Intestinal path II 1/31

Question 1

synonyms for Crohn disease

Answer 1

terminal ileitis, regional colitis, granulomatous colitis

Question 2

Crohn

Answer 2

skip lesions, earliest lesion can be aphthus ulcer, multiple lesions can coalesce to form linear ulcers, cobblestone mucosa, fissures, creeping fat

Question 3

repeated cycles of mucosal destruction in crohn can lead to

Answer 3

distortion of mucosal architecture

epithelial metaplasia with pseudopyloric metaplasia or paneth cell metaplasia

mucosal atrophy with loss of crypts

Question 4

crohn and neoplasia

Answer 4

6x increased risk of CA

risk of EBV-associated lymphoma related to therapy

Question 5

UC and neoplasia

Answer 5

20-30x increased risk of CA

risk highest in those>10 years of disease or pancolitis

start screening 8 years after dx

inactive disease is not protective

Question 6

collagenous form of microscopic colitis

Answer 6

women 40-70

focal thickening of subepithelial collagen with increase in intraepithelial lymphocytes and mixed inflammatory cells in lamina propria

Question 7

lymphocytic form of microscopic colitis

Answer 7

marked increase in intraepithelial lymphocytes

associations with celiac sprue or other autoimmune disease

Question 8

angiodysplasia

Answer 8

malformed mucosal and submucosal vessels

most often seen in cecum and right colon usually after age of 60

could be due to interference with submucosal venous drainage–> retrograde distention

Question 9

pseudomyxoma peritonei

Answer 9

implant of mucus producing cells on peritoneum

often from appendiceal tumors

5 year survival<50%

Question 10

carcinoid tumor common locations

Answer 10

appendix>small intestine>rectum>stomach>colon

intramural or submucosal lesion with overlying mucosa that can ulcerate

tumors yellow or tan and firm

Question 11

carcinoid tumor histology

Answer 11

salt and pepper chromatin

stain with chromogranin, synaptophysin

see NE granules

Question 12

prognosis of carcinoid tumor

Answer 12

foregut=rare mets, includes stomach

midgut=aggressive,in jejunum and ileum, can invade

hindgut=appendix and colorectum, discovered incidentally, worse behavior in prox colon than in rectum, rarely mets

Question 13

clinical features of carcinoid syndrome

Answer 13

vasomotor distrubances

intestinal hypermotility

bronchoconstriction

hepatomegaly

systemic fibrosis