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Systems Pathology II > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

Canker sore AKA

A

Aphthous ulcer

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2
Q

What is a painful ulceration of the oral mucosa and/or pharynx that has white exudate with a red rim

A

Aphthous ulcer

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3
Q

Cause and treatment of aphthous ulcers

A

Idiopathic (non contagious)

Self limiting for 7-10 days (recur)

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4
Q

What is behcet disease

A

Aphthous ulcers everywhere from oral cavity into esophagus

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5
Q

Cold sores, fever blisters, heroatis stomatitis are AKA

A

Herpes simplex virus

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6
Q

How do most people with herpes simplex virus acquire its

A

As a childhood HSV infection

**most (80%) are asymptomatic

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7
Q

What percentage of adults are HSV carriers

A

60%

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8
Q

What is advanced HSV infection called

A

Acute hermetic gingiovostomatitis

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9
Q

What structure is the HSV carried in

A

Trigeminal ganglion (CN V)

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10
Q

What is re-activated HSV (after dormancy) called

A

Recurrent hermetic stomatitis

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11
Q

Herpes simplex 1 vs herpes simplex 2

A

Herpes simplex 1 = MC orofacial

Herpes simplex 2 = MC genital

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12
Q

What type of vesicles are associated with HSV

A

Grouped vesicles about 1-3mm

That burn, tingle and/or itch

May cause HA, pharyngitis, fever/malaise in serious cases

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13
Q

What is it called if HSV spreads to the CNS

A

Herpesviral encephalitis

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14
Q

Herpesviral encephalitis is MC caused by

A

HSV 1

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15
Q

Oral thrush is AKA

A

Candidiasis

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16
Q

Thrush is caused by what fungus

A

Candida albicans

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17
Q

Thrush usually affects what structures

A

Tongue
Cheeks
Gums
Tonsils

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18
Q

Gray/white pseudomembranes with underlying erythema are characteristic of what pathology

A

Oral candidiasis (thrush)

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19
Q

What three opportunistic types of patients is thrush commonly found in

A
  • decreased immune status
  • broad spectrum antibiotics
  • diabetes
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20
Q

Differential Dx for thrush

A

Leukoplakia

Oral CA

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21
Q

Leukoplakia is similar to thrush but has what other defining characteristic

A

White overgrowth

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22
Q

With is a fibroma oral proliferative lesion

A

Nodular mass along bite line

Usually following chronic irritation (hyperplasia and fibrosis)

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23
Q

Is an oral fibroma a tumor?

A

Nope! it’s a “reactive growth”

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24
Q

What is the “pregnancy tumor”

