Colonic Disease

Question 1

What is a polyp?

Answer 1

A protrusion of an epithelial surface

Question 2

What is an adenoma?

Answer 2

A benign epithelial tumour that produces glands

Question 3

All polyps are adenomas. True/False?

Answer 3

False

Question 4

What are the 3 types of polyp?

Answer 4

Pedunculated (stalks)
Serrated (from villous)
Flat

Question 5

All adenomas are dysplastic and may form adenocarcinoma. True/False?

Answer 5

True

Question 6

What is the primary treatment of adenocarcinoma of the colon?

Answer 6

Surgical excision

Question 7

Colorectal carcinoma is found most commonly on which side - right or left?

Answer 7

Left (75%)

Question 8

What is a diverticulum?

Answer 8

Outpouching of epithelial lining

Question 9

What is the difference between diverticulosis and diverticulitis?

Answer 9

Diverticulosis = diverticular disease = the presence of diverticula
Diverticulitis = inflammation of diverticula

Question 10

What is the proposed aetiology of diverticular disease?

Answer 10

Low fibre diet, high fatty diet

Reduces motility and increases colonic pressure

Question 11

List some investigations for diverticular disease

Answer 11

Sigmoidoscopy

Barium enema

Question 12

Which part of the colon is most susceptible to diverticular disease?

Answer 12

Sigmoid colon

Question 13

What is a fistula?

Answer 13

Pathological connection/link between two epithelial surfaces

Question 14

What would a fistula between the colon and the bladder be called?

Answer 14

Colovesical fistula

Question 15

What are the main management procedures for diverticular disease?

Answer 15

Percutaneous drainage

Hartmann procedure

Question 16

Describe Hartmann procedure

Answer 16

Remove sigmoid colon and connect colostomy bag to descending colon

Question 17

What are the most common organisms that cause infective colitis?

Answer 17

C. difficile
Campylobacter
E. coli

Question 18

Name some symptoms of acute and chronic colitis

Answer 18

Diarrhoea with/without blood
Cramping pain
Dehydration
Weight loss

Question 19

List investigations for acute and chronic colitis

Answer 19

AXR
Stool culture
Sigmoidoscopy
Barium enema

Question 20

Name some causes of large bowel obstruction

Answer 20

Colonic cancer
Volvulus
Faecal impaction
Pseudo-obstruction

Question 21

Which part of the colon is most commonly affected by ischaemic colitis?

Answer 21

Sigmoid colon (diverticular disease too - it just gets all the shit…)

Question 22

What is the most common cause of ischaemic colitis?

Answer 22

Atherosclerosis of mesenteric vessels

Question 23

Which organism is mostly behind antibiotic-induced colitis?

Answer 23

C. difficile

Question 24

How does C. difficile cause colitis?

Answer 24

Produces toxin A and B in response to broad-spectrum antibiotics which attack epithelium

Question 25

What is the classic presentation of collagenous colitis?

Answer 25

Watery diarrhoea

Normal endoscopy

Question 26

Familial adenomatous polyposis is a type of CRC caused by mutation in which gene?

Answer 26

APC (tumour suppressor) gene

Question 27

Hereditary nonpolyposis colorectal cancer is caused by mutation in which gene?

Answer 27

DNA mismatch repair gene

Question 28

HNPCC is more common than FAP. True/False?

Answer 28

True