17-8 -- Polyps and Adenocarcinoma Flashcards

1
Q

Polyps that are small elevations of mucosa WITHOUT a stalk?

A

Sessile

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2
Q

Polyps that have a stalk?

A

Pedunculated

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3
Q

Hamartomatous polyps increased ____ risk

A

Cancer risk increases

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4
Q

2 types of Hamartomatous polyps?

A

Juvenile polyps

Peutz - Jeghers Syndrome

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5
Q

Juvenile polyps can be sporadic or syndromic. At what age do they usually present?

A

Less than 5 years old

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6
Q

Sporadic Juvenile polyps

A

Single polyp

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7
Q

Syndromic Juvenile polyps

A

3 - hundreds of polyps

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8
Q

With Juvenile polyps, what location is the most common?

A

Rectum = rectal bleeding

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9
Q

What genes are mutated with syndromic Juvenile Polyps?

A

SMAD4

BMPR1A

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10
Q

What other congenital malformation may be seen with Juvenile Polyps?

A

Digital clubbing

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11
Q

Peutz - Jeghers Syndrome occurs between what ages?

A

10-15

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12
Q

What gene is mutated with Peutz - Jeghers Syndrome?

A

STK11

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13
Q

What is present with Peutz - Jeghers Syndrome?

A

Multiple hamartomatous polyps

Buccal mucosal hyperpigmentation

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14
Q

What is present with Peutz - Jeghers Syndrome?

A

Multiple hamatomatous polyps

Buccal mucosal hyperpigmentation

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15
Q

Peutz - Jeghers Syndrome is at risk for?

A

Many different malignancies

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16
Q

What gene is mutated with Familial Adenomatous Polyposis (FAP)?

A

APC gene

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17
Q

With FAP, there are hundreds - thousands polyps. What do those polyps look like?

A

Sporadic Adenomas

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18
Q

At what age do those colorectal Adenomas present with FAP?

A

Teenager

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19
Q

What else can be seen with FAP?

A

Congenital hypertrophy of retinal pigment epithelium

20
Q

Congenital hypertrophy of retinal pigment epithelium can be seen with?

A

FAP

21
Q

The ___ of polyps correlates with risk of malignancy

A

SIZE

22
Q

Colonic Adenomas are neoplastic polyps. What do they usually turn into?

A

Colonic Adenocarcinomas

23
Q

What is the most common malignancy of the GI tract?

A

Adenocarcinoma

24
Q

What diet changes increase risk for colonic adenocarcinomas?

A

Low fiber

High carbs/fat

25
Q

What common medications may lower the risk of colonic adenocarcinomas due to the (-) of COX2?

A

ASA/NSAIDs

26
Q

What 2 genetic pathways give rise to colonic adenocarcinomas?

A

APC/Beta catenin/WNT pathway

MSI (microsatellite instability) pathway

27
Q

FAP is inherited?

A

Autosomal Dominant

28
Q

What adenoma and what adenocarcinoma present with FAP?

A

Tubular Villous Adenoma

– Typical Adenocarcinoma

29
Q

What is impaired with MYH - associated adenocarcinoma?

A

DNA mismatch repair

30
Q

What gene is mutated with MYH - associated adenocarcinoma?

A

MYH

31
Q

What adenoma and what adenocarcinoma present with MYH - associated adenocarcinoma?

A

Sessile, serrated adenoma

– Mucinous adenocarcinoma

32
Q

What is impaired with Hereditary Non-polyposis colorectal cancer?

A

DNA mismatch repair

33
Q

What genes are mutated with Hereditary Non-polyposis colorectal cancer?

A

MSH2 and MLH1

34
Q

Hereditary Non-polyposis colorectal cancer commonly affects what side?

A

Right side

ascending colon

35
Q

Hereditary Non-polyposis colorectal cancer is also known as?

A

Lynch Syndrome

36
Q

What adenoma and what adenocarcinoma present with Hereditary Non-polyposis colorectal cancer?

A

Sessile, serrated adenoma

– Mucinous adenocarcinoma

37
Q

What gene/pathway is usually mutated with Sporadic colon cancer?

A

APC gene/ WNT pathway

38
Q

Sporadic colon cancer usually affects what side?

A

Left side

39
Q

What adenoma and what adenocarcinoma present with sporadic colorectal cancer?

A

Tubular, villous adenoma

Typical adenocarcinoma

40
Q

Proximal colon tumors usually are ____ that extend along 1 wall

A

Exophytic masses

41
Q

Do Proximal colon tumors cause obstruction?

A

NO

42
Q

Distal colon tumors are ____ lesions that produce “napkin ring” constrictions

A

Annular lesions

43
Q

Do Distal colon tumors cause obstruction?

A

YES - annular napkin ring constrictions

44
Q

Proximal and Distal colon tumors both grow into?

A

Into bowel

45
Q

Right side colon tumor symptom?

A

Iron deficient anemia

46
Q

Left side colon tumor symptom?

A

Bleeding and changes in bowel habits