MCQ Quiz: Colorectal Screening

Colorectal cancer screening is a vital component of preventative health and wellness, a “transcending concept” highlighted in the Patient Care 4 curriculum. It is one of the few screening strategies that can actively prevent cancer by detecting and removing precancerous lesions. With multiple screening options now available, pharmacists are in a prime position to educate patients, promote adherence to screening guidelines, and play a crucial role in reducing the burden of this largely preventable disease. This quiz will test your knowledge on the different screening modalities, current recommendations, and the pharmacist’s role in this key public health initiative.

1. What is the primary goal of colorectal cancer (CRC) screening in an asymptomatic, average-risk individual?

• a. To diagnose active metastatic disease.
• b. To detect and remove precancerous adenomatous polyps.
• c. To treat iron-deficiency anemia.
• d. To determine the patient’s genetic risk.

Answer: b. To detect and remove precancerous adenomatous polyps.

2. According to major US guidelines, what is the recommended age to begin colorectal cancer screening for an individual at average risk?

• a. 40
• b. 45
• c. 50
• d. 55

Answer: b. 45

3. Which of the following is considered the “gold standard” for colorectal cancer screening because it can visualize the entire colon and remove polyps during the same procedure?

• a. Fecal immunochemical test (FIT)
• b. Flexible sigmoidoscopy
• c. CT colonography (“virtual colonoscopy”)
• d. Colonoscopy

Answer: d. Colonoscopy

4. The Fecal Immunochemical Test (FIT) works by detecting which of the following in the stool?

• a. Abnormal cancer DNA
• b. The enzyme guaiac peroxidase
• c. Human hemoglobin (globin)
• d. General heme from any source

Answer: c. Human hemoglobin (globin)

5. A patient receives a positive result from a stool-based screening test like FIT or Cologuard. What is the necessary next step?

• a. Repeat the same test in one year.
• b. Follow-up with a diagnostic colonoscopy.
• c. Start chemotherapy immediately.
• d. No further action is needed.

Answer: b. Follow-up with a diagnostic colonoscopy.

6. The lecture “Colorectal Screening” is a specific “Transcending Concept” in which course?

• a. PHA5784C Patient Care 4
• b. PHA5104 Sterile Compounding
• c. PHA5703 Pharmacy Law and Ethics
• d. PHA5878C Patient Care 3

Answer: a. PHA5784C Patient Care 4

7. A major advantage of the Fecal Immunochemical Test (FIT) over the older guaiac-based FOBT (gFOBT) is that:

• a. FIT does not require any dietary or medication restrictions before the test.
• b. FIT is more sensitive for upper GI bleeding.
• c. FIT is performed every 10 years.
• d. FIT can remove polyps.

Answer: a. FIT does not require any dietary or medication restrictions before the test.

8. For an average-risk individual, how often should a colonoscopy with normal findings be repeated?

• a. Every year
• b. Every 3 years
• c. Every 5 years
• d. Every 10 years

Answer: d. Every 10 years

9. Which of the following conditions would place a patient in a high-risk category for colorectal cancer, requiring earlier and more frequent screening?

• a. Hypertension
• b. A personal history of Inflammatory Bowel Disease (Ulcerative Colitis or Crohn’s Disease).
• c. GERD
• d. Asthma

Answer: b. A personal history of Inflammatory Bowel Disease (Ulcerative Colitis or Crohn’s Disease).

10. What is the pharmacist’s role in the colonoscopy process?

• a. To perform the procedure.
• b. To diagnose any polyps that are found.
• c. To counsel patients on how to properly use the bowel preparation kit.
• d. To administer sedation for the procedure.

Answer: c. To counsel patients on how to properly use the bowel preparation kit.

11. The management of colorectal cancer is a specific module within the Patient Care 4 curriculum.

• a. True
• b. False

Answer: a. True

12. The stool DNA test (e.g., Cologuard) detects human hemoglobin and what else?

• a. The presence of H. pylori.
• b. Abnormal DNA biomarkers associated with polyps and cancer.
• c. The presence of parasites.
• d. The level of inflammation in the colon.

Answer: b. Abnormal DNA biomarkers associated with polyps and cancer.

13. A patient has a first-degree relative (parent or sibling) diagnosed with colorectal cancer at age 52. When should this patient begin screening?

• a. At age 45.
• b. At age 50.
• c. At age 42 (10 years prior to the relative’s diagnosis).
• d. They do not need screening.

Answer: c. At age 42 (10 years prior to the relative’s diagnosis).

14. What is the most critical component for a successful colonoscopy?

• a. An adequate and complete bowel preparation.
• b. The time of day the procedure is scheduled.
• c. The brand of colonoscope used.
• d. The patient’s diet on the day of the procedure.

Answer: a. An adequate and complete bowel preparation.

15. A “split-dose” bowel prep regimen is often recommended because:

• a. It is less effective but easier to tolerate.
• b. It improves the quality of the colon cleansing compared to taking the full volume the night before.
• c. It is more expensive.
• d. It requires less total volume of prep solution.

Answer: b. It improves the quality of the colon cleansing compared to taking the full volume the night before.

16. Which of the following is NOT a recognized screening modality for colorectal cancer?

• a. CT Colonography
• b. Flexible Sigmoidoscopy
• c. A serum tumor marker test (like CEA)
• d. Fecal Immunochemical Test (FIT)

Answer: c. A serum tumor marker test (like CEA)

17. Promoting public health and disease prevention, such as cancer screening, is a key role for a community pharmacist.

• a. True
• b. False

Answer: a. True

18. A key counseling point for a patient undergoing a colonoscopy bowel prep is:

• a. To avoid drinking any fluids to prevent nausea.
• b. To stay close to a restroom once they start the prep.
• c. To mix the prep solution with a red or purple sports drink.
• d. To take an anti-diarrheal medication with the prep.

Answer: b. To stay close to a restroom once they start the prep.

19. A flexible sigmoidoscopy visualizes:

• a. The entire colon.
• b. Only the rectum.
• c. The rectum and the lower (sigmoid) portion of the colon.
• d. The small intestine.

Answer: c. The rectum and the lower (sigmoid) portion of the colon.

20. An active learning session on colorectal cancer screening is part of the Patient Care 4 course.

• a. True
• b. False

Answer: a. True

21. A patient taking diabetes medications like insulin needs special instructions before a colonoscopy because:

• a. The bowel prep and clear liquid diet can cause hypoglycemia.
• b. The medications will not be absorbed.
• c. The medications can interfere with the camera.
• d. The medications will cause constipation.

Answer: a. The bowel prep and clear liquid diet can cause hypoglycemia.

22. Which of the following is a potential risk of a colonoscopy?

• a. Bowel perforation
• b. Bleeding
• c. Complications from sedation
• d. All of the above

Answer: d. All of the above

23. The recommended frequency for a stool DNA-FIT test (e.g., Cologuard) is:

• a. Every year
• b. Every 3 years
• c. Every 5 years
• d. Every 10 years

Answer: b. Every 3 years

24. The main advantage of stool-based screening tests compared to colonoscopy is that they are:

• a. More accurate.
• b. Non-invasive and can be done at home.
• c. Better at removing polyps.
• d. Recommended less frequently.

Answer: b. Non-invasive and can be done at home.

25. A pharmacist can contribute to colorectal cancer screening by:

• a. Identifying patients who are due for screening.
• b. Educating patients about the importance of screening.
• c. Helping patients choose an appropriate screening test with their provider.
• d. All of the above.

Answer: d. All of the above.

26. Most colorectal cancers develop from:

• a. Inflammatory bowel disease
• b. Adenomatous polyps
• c. Hemorrhoids
• d. Diverticula

Answer: b. Adenomatous polyps

27. Patients with certain genetic syndromes, like Lynch syndrome or FAP, require much earlier and more intensive CRC screening.

• a. True
• b. False

Answer: a. True

28. Why are red or purple liquids avoided during a colonoscopy prep?

• a. They can stain the colon and be mistaken for blood.
• b. They taste bad with the prep solution.
• c. They can cause an allergic reaction.
• d. They neutralize the prep solution.

Answer: a. They can stain the colon and be mistaken for blood.

29. The “Transcending Concept – Health and Wellness: Colorectal Screening” is a module in which course?

• a. PHA5784C Patient Care 4
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5784C Patient Care 4

30. Which of the following is NOT a risk factor for colorectal cancer?

• a. A diet high in fiber
• b. Obesity
• c. A diet high in red and processed meats
• d. Smoking

Answer: a. A diet high in fiber

31. The primary difference between a screening colonoscopy and a diagnostic colonoscopy is:

• a. The type of scope used.
• b. A screening colonoscopy is done on an asymptomatic person, while a diagnostic one is done to evaluate symptoms.
• c. The length of the procedure.
• d. The quality of the bowel prep.

Answer: b. A screening colonoscopy is done on an asymptomatic person, while a diagnostic one is done to evaluate symptoms.

32. A patient on warfarin undergoing a colonoscopy may need to:

• a. Increase their warfarin dose.
• b. Stop their warfarin several days before the procedure and may require bridging therapy.
• c. Continue their warfarin without any changes.
• d. Switch to aspirin.

Answer: b. Stop their warfarin several days before the procedure and may require bridging therapy.

33. The FIT test is more specific for lower GI bleeding than gFOBT because:

• a. It reacts to any heme, including from red meat.
• b. It uses antibodies specific to human globin, which is degraded in the upper GI tract.
• c. It is a newer test.
• d. It detects DNA.

Answer: b. It uses antibodies specific to human globin, which is degraded in the upper GI tract.

