QuestionSBA
QuestionChoice
Whilst active cancer greatly increases the risk of pulmonary embolism (PE), there is nothing in the history to suggest PE (e.g. oxygen requirement or tachycardia etc.). A CT CAP would therefore be better to assess for the presence of metastases.
10035001
e
CT pulmonary angiogram
QuestionChoice
Whilst colorectal cancers often metastasise to the liver, a CT CAP is a preferable imaging study to perform as it can rule out metastases to other areas in the chest, abdomen and pelvis.
10034998
b
Liver ultrasound
QuestionChoice
This is unlikely to be a useful imaging study unless the patient has symptoms to suggest obstruction or perforation secondary to their cancer. Even in these cases, a CT abdomen would be a much more appropriate imaging study to perform.
10035000
d
Abdominal X-ray
QuestionChoice
Although colorectal cancers can metastasise to the liver and pancreas, this specific imaging is unlikely to be as useful as a CT CAP could assess for metastases in a wider range of areas.
10034999
c
Magnetic resonance cholangiopancreatography (MRCP)
QuestionChoice
In the case of confirmed malignancy, a CT CAP is advised to check for metastatic spread and help stage disease. The other investigations would not be able to assess for this adequately.
10034997
a
CT scan of the chest, abdomen and pelvis (CT CAP)
Concept
Chapter
2693
4443
Colorectal cancer
Topic
225
Oncology and Palliative Care
19403
In colorectal adenocarcinoma, a CT scan of the chest, abdomen, and pelvis is essential for staging and detecting metastatic spread.
A 78-year-old male is found to have a positive faecal immunochemistry (FIT) test and undergoes colonoscopy.

A suspicious mass is found in the sigmoid colon. Biopsy samples are taken and confirm a colorectal adenocarcinoma.

What is the next most important investigation to perform?
a