Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal System > EXAM #1: GI NEOPLASIA > Flashcards

EXAM #1: GI NEOPLASIA Flashcards

1
Q

What type of tumor is the most common in the GI tract?

A

Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What site is most commonly affected by neoplasia in the GI system?

A

Colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the most common benign tumors of the small bowel?

A

1) Adenomas

2) Mesenchymal tumors i.e. GISTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the most common malignant tumors of the small bowel?

A

1) Adenocarcinoma

2) Carcinoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What genetic conditions predipose patients to carcinomas of the small bowel?

A

1) Familial Adenomatous Polyposis (FAP)

2) Gardner’s Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is an adenoma?

A

Neoplastic proliferation of glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where are adenomas in the small bowel most common?

A

Amupulla of Vater –this is the union of the pancreatic duct and common bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the clinical features of adenomas?

A
  • Seen in middle age
  • Cause occult blood loss
  • Can precipitate obstruction/ intussusception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where do most adenocarcinomas occur in the small bowel?

A

Duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of pattern do adenocarcinomas grow in?

A

Napkin ring i.e. encircling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the major non genetic risk factor for adenocarcinomas?

A

Crohn’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a polyp?

A

Benign mass protruding from the mucosa into the lumen of the gut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Are most polyps malignant or non-malignant?

A

Non-malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the two types of polyps seen in the colon?

A

1) Adenomatous

2) Hyperplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a hyperplastic polyp?

A

Hyperplasia of glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a Hamartomatous polyps?

A

A polyp formed by disorganized normal tissue (seen mostly in kids; therefore, called a “Juvenile Polyp”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is an inflammatory polyp?

A

This is an alternate name for pseudopolyps seen in Ulcerative Colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of polyp is most common?

A

Hyperplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where do most hyperplastic polyps occur?

A

Rectosigmoid region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are harmatomatous polyps called in kids?

A

Juvenile polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are harmatomatous polyps called in adults?

A

Retention polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are Peustz-Jegher’s polyps?

A

Hamartomatous polyps seen in Peutz-Jegher’s Syndrome

- Polyps seen throughout the GI tract (vs. solitary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Peutz-Jegher’s Syndrome?

A
  • Autosomal Dominant disorder
  • Characterized by:
    1) Mucocutaneous pigmentation around the mouth (freckles around the mouth)
    2) Multiple hamartomatous polyps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What gene is mutated in Peutz-Jegher’s Syndrome?

A

STK11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the hamartomatous polyps of Peutz-Jegher’s Syndrome composed of?

A

1) Connective tissue

2) Smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are patients with Peutz-Jegher’s Syndrome at risk for?

A
  • Intussusception
  • Cancer
    1) Colorectal
    2) Breast
    3) GYN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the four different types of adenomas?

A

1) Tubular
2) Tubulovillous
3) Villous
4) Serrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common type of ademona? What is the association with carcinoma?

A

Tubular

Lowest neoplastic potential b/c of “buffering” of the stalk*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which type of adeoma is most associated with carcinoma?

A

Villous adenomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the three risk factors that confer greatest potential to transition from adenoma to carcinoma?

A

1) Size greater than 2cm
2) Sessile (flat) growth
3) Villous histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the cancer risk associated with Tubulovillous Adenomas?

A

Intermediate

Associated with the villous portion

32
Q

When is there highest concern for cancer in villous adenoma?

A

Progression to greater than 4 cm

33
Q

What type of adenomas are most associated with being symptomatic? What is the presentation?

A

Villous adenomas:

  • Overt rectal bleeding causing
  • Hyponatremia
  • Hypokalemia
34
Q

What is the only adequate treatment for pedunculated or sessile adenoma?

A

Complete resection

35
Q

What is carcinoma in situ?

A

Neoplastic cells that have NOT breached the basement membrane

36
Q

What is the Adenoma-Carcinoma Sequence?

A

1) APC mutations= increased risk
2) K-ras mutation= adenoma
3) p53 and increased COX= carcinoma

37
Q

What are the risk factors for colorectal carcinoma?

A

1) Increased age
2) Prior colorectal CA or polyps
3) UC/ CD
4) Poor diet

38
Q

What environmental factors may be protective in colorectal carcinoma?

A

NSAIDs esp. ASA b/c of COX inhibition

39
Q

Where to colorectal cancers commonly metastasize?

A

Liver

40
Q

Iron-deficiency anemia in an older male is ____ until proven otherwise?

A

Colorectal carcinoma

41
Q

What side of the colon is commonly implicated in colorectal carcinoma leading to anemia?

