135b Colonic disorder histo Flashcards Preview

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Flashcards in 135b Colonic disorder histo Deck (31):
1

large intestine histo

perpendicular tubules extending to muscularis mucosae with a lot of goblet cells (fewer absorption cells than small intestine)

some lymhoid nodules

2

colon main fxn

absorption of water
transport of fecal mater

3

Pseudomembraneous colitis (PMC) - what is it? what causes it?

necrotic epi cells with acute inflammatory (PMNs) cells and fibrinous material

caused - antibiotic --> C. Diff + any other colitis

4

color of PMC

creamy yellow plaque - may be diffuse or patchy

5

C. Diff appearance? what histo appearance can it cause in the colon? how?

gram + rod

pseudomembranes via toxins --> damage epi/endo cells --> inflammation

6

ulcerative colitis - where does it start?

rectum (crohn's usually doesn't affect rectum)

can progress to the entire colon in a continuous fashion

7

idiopathic inflamm bowel disease - types (2)?

what increases risk for both?

ulcerative colitis

crohn's disease

family hx (genetic factor) + environmental action

8

ulcerative coloitis - what does it affect?

mucus membrane inflammation only (crohn's is transmural)

9

UC presenting age

3rd decade

10

smoking risk for UC and Crohn's

increases Crohn's risk

decreases UC risk

11

UC vs Crohn's - which one is continuous?

UC

Crohn's is discontinuous (skip, cobblestones)

12

UC vs Crohn's - which involves rectum always?

UC

13

UC vs Crohn's - which never involves terminal ileum?

UC
Crohn's 60% + anal lesions

14

UC vs Crohn's - which is transmural inflammation?

crohn's - linear/knife like

UC - mucous inflammation

15

UC vs Crohn's - which involves strictures and fistulas?

Crohn's

16

UC vs Crohn's- which never has granulomas?

UC

Crohn's present 50%

17

UC vs Crohn's - which has crypt abscess and pseudopolyps?

UC

18

complications of UC?

hemorrhage
toxic megacolon
cancer

19

neoplastic colon polyps - types and location? what is the most important factor for risk of cancer progession?

tubular adenoma - descending colon

villous adenoma - rectum

villotubular adenoma

size is most important factor (>1 cm = bad)

20

cancer/dysplasia - high risk for UC patients?

onset in childhood
pancolitis
duration of disease > 10 years

21

what is the colitis cancer?

mucinous/signet cell carcinoma?

aggressive

22

familial polyposis (FAP) - cause

germ line mutation of APC (Gatekeeper)

23

Adenocarcinoma of colon and rectum - risk factors?

familial polyposis

large adenomas

UC

Crohn's

24

familial polyposis (FAP) - appearance

> 100 polyps/adenomas in colon and rectum

25

familial polyposis (FAP) - when do polyps appear? symtoms? cancer?

24

34

39

26

Adenocarcinoma of colon and rectum - diet risk? genetics?

high fat diet + genetics

27

what inhibits aging, decreases cancer?

25% reduction in caloric intake

28

cancer - genetics?

yes,

29

lynch syndrome - hereditary nonpolyposis colorectal cancer -- genetics?

AD - mutation in BRAF (mutation repair) --> microsatellite instability ?

30

where do most colon carcinomas present?

75% in sigmoid and distal

almost all adenocarcinomas

31

how do you monitor patients with colon carcinoma?

Carcinoembryonic antigen (CEA) is good to monitor for metastasis and recurrence