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22 Cards in this Set
- Front
- Back
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what is the condition assumed w new onset of constipation and unexplained weight loss?
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carcinoma of colon and rectum
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who should you refer pt to?
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PCP who will send them to a specialist
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What are the ss of an advanced case of cancer of the descending colon?(2) RED Flags
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1.SIGNIFICANT weight loss w no explanation - 8-10 lbs
2. Several weeks of constipation |
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w colon cancer what is the earliest ss?
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no ss at all -the tumor has to get big before there are noticeable ss
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What are some significant ss in that are RED FLAGS ? (5)
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1.Weight loss-unexplained 8-10 lbs.(later stg)
2.No ss in early stg. 3. constipation for several weeks( late stg) 4. persistant change is bowel habits 5.feeling of incomplete defecation( this happens when tumor is close to rectum) 6.Bright bld or dark melanotic bld 7.stools get skinnier or thinner or a flat stool depending where tumor is |
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Tumors near the rectum and in descending colon( left side tumors) are different than those near the cecum( r sided tumors) ?
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L side tumors near the rectum and in the descending colon are more likely to cause OBSTRUCTION.
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If a tumor is spread outside of the colon throughout the abdomen what is it called?
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Peritoneal carcinomatosis
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Later stages of colon cancer are ? ( 3)
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1. anemia that can't be explained
2. fatigue 3. weakness |
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is abdominal pain common with colon cancer? are there any exceptions to this or does it never happen?
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No. ab pn with colon cancer is rare. The only time it happens is when the tumor has spread outsife of the colon through the abdomen . This is called "peritoneal carcinomatosis"
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if palpating a patients abdomen are you likely to feel for a tumor of the colon?
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no. the patient may look skinny and emaciated as the cancer progresses but in order to feel it through the abdomen the tumor has to be very large and the patient has to be very thin or both.
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When palpating a patient is it likely that you will be able to find a tumor of the colon?
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No. Palpation is not a good way to determine this. In a rare case you may feel if but it would be if the patient was extra thin and the tumor was really big or both or even very advanced cuz they lose a lot of weight at that point..
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What is the age for increased risk for colon cancer?
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after age 45
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Once patients hit this age range they are at the greatest risk?
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over 50
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More risk factors besides age are ( 6)
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1.fam hx
2.personal hx of colorectal polyps or colorectal cancer 3.hx of inflammatory bowel dx IBD Crohn's Dx or ulcerative colitis 4. African American and Jews (ashkanasi) -highest rate 5.Type 2 Diabetes Mellitus 6. Inherited syndromes ex: familial adenomatous polyposis |
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What are lifestyle factors for colon cancer? (5)
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1.Alcoholism
2.diet high in animal fat and red meat and low in veggies and fiber 3. obesity 4.Sitting around a lot 5. Smoking |
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Why is there constipation with colon cancer?
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Because the colonic lumen gets blocked due to too increase in number of cells. The lumen gets narrowed after the cancer has grown big. A large tumor.
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best overall test for colon cancer is ?
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colonoscopy from rectum to cecum
it directly sees the Left descending colon, the transverse colon and the R colon to the ceum and allows for biopsy of precancerous lesions. |
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What tests are advised for a pt not undergoing colonoscopy ?
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Routine fecal occult blood test and sigmoidoscopy every 5 yrs at 50 yrs of age.
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is it enough to just find a hemorrhoid on a 40-45 yr old and call it good?
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Hemorrhoids are common but DOES NOT Preclude looking for other causes.
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Pt with risk factors should be?
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screened sooner than later.
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Bright red bleeding most often means?
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Hemorrhoids ( bright bld or dark melonitic stool) can also be part of risk factor for colon cancer. Colon bld is more red
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If bld comes out after the patient defacates what does that mean?
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Melena
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