A

Right-sided

42
Q

What familial syndromes cause colorectal cancer?

A

1) Classic FAP
2) Attenuated FAP
3) Gardner Syndrome
4) Turcot Syndrome

FAP= Familial Adenomatous Polyposis

43
Q

What is Classic Familial Adenomatous Polyposis?

A
  • AD
  • Avg. onset at 25 y/o
  • Causes thousands of polyps
44
Q

What gene is implicated in Classic FAP?

A

APC on chromosome 5q21

45
Q

What treatment is available for patients with Classic FAP?

A

Total colectomy (preventative)

46
Q

What is Attenuated FAP?

A
  • Delayed appearance (50 y/o)
  • Fewer polyps
  • Proximal colon
47
Q

What mutations are associated with Attenuated FAP?

A

APC and MUTYH

48
Q

What is Gardner Syndrome?

A

Classic FAP +

  • Osteomas of skull/ mandible
  • Epidermal cysts
49
Q

What is Turcot Syndrome?

A

FAP + CNS tumors

50
Q

What is HNPCC?

A

Hereditary Nonpolyposis Colorectal Cancer

  • Genetic mutation predisposes to carcinoma
  • NO adenoma first
51
Q

What is the eponym for HNPCC?

A

Lynch Syndrome

52
Q

What gene is involved in HNPCC?

A

MSH1 and MSH2

  • DNA mismatch repair enzymes
  • DNA microsatellite instability
53
Q

What cancers are seen in HNPCC?

A

Colorectal cancer WITHOUT polyps + cancer outside the colon

54
Q

Outline the associations with left-sided carcinoma and right sided colorectal carcinoma.

A

Left=

  • “Pencil thin” stool
  • Napkin ring
  • APC related mutations

Right=

  • Iron deficiency anemia/occult bleeding
  • Raised lesions
  • MSH mutations
55
Q

In colon cancer, what is mucin production associated with?

A

Poor prognosis

56
Q

What is the relationship between lymph node mets and prognosis in colorectal cancer?

A
  • Less than 3 nodes= better prognosis

- More than 3 nodes= poor prognosis

57
Q

What is Stage TI colorectal cancer?

A

Invasion of the submucosa

58
Q

What is Stage TII colorectal cancer?

A

Invasion of the muscularis propria

59
Q

What is Stage TIII colorectal cancer?

A

Penetration through the bowel wall

60
Q

What is Stage TIV colorectal cancer?

A

Spread to other organs

61
Q

In the Modified Duke’s Staging scheme for colorectal cancer, what indicates a better prognosis? Poor prognosis?

A 
A= good 
B= bad
62
Q

What is a carcinoid tumor?

A
  • Neuroendocrine cell tumor
  • Forms a polyp most common in small bowel
  • Produces 5-HT and bradykinin
63
Q

What is Carcinoid Syndrome? What is Carcinoid Syndrome associated with?

A

Carcinoid syndrome is the process initiated by systemic 5-HT; associated with liver mets b/c this allows 5-HT to bypass liver MAO

64
Q

What are the symptoms of Carcinoid Syndrome?

A

Flushing
Bronchospasm
Diarrhea

65
Q

What is Carcinoid Heart Disease?

A

Carcinoid Syndrome that causes right-sided valvular fibrosis

  • Tricuspid valve regurgitation
  • Pulmonary stenosis
66
Q

What are the three types of GI Lymphomas?

A

1) MALToma
2) Sprue-associated
3) Mediterranean

67
Q

What is Mediterrranean Lymphoma?

A

B-cell lymphoma in patients of Mediterranean ancestry

68
Q

What is the hallmark of Mediterranean Lymphoma?

A

Abnormal IgA heavy chain synthesis

69
Q

What type of Lymphoma is associated with Spure-associated Lymphoma?

A

Intestinal T-cell Lymphoma
- Seen in patients with longstanding malabsorption

Worst prognosis

70
Q

What is acute appendicitis?

A

Inflammation of the appendix

71
Q

What is the most common cause of appendicitis?

A

Impacted fecolith

72
Q

What are the hallmark symptoms of acute appendicitis?

A

Anorexia
RLQ pain
N/V
Fever

73
Q

What is the classic immune cell associated with acute appendicitis?

A

Neutrophils

74
Q

What is the most common tumor of the appendix?

A

Carcinoid

75
Q

What are the three mucus related tumors of the appendix? Which has the worst prognosis?

A

1) Mucocele
2) Mucinous cystadenoma
3) Mucinous cystadenocarcinoma

Gastrointestinal System (42 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions