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GI Nelson > Part 4 GI > Flashcards

Part 4 GI Flashcards

1
Q

What is the typical sequence for CRC?

A

First hit (APC or MMR mutation) –> second hit (KRAS or APC mutation) –> loss of tumor suppressor

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2
Q

Where does a obstructive annular lesion usually occur?

A

Left side

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3
Q

Where does microsatellite instability (MSI) usually occur?

A

Right side

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4
Q

What is the clinical presentation of left sided CRC?

A

Cramping
Change in bowel habits
Occult bleeding

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5
Q

What is the clinical presentation of right sided CRC?

A

Iron deficiency anemia (fatigue and weakness) d/t occult bleeding

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6
Q

What are some ways to reduce the likely hood of developing CRC?

A

Screening
COX inhibitors (COX2)
MMR testing
KRAS testing

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7
Q

What medications are not effective in patients with activating K-RAS mutations? (Cormier)

A

Cetuximab

Panitumumab

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8
Q

What is the most common location of small bowel adenocarcinomas?

A

Duodenum (Ampulla of Vater)

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9
Q

What are the risk factors for developing small bowel adenocarcinoma?

A

FAP
Crohn’s Disease (dysplasia in the ileum)
Celiac disease

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10
Q

What is the general presentation of GI tract neuroendocrine tumors?

A

Crampy abdominal pain, nausea, vomiting, and weight loss

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11
Q

What is the usual presentation of a neuroendocrine tumor in the ileum/jejunum?

A 
Carcinoid syndrome (the serotonin process)
Asymptomatic...obstructive metastatic disease
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12
Q

What is the usual presentation of a neuroendocrine tumor in the colon (rare)?

A

Bulky, right-sided high grade carcinoma

Morphology similar to small cell carcinoma of the lung

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13
Q

What is the usual presentation of a neuroendocrine tumor in the rectum?

A

Polyps (<1cm)

Favorable prognosis

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14
Q

What is the usual presentation of a neuroendocrine tumor in the appendix?

A

Asymptomatic

Incidental finding

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15
Q

What is melanosis coli?

A

Associated with use of anthraceneline laxatives

Causes a brown mucosa

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16
Q

What are some features of lymphomatosis polyposis?

A

Usually small bowel

Usually B-cell

17
Q

Appendicitis?

A

Don’t over think it

18
Q

When is an appendiceal carcinoma usually benign? Malignant?

A

Benign if 2cm

19
Q

What is pseudomyxoma peritonei?

A

Term for presence of abundant mutinous material on the peritoneal surfaces

20
Q

What is condyloma accuminatum? What is it associated with?

A

Polypoid wart

HPV

21
Q

What is Anal Intraepithelial Neoplasia (AIN)?

A

Premalignant squamous dysplasia of the anal canal

22
Q

What is AIN associated with? What does it indicate in an HIV patient?

A

HPV

Invasive cancer

23
Q

What is the most common type of anal carcinoma?

A

Squamous cell carcinoma

24
Q

What is an important risk factor for developing anal carcinoma?

A

HPV (type 16)

GI Nelson (11 decks)

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