17-8 -- Polyps and Adenocarcinoma

Question 1

Polyps that are small elevations of mucosa WITHOUT a stalk?

Answer 1

Sessile

Question 2

Polyps that have a stalk?

Answer 2

Pedunculated

Question 3

Hamartomatous polyps increased ____ risk

Answer 3

Cancer risk increases

Question 4

2 types of Hamartomatous polyps?

Answer 4

Juvenile polyps

Peutz - Jeghers Syndrome

Question 5

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

Answer 5

Less than 5 years old

Question 6

Sporadic Juvenile polyps

Answer 6

Single polyp

Question 7

Syndromic Juvenile polyps

Answer 7

3 - hundreds of polyps

Question 8

With Juvenile polyps, what location is the most common?

Answer 8

Rectum = rectal bleeding

Question 9

What genes are mutated with syndromic Juvenile Polyps?

Answer 9

SMAD4

BMPR1A

Question 10

What other congenital malformation may be seen with Juvenile Polyps?

Answer 10

Digital clubbing

Question 11

Peutz - Jeghers Syndrome occurs between what ages?

Answer 11

10-15

Question 12

What gene is mutated with Peutz - Jeghers Syndrome?

Answer 12

STK11

Question 13

What is present with Peutz - Jeghers Syndrome?

Answer 13

Multiple hamartomatous polyps

Buccal mucosal hyperpigmentation

Question 14

What is present with Peutz - Jeghers Syndrome?

Answer 14

Multiple hamatomatous polyps

Buccal mucosal hyperpigmentation

Question 15

Peutz - Jeghers Syndrome is at risk for?

Answer 15

Many different malignancies

Question 16

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

Answer 16

APC gene

Question 17

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

Answer 17

Sporadic Adenomas

Question 18

At what age do those colorectal Adenomas present with FAP?

Answer 18

Teenager

Question 19

What else can be seen with FAP?

Answer 19

Congenital hypertrophy of retinal pigment epithelium

Question 20

Congenital hypertrophy of retinal pigment epithelium can be seen with?

Answer 20

FAP

Question 21

The ___ of polyps correlates with risk of malignancy

Answer 21

SIZE

Question 22

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

Answer 22

Colonic Adenocarcinomas

Question 23

What is the most common malignancy of the GI tract?

Answer 23

Adenocarcinoma

Question 24

What diet changes increase risk for colonic adenocarcinomas?

Answer 24

Low fiber

High carbs/fat

Question 25

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

Answer 25

ASA/NSAIDs

Question 26

What 2 genetic pathways give rise to colonic adenocarcinomas?

Answer 26

APC/Beta catenin/WNT pathway | MSI (microsatellite instability) pathway

Question 27

FAP is inherited?

Answer 27

Autosomal Dominant

Question 28

What adenoma and what adenocarcinoma present with FAP?

Answer 28

Tubular Villous Adenoma | -- Typical Adenocarcinoma

Question 29

What is impaired with MYH - associated adenocarcinoma?

Answer 29

DNA mismatch repair

Question 30

What gene is mutated with MYH - associated adenocarcinoma?

Answer 30

MYH

Question 31

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

Answer 31

Sessile, serrated adenoma | -- Mucinous adenocarcinoma

Question 32

What is impaired with Hereditary Non-polyposis colorectal cancer?

Answer 32

DNA mismatch repair

Question 33

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

Answer 33

MSH2 and MLH1

Question 34

Hereditary Non-polyposis colorectal cancer commonly affects what side?

Answer 34

Right side | ascending colon

Question 35

Hereditary Non-polyposis colorectal cancer is also known as?

Answer 35

Lynch Syndrome

Question 36

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

Answer 36

Sessile, serrated adenoma | -- Mucinous adenocarcinoma

Question 37

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

Answer 37

APC gene/ WNT pathway

Question 38

Sporadic colon cancer usually affects what side?

Answer 38

Left side

Question 39

What adenoma and what adenocarcinoma present with sporadic colorectal cancer?

Answer 39

Tubular, villous adenoma | Typical adenocarcinoma

Question 40

Proximal colon tumors usually are ____ that extend along 1 wall

Answer 40

Exophytic masses

Question 41

Do Proximal colon tumors cause obstruction?

Answer 41

NO

Question 42

Distal colon tumors are ____ lesions that produce "napkin ring" constrictions

Answer 42

Annular lesions

Question 43

Do Distal colon tumors cause obstruction?

Answer 43

YES - annular napkin ring constrictions

Question 44

Proximal and Distal colon tumors both grow into?

Answer 44

Into bowel

Question 45

Right side colon tumor symptom?

Answer 45

Iron deficient anemia

Question 46

Left side colon tumor symptom?

Answer 46

Bleeding and changes in bowel habits