Pathology of the small intestine II Flashcards

1
Q

what is the major cancer of the GI tract?

A

adenocarcinoma

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2
Q

familial polyposis coli increases the risk of progression to what disease?

A

adenoma

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3
Q

which condition grows in a napkin ring formation?

A

small bowel adenocarcinoma

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4
Q

what is the most common type of polyp?

A

hyperplastic

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5
Q

what is the cause of hyperplastic polyps?

A

decreased epithelial cell turnover and delayed shedding, with accumulation of mature cells on surface

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6
Q

what is the morphology of hyperplastic polyps?

A

well formed glands and crypts, lined by non-neoplastic mature goblet and absorptive cells

irregular tufting, sawtooth pattern secondary to delayed shedding

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7
Q

what are hamartomatous polyps?

A

malformations of mucosal epithelium and lamina propria

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8
Q

what is the inheritance pattern of peutz jeghers syndrome?

A

autosomal dominant

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9
Q

peutz jeghers syndrome is the result of mutation of what gene?

A

STK11

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10
Q

polyps in peutz jeghers syndrome are composed of what type of tissue?

A

smooth muscle

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11
Q

patients with peutz jeghers syndrome are at increased risk of what conditions?

A

intussusception, carcinoma

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12
Q

what physical sign is associated with peutz jeghers syndrome?

A

mucocutaneous pigmentation

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13
Q

neoplastic polyps are a precursor to what type of cancer?

A

colorectal carcinoma

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14
Q

what is the most important determinant of malignant risk for neoplastic polyps?

A

size

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15
Q

what are the four types of neoplastic polyps?

A

tubular adenoma
tubulovillous adenoma
villous adenoma
serrate adenoma

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16
Q

what is the most common neoplastic polyp?

A

tubular adenoma

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17
Q

what is the least malignant neoplastic polyp?

A

tubular adenoma

18
Q

tubular adenomas may contain what what type of cancer?

A

intramucosal carcinoma

19
Q

what constitutes invasive adenocarcinoma?

A

carcinomatous invasion of stalk of tubular adenoma

20
Q

villous adenomas have a propensity for what part of the GI tract?

A

rectum and rectosigmoid

21
Q

do villous adenomas have a stalk?

A

no

22
Q

risk of carcinoma in tubulovillous adenoma depends on what factor?

A

villous proportion

23
Q

which type of adenoma is most often symptomatic?

A

villous

24
Q

which type of malignant polyp adenoma can metastasize? why?

A

invasive adenocarcinoma

crosses muscularis muscosae

25
Q

what are the three histological conditions that must be met for adequate excision of a pedunculated adenoma?

A

adenocarcinoma is superficial - dose not approach margin of excision

no vascular or lymphatic invasion

carcinoma is not poorly differentiated

26
Q

what is the only adequate treatment for a pedunculated or sessile adenoma?

A

complete resection

27
Q

what does iron deficiency anemia in an older male indicate until proven otherwise?

A

colorectal carcinoma

28
Q

what are the different types of familial adenomatous polyposis?

A

classic
attenuated
gardner
turcot

29
Q

classic FAP is caused by mutation of what gene?

A

APC (adenomatous polyposis coli)

30
Q

what are the clinical manifestations of gardner syndrome?

A

same as FAP but with distinctive extraintestinal manifestiations

benign bone tumors in skull and mandible
epidermal cysts
unerupted and/or supernumerary teeth
increased incidence of duodenal and thyroid carcinoma

31
Q

what is turcot syndrome?

A

combination of adenomatous colonic polyposis and tumors of CNS

32
Q

what is hereditary nonpolyposis colorectal cancer? what is the hallmark pathogenesis?

A

Lynch syndrome

inherited mutations in genes that encode proteins responsible for detection, excision, and repair of errors that occur during DNA replication

leads to colorectal tumors as well as stomach, ovary, ureters, brain, skin

33
Q

what is the pathogeneis of colonic carcinogenesis?

A

DNA mismatch repair

34
Q

poorly differentiated adenocarcinoma is indicated by the presence of what cell type?

A

signet ring cell

35
Q

what does stage III colorectal adenocarcinoma indicate?

A

progression through bowel wall

36
Q

carcinoid tumors secrete what hormone?

A

serotonin

37
Q

what can be detected in the urine during carcinoid syndrome?

A

5-HIAA

38
Q

what is the most common extra-nodal site of GI lymphomas? what is the most typical cell type?

A

gut

B cell

39
Q

how do MALT lymphomas differ from nodal lymphomas?

A

MALT lymphomas are focal tumors and can be surgically resected

40
Q

what is the most common tumor of the appendix?

A

carcinoid

41
Q

mucinous cystadenomacarcinoma can lead to what condition? what is the result?

A

pseudomyxoma peritonei

mucus secreting cells fill abdomen