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BHP Exam 3 > GI 2 > Flashcards

GI 2 Flashcards

1
Q

Ulcerative colitis affects what?

A

Rectal mucosa, can expand to entire colon

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2
Q

Active acute pattern of ulcerative colitis - six manifestations?

A

PACHED

Pseudopolyps
Abcess in crypts
Confluence
Hemorrhage
Edema, lymphoid
Depletion of goblet cells & mucin
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3
Q

Chronic quiescent/treated ulcerative colitis state of mucosa?

A

red, granular, thinned/atrophied

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4
Q

Acute active ulcerative colitis inflammation occurs where?

A

Lamina propria - increased chronic inflammation

Lumen of glands/crypt abcesses - increased acute inflammation

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5
Q

One local complication of ulcerative colitis?

A

pancolitis of 8-10+ years increases cancer risk

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6
Q

80% of ulcerative colitis cases have what history?

A

chronic, quiescent with infrequent relapse

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7
Q

Polyps of the colon can be what two types?

A
  1. non-neoplastic hyperplastic

2. neoplastic

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8
Q

Two signs of Peutz-Jegher syndrome?

A
  1. multiple GI hamartomatous polyps

2. perioral pigmentation

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9
Q

Peutz-Jegher sydnrome associated with what risk of cancer? (8)

A 
40% lifetime risk of:
GI:
1. Gastric
2. small intestine
3. pancreas
4. colon
Reproductive:
5. testicular
6. ovary
7. uterus

8.lung

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10
Q

What is the biggest factor in determining risk of malignant transformation in adenomas of the colon?

A

size of polyp

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11
Q

Villous tumor of colon - malignant or benign? Typical pattern?

A

Benign. Show invasion more often than tubular pattern

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12
Q

4 properties of malignancies of colon

A
  1. poorly differentiated
  2. highly aggressive
  3. mucin producing
  4. adenocarcinomas
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13
Q

Peak incidence (age) of malignancies of colon?

A

age > 60

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14
Q

Polyp-colon cancer sequence?

A

normal mucosa –> adenoma –> adenocarcinoma

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15
Q

What has to happen to normal mucosa to change it to coloncancer?

A

multiple mutations over time

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16
Q

Greater risk of malignancy in adenocarcinoma associated with what

A

larger lesions

17
Q

Familial adenomatous polyposis age of onset? frequency?

A

childhood onset, hundreds by 30-40

18
Q

Familial adenomatous polyposis - what risk of adenocarcinoma?

A

100% risk lifetime, often by 35, nearly all by 50

19
Q

Two forms of inherited polyposis syndromes?

A

Turcot syndrome

Gardner syndrome

20
Q

Five properties of Gardener syndrome?

A 
Adenomata in colon, rectum, and small intestine
High risk of carcinomas
Osteomas of bone
Soft tissue tumors
Supernumerary teeth
21
Q

Different clinical patterns of colon malignancies results from what?

A

Different morphology

22
Q

Main clinical features of colon malignancies for…
Right
Left

A

Right: fatigue and anemia
Left: Bleeding, change in bowel habits, or cramping

23
Q

The fact that feces are mainly ____ in the right ascending colon means what for tumor size & diagnosis?

A

fluid; tumors can be large without obstruction which means late diagnosis

24
Q

Feces are mainly ____ in left colon, means what for tumor size & diagnosis?

A

solid; tumors not as large before obstruction noted, earlier diagnosis

25
Q

Right-side colon carcinomas appearance?

A

large, polypoid, exophytic

26
Q

Left-side colon carcinomas appearance?

A

annular type “napkin ring”

circumferential, small

27
Q

Malignancies of colon prognosis?

A

best 5 year survival in US (65%)

90% if localized, 13% if metastatic

28
Q

Diverticulosis cause?

A

abnormal gut motility

29
Q

Diverticulosis abnormally high intraluminal pressure cause?

A

contractility of muscularis propria

30
Q

Diverticulosis pathogenesis?

A

Herniation of the mucosa of the colon through the muscularis propria leading to outpouches of the bowel lumen and thickening of the muscularis propria

31
Q

One complication of diverticulosis?

A

Perforation of colon wall

32
Q

Acute appendicitis involves what?

A

Acute inflammation of the muscularis propria

33
Q

Malignant mesothelioma associated with what exposure?

A

asbestos

34
Q

Meckel diverticulum is what?

A

blind pouch in ileum, acts as apex of volvulus or site of acute inflammation or ulceration

35
Q

Intussusception - what valve most common site?

A

ileocecal

BHP Exam 3 (7 decks)

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