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Pathology II Exam II > Colon > Flashcards

Flashcards in Colon Deck (42):
1

What percent of the lamina propria is inflammatory cells in normal colonic mucosa?

50%

2

T/F- water must cross the surface epithelium and collagen table to enter the capillaries of the superficial lamina propria

true

3

Hirschsprung disease is associated with what genetic abnormality?

Down syndrome

4

T/F- Although males get hirschsprung disease more frequently than females, females are more severely affected

true

5

A neonate presents with failure to pass meconium in the immediate postnatal period. What is most likely diagnosis?

Hirschsprung disease

6

Name 5 common causes of acute colitis

Bacterial
viral (norovirus, rotavirus, adenovirus)
Protozoal and parasitic
Toxin
Ischemic

7

Name 4 causes of chronic colitis

Ulcerative colitis, Crohn's disease
Lyphocytic colitis, collagenous colitis

8

T/F- crypt architecture is not preserved in acute bacterial colitis

False, it is preserved

9

Name 2 examples of toxin damage causing colitis

1. C. dificile (pseudomembranous colitis), most commonly after 3rd gen cephalosporin
2. Enterohemorrhagic E. Coli (fecal contamination, raw hamburger, sprouts, apples picked in pasture)

10

What is the pseudomembrane composed of?

fibrin, mucin, neutrophils

11

ichemic colitis most often occurs in older patients with vascular disease and presents with abdominal pain, nausea, vomiting, bloody stools. Where are the watershed zones where this most often occurs?

splenic flexure, sigmoid colon, rectum

12

T/F- Irritable bowel syndrome will show gross and microscopic abnormalities

False, it will be normal

13

In chronic colitis, is crypt architecture and branching preserved or distorted?

distorted and irregular crypts are signs of chronicity

14

Compare ulcerative colitis and Crohns disease

-UC: diffuse, superficial (only mucosal layer affected), colon only
-Crohns: focal (lymphoid aggregates or granulomas), transmural (mucosa through to serosa), anywhere in the GI tract (especially ileum and colon)

15

If you see a terminal ileum with a thick wall, stricture, and linear ulcer what is it most likely?

Crohn's disease

16

Does Crohn's or ulcerative colitis carry a greater risk for cancer?

Ulcerative colitis

17

The term microscopic colitis encompasses what two diseases?

-Lymphocytic and collagenous colitis
-these will appear normal endoscopically

18

T/F- in collagenous colitis you will see microscopically normal crypt architecture, increased superficial chronic inflammation of the lamina propria, increased numbers of intraepithelial lymphocytes

False, that is lymphocytic colitis

19

What will you see histologically in collagenous colitis?

A thickened, irregular subepithelial collagen layer entrapping capillaries and cells

20

Is diverticulosis related to the western diet?

yes

21

Although only 20% of patients are symptomatic for diverticulosis, what will they present with?

cramping, lower abdominal discomfort, constipation/diarrhea, distention

22

Where is the weakest spot in the muscle that allows for diverticuli to form?

where
nerves and vessels
penetrate

23

Can diverticulitis perforate?

yes

24

T/F- Inflammatory polyps are often associated with IBD, but also seen with ischemic colitis, infectious colitis, necrotizing enterocolitis

true

25

Juvenile polyps often present with rectal bleeding or prolapse of polyp through the rectum. Does polyposis syndrome increase risk of malignancy?

risk of upper and lower GI malignancies

26

For Peutz-Jeghers syndrome, what is the mode of inheritance? Symptoms? Complications?

-Autosomal dominant
-Mucocutaneous pigmentation
-polyps of the upper and lower GI tract with increased risk of carcinoma, pancreatic, breast, and ovarian carcinomas

27

Hyperplastic polyps are commonly found where? Are they malignant or benign?

-Left colon and rectum
-Benign

28

Do sessile, serrated adenomas/polyps have malignant potential? Where are they commonly found?

yes, most often on right side of colon

29

How do you distinguish a sessile serrated adenoma from a hyper plastic polyp?

Sessile serrated adenoma has normal base, hyper plastic polyp has abnormal base

30

Name three different types of adenomas

1. tubular
2. tubulovillous
3. villous

31

Are adenomas a precursor to colon cancer?

yes "These are the MAJOR precursor to colon cancer"

32

Once an adenoma passes ______ layer it becomes invasive

muscularis mucosae

33

T/F- adenocarcinoma is rare in western populations

False, VERY common in western populations and account for 3% of cancer deaths

34

Are adenocarcinomas related to dietary factors?

yes, low intake of vegetable fiber and high intake of refined carbohydrates and fat

35

Is the preclinical phase of colorectal cancer long or short?

long (10 years)

36

What lesion do the vast majority of colorectal cancers begin with?

tubular adenoma

37

T/F- The majority of colorectal adenocarcinomas are associated with familial syndromes such as FAP, HNPCC, juvenile polyposis coli

False, 90% are sporadic!
FAP: 1%
HNPCC: 5%
Juvenile Polyposis coli: 1%
IBD: 1%

38

Familial adenomatous polyposis is an autosomal dominant mutation in what gene?

APC (adenomatous polyposis coli) gene

39

How many adenomas would you find in a colon of a person with FAP?

at least 100, often more than 1000

40

T/F- colorectal adenocarcinoma will develop in 100% of untreated FAP patients

true

41

HNPCC includes lynch syndrome I and II, what is the difference?

-Lynch Syndrome I – confined to colorectum

-Lynch syndrome II – colorectal carcinoma associated with extra-colonic cancers
(Endometrium, stomach, small bowel, hepatobiliary tract, pancreas, ovary, urinary tract, brain (GBM), sebaceous neoplasms of the skin (Muir-Torre syndrome))

42

Is HNPCC autosomal dominant or recessive? What type of gene does this affect?

dominant
DNA mismatch repair gene (risk of colorectal cancer is 70% by age 70)