CH10 - Gastrointestinal Pathology Flashcards Preview

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Flashcards in CH10 - Gastrointestinal Pathology Deck (345)
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271

What are the complications for colonic diverticula?

1. Rectal bleeding (hematochezia) 2. Diverticulitis 3. Fistula

272

What is diverticulitis due to?

obstructing fecal material

273

How does diverticulitis present?

with appendicitis-like symptoms in the left lower quadrant

274

What is the relationship between colonic diverticula and a fistula?

Inflamed diverticulum ruptures and attaches to a local structure.

275

What does the colovesicular fistula present with?

air (or stool) in urine

276

What is angiodysplasia?

Acquired malformation of mucosal and submucosal capillary beds

277

How does angiodysplasia usually arise?

in the cecum and right colon due to high wall tension

278

How does rupture in angiodysplasia classically present?

as hematochezia in an older adult.

279

What is hereditary hemorrhagic telangiectasia?

Autosomal dominant disorder resulting in thin-walled blood vessels, especially in the mouth and GI tract

280

What does rupture in hereditary hemorrhagic telangiectasia present as?

presents as bleeding.

281

What is ischemic colitis?

Ischemic damage to the colon, usually at the splenic flexure, watershed area of superior mesenteric artery (SMA)

282

What does ischemic cholitis present with?

postprandial pain and weight loss; infarction results in pain and bloody diarrhea.

283

What is irritable bowel syndrome?

Relapsing abdominal pain with bloating, flatulence, and change in bowel habits (diarrhea or constipation) that improves with defecation

284

What is irritable bowel syndrome classically seen in?

middleaged females

285

What is irritable bowel syndrome related to?

disturbed intestinal motility; no identifiable pathologic changes

286

What may improve the symptoms of irritable bowel syndrome?

Increased dietary fiber may improve symptoms.

287

What are colonic polyps?

Raised protrusions of colonic mucosa

288

What are the most common types of colonic polyps?

hyperplastic and adenomatous polyps

289

What are hyperplastic polyps due to?

hyperplasia of glands; classically show a serrated appearance on microscopy

290

What is the most common type of polyp and where does it usually arise?

Hyperplastic polyps and it usually arises in the left colon (rectosigmoid)

291

Can hyperplastic polyps result in cancer?

No its benign, with no malignant potential

292

What are adenomatous polyps due to?

neoplastic proliferation of glands

293

What is the 2nd most common type of colonic polyp?

Adenomatous polyps

294

Can andenomatous polyps lead to cancer?

Benign, but premalignant, it may progress to adenocarcinoma via the adenoma-carcinoma sequence

295

What is the adenoma-carcinoma sequence?

it describes the molecular progression from normal colonic mucosa to adenomatous polyp to carcinoma.

296

What is APC?

APC (adenomatous polyposis coli gene)

297

What do mutations in the APC lead to?

either sporadic or germline mutations increase risk for the formation of polyp.

298

Mutations of what leads to increased risk for polyp progression to carcinoma?

APC, k-ras and p53

299

How does k-ras mutation affect polyps?

leads to formation of polyp

300

What is the effect of p53 mutation and polyps?

p53 mutation and increased expression of COX allow for progression to carcinoma; aspirin impedes progression from adenoma to carcinoma.