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GI II Exam 1 > Bowel Path IV > Flashcards

Bowel Path IV Flashcards

1
Q

lymphoid polyp

A

non-neoplastic

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2
Q

adenoma

A

adenomatous polyp

neoplastic

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3
Q

most common adenoma

A

tubular adenoma - small and pedunculated

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4
Q

greater than 4cm diameter polyp

A

40% chance contain foci of cancer

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5
Q

epithelial dysplasia

A

in adenoma

is pre-malignant

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6
Q

tubular adenoma

A

neoplastic

pedunculated

velvety surface

have small round tubular glands

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7
Q

villous adenomas

A

larger and sessile - covered in villi

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8
Q

sessile serrated adenomas

A

like hyperplastic polyp

-but more common in right colon

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9
Q

hyperplastic polyp vs. sessile serrated adenoma

A

serrated architecture throughout in a sessile serrated adenoma
-also in right colon

only on surface of hyperplastic polyp

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10
Q

malignant risk

A

larger polyp
more epithelial dysplasia
villous > tubular

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11
Q

APC/WNT pathway

A

typical adenocarcinoma of colon

both familial and sporadic colon cancer

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12
Q

FAP

A

100% patients get colon cancer if don’t do anything hundreds to thousands of polyps

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13
Q

microsatellite instability

A

mutation of MSH2 or MLH1 gene result in loss of enzymes in repair of damaged DNA - accumulation of microsatellite repeats

  • mutation in TGF-beta receptor
  • BAX genes
  • BRAF gene

seen with HNPCC
-MLH1 and MSH2

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14
Q

familial adenomatous polyposis

A

auto dominant
-500-2500 colon polyps

colon cancer in 100% by age 30

most have APC gene defect, some MYH

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15
Q

HNPCC

A

lynch syndrome

hereditary non-polyposis colorectal cancer

auto dom

colon ca at young age

right sided and mucinous

microsatellite instability due to mismatch repair gene defect

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16
Q

CHRPE

A

congeintal hyperplasia of retinal pigmented epithelium

newborn with FAP

1st indication of mutation

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17
Q

colon carcinoma

A

common

clinical sx - mild abdominal discomfort, fatigue, weight loss, anemia

elevated CEA

with strep bovis

majority left sided

diet, smoking, alcohol, adenoma hx, black, older age

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18
Q

iron deficiency anemia in older man or postmenopausal woman

A

GI cancer - unless proven otherwise

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19
Q

path of colon carcinoma

A

requires multiple hits

two pathways:

  • classic -APC/beta catenin - majority
  • microsatellite instability - DNA mismatch repair defect
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20
Q

microsatellite instability

A

DNA mismatch repair defect

in colon carcinoma

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21
Q

majority of colorectal neoplasias

A

sporadic 97%

familial 3%

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22
Q

napkin ring lesion

A

colorectal carcinoma

typically left sided

aka apple core lesion

23
Q

regional lymph nodes of colon

A

in pericolonic fat

24
Q

VEGF

A

induces vessels to tumor

25
Q

hard node

A

cancer

26
Q

colon carcinoma mets

A

lymph node, lung, liver

27
Q

dukes criteria

A

for level of invasion of colorectal carcinoma

28
Q

T-IS

A

in situ

29
Q

T1

A

no muscularis

30
Q

T3

A

to serosa

31
Q

T4

A

to adjacent organ

32
Q

T2

A

to muscularis

33
Q

staging of colorectal carcinoma

A

T - tumor
N - nodes
M - mets

34
Q

stage 1 and 2

A

no nodes, no mets

35
Q

stage 3

A

nodes, no mets

36
Q

stage 4

A

nodes and mets

37
Q

screening for colorectal cancer

A

after age 50yo - colonoscopy every 10 years is gold standard

38
Q

carcinoid tumor of small bowel

A

neuroendocrine origin

mostly distal in ileum

malignant

39
Q

adenomas and adenocarcinomas of small bowel

A

mostly in duodenum - proximal

40
Q

carcinoid tumor

A

well differentiated neuroendocrine carcinoma

foregut - rarely met
midgut - often met and aggresive
hindgut - incidental finding

secrete - serotonin**

41
Q

severe episodic skin flushing, diarrhea, cramping, asthma, tricuspid valve insufficiency

A

carcinoid tumor

42
Q

serotonin secretion

A

carcinoid tumor

43
Q

salt and pepper pattern of tumor

A

carcinoid tumor

cytoplasmic dense neurosecretory granules

44
Q

vermiform appendix

A

in cecum - lymphoid rich

no known function

blind end tube attached to cecum

45
Q

acute appendicitis

A

peri-umbilical pain - localizes to RLQ - mcburney

N/V

abdominal tenderness, rebound

mild fever

leukocytosis

exploratory laparoscopy outweighs risk of appendix perforation

46
Q

fecalith

A

hard stool in appendix

-can cause inflammation and appendicitis

47
Q

tumors of appendix

A

mostly carcinoid

48
Q

mucocele and pseudomyxoma pertonei

A

tumor of appendix secreting mucin to abdominal cavity

jelly belly

49
Q

jelly belly

A

mucin in abdominal cavity
-with tumor of appendix

mucocele and pseudomyxoma peritonei

50
Q

peritonitis

A

bile leak, pancreatic enzymes, foreign material, endometriosis, ruptured dermoid cyst, perforation

51
Q

bacterial peritonitis

A

may be fatal or heal with adhesions

e. coli, pneumococcus

52
Q

mesothelioma

A

malignant tumor of peritoneal cavity

with asbestos exposure

53
Q

tumors in peritoneal cavity

A

majority secondary to mets - ovary, pancreas, GI

GI II Exam 1 (29 decks)

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