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Gastro > GI Neoplasia II: CRC (Nichols/Jackson) > Flashcards

GI Neoplasia II: CRC (Nichols/Jackson) Flashcards

1
Q

Defn of polyp

A

Bump or nodule in the mucosa

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2
Q

result of KRAS mutation without APC mutation

A

Hyperplastic polyp

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3
Q

mass of mature, but disorganized tissue indigenous to site

A

Hamartoma

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4
Q

Is a papilloma a polyp?

A

Yes

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5
Q

What are the types of polyps with malignant potential?

A

Adenomatous

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6
Q

What are the types of polyps that do not have malignant potential

A

Hyperplastic and inflammatory

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7
Q

Inflammatory polyps-occur in long-standing ____

A

IBD

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8
Q

Is CRC more common in developed or underdeveloped counties

A

developed

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9
Q

What components in diet may be protective against CRC

A

Ca++ and folate

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10
Q

Increases risk for CRC

A 
Age and FH
IBD colitits  
Lack of exercise
Consumption of red meat
Obesity 
Smoking 
ETOH use
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11
Q

Decreases risk for CRC

A 
Multivitamins containing folic acid 
Aspirin and NSAIDs
HRT (post menopausal)
Ca++ supplement 
Selenium 
Inc fiber in diet (veggies and fruit)
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12
Q

How does CRC present in the right vs left colon

A

Left = obstructive symptoms and overt bleeding

Right: occult bleeding and anemia

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13
Q

Apple core lesion

A

Barium enema shows this in the diagnosis of CRC

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14
Q

Goals of colonoscopy

A

Locates lesions, removes polyps, and biopsies lesions

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15
Q

What determines the prognosis of CRC

A

Extent of invasion (how deep it goes)

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16
Q

Is chemo used to treat CRC?

A

Yes, but as an adjuvant in pts with + nodes

Surgery is the mainstay

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17
Q

What is the molecular/mutatio pathogenesis in CRC

A

Loss of APC → KRAS mut → loss of p53

  • *AK-53**
  • This is from First aid, ppt has more confusing/detailed pictures of this
18
Q

Defn Tumor suppressor gene vs oncogene

A

Genes that function normally in inhibition of cell growth
Vs
Activation results in uncontrolled cellular proliferation

19
Q

Tumor suppressor gene or oncogene is normally inherited

A

Tumorsuppressor gene mutation

20
Q

Mutation in Familial Adenomatous Polyposis

A

Autosomal dominat mutation in APC gene on chromosome 5q (2 hit hypothesis)

21
Q

How does FAP present

A

> 100 adenomatous polyps starting in 2md to 3rd decade

Pancolonic and always involves rectum (according to First Aid)

22
Q

Mutation in hereditary non-polyposis CRC

A

Germline mutation of DNA repair genes

23
Q

What part of the colon does HNPCC affect? FAP?

A

HNPCC: more commonly proximal
FAP: pancolonic

24
Q

How is HNPCC diagnosed?

A
  1. 1 releative with CRc < 50 yo
  2. CRC spans 2 generations
  3. 3 relatives eith HNPCC (2 must be 1st degree relatives of the first)
25
Q

What are the goals of screening for CRC?

A

Decrease mortality from CRC and prevent CRC by removing polyps

26
Q

How is fecal occult blood used to diagnose CRC

A

Put poop on card …. WIKI THIS

27
Q

What are the limitations to fecal immunochemical test?

A

Does not detect upper GU bleeding
More expensive that poop card
May require 2 stool samples

28
Q

What are the advantages to fecal immunochemical test?

A

Responds only to human Hgb
More sensitive and specific than Guiac tests
Not a colonoscopy—people don’t have to take off work and, ya know, get probed

29
Q

Helical CT reconstructed into 3D images. Studies on sensitivity and specificity have been variable. Requires bowel prep

A

Virtual colonoscopy

30
Q

What are the barriers to colon screening?

A
  1. limited acess to medical care in general
  2. bowel prep and time off work
  3. risk and expense of tests
31
Q

Major complication seen with colonoscopy

A

Perforation

32
Q

What are the types of benign adenoma polyps

A

Tubular and villous adenomas

33
Q

Diff between tubular and villous adenomas

A

Tubular are more pedunculated and villous are more sessile and have a higher risk of malignancy

34
Q

What are the types of malignant colon adenocarcinomas

A

Polypoid and annular

35
Q

Poly Exophytic Carcinoma is more common in left or right side of colon?

36
Q

Annular “napkin ring” form is more common on left or right side of colon?

A

Left colon

37
Q

What are the signs and syptoms of small bowel tumors

A

Non-specific: crampy, weight loss, nausea/vomiting, GI bleeding/anemia, Jaundice with ampullary lesions

38
Q

Colon cancer is the (1st, 2nd, 3rd, 4th, 5th, 6th, or 7th) leading cause of cancer death

39
Q

Most important risk factors for CRC

A

Age > 50 and FH

40
Q

Precursor lesion to most CRC

A

Adenomatous polyp

41
Q

The goal of screening for CRC is to

A

decrease mortality from colon cancer or to prevent colon cancer by removing adenomatous polyps

Gastro (25 decks)

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