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Методички онкология / 5 курс / САРС / 4 колоректальный.doc
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Indications for combined treatment. Long-term results.

The incidence of CRC. Etiologic factors.

Forms growth and histological structure of the tumor.

Separation on stage. Patterns of metastasis.

Symptoms PKK. The clinical picture depending on the location and shape of the tumor.

Differential diagnosis of bleeding from the rectum (hemorrhoids, polyps, dysentery, anal fissures).

Diagnosis PKK. Minium clinical examination of patients. Finger test, sigmoidoscopy, irihohrafiya, fibrokolonoskopiyu.

Surgical and combined treatment. Radical and palliative surgery. Indications for specific operations. Management of unnatural anus.

The value of radiotherapy and chemotherapy. Long-term results of treatment.

test tasks (Correct answers are marked *)

Enter the country with high cancer of the colon:

1. Japan;

2. USA *

3. Senegal;

4.Yamayka;

5. Sri Lanka

2. What place in the world occupies colon cancer among all malignant tumors:

1. second;

2. fifth

3. third *

4. fourth

5. sixth

3. What is the most common location of cancerous lesions of the colon:

1.               descending colon;

2. cecum *

3. sigmoid colon;

4. ascending colon;

5. transverse colon

4. What differentiated exophytic growth forms of colon cancer:

1.               polipopdibna;

2.               mushroom;

3.               ulcer;

4.               ulcerative-infiltrative

5. 1 and 2 *

5. Chashepodibnyy cancer attributed to:

1.               Endophytic;

2.               exophytic;

3. Ezofitnoho m *

4.               infiltrative

5.               in situ

6. Hematogenous colon cancer often amazed:

1. Echinka p *

2.               brain;

3.               lungs;

4.               bone.

5.               kidneys

7. Most informative method for studying colon cancer suggest:

1. x-ray;

2. sigmoidoscopy;

3. fibrokolonoskopiyu *

4. Ultrasound;

5. hemokulttest.

8. The main radiological method of study of colon cancer:

1.               retropnevmoperetoneum;

2.               irrigoskopiya *

3.               pnevmoren.

4.               Plain radiographs of the abdomen

5.               fluoroscopy with barium sulfate per os

9. Specify the radical treatment of colon cancer:

1. chemoradiotherapy;

2. radiotherapy;

3. Surgery *

4. hormones and immunotherapy;

5. All answers are correct.

10. The incidence of CRC in Ukraine is:

1. 17-18 of 100 thousand;

2. 14-15 of 100 thousand *

3. 16-17 of 100 thousand

4. 18-19 of 100 thousand

5. 20-21 of 100 thousand

11. The reasons that lead to the development of the PKK:

1. nature of power *

2.               occupational hazard;

3.               heredity.

4.               smoking

5.               sex hormones

12. What is the most common location of PKK:

1. Nyzhnoampulyarnyy department;

2. serednoampulyarnyy department *

3. verhnoampulyarnyy department.

4. anal canal

5. rektosihmoyidnyy department

13. By endophytic growth PKK forms include:

1. ulcerative cancer *

2. polipopodibnyy cancer:

3. mushroom cancer.

4. saucer-cancer

5. infiltrative cancer

14. The main way metastatic CRC:

1.               hematogenous;

2.               implantation;

3.               lymphogenous. *

4.               not metastasizing

5.               to within

15. The most frequent symptom in PKK:

1. presence of abnormal discharge *

2. pain;

3. constipation;

4. bloating

5. vomit

16. The basic method of screening for CRC:

1.               sigmoidoscopy;

2.               finger research *

3.               irihoskopiya.

4.               Laparoscopy

5.               determination of tumor markers

17. Radical treatment PKK:

1.               Surgery *

2.               chemotherapy;

3.               radiotherapy;

4.               immunotherapy

5.               hormone

18.               The choice of surgery for CRC depends on:

1.               form of tumor growth;

2.               morphological structure of the tumor;

3.               tumor. *

4.               sex of the patient

5.               concomitant hemorrhoids

19.               Five-year survival of patients with CRC is:

1. 50-60% *

2. 30-40%;

3. 60-70%;

4. 15-20%;

5. 70-80%.

 

clinical case studies (Correct answers are marked *)

 

Task 1. Patient '78 URGENT admitted to the surgical department for chronic intestinal obstruction. Examination revealed plans to Leno sharp narrowing anus by a dense mound of cotton tumor, which occupies more than half of the circle anal ring. In ampoule rectum in finger study - dense as stone stool.

A. Heme at Roy

B. Cancer Anal b tion of direct ki ki w *

C. Chronic pairs and proctitis

D. Atresia anal canal

E. Polyp anal rectum

 

Task 2. Man '55 complains of pain and foreign body sensation in the rectum, bloating, tighten, alternating with Pron at most, the presence of mucus and blood in the stool. Sick for 6 months, not treated. OBJECTIVE: swollen abdomen, liver near the edge of the Rebbe Mr. Noah arc, negative symptoms of peritoneal irritation. Total blood - no change. When researching finger straight w ki ki defined thick shaft with knobby surface, painful on palpation, on the glove after study - traces of blood. At sigmoidoscopy - 3 cm from the anus determined thick shaft with knobby erozov Noah and surface contact bleeding.

A. Heme at Roy

B. Polyp direct ki ki wi

C. Nesp is aspecific ulcerative proctitis

D. Rectal ki ki w *   

E. Dysentery, kolitychna form hard n e rebih

 

Task 3 Patient '67 complains of pain in the right iliac region, and suspen governmental body temperature, weight loss protihom the last 2 months. Palpation is moderately painful infiltrate in blood - anemia, mild leukocytosis, a deviation to the left. Another symptom tons Film - negative. Symptom Rovzynha and Bartom'ye-Michelson-sad in ny.

A. Apendykulya p tion infil t pam

B. Salpinhoof at rhythmsmichnoe

C. Psevdozapalna form of cancer blind ki ki w *

D. Inflammatory PSE in dopuhlyna h e same zealous powder nyny

E. Destructive and p HDPE and op  

 

Problem 4. Patient S., 47 years old, enrolled in the urgent procedure in the surgical department of the hospital with complaints of nevidhodzhennya gas and feces, intestinal contents vomiting, sudden bloating stomach. In Plain radiographs of the abdomen, multiple "bowl Kloyberha." The diagnosis: "Acute decompensated ki w Cova obstruction." In urgent procedure performed lyaparatomiya during which rektosyhmoyidnomu in colon tumor revealed 3x4 cm, obturuye intestine, small intestine loop dramatically overblown. Colon increased to 10 cm in diameter. What is the volume of operas and tive intervention to perform?

A. Front R ​​E zektsiya rectum.

B. Colostomy sigmoid straight w ki ki

C. Operation Hartm and on *

D. Tsekostoma.

E. Laparo trial and volume

Problem 5. Patient '67 complains of pain in the right iliac region, helmet to the bone resistant constipation for more than 6 months. OBJECTIVE: patient is pale, palpation in the right iliac region - infiltrate 8 to 10 cm, which is not shifted, with percussion over it dull sound. Hb levels 80 g / l. What is on and a diagnosis?

A. Apendykulyar infiltrate

B. Crohn’s Disease

C. Malignant tumor of caecum*

D. Cancer right kidney

E. Pozaocherevna pu's lin

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