPEOX + Bevacizumab

C. FOLFIRI + Bevacizumab

D. FOLFIRI + Cetuximab

E. CAPEOX + Panitumumab

A. FOLFOX + Bevacizumab

B. CAPEOX + Bevacizumab

C. FOLFIRI + Bevacizumab

21

Patient VT presents with metastatic stage IV colon cancer and requires treatment. Tumor reveals KRAS WT and is left sided on the sigmoid colon. Which of the following is a preferred treatment option for this patient? (Select All)

A. FOLFOX + Bevacizumab

B. FOLFOX + Cetuximab

C. FOLFIRI + Panitumumab

D. FOLFIRI + Bevacizumab

E. FOLFOX + Panitumumab

B. FOLVOX + Cetuximab

C. FOLFIRI + Panitumumab

E. FOLFOX + Panitumumab

Her cancer is left sided and reveals the KRAS WT. Both of which makes the patient able to receive either Cetuximab or Panitumumab in conjunction with FOLFOX and FOLFIRI

22

Patient IT presents to the clinic with metastatic stage IV colon cancer and requires treatment. Patient tumor reveals KRAS WT and left-sided tumor in the descending colon. Patient has an extensive history of peripheral neuropathy from previous chemotherapy. Which of these regimens is BEST for this patient?

A. FOLFOX + Bevacizumab

B. FOLFIRI + Bevacizumab

C. FOLFOX + Panitumumab

D. FOLFIRI + Cetuximab

E. FOLFOX + Cetuximab

D. FOLFIRI + Cetuximab

Oxaliplatin has a dose-limiting toxicity of peripheral neuropathy and the patient has history of neuropathy from chemotherapy. So FOLFIRI would be the better option

23

Patient IT presents to the clinic with metastatic stage IV colon cancer and requires treatment. Patient has an extensive history of peripheral neuropathy from previous chemotherapy and a history of DVT and is currently healing from surgery. Which of these regimens is BEST for this patient?

A. FOLFIRI + Bevacizumab

B. FOLFOX

C. FOLFIRI

D. FOLFOX + Bevacizumab

D. FOLFIRI + Panitumumab

C. FOLFIRI

Patients with DVT should not be given bevacizumab. Also patient is currently healing from surgery and bevacizumab is known to cause wound dehiscence (impaired wound healing)

Patient also has a history of peripheral neuropathy and should not use FOLFOX due to having Oxaliplatin. 

24

Patient CC presents to the hospital with Metastatic stage IV colon cancer and requires treatment. Upon further evaluation the patient is deemed UNFIT. Which of the following is a possible recommendation for this patient? (Select All)

A. Infusional 5-FU+ Leucovorin + Bevacizumab

B. Capecitabine + Bevacizumab

C. Infusional 5-FU + Leucovorin + Oxaliplatin + Bevacizumab

D. Cetuximab or Panitumumab

E. Nivolumab or Pembrolizumab 

A. Infusional 5-FU + Leucovorin + Bevacizumab

B. Capecitabine + Bevacizumab

Option C is the FOLFOX regimen and is not appropriate for patients that are UNFIT.

D and E are appropriate for UNFIT patients however D requires KRAS WT and left sided tumor and E requires DMMR/MSI-H

 

25

Patient CC presents to the hospital with Metastatic stage IV colon cancer and requires treatment. Upon further evaluation the patient is deemed UNFIT and the tumor reveals KRAS WT. Which of the following is a possible recommendation for this patient? (Select All)

A. Infusional 5-FU + Leucovorin + Bevacizumab

B. Cetuximab

C. Panitumumab

D. Nivolumab

E. FOLFOX + Panitumumab

B. Cetuximab

C. Panitumumab

In UNFIT patients Cetuximab or Panitumumab are used as monotherapy for KRAS WT and left sided tumors

 

26

Patient CC presents to the hospital with Metastatic stage IV colon cancer and requires treatment. Upon further evaluation the patient is deemed UNFIT and the tumor reveals dMMR. Which of the following is a possible recommendation for this patient? (Select All)

A. Nivolumab

B. Panitumumab

C. Capecitabine + Bevacizumab

D. Pembrolizumab

E. FOLFIRI

A. Nivolumab

D. Pembrolizumab

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