Rubin's Colon Flashcards
“defective relaxation and peristalsis of rectum and distal sigmoid colon, segmental absence of ganglion cells”
Hirschsprung disease
What is hirschsprung disease associated with?
Down syndrome
Where is the myenteric plexus located?
between the inner circular and outer longitudinal layers of muscularis propria
Where is submucosal (meissner) located?
in the submucosa and regulates blood flow, secretion and absorption
Symptoms of hirschprung disease?
delayed meconium passage and vomiting i the neonate, constipation and abd distention
Treated by surgery
“arrested development of the causal region of the gut in the first 6 months of fetal life”
anorectal megacolon
Pseudomembranous colitis usully follows…
antibiotic treatment
“outpouching of mucosa and submucosa through the muscularis propria”
colonic divertisulosis
What part of the colon does diverticulosis usually affect?
Sigmoid colon
“inflammation at the base of the diverticulum that results from retained fecal matter”
diverticulitis
Possible complications of diverticulosis?
Rectal bleeding
Diverticulitis
Fistula
“full thickness inflammation of the intestinal wall with knife-like fissures”
Crohn disease
Which area is most affected by Crohn disease?
Terminal ileum
Gross appearance of Crohn disease?
cobblestone mucosa, creeping fat, strictures
What are the complications of crohn disease?
Malabsorption with nutritional deficiency, calcium oxalate stones, fistula formation, carcinoma
“chronic superficial inflammation of the colon and rectum, you see mucosal/ submucosal ulcers”
ulcerative colitis
Where in the GI tract does ulcerative colitiss begin?
begins in the rectum and progresses to the cecum
Of crohn disease and ulcerative colitis, which has LLQ pain and which has RUQ pain?
Crohn–> RUQ
Ulcerative colitis–> LLQ
Name 2 complications of ulcerative colitis?
psuedopolyps, toxic megacolon and carcinoma
Symptoms of ulcerative colitis?
rectal bleeding, chronic diarrhea
Name 3 extraintestinal manifestations of ulcerative colitis?
sclerosing cholangitis, pANCA +, joint problems
“inflammatory disorder characterized by chronic watery diarrhea and thickened subepithelial collagen band”
collagenous colitis
“infiltration of damaged colonic epithelium by lymphocytes but lacks collagen tube”
Lympocytic colitis
“aquired malformations of mucosal and submucosal capillary beds”
angiodysplasia
Where does angiodysplasia usually arise?
cecum and right colon (due to high wall tension)
Most common site of ischemic colitis?
splenic flexure
What is the most common cause of ischemic colitis?
atherosclerosis of the SMA
“dilated venous channels of the hemorrhoidal plexus”
hemorrhoids
“raised protrusion of colonic mucosa”
colonic polyps
What are the 2 most common cause of colonic polyps?
Hyperplastic and adenomatous polyps
Which type of colonic polyps are premalignant?
adenomatous
Name the 3 types of adenomatous polyps? Which is more common?
Tubular (more common)
Villous (higher risk of malignant trasnformaiton)
Tubulovillous
3 mutations seen in adenoma- carcinoma transformation?
APC mutation and k-ras mutation (increased risk for polyp formation
p53 mutation and increased expression of COX (progress to carcinoma)
“small, sessile mucosal protrusions with exaggerated crpt architecture”
hyperplastic polyps
“AD disorder characterized by 100’s to 1000’s of adenomtous colonic polyps”
Familial adematous polyposis (FAP)
What mutation is inherited in FAP?
APC mutation
What is gardener syndrome?
FAP + osteomas
What is turcot syndrome?
FAP + malignant tumors of the CNS
“sporadic, hamartomatous (benign) polys that arises in children (
Juvenile polyps
“multiple juvenile polyps in the stomach and colon”
juvenile polyosis
“hamartomatous (benign) polyps throughout the GI tract and mucocutaenous hyperpigementation on lips, oral mucos and genital skin”
Peutz- Jeghers syndromes
Peutz- Jeghers syndromes puts individuals at an increased risk for which types of cancers?
colorectal, breast, gynecologic
Adenocarcinoma of the colon and rectum mainly arises from…
adenomatous polysps
“inherted mutation in DNA mismatch repair enxymes that increases risk for colorectal cancer, ovarian and endometrial cancers”
HNPCC
Colonic carcinoma is associated with an increased risk for which type of infection?
S. bovis endocarditis
Tumors of the anal canal are mainly….
epidermoid carcinomas
“due to chronic use of laxatives lipofushin like pigment”
Melaosis coli
