Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MHD > Small/Large Intestine 2 > Flashcards

Small/Large Intestine 2 Flashcards

1
Q

True vs pseudo diverticulum

A

true-all three wall layers (meckel’s)

false-only mucosa and submucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diverticulosis

A
  • many diverticuli, usually in the sigmoid colon where vasa recta perforate colon
  • 50% >60 y.o
  • associated with low fiber diet
  • symptoms: vague discomfort, feeling of incomplete emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diverticulitis

A

Inflammation of diverticula

  • LLQ pain, fever, leukocytosis
  • may perforate-peritonitis, abscess formation, pneumaturia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hernias

A

serosal lined outpouching of peritoneum

  • loop of intestines becomes trapped within hernia sac
  • bowel compressed twisted in the mouth of heria, compromising blood supply-infarction-strangulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ischemic bowel disease

A 
Symptoms: 
-sudden severe abdominal pain
-tenderness
-bloody diarrhea, melanotic stools
More severe injury: shock, sepsis, death 
Causes: Acute arterial occlusion 
-Atherosclerosis
-Aortic aneurysm
-Hypercoagulable state 
-Oral Contraceptive use
-Embolization of cardiac vegetations 
Other intestinal hypoperfusion:
-cardiac failure
-shock dehydration
-vasoconstrictive drugs

Pathogenesis:
hypoxic injury
reperfusion injury

Variable degree of injury
-severity of vascular compromise
length of time of injury
-vessels affected

Watershed zones:
splenic flexure**
-ranges from mucosal hemorrhage to transmural necrosis of bowel wall

Histology:
necrotic mucosa, hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Internal Hemorrhoids

A

Above pectinate line

  • receive visceral innervation =NOT painful
  • rectal bleeding, pain, worse with defecation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

External Hemorrhoids

A

Below pectinate line

  • receive somatic innervation=PAINFUL
  • rectal bleeding, worse with defecation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 Non-neoplastic polyps of the intestine

A
  1. Inflammatory Polyp
  2. Hamartomatous (Peutz-Jeghers Syndrome)
  3. Juvenile Polyp
  4. Hyperplastic Polyp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Inflammatory Polyp

A

Solitary Rectal ulcer syndrome (rectal prolapse syndrome)

  • impaired relaxation of anorectal sphincter creates a sharp angle at anterior rectal shelf which leads to abrasion and ulceration of overlying rectal mucosa
  • polyp forms as a result of chronic cycles or injury
  • pulled into fecal stream this leads to mucosa prolapse

Histology:
-lamina propria fibromuscular hyperplasia, inflammation and erosion of epithelial hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Juvenile Polyp

A

mostly sporadic in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hamartomatous (peutz-Jeghers syndrome)

A

AD syndrome
multiple non malignant hartomas throughout GI tract
-hyperpigmented melanotic macules of mouth, lips, gentalia, hands
-polyps have no malignant potential
-but patients are at an increased risk of CRC and other malignancies (pancreas, breast, ovary, uterus, testicle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hyperplastic polyp

A

prevalence: up to 30% of people>50
- asymptomatic
- endoscopically looks similar to adenomas
- majority 50% in rectosigmoid colon
- proliferation of mature goblet cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Neoplasm small and large intestine

A
  1. adenomatous
  2. sessile serrated adenoma
  3. adenomatous dysplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adenomatous

A
  • Benign polps that are precursors to majority of colorectal adenocarcinomas
  • 50% of people older than 50 in western world
  • most clinically silent
  • .3-10cm

Gross:
pedunculated or sessile(bad)
Histology:
Tubular or villous (bad)

Risk of cancer:

  • size
  • presence of high grade dysplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

sessile serrated adenoma

A

type of adenomatous polyp occurring predominantly in the right colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Adenomatous dysplasia

A

neoplastic dysplastic epithelium

-lines the glands as hyperchromic somewhat disordered cells with or without mucin production

