Master the board step 3

Master the Boards: USMLE Step 3
The following table summarizes the recommendations for colon cancer
screening:
General
Population
Single Family
Member with
Colon Cancer
Three Family
Members, Two
Generations, One
< 50
Familial
Adenomatous
Polyposis
Gardner’s, Peutz-
Jeghers, Juvenile
Polyposis, Turcot’s
Syndrome
Start screening
at age 50.
Colonoscopy
every 10 years.
Start screening
at age 40 or
10 years earlier
than the age
at which the
family member
contracted
cancer.
Colonoscopy every
1–2 years starting
at age 25.
Sigmoidoscopy every
1–2 years starting at
age 12.
No extra screening
recommendations.
Diverticular Disease
Diverticulosis and Diverticulitis
Diverticulosis
Diverticulosis is incredibly common in older Americans due to a low-fiber,
high-fat, hamburger-filled, low-residue diet. They often present as follows:
··
Left lower quadrant (LLQ) abdominal pain
··
Lower GI bleeding
Diagnostic Testing
··
Most accurate test: Barium enema is more accurate test than colonoscopy
Treatment
Treat with a high-fiber diet.
Colonoscopy and barium
enema are contraindicated
in diverticulitis because
of an increased risk of
perforation.
Diverticulitis
Diverticulitis is a complication of diverticulosis. It presents as:
··
Left lower quadrant (LLQ) abdominal pain
··
Tenderness
··
Fever
··
Elevated white cell count in blood
Diagnostic Testing
··
Best diagnostic test: Abdominal and pelvic CT scan
206