Pathology

Question 1

What types of polyps are seen in ulcerative colitis?

Answer 1

Inflammatory polyps

Question 2

Benign neoplastic polyps (pre-malignant) are classified how?

Answer 2

Tubular, tubulovillous, villous adenomas

Question 3

How are pedunculated and sessile polyps different and which is more worrysome?

Answer 3

pedunculated look like mushrooms growing
Sessile grow more like coral on a shelf without a stem

sessile growth is more worrysome especially with villous histology

Question 4

Compare colon cancer tumors of the left and right side of the large intestine

Answer 4

Left: sigmoid and rectum. Infiltrate the intestine circumferentially producing the napkin ring lesion (apple core lesion on barium X-ray). Present with decreased stool caliber, lower left quadrant pain, and blood streaked stool.

Right: Growth as a fungating masses or ulcerated, shallow like craters. Present with Fe deficiency anemia (occult bleeding) and vague pain. In the elderly someone with Fe deficiency anemia has colorectal cancer until proven otherwise.

Question 5

Most adenocarcinomas release what glycoprotein into circulation, why is this unusual?

Answer 5

Carcinoembryonic Ag (CEA), strange b/c normally produced by fetal intestines

Not used for early detection b/c other non specific intestinal inflammations can elevate it. Used to asses treatment response or detect recurrence.

Question 6

How do cholesterol gallstones form?

Answer 6

They are formed in bile supersaturated with cholesterol which typically occurs in an obese person who secretes large amounts. The cholesterol, bile acids, and lecithin form water soluble micelles only if the three are in appropriate concentrations, if the ratio is altered stones can form. Other causes are a decrease in bile acids or phospholipids (lecithin), and bile stasis.

Question 7

What are some risk factors for cholesterol gallstones?

Answer 7

4F’s

Fat, forty, female, and fertile