17
Q

Familial adenomatous polyposis

A
  • AD
  • defect: APC
  • 100-thousands polyps
  • 100% develop colorectal adenocarcinoma
  • prophylactic colectomy-but may still develop adenomas at other sites (ampulla of vater, stomach)
18
Q

Gardner Syndrome

A
  • AD
  • polyps similar to FAP but with osteomas of the mandible, skull, and long bon, epidermal cysts, desmoid tumors, thyroid tumors, and dental abnormalities
19
Q

Turcots Syndrome

A
  • Intestinal adenomas
  • tumors of the CNS
  • 2/3 have APC mutations and develop medulloblastoma
  • 1/3 have other DNA repair mutations and develop gliobasotmas
20
Q

Hereditary nonpolyposis colorectal cancer (HNPCC)

Lynch syndrome

A
  • AD
  • lower number of polyps but cancer occurs at younger ages than sporadic colon cancer
  • increase risk of cancers of endometrium, stomach, ureter, renal pelvis, bladder, pancreas, and biliary tract
  • *caused by mutation in DNA mismatch repair gene
21
Q

What pathway do is irregular in FAP and sportic CRC? What is the pathway? What side of the colon is affected?

A

APC/WNT pathway
APC is negative regulator of Beta catenin-loss of APC–>B catenin translocates to nucleus and activates genes encoding MYC and cyclin D1 which promote proliferation

1. Germline or somatic mutation of APC 
Normal colon
2. Second hit
Mucosa at risk 
3. Proto Oncogene mutation (K-RAS)
4. Homozygous loss of additional cancer suppressor genes ( p53)
adenomas
5. additional mutations, gross chromosome alteration (telomerase) 
carcinoma
22
Q

What pathway do is irregular in HNPCC and SSA? What is the pathway? What side of the colon is affected?

A

DNA mismatch repair
(about 10% are Sporadic and FAP)
-microsatellite instability in coding area or promoter region
1. germline or somatic mutation of mismatch repair gene
(MLH1, MSH2)
2. alteration of second allele
3. microsatellite instability/mutator phenotype
(sessile serrated adenoma)
4. accumulation of mutations in genes that regulate differentiation and growth and apoptosis
carcinoma

23
Q

CRC presentation

A 
retrosigmoid>ascending>descending 
-apple core lesion barium x-ray
-CEA for monitoring not screening 
peak incidence 60-79 
25% have family history
24
Q

right sided CRC

A

usually asymptomatic for long period of time

-iron deficiency anemia due to surface ulceration and blood loss

25
Q

Left sided carcinoma

A 
generally annular -narrow the lumen
-change in bowel habits or obstruction 
-blood in stool (obvious or occult)
-originating from ruptured vessels at the edge of ulceration
Napkin ring
26
Q

Rectal cancer

A

adenocarcinoma

27
Q

Anal cancer

A

Squamous cell carcinoma

-rectosigmoid most common location

28
Q

TNM cancer staging

A 
T- intraepithelial or lamina propria
T1- invading into the submucosa
T2-invading into the muscularis propria
T3- invading into the subserosal tissue
T4-invades to visceral peritoneum, other organs or perforates
29
Q

Acute Appendicitis

A

-Nausea/vomiting with periumbilical pain that localizes to RLQ
-obstruction that leads to impaired blood flow and bacterial contamination
-transmural and luminal acute inflammation
(green and yellow exudate)
Histology
-Neutrophils

30
Q

Mucocele

A

benign dilation of the lumen by mucinous secretions

31
Q

Mucinous cystadenoma

A

proliferation of benign neoplastic cells-dilation by mucinous material-may rupture

32
Q

Mucinous cystadenocarcinoma

A

invasion of neoplastic cells

33
Q

pseudomyxoma peritonei

A

distention of the peritoneal cavity by the presence of semisolid mucin and epithelial mucin producing implants and or malignant cells

MHD (81 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions