Gastro 9 - Large Instestine Part 2

Question 1

Where can carcinoid tumor arise?

Answer 1

It is a neuroendocrine tumor that can arise in bronchial tree, small intestine, or appendix.

Question 2

What is the most common type of colon polyp?

Answer 2

The hyperplastic polyp; they do not have a precancerous risk.

Question 3

What are the three main types of adenomatous colonic polyp? Which one is the most precancerous?

Answer 3

Tubular adenoma. Tubulovillous adenomas. Villous adenomas. The villous adenoma is the most precancerous.

Question 4

What is Juvenile polyposis syndrome?

Answer 4

Multiple polyps in very young children. It increases risk of adenocarcinoma.

Question 5

What is Peutz-Jeghers syndrome?

Answer 5

An autosomal dominant, causes multiple bening hamartomas (excess accumulation of normal tissue). Can also cause hyperpigmented areas in the lips, mouth, hands, genitalia. It increases risk of colorectal cancer.

Question 6

What are the malignancies associated with Peutz-Jeghers syndrome?

Answer 6

Colorectal cancer. Small intestinal tumor. Stomach Cancer. Pancreatic cancer. Breast cancer. Ovarian cancer. Uterine cancer.

Question 7

What is the third most common cancer in men and women in the USA and the third most killer cancer?

Answer 7

Colon cancer.

Question 8

What are the three main gene mutations associated with colon cancer?

Answer 8

APC gene mutation. K-RAS. Loss of p53.

Question 9

What are the risks factors of colon cancer?

Answer 9

Ulcerative colitis more so than Crohns. Smoking. High-fat/low-fiber diet. Alcohol use. Obesity. Adenomatous polyps (Villous adenoma). Strep bovis bacteremia.

Question 10

What are the symptoms of colon cancer that is in the ascending colon?

Answer 10

Blood in stool. Iron deficiency.

Question 11

What are the symptoms of colon cancer that is in the descending colon?

Answer 11

Partial obstruction. Pencil-thin stools. Colicky pain. Hematochezia.

Question 12

What studies can be employed to screen colon cancer?

Answer 12

Colonoscopy. Fecal occult blood testing. Barium enema. Flexible sigmoidoscopy.

Question 13

What would be a pathonemonic sign of colon cancer in a barium study?

Answer 13

Apple-core lesion.

Question 14

What is Turcot syndrome?

Answer 14

Related to familial adenomatous polyposis plus malignant CNS tumors (specifically a medulloblastoma).

Question 15

What is Gardner syndrome?

Answer 15

Familial adenomatous polyposis plus Bone and soft tissue tumors, Lipomas, Retinal hyperplasia.

Question 16

What is Hereditary non-polyposis colorectal cancer and what is another name for it?

Answer 16

AKA Lynch syndrome, it DOES NOT arise from a polyp. Autosomal dominant, caused by defect in DNA mismatch repair. This one arise in proximal colon.

Question 17

RFF: most common cancer of the appendix.

Answer 17

Carcinoid tumor.

Question 18

RFF: GI hamartomas, hyperpigmentation of the mouth and hands.

Answer 18

Peutz-Jeghers syndrome.

Question 19

RFF: Multiple colon polyps, osteomas, soft tissue tumors.

Answer 19

Gardner syndrome.

Question 20

RFF: “Apple core” lesion on barium enema.

Answer 20

Colon cancer.