Rubin's Colon

Question 1

“defective relaxation and peristalsis of rectum and distal sigmoid colon, segmental absence of ganglion cells”

Answer 1

Hirschsprung disease

Question 2

What is hirschsprung disease associated with?

Answer 2

Down syndrome

Question 3

Where is the myenteric plexus located?

Answer 3

between the inner circular and outer longitudinal layers of muscularis propria

Question 4

Where is submucosal (meissner) located?

Answer 4

in the submucosa and regulates blood flow, secretion and absorption

Question 5

Symptoms of hirschprung disease?

Answer 5

delayed meconium passage and vomiting i the neonate, constipation and abd distention

Treated by surgery

Question 6

“arrested development of the causal region of the gut in the first 6 months of fetal life”

Answer 6

anorectal megacolon

Question 7

Pseudomembranous colitis usully follows…

Answer 7

antibiotic treatment

Question 8

“outpouching of mucosa and submucosa through the muscularis propria”

Answer 8

colonic divertisulosis

Question 9

What part of the colon does diverticulosis usually affect?

Answer 9

Sigmoid colon

Question 10

“inflammation at the base of the diverticulum that results from retained fecal matter”

Answer 10

diverticulitis

Question 11

Possible complications of diverticulosis?

Answer 11

Rectal bleeding

Diverticulitis

Fistula

Question 12

“full thickness inflammation of the intestinal wall with knife-like fissures”

Answer 12

Crohn disease

Question 13

Which area is most affected by Crohn disease?

Answer 13

Terminal ileum

Question 14

Gross appearance of Crohn disease?

Answer 14

cobblestone mucosa, creeping fat, strictures

Question 15

What are the complications of crohn disease?

Answer 15

Malabsorption with nutritional deficiency, calcium oxalate stones, fistula formation, carcinoma

Question 16

“chronic superficial inflammation of the colon and rectum, you see mucosal/ submucosal ulcers”

Answer 16

ulcerative colitis

Question 17

Where in the GI tract does ulcerative colitiss begin?

Answer 17

begins in the rectum and progresses to the cecum

Question 18

Of crohn disease and ulcerative colitis, which has LLQ pain and which has RUQ pain?

Answer 18

Crohn–> RUQ

Ulcerative colitis–> LLQ

Question 19

Name 2 complications of ulcerative colitis?

Answer 19

psuedopolyps, toxic megacolon and carcinoma

Question 20

Symptoms of ulcerative colitis?

Answer 20

rectal bleeding, chronic diarrhea

Question 21

Name 3 extraintestinal manifestations of ulcerative colitis?

Answer 21

sclerosing cholangitis, pANCA +, joint problems

Question 22

“inflammatory disorder characterized by chronic watery diarrhea and thickened subepithelial collagen band”

Answer 22

collagenous colitis

Question 23

“infiltration of damaged colonic epithelium by lymphocytes but lacks collagen tube”

Answer 23

Lympocytic colitis

Question 24

“aquired malformations of mucosal and submucosal capillary beds”

Answer 24

angiodysplasia

Question 25

Where does angiodysplasia usually arise?

Answer 25

cecum and right colon (due to high wall tension)

Question 26

Most common site of ischemic colitis?

Answer 26

splenic flexure

Question 27

What is the most common cause of ischemic colitis?

Answer 27

atherosclerosis of the SMA

Question 28

“dilated venous channels of the hemorrhoidal plexus”

Answer 28

hemorrhoids

Question 29

“raised protrusion of colonic mucosa”

Answer 29

colonic polyps

Question 30

What are the 2 most common cause of colonic polyps?

Answer 30

Hyperplastic and adenomatous polyps

Question 31

Which type of colonic polyps are premalignant?

Answer 31

adenomatous

Question 32

Name the 3 types of adenomatous polyps? Which is more common?

Answer 32

Tubular (more common)

Villous (higher risk of malignant trasnformaiton)

Tubulovillous

Question 33

3 mutations seen in adenoma- carcinoma transformation?

Answer 33

APC mutation and k-ras mutation (increased risk for polyp formation

p53 mutation and increased expression of COX (progress to carcinoma)

Question 34

“small, sessile mucosal protrusions with exaggerated crpt architecture”

Answer 34

hyperplastic polyps

Question 35

“AD disorder characterized by 100’s to 1000’s of adenomtous colonic polyps”

Answer 35

Familial adematous polyposis (FAP)

Question 36

What mutation is inherited in FAP?

Answer 36

APC mutation

Question 37

What is gardener syndrome?

Answer 37

FAP + osteomas

Question 38

What is turcot syndrome?

Answer 38

FAP + malignant tumors of the CNS

Question 39

“sporadic, hamartomatous (benign) polys that arises in children (

Answer 39

Juvenile polyps

Question 40

“multiple juvenile polyps in the stomach and colon”

Answer 40

juvenile polyosis

Question 41

“hamartomatous (benign) polyps throughout the GI tract and mucocutaenous hyperpigementation on lips, oral mucos and genital skin”

Answer 41

Peutz- Jeghers syndromes

Question 42

Peutz- Jeghers syndromes puts individuals at an increased risk for which types of cancers?

Answer 42

colorectal, breast, gynecologic

Question 43

Adenocarcinoma of the colon and rectum mainly arises from…

Answer 43

adenomatous polysps

Question 44

“inherted mutation in DNA mismatch repair enxymes that increases risk for colorectal cancer, ovarian and endometrial cancers”

Answer 44

HNPCC

Question 45

Colonic carcinoma is associated with an increased risk for which type of infection?

Answer 45

S. bovis endocarditis

Question 46

Tumors of the anal canal are mainly….

Answer 46

epidermoid carcinomas

Question 47

“due to chronic use of laxatives lipofushin like pigment”

Answer 47

Melaosis coli