9: Polyps, Cancer, Anus, Appendix

Question 1

Sessile polyp

Answer 1

Without a stalk

Question 2

Most polyps start out as which structural type?

Answer 2

Sessile -> enlarge and become pedunculated (have a stalk)

Question 3

SRUS stands for?

Answer 3

Solitary rectal ulcer syndrome

Question 4

SRUS triad

Answer 4

Rectal bleeding + mucus discharge + anterior rectal wall location

Question 5

Name five gastrointestinal polyposis syndromes

Answer 5

1. Juvenile polyposis
2. Peutz-Jegher’s syndrome
3. FAP
4. Gardner syndrome
5. Cowden syndrome

Question 6

What is a common cause of death in a pt with Peutz-Jegher’s syndrome

Answer 6

Intussuscepti on

Question 7

Hamartoma on histo

Answer 7

Arborizing network of CT, smooth muscle, lamina propria, glands, lined with normal-appearing epithelium

Question 8

Most common neoplastic polyp

Answer 8

Adenoma toys polyp

Question 9

Most important characteristic that correlates with risk of malignancy in a polyp

Answer 9

Size

Question 10

APC

Answer 10

A tumor suppressor gene

Question 11

Pectinate/dentate line

Answer 11

Site of transition of protoceum below + post-allantoic hindgut above

Question 12

Histo below and above pectinate line

Answer 12

Above: columnar epithelium
Below: squamous ep

Question 13

Cancers above and below the pectinate line are mostly what?

Answer 13

Above: adenocarcinoma
Below: squamous cell carcinoma

Question 14

External vs internal hemorrhoids

Answer 14

External: below pectinate line, very painful
Internal: above pectinate line, painless unless complicated

Question 15

Is the appendix a true or false diverticulum

Answer 15

True diverticulum

Question 16

Two most important prognostic factors of adenocarcinomas

Answer 16

1. Depth of invasion

2. Presence of LN metastases