Small and Large Bowel III Flashcards

1
Q

What is the morphology of an inflammatory polyp?

A

Inflamed and regenerating mucosa that projects above the level of surrounding mucosa which is also ulcerated

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2
Q

What syndromes can cause inflammatory polyps? Where do they occur?

A

Caused by solitary rectal ulcer syndrome, ulcerative colitis, and crohn’s disease
Occurs anywhere in GI tract

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3
Q

What are the two ways juvenile (retention) polyps can generate?

A

Sporadically or as a result of polyposis syndrome

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4
Q

When retention polyps arise from polyposis syndrome, what is the individual at an increased risk of developing?

A

Adenocarcinoma

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5
Q

What is the microscopic morphology of a juvenile retention polyp? Gross morphology?

A

Microscopic: Multiple dilated, mucin filled crypts.
Gross: Usually rounded, smooth, unilobular with erythematous cap

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6
Q

What is the presentation of Peutz-Jeghers polyps?

A

In childhood with GI bleed and intussusception

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7
Q

What is mutated in Peutz-Jeghers syndrome?

A

Tumor suppressor gene STK11

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8
Q

What is the microscopic morphology of PJ polyps?

A

Hyperpigmentation

Smooth muscle arborizing pattern

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9
Q

What region is common to see lesions in PJS?

A

Oral

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10
Q

What is the clinical presentation of a hyperplastic polyp?

A

Single or multiple
Mostly in left colon
No worry of cancer progression

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11
Q

What is the microscopic morphology of hyperplastic polyps?

A

Serration of midportion of individual glands

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12
Q

If in the small bowel, where do adenomatous polyps most often present?

A

Duodenum

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13
Q

Where do adenomatous polyps mostly occur?

A

Colon

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14
Q

What are the two common morphologies for adenomatous polyps?

A

Sessile (attachment with flat base)

Pedunculated polyp

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15
Q

Where do sessile serrated adenomas most often present?

A

Right colon

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16
Q

What do sessile serrated adenomas turn into?

A

Adenocarcinoma

17
Q

What is the gross appearance of sessile serrated adenomas?

A

Lacks adenomatous epithelium of regular adenomas

Flat

18
Q

What is important about crypt morphology in sessile serrated adenomas?

A

Dilation of crypts

19
Q

What is the inheritance pattern of FAP?

A

Autosomal dominant

20
Q

What is mutated in Lynch syndrome?

A

MMR

21
Q

What happens to DNA with MMR mutation?

A

Accumulation of mutations in microsatellite DNA

22
Q

What is Gardner’s syndrome?

A

Desmoid tumors, dental abnormalities, thyroid tumors, osteomas, and epidermal cysts in addition to FAP

23
Q

What is Turcot syndrome?

A

Hereditary colon cancer syndrome along with CNS tumors

24
Q

Which side does MMR tend to show up on?

A

Right

25
Q

What is the clinical presentation of left sided tumors?

A

LLQ disomfort
Occult bleeding
Bowel habit changes
Cramping

26
Q

What is the clinical presentation of right sided tumors?

A

Fatigue and weakness due to iron deficiency anemia

27
Q

What is important about finding out the KRAS mutation?

A

If KRAS mutaiton, Cetuximab is not as effective

28
Q

What are risk factors for small bowel adenocarcinoma?

A

FAP
Crohn’s
Celiac disease

29
Q

What do nonfunctioning GI tract Neuroendocrine tumors present as?

A

Vague
Abdominal pain
Nausea, vomiting
Weight loss

30
Q

What GI cancer can result in Zollinger ellingson syndrome?

A

Functioning neuroendocrine tumors

31
Q

What is described as pigmentation of mucosa due to certain laxatives?

A

Melanosis coli

32
Q

What can MALT lymphoma turn into?

A

lymphomatous polyposis

33
Q

What is the morphological findings for acute appendicitis?

A

Supperative inflammation with gangrenous necrosis

34
Q

How does acute pancreatitis present?

A

Periumbilical pain that localizes to RLQ

35
Q

What are the best diagnostic tests for acute appendicitis?

A

Ultrasound and CT

36
Q

What complications can come from acute appendicitis?

A

Periappendiceal abscess
Pyelophlebitis
Portal venous thrombosis
Bacteremia, sepsis