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DIG: Biweekly 3 > Sos: Pathology of Large Intestine > Flashcards

Sos: Pathology of Large Intestine Flashcards

1
Q

RLQ pain
+ McBurney’s sign

A

acute appendicitis

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2
Q

Lumen obstruction > wall compression from continued mucus formation > wall necrosis > acute inflammation > perforation

A

acute appendicitis pathophys

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3
Q

pt has fever
N/V
RLQ pain

A

acute appendicitis

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4
Q
A

acute appendicitis

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5
Q

common chronic disorder involving large intestine w/ unknown cause

A

IBS

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6
Q

control sx’s of this w/ stress reduction, diet management, and healthy lifestyle choices

A

IBS

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7
Q

No histopathologic findings of this syndrome or increase chance of colorectal adenocarcinoma

A

IBS

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8
Q

chronic inflammation of GI tract resulting in permanent damage possibly leading to adenocarcinoma

A

IBD

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9
Q

2 types of IBD

A

Ulcerative colitis
Crohn’s disease

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10
Q

chronic inflammation of intestines that can lead to cancer

A

IBD

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11
Q

20s and 60s
starts in rectum and progresses to cecum in a linear fashion

A

Ulcerative colitis

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12
Q

large intestine lose haustra and contains pseudopolyps

A

Ulcerative colitis

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13
Q

normal mucosa surrounded by erosion

A

pseudopolyps

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14
Q

“lead pipe” appearance on imaging

A

ulcerative colitis

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15
Q

inflammation restricted to mucosa and submucosa

A

UC

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16
Q

contains crypt abscesses

A

UC

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17
Q

pt presents w/ LLQ abdominal pain and bloody diarrhea

A

ulcerative colitis

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18
Q

associated w/ primary sclerosing cholangitis and pANCA

A

ulcerative colitis

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19
Q

can develop toxic megacolon and adenocarcinoma if disease progresses

A

ulcerative colitis

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20
Q
A

L: normal
middle: UC
R: UC

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21
Q

lead pipe (loss of haustra)

A

ulcerative colitis

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22
Q
A

ulcerative colitis

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23
Q
A

pseudopolyp

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24
Q

2 ways to describe large intestine on histology

A

test tubes and daisy fields

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25
Q
A

test tubes (large intestine)

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26
Q
A

crypt abscess on daisy field (large intestine)

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27
Q
A

crypt abscess

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28
Q

15 to 35 yrs
lesions found anywhere on GI tract (from oral cavity to anus—->rectum sparing)

A

Crohn’s disease

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29
Q

most common site for Crohn’s disease

A

Ileum

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30
Q

least common site for Crohn’s disease

A

rectum

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31
Q

contains skip lesions and strictures

A

Crohn’s disease

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32
Q

in Crohn’s disease, wall can become so thick that mesenteric fat wraps around serosa

A

“creeping fat”

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33
Q

mucosal “cobblestone” appearance

A

Crohn’s disease

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34
Q

people with this disease can develop malabsorption w/ nutritional deficiency and fistula formation

A

Crohn’s disease

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35
Q

sx’s of this focus on RLQ abdominal pain and non-bloody diarrhea

A

Crohn’s disease

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36
Q

cobblestone mucosa

A

Crohn’s disease

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37
Q
A

string sign of Kantor (Crohn’s disease)

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38
Q
A

Crohn’s disease

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39
Q

can be associated with internal or external fistulas

A

Crohn’s disease

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40
Q

“blue balls in the wall”

A

Crohn’s disease

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41
Q

“granuloma in mucosa”

A

Crohn’s disease

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42
Q

dysplasia to adenocarcinoma by what 2 IBDs

A

UC and Crohn’s

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43
Q

C. difficile overgrowth, within days, due to antibiotic treatment during hospital stay

A

Pseudomembranous colitis

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44
Q

Symptoms include watery diarrhea, abdominal cramps/pain, fever, nausea and dehydration

A

pseudomembranous colitis

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45
Q

Rx C.diff

A

Vancomycin or Fidaxomicin

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46
Q
A

pseudomembranous colitis

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47
Q

mushroom exudate living on top of mucosa

A

pseudomembranous colitis

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48
Q
A

pseudomembranous colitis

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49
Q

Thinning and dilation of the abdominal aorta caused by smoking, diet and hypertension increasing atherosclerosis of the wall

A

Abdominal Aortic Aneurysm (AAA)

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50
Q

Atherosclerosis and increased inflammation destroys the elastic properties of the wall allowing for both dilation and obstruction

A

AAA

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51
Q

Typically asymptomatic until rupture which is often quickly fatal

Symptoms include back and naval pain, sharp extreme pain during rupture

A

AAA

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52
Q

____ can cause IMA obstruction or insufficiency

A

AAA

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53
Q
A

AAA

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54
Q

Caused by atherosclerosis or hypoperfusion commonly at the splenic flexure due to the SMA being occluded

A

Ischemic Colitis

55
Q

Sudden or gradual onset of Abdominal pain
Bright red blood in stool
Nausea/vomiting

A

Ischemic Colitis

56
Q

portal vein has huge clot

A

Ischemic colitis

57
Q
A

Ischemic colitis

58
Q

most common type of colorectal polyp that CAN become cancer

A

tubular adenoma

59
Q

common type of colorectal polyp that does NOT become cancer

A

Hyperplastic polyp

60
Q
A

hyperplastic glands (polyp)

61
Q

polyp most often found in rectosigmoid region

A

hyperplastic polyp

62
Q

Due to lack of apoptosis of cells at the surface of the glands causing cells to push into the lumens of the glands appearing sawtooth in pattern

A

hyperplastic polyp

63
Q
A

hyperplastic polyp

64
Q

3rd most commonly diagnosed cancer

A

colorectal cancer

65
Q

85% of colorectal cancer is due to what

A

chromosomal instability (adenoma to adenocarcinoma)

66
Q

adenoma to adenocarcinoma following genetic mutations

A

colorectal cancer

67
Q
A

tubular adenoma

68
Q
A

tubular adenoma

69
Q

forms from a stalk

A

tubular adenoma

70
Q

25% risk of malignant potential

A

Tubulovillous adenoma

71
Q
A

tubulovillous adenoma

72
Q

40% risk of malignant potential

A

Villous Adenoma

73
Q

can be polyps (15%) or sessile (85%)

A

villous adenoma

74
Q
A

Villous Adenoma

75
Q

Right?

A

Villous Adenoma

76
Q
A

villous adenoma

77
Q

90% of adenomas will have ____ mutations

A

APC

78
Q

what gene mutation would be identified in these cells if they show a POLYP?

A

APC

79
Q

APC to KRAS to ____ mutation for carcinoma

A

p53

80
Q

what is the most common mutation in this LESION

A

p53

81
Q

uncontrolled cell growth without differentiation

A

APC mutation

82
Q

system stays on; TF’s constantly being produced for cell growth and can migrate or metastasize

A

KRAS mutation

83
Q

most common mutation in carcinomas

A

p53 mutation

84
Q

triggers both mitochondrial and death receptor induced apoptotic pathways

A

p53

85
Q

cancer cell survives if _____ is mutated

A

p53

86
Q

these make up 96% of the neoplasms for colorectal cancer

A

adenocarcinomas

87
Q

commonly tested for colorectal cancer recurrence

A

carcinoembryonic antigen (CEA)

88
Q

elderly patient with iron deficiency anemia, blood in stool; what to rule out

A

colorectal carcinoma

89
Q

Feces is reshaped to “pencil-thin” in descending colon due to what

A

adenocarcinoma

90
Q

apple core sign

A

adenocarcinoma

91
Q
A

colon mass

92
Q
A

metastatic lymph nodes

93
Q
A

normal colon

94
Q
A

adenocarcinoma

95
Q
A

adenocarcinoma

96
Q
A

cancer going all the way into fat (high stage)

97
Q
A

neural invasion (painful)

98
Q

what to stain for adenocarcinoma

A

IHC: cytokeratin

99
Q

No polyps present or polyps at early age before cancer;
Autosomal dominant, family member with colon cancer before age of 50

A

Lynch syndrome

100
Q

due to mutations in DNA repair genes

A

Lynch syndrome

101
Q

Increased risk of cancer of uterus and ovaries, gastrointestinal tract, urinary tract and kidneys

A

Lynch syndrome

102
Q

60% risk of uterine cancer by 70 yrs

A

Lynch syndrome

103
Q

80% risk of colorectal cancer by 70 yrs

A

Lynch syndrome

104
Q

autosomal dominant disorder characterized by colorectal cancer due to APC mutation

A

familial adenomatous polyposis (FAP)

105
Q

1000s of polyps identified, usually start to develop in their teens

A

Familial adenomatous polyposis (FAP)

106
Q

teeth and soft tissue tumors associated with FAP

A

Gardner syndrome

107
Q

APC, MLH1, PMS2 mutations

A

Turcot syndrome

108
Q

FAP w/ CNS tumors

A

Turcot syndrome

109
Q

hamartomatous polyps
pigmentation of lips and tongue area

A

Peutz-Jeghers syndrome

110
Q
A

Peutz-Jeghers syndrome

111
Q

left?

A

Peutz-Jeghers syndrome

112
Q

elderly
most common vascular malformation of the intestines

A

Angiodysplasia

113
Q
A

Angiodysplasia

114
Q

intestines

A

angiodysplasia

115
Q

innervated by parasympathetic NS and made of smooth muscle

A

internal anal sphincter

116
Q

under conscious control
made of skeletal muscle

A

external anal sphincter

117
Q

The inability to correctly tighten and relax the pelvic floor muscles to have a bowel movement

A

Pelvic Floor Dysfunction

118
Q

can have urine or stool leakage
age contributes to this

A

pelvic floor dysfunction

119
Q

best position to defecate

A

squatting

120
Q

below pectinate line (aka dentate line)
painful and itchy

A

external hemorrhoids

121
Q

above pectinate line
painless but pressure

A

internal hemorroids

122
Q

tears in mucosa around anus

A

fissures

123
Q

blood in stool think what

A

fissures
hemorrhoids
scope for cancer or IBD

124
Q

above pectinate line receive ____innervation and not painful

A

visceral

125
Q

below pectinate line receive ___innervation and are painful

A

somatic

126
Q

tear in anal mucosa (fissure) area innervated by what nerve

A

Pudendal

127
Q

artery and vein supplying area above pectinate line

A

superior rectal a and v

128
Q

superior rectal a. is branch of what

A

IMA

129
Q

artery and vein supplying area below pectinate line

A

inferior rectal a and v

130
Q

inferior rectal a. is a branch of what

A

internal pudendal a.

131
Q

anal warts associated with HPV

A

Condyloma acuminata

132
Q

most common cancer of anus often found in advanced stage in older people

A

anal SCC

133
Q

risk factor for anal SCC

A

HPV

134
Q

anal wart

A

Condyloma

DIG: Biweekly 3 (12 decks)

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