HKDU Symposium > Premalignant lesions in the GI tract video 201804B
Dr. Lee Ming Kai Derek
Specialist in Gastroenterology & Hepatology

Direction: Choose the single best answer and give a tick in the corresponding box on the answer form.


1.

A 36 yo man is in clinic for a routine exam. He has no GI complaints and has not had any prior colorectal cancer screening. Family history is significant for his mother who was diagnosed with colon cancer at age 54.

Physical examination is normal.

Which of the following is the most appropriate management?


2.

A 57-year-old man is in clinic for 1-week follow up after his first screening colonoscopy. He has no history of colorectal neoplasia in first- or second-degree relatives. 

Physical examination is normal.

A colonoscopy to the cecum was performed. The preparation was described as poor, with collections of semisolid debris that could not be effectively cleared from several colonic segments. According to the colonoscopy report, mass lesions 1 cm or larger are unlikely to have been obscured by the debris. Three diminutive (<3 mm) hyperplastic polyps were removed from the rectum. 

Which of the following is the most appropriate management strategy  


3.

A 50 yo woman is in clinic for a routine exam. She has no significant PMHx and denies any GI symptoms. She has no history of colorectal malignancy.

Physical examination is normal.

She is sent home with high-sensitivity guaiac fecal occult blood test (gFOBT) cards and is asked to collect two specimens each from three consecutive stools. One of the six samples is positive.

Which of the following is the most appropriate management for this patient?


4.

A 35-year-old woman is evaluated during a routine clinic follow-up. She has no medical history and is generally healthy, exercising regularly with a balanced diet. She has no GI symptoms, but would like to discuss whether she should undergo colorectal cancer screening. Physical examination is normal.

Her family history is as follows:

 Father: Colorectal cancer, age 52 years      

 Mother: Healthy, no malignancies

 Paternal aunt: Endometrial cancer, age 37 years      

 Paternal uncle: Large 2.5 cm colorectal adenoma, age 45 years

 Brother: Colorectal cancer, age 46 years 

Which of the following is the most appropriate management strategy


5.

A 38-year-old man with ulcerative colitis diagnosed 10 years ago is evaluate during a routine examination. He is tolerating his mesalamine and feeling well without any symptoms. His last colonoscopy was performed when he was diagnosed and showed mildly active extensive colitis extending to the hepatic flexure. He has no other family history of colon cancer, polyps or malignancy. There is no family history of colon cancer or colon polyps.

 Physical exam and labs, including CBC, CMP and CRP, are all normal.

 Which of the following is the most appropriate colonoscopy interval for this patient?