34. The ultimate goal of a colorectal cancer screening program is to:

• a. Increase the number of colonoscopies performed.
• b. Reduce the incidence of and mortality from colorectal cancer.
• c. Sell more stool-based test kits.
• d. Identify every polyp in the population.

Answer: b. Reduce the incidence of and mortality from colorectal cancer.

35. A patient should be instructed to start their clear liquid diet:

• a. The morning of the colonoscopy.
• b. Three days before the colonoscopy.
• c. The entire day before the colonoscopy.
• d. One hour before the procedure.

Answer: c. The entire day before the colonoscopy.

36. Which of the following is allowed on a clear liquid diet for a bowel prep?

• a. Milk
• b. Orange juice with pulp
• c. Black coffee or tea
• d. A protein shake

Answer: c. Black coffee or tea

37. The most effective screening tests are those that have a high:

• a. Cost
• b. Risk of complications
• c. Sensitivity and specificity
• d. Rate of false positives

Answer: c. Sensitivity and specificity

38. The pharmacist’s role in public health includes advocating for preventative services like cancer screenings.

• a. True
• b. False

Answer: a. True

39. A “polypectomy” is the:

• a. Visualization of a polyp.
• b. Biopsy of a polyp.
• c. Surgical removal of a polyp.
• d. Measurement of a polyp.

Answer: c. Surgical removal of a polyp.

40. An active learning session on colorectal cancer screening is part of which course?

• a. PHA5784C Patient Care 4
• b. PHA5163L Professional Skills Lab 3
• c. PHA5781 Patient Care I
• d. PHA5782C Patient Care 2

Answer: a. PHA5784C Patient Care 4

41. If a patient has an incomplete colonoscopy due to a poor prep, what is the usual recommendation?

• a. No further screening is needed for 10 years.
• b. Repeat the procedure much sooner, often within one year, with a more aggressive bowel prep.
• c. Switch to a stool-based test.
• d. Proceed directly to surgery.

Answer: b. Repeat the procedure much sooner, often within one year, with a more aggressive bowel prep.

42. Which of the following is NOT a lifestyle factor that can reduce the risk of colorectal cancer?

• a. Maintaining a healthy weight.
• b. Regular physical activity.
• c. A diet low in red and processed meats.
• d. Heavy alcohol consumption.

Answer: d. Heavy alcohol consumption.

43. A pharmacist counseling a patient on a polyethylene glycol (PEG) based bowel prep kit should emphasize:

• a. The importance of drinking the entire large volume of solution for an effective prep.
• b. That the solution can be mixed with juice to improve the taste.
• c. That they only need to drink half of the solution.
• d. That it will cause constipation.

Answer: a. The importance of drinking the entire large volume of solution for an effective prep.

44. After a colonoscopy with sedation, a patient must:

• a. Drive themselves home immediately.
• b. Have a responsible adult drive them home.
• c. Return to work the same day.
• d. Eat a large, high-fat meal right away.

Answer: b. Have a responsible adult drive them home.

45. What is the main limitation of a flexible sigmoidoscopy?

• a. It is very painful.
• b. It requires a 3-day bowel prep.
• c. It can only visualize the lower third of the colon and can miss polyps or cancers in the upper colon.
• d. It is more expensive than a colonoscopy.

Answer: c. It can only visualize the lower third of the colon and can miss polyps or cancers in the upper colon.

46. A patient is hesitant to get a colonoscopy due to fear of the procedure. An appropriate pharmacist response would be to:

• a. Tell them they must do it.
• b. Acknowledge their concerns and discuss the benefits of screening and the availability of less-invasive stool-based test options as a first step.
• c. Ignore their concerns.
• d. Agree that the procedure is too scary.

Answer: b. Acknowledge their concerns and discuss the benefits of screening and the availability of less-invasive stool-based test options as a first step.

47. The most common pathology of colorectal cancer is:

• a. Squamous cell carcinoma
• b. Adenocarcinoma
• c. Melanoma
• d. Lymphoma

Answer: b. Adenocarcinoma

48. An active learning session on colorectal screening is part of which course module?

• a. Module 6: Colorectal Cancer
• b. Module 1: PUD and GERD
• c. Module 4: Gastrointestinal Infections
• d. Module 5: Nutrition & Weight Management

Answer: a. Module 6: Colorectal Cancer

49. Promoting patient adherence to screening guidelines is a key part of:

• a. Dispensing
• b. Compounding
• c. Public health and wellness initiatives
• d. Drug information

Answer: c. Public health and wellness initiatives

50. The single most effective strategy to prevent death from colorectal cancer is:

• a. Taking a daily aspirin.
• b. Following a healthy diet.
• c. Getting screened according to recommended guidelines.
• d. Taking a multivitamin.

Answer: c. Getting screened according to recommended guidelines.

Generate Audio Overview