Pathoma: Colon (1) Flashcards

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1
Q

The disease that presents with defective peristalsis and relaxation of the rectum is associated with what congenital disorder?

A

Down syndrome (the disease described is Hirschsprung’s)

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2
Q

True or false: you need Meissner’s plexus for peristalsis.

A

False. Meissner’s plexus (also called the submucosal plexus) is involved in secretion of mucus and regulation of blood flow. Auerbach’s plexus in the muscularis propria controls peristalsis.

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3
Q

Why is a suction biopsy necessary for a diagnosis of Hirschsprung’s?

A

Because in a normal biopsy you only get the mucosa. You need to suction to suck up deeper layers and see if there are enteric ganglia present.

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4
Q

Which layers get pushed out in diverticula?

A

Mucosa and submucosa push through the muscularis propria

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5
Q

The most common location for diverticula is __________.

A

the sigmoid (typically where vasa recta pass through the muscularis propria)

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6
Q

Three things can result from diverticula: ________________.

A
  • hematochezia
  • fistula (between the bladder or anything)
  • diverticulitis
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7
Q

What is angiodysplasia?

A

An acquired malformation of the mucosal and submucosal capillary bed; induced by stress; often occurs on the right side and can lead to hematochezia

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8
Q

_____________ leads to dilation of thin-walled blood vessels throughout the GI tract.

A

Hereditary hemorrhagic telangiectasia

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9
Q

The most common cause of ischemic colitis is _____________.

A

atherosclerosis of the superior mesenteric artery

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10
Q

______________ pain improves with defecation.

A

Irritable bowel syndrome

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11
Q

Polyps are raised ______________.

A

colonic mucosa

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12
Q

The most common type of colonic polyp has a ___________ appearance on microscopy and usually arises in the ____________ colon. What malignant potential does it have?

A

serrated; left; none (this is hyperplastic polyp)

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13
Q

______________ polyps are premalignant.

A

Adenomatous

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14
Q

APC mutation by itself does not induce malignant transformation. However, combined with _________ mutations, a polyp will form. Lastly, ___________ and __________ mutations can lead to malignancy.

A

KRAS; p53; increased COX

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15
Q

Why is aspirin protective against colon cancer?

A

Cyclooxygenase production is usually necessary in the most common adenoma-carcinoma sequence, so inhibiting COX with aspirin (irreversibly) slows progression.

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16
Q

Why are all polyps removed during colonoscopy?

A

Because you can’t tell the difference between a hyperplastic (benign) polyp and an adenomatous (premalignant) polyp through the colonoscope

17
Q

Which pattern of growth –sessile or pedunculated – is more concerning?

A

Sessile

18
Q

True or false: tubular histology is more worrisome than villous histology.

A

False. Villous is the villain.

19
Q

FAP with osteomas and ______________ present in Gardner syndrome.

A

fibromatosis