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GI Nelson > Part 3 GI > Flashcards

Part 3 GI Flashcards

1
Q

What is lymphocytic colitis often seen with?

A

Autoimmune disorder (Celiac sprue)

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2
Q

What is the presentation of lymphocytic colitis?

A

Increased lamina propria
Chronic inflammation (plasma cells)
Increased intraepithelial lymphocytes
Surface epithelium damage

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3
Q

What is collagenous colitis often seen with?

A

Autoimmune disorder (Celiac sprue)

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4
Q

What is the presentation of collagenous colitis?

A

A band of subepithelial collagen in addition to the presentation of lymphocytic colitis

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5
Q

What drugs can cause drug induced enterocolitis?

A

NSAIDs
Chemo
Antibiotics (cause pseudomembranous colitis d/t C. diff)

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6
Q

What is Irritable Bowel Syndrome (IBS)?

A

Chronic, relapsing abdominal pain/discomfort/habits with NO known causative agent

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7
Q

What characterizes sigmoid diverticulitis?

A

Inflammation of one of the multiple diverticula in the sigmoid colon

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8
Q

What causes multiple diverticula to form in the sigmoid colon?

A

Elevated intra-luminal pressure

Exaggerated peristaltic contractions + low fiber diet –> increased intra-luminal pressure

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9
Q

What are the symptoms of sigmoid diverticulitis?

A 
Usually asymptomatic, but:
Lower GI bleed
Lower abdominal pain
Intermittent cramping
Fever
Change in bowel habits
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10
Q

An otherwise healthy young adult comes in with bloody stool, pain with defecating, and alternates between diarrhea and constipation. What is the likely diagnosis?

A

Solitary rectal ulcer syndrome

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11
Q

What is seen on microscopy of solitary rectal ulcer syndrome?

A

Fibromuscular hyperplasia of the lamina propria
Inflammation and ulceration
Reactive crypt hyperplasia

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12
Q

What is the clinical significance of an inflammatory polyp?

A

Associated with:
Solitary rectal ulcer syndrome
Ulcerative colitis
Crohn’s disease

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13
Q

What is the morphology of inflammatory polyps?

A

Anywhere in GI tract

Hamartomatous polyp

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14
Q

What is clinical difference between sporadic juvenile (retention) polyps and juvenile polyps?

A

Non-sporadic indicates an increased risk for GI tract adenocarcinomas…mutations in SMAD4 (TGFb pathway) and BMPRIA (a kinase)

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15
Q

What is the morphology of juvenile polyps?

A

Occurs in colon…usually rectum
Usually solitary
Hamartomatous polyp

Children < 5yo

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16
Q

What is the significance of Peutz-Jeghers polyps?

A

There is a mutation in a tumor suppressor gene (LKB1/STK11)…increased risk of CRC

17
Q

What is the morphology of Peutz-Jehgers polyps?

A

Multiple polyps with mucocutaneous hyperpigmentation (mouth, lips, hands, genitals)

Usually in small intestine

18
Q

What are the features of Peutz-Jeghers polyps?

A 
Pedunculate polyps (long stemmed)
Children present with GI bleeding and intussusception
19
Q

What is the significance of hyperplastic polyps?

A

Usually not malignant…need to distinguish from sessile serrated adenomas and serrated adenomas

20
Q

What are some things to know about hyperplastic polyps?

A

Most common type of adult colonic polyp…left colon/rectum
Small (<0.5cm)
Singular or multiple

21
Q

What is the clinical significance of adenomatous polyps?

A

They are benign, but are precancerous…need to remove

22
Q

What is one feature that may indicate that an adenomatous polyp is malignant?

A

More villous

Villous = vill-ain-ous

23
Q

What are some morphological features of adenomatous polyps?

A

Dysplastic glandular proliferation

Usually anywhere in the colon

24
Q

What is the clinical significance of sessile serrated adenoma?

A

Precursor to adenocarcinoma

25
Q

What are some features of sessile serrated adenoma?

A

Attached with a flat base
Lack the adenomatous epithelium of the conventional adenoma
Found in right colon

26
Q

What are the features of Familial Adenomatosis Polyposis (FAP)?

A

Autosomal dominant
100% risk of colorectal adenocarcinoma
Lots of polyps
Hypertrophy of retinal epithelium (might just be in Gardner’s)

27
Q

What the features of Lynch syndrome?

A

Mutations in MMR proteins
Rarely have lots of polyps
Associated with many other cancers

28
Q

What are the features of Gardner’s syndrome?

A

FAP + osseous and soft tissue tumors

Desmoid tumors, osteomas, epidermal cysts, dental abnormalities, thyroid tumors

29
Q

What are the features of Turcot syndrome?

A

FAP + malignant CNS tumor

GI Nelson (11 decks)

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