Team A
Which of the following hemogram measures would likely be elevated in microcytic anemia?
Hb
MCV
Both
Neither
D. Microcytic anemia is characterized by low (< 70) MCV. Commonly, it is due to defective heme synthesis. We would expect Hb levels to be low.
What does T1 refer to in TNM staging for colorectal cancer?
The cancer has infiltrated the submucosa.
In our case, Janine is found to have a mucinous adenocarcinoma of the colon. Define “mucinous adenocarcinoma.”
“Mucinous” = more than half of the tumor tissue is EC mucinous components
“Adeno” = epithelial origin
“Carcinoma” = malignant
Name an inherited colorectal disease highly associated with mutations leading to dysregulation of the Wnt pathway.
Familial adenomatous polyposis.
Hematochezia and/or melena can be symptoms of colorectal cancer. Which of the tests discussed in this case is most directly related to these symptoms?
FOBT— it detects blood in feces. Hematochezia refers to rectal bleeding and melena refers to blood in the feces, both of which are the basis for the FOBT.
Name 3 potential causes of iron deficiency microcytic anemia.
Blood loss due to ulcer/internal bleed, loss in stool, menorrhagia, and diet issues).
True or False: Despite being the most sensitive diagnostic test for CRC, colonoscopies are still only estimated to have a sensitivity of ~50%.
False. Colonoscopies have a sensitivity of ~95%.
What is the main function of the lymph nodes?
To eliminate threats to the body that could be infection or cancerous cells. They are attached to the lymphatic system and contain lots of antibodies.
What is the main difference between a colostomy and a colectomy?
Colostomy is a procedure in which an opening for the colon is created through the abdominal wall, whereas a colectomy refers to the surgical removal of all or part of the colon.
Describe the inheritance pattern for each of the following colon cancer diseases.
Lynch, Familial Adenomatous Polyposis, Peutz-Jegher Syndrome.
All AD.
At what age does the USPSTF and AGC currently recommend initiating colorectal cancer screening?
45.
True or False. Familial colorectal cancers account for a higher proportion of newly diagnosed CRC, compared to sporadic CRC.
False.
Janine has a “guaiac positive” FOBT. Which component of her blood is most directly involved in the color-change reaction which produced this result?
Heme.
What is the mechanism of action of oxaliplatin in the treatment of colorectal cancer?
The platinum complex in the drug binds to DNA and forms cross-links. The cross-links inhibit DNA replication, transcription, and arrest of the cell cycle, resulting in cell death.
A CT scan is most useful in showing which of the following features of colorectal cancer?
Tumor extension
Tumor suppressor gene mutations
Tumor metastases
Melena
A and C
A and D
All of the above
E. CT imaging can show structural abnormalities due to cancer, such as tumor extension and metastases.
What accumulates when Wnt ligand-binding is hyper activated and what occurs?
Beta-Catenin accumulates and increases cell proliferation.
For each of the following tests, describe what they measure and if they are elevated or reduced in anemia.
TIBC, serum iron, ferritin.
TIBC: Blood iron binding capacity; How much “extra” iron can the blood bind? Elevated.
Serum iron: How much iron is “floating around?” Reduced.
“How much ferritin is there?” (“How much iron is being stored?”) Reduced.
Fix these sentences to be correct:
Leocovorin/Folinic Acid - enhances the effect of VEGF.
Bevacizumab - enhances vascular growth of tumor blood cells
Fluorouracil - acts as an enhancer for thymidylate synthase enzyme.
Leucovorin/Folinic Acid - enhances the effect of fluorouracil.
Bevacizumab - inhibits vascular growth of tumor blood cells.
Fluorouracil - acts as a fallse substrate for thymidylate synthase enzyme.
ESTEBAN LORE:
What is my dog's name?
Sunny.
ESTEBAN LORE:
My favorite Latina pop singer.
Becky G.