Miscellaneous Flashcards
What are these genes associated with?
LKB1
SMAD4
HLA-DR1
NOD2
LKB1: Peutz jegher
SMAD4: juvenile polyposis
HLA-DR1: extra intestinal manifestation of IBD
NOD2: pouchitis
What is Heyde syndrome?
Aortic stenosis breaks platelets due to shear force and results in von willebrand type of situation. Bleeds from small bowel angioectasias.
Treatment is aortic valve replacement
BMPR1A?
juvenile polyposis
P16 and ki 67?
Hpv
Endoglin (CD105)
Hemorrhoids
Periodic acid-Schiff stain (+)?
Perianal pagets
SMAD4
Juvenile polyposis
Scimitar sign
sacral defect through which the dura protrudes
Meningocele
Chromosome 5
APC. Fap
5q21
CHRPE
congenital hyperplasia of the retinal pigment epithelium (CHRPE)
Associated with FAP. Not pathognomonic but if four or more then most likely FAP
When should you repeat cscope?
< 10 mm hyperplastic polyps in rectum/sigmoid
1-2 tubular adenomas, < 10 mm
3-10 tubular adenomas
> 10 tubular adenomas
1 or more tubular adenomas >10 mm
1 or more villous adenomas
Adenomas with high grade dysplasia
< 10 mm hyperplastic polyps in rectum/sigmoid
10 yrs
1-2 tubular adenomas, < 10 mm
5 yrs
3-10 tubular adenomas
3 yrs
> 10 tubular adenomas
< 3 yrs
1 or more tubular adenomas >10 mm
3 yrs
1 or more villous adenomas
3 years
Adenomas with high grade dysplasia
What is a favorable ki67 index?
<3%
How many mitosis are acceptable for local excision of rectal NET?
<2
G1 (low-grade tumors) have less than 2 mitoses per hpf and less than 3% Ki-67 index;
G2 (intermediate grade) tumors have 2 to 20 mitoses per hpf or 3% to 20% Ki-67 index;
G3 (high grade) tumors have more than 20 mitoses per hpf or more than 20% Ki67 index
chromogranin and synaptophysin
Gold standard for carcinoid
When should you repeat colonoscopy?
Sessile serrated polyp(s) < 10 mm with no dysplasia
Sessile serrated polyp(s) ≥10 mm
Sessile serrated polyp with dysplasia
Traditional serrated adenoma
Serrated polyposis syndrome
Sessile serrated polyp(s) < 10 mm with no dysplasia
5 yrs
Sessile serrated polyp(s) ≥10 mm
3 yrs
Sessile serrated polyp with dysplasia
3 yrs
Traditional serrated adenoma
3 yrs
Serrated polyposis syndrome
1 yr
KRAS wildtype vs KRAS mutation
Effectiveness of cetuximab vs bevacizumab?
The use of bevacizumab is not limited by KRAS or other mutations
Cetuximab is INEFFECTIVE in patients with the KRAS/NRAS/BRAF mutation
Right-sided cancers have worse overall survival and derive less benefit from cetuximab even without KRAS mutations
Combination therapy with cetuximab and bevacizumab is not recommended due to increased toxicity and poor oncologic outcomes such as progression-free survival and overall survival.
What surgery to do for anal melanoma?
thicknesses of less than 1 mm, WLE with a 1-cm margin is appropriate.
For tumor thickness between 1 and 4 mm, WLE with a 2-cm margin should be performed if the anal sphincter complex in not affected.
In lesions greater than 4 mm, APR is suggested.
Lymphatic drainage of the rectum
Upper
Middle
Lower 1/3
Upper: IMA, para aortic
Middle: IMA, para aortic
Lower 1/3: superior rectal, middle rectal, internal iliac
Cytokeratin 7
Perianal pagets
Lymphatic drainage of anal canal
Above the dentate line
Below the dentate line
Above the dentate line: mesorectal and internal iliac nodes
Below the dentate line: superficial and external iliac (deep) inguinal nodes
HMB45
melanoma
CDX2
TTF1
ISL-1
CDX2: Midgut primary NET.
TTF1: Lung primary
ISL-1: Pancreas primary
OCTN1/OCTN2
IBD5 locus on chromosome 5. Defects lead to UC
Which chromosome is Ibd1 found on?
IBD3?
16
IBD 3 is found on chromosome 6.
CARD12/NOD2
Fibrostenosing Crohn’s in SB but not colon
