GI 2 Flashcards
Ulcerative colitis affects what?
Rectal mucosa, can expand to entire colon
Active acute pattern of ulcerative colitis - six manifestations?
PACHED
Pseudopolyps Abcess in crypts Confluence Hemorrhage Edema, lymphoid Depletion of goblet cells & mucin
Chronic quiescent/treated ulcerative colitis state of mucosa?
red, granular, thinned/atrophied
Acute active ulcerative colitis inflammation occurs where?
Lamina propria - increased chronic inflammation
Lumen of glands/crypt abcesses - increased acute inflammation
One local complication of ulcerative colitis?
pancolitis of 8-10+ years increases cancer risk
80% of ulcerative colitis cases have what history?
chronic, quiescent with infrequent relapse
Polyps of the colon can be what two types?
- non-neoplastic hyperplastic
2. neoplastic
Two signs of Peutz-Jegher syndrome?
- multiple GI hamartomatous polyps
2. perioral pigmentation
Peutz-Jegher sydnrome associated with what risk of cancer? (8)
40% lifetime risk of: GI: 1. Gastric 2. small intestine 3. pancreas 4. colon Reproductive: 5. testicular 6. ovary 7. uterus
8.lung
What is the biggest factor in determining risk of malignant transformation in adenomas of the colon?
size of polyp
Villous tumor of colon - malignant or benign? Typical pattern?
Benign. Show invasion more often than tubular pattern
4 properties of malignancies of colon
- poorly differentiated
- highly aggressive
- mucin producing
- adenocarcinomas
Peak incidence (age) of malignancies of colon?
age > 60
Polyp-colon cancer sequence?
normal mucosa –> adenoma –> adenocarcinoma
What has to happen to normal mucosa to change it to coloncancer?
multiple mutations over time
Greater risk of malignancy in adenocarcinoma associated with what
larger lesions
Familial adenomatous polyposis age of onset? frequency?
childhood onset, hundreds by 30-40
Familial adenomatous polyposis - what risk of adenocarcinoma?
100% risk lifetime, often by 35, nearly all by 50
Two forms of inherited polyposis syndromes?
Turcot syndrome
Gardner syndrome
Five properties of Gardener syndrome?
Adenomata in colon, rectum, and small intestine High risk of carcinomas Osteomas of bone Soft tissue tumors Supernumerary teeth
Different clinical patterns of colon malignancies results from what?
Different morphology
Main clinical features of colon malignancies for…
Right
Left
Right: fatigue and anemia
Left: Bleeding, change in bowel habits, or cramping
The fact that feces are mainly ____ in the right ascending colon means what for tumor size & diagnosis?
fluid; tumors can be large without obstruction which means late diagnosis
Feces are mainly ____ in left colon, means what for tumor size & diagnosis?
solid; tumors not as large before obstruction noted, earlier diagnosis
Right-side colon carcinomas appearance?
large, polypoid, exophytic
Left-side colon carcinomas appearance?
annular type “napkin ring”
circumferential, small
Malignancies of colon prognosis?
best 5 year survival in US (65%)
90% if localized, 13% if metastatic
Diverticulosis cause?
abnormal gut motility
Diverticulosis abnormally high intraluminal pressure cause?
contractility of muscularis propria
Diverticulosis pathogenesis?
Herniation of the mucosa of the colon through the muscularis propria leading to outpouches of the bowel lumen and thickening of the muscularis propria
One complication of diverticulosis?
Perforation of colon wall
Acute appendicitis involves what?
Acute inflammation of the muscularis propria
Malignant mesothelioma associated with what exposure?
asbestos
Meckel diverticulum is what?
blind pouch in ileum, acts as apex of volvulus or site of acute inflammation or ulceration
Intussusception - what valve most common site?
ileocecal