A

Pyogenic granuloma

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25
What is a red/purple hemangioma on the gingiva usually found in pregnant women and children
Pyogenic granuloma
26
Do pyogenic granuloma’s have pus ?
NO!! Remember this is weirdly named... no pus or even granuloma tissue (it’s actually a hemangioma)
27
Treatment for pyogenic granuloma
Remove irritant or surgical removal
28
What is a raised, white patch that can’t be scraped off and is dx via exclusion
Leukoplakia
29
Who is most likely to get leukoplakia
Males (2x) aged 40-70 years old
30
What are the risks that often lead to leukoplakia
Tobacco, alcohol, candidiasis | Inflammation
31
What percentage of leukoplakia are pre-cancerous and what type of CA
25% Squamous cell carcinoma (oral cancer)
32
What is a red, velvety oral lesion with irregular borders
Erythroplakia
33
Who is most likely to get erythroplakia
Males aged 40-70
34
Who is more rare and aggressive - leukoplakia or erythroplakia
Erythroplakia is both more rare and aggressive
35
What is the main risk causing erythroplakia
Tobacco (irritants)
36
What percentage of erythroplakia turn into oral CA and what type?
More than 50% Squamous cell carcinoma
37
Sites of _______ usually cause oral CA along with ________ gene mutation
Dysplasia TP53
38
__________ are 95% of cases of oral CA
Squamous cell carcinoma
39
What stage is oral CA usually dx in and what is the treatment
Usually dx in advanced stage Treatment = excision
40
What pathology? - oropharyngeal pain/dysfunction - multiple tumors common - poor prognosis
Squamous cell carcinoma
41
Risks for squamous cell carcinoma
Alcohol Tobacco Older than 30 years old HPV-16
42
What is a raised firm lesion (plaque) that can be whitish-gray or erythematous (red) with irregular borders and possible ulceration
Oral squamous cell carcinoma
43
MC and 2nd MC places for oral squamous cell carcinoma
MC = Ventral (inferior) tongue 2nd MC = Floor of mouth
44
What type of CA may develop atop a background of leukoplakia or erythrolakia
Oral squamous cell carcinoma
45
What local areas of invasion or metastasis may oral squamous cell carcinoma travel to
Cervical nodes (MC) Mediastinal nodes Lungs Liver
46
What type of CA is associated with HPV 16 associated with and in what two areas
Oral squamous cell carcinoma Base of tongue and tonsillar crypts
47
Are primary salivary gland pathologies common or rare
Rare
48
What type of antibodies are associated with salivary glands
IgA | Remember that IgA is commonly found near the body orifices
49
What salivary gland is most commonly effected by pathologies
Parotid gland
50
What is xerostomia
Dry mouth due to decreased saliva production
51
Dysphasia and dysarthria along with a tongue that may fissure or ulcerate is associated with
Xerostomia (dry mouth)
52
Xerostomia may be a risk for
Dental caries (cavities) and candidiasis
53
What is sjogren syndrome
Autoimmune attack on salivary and lacrimal glands
54
What is sialadenitis
Inflammation and enlargement of salivary glands
55
What is the most common viral cause of sialadenitis
Mumps virus infection
56
What is the most common bacterial cause of sialadenitis
Staph aureus
57
Symptoms of mumps virus infection in pediatrics and adults
Pediatrics = self limited Adults = pancreatitis and orchitis (testicular inflammation)
58
What are two risks of staph aureus infection of the salivary glands
Dehydration or obstruction
59
What is a mucocele
When saliva collects within a tissue (salivary gland) and becomes an inflamed cyst May cause ductal obstruction
60
What area(s) do mucoceles usually form in
Lower lip | Postprandial
61
What is the trend between salivary gland size and likelihood of CA
The larger the gland, the lower the CA risk
62
Are salivary gland neoplasms common or rare
Rare (<2% tumor Dx)
63
Who do salivary gland neoplasms MC occur in
Females 60-80 years old
64
What % of salivary gland neoplasms occur in which glands
75% parotid 10% submandibular 15% in sublingual and minor salivary glands
65
What % of salivary gland neoplasms are malignant in each of the glands
25% parotid 40% submandibular 75% sublingual and minor salivary glands
66
What is a painless and encapsulated benign tumor full of mixed tissue found in the parotid gland What percentage are cancerous
Pleomorphic adenoma 10% —> CA
67
What is an aggressive, invasive and affixed tumor found in the parotid gland
Carcinoma ex pleomorphic adenoma
68
Where is zenker’s diverticulum found
Just superior to upper esophageal sphincter
69
Lower pharyngeal outpouching due to increased pressure in the pharynx is known as
Zenker’s diverticulum
70
Zenker’s diverticulum is AKA
Pharyngoesophageal diverticulum
71
What is it called when a bolus accumulates in zenker’s diverticulum
Halitosis
72
What condition are these symptoms associated with Uncoordinated swallowing Cricopharyngeus muscle spasm Dysphagia, regurgitation and aspiration
Zenker’s diverticulum
73
What does achalasia mean
Failure to relax
74
What is the triad associated with esophageal achalasia
Incomplete LES relaxation Increased LES tone Esophageal aperistalsis
75
Bird beak sign is associated with
Esophageal achalasia
76
Dysphagia, regurgitation, chest pain that may be described as heart burn are associated with
Esophageal achalasia
77
What is the MC type of achalasia
Primary achalasia
78
Primary achalasia is caused by
Loss of inhibitory innervation to the LES | Idiopathic
79
Secondary achalasia is caused by
A co morbidity that impairs LES function such as Chagas’ disease Irradiation, diabetes, polio Inflammation near auerbach’s plexus
80
Esophageal varices can be caused by
Portal venous congestion Cirrhosis from alcoholic liver disease or hepatic schistosomiasis
81
90% of liver cirrhosis cases are caused by
Alcoholic liver disease
82
Inflamed esophageal mucosa
Esophagitis
83
Esophagitis may be caused by
GERD Chemicals Infections
84
What is the MC cause of esophagitis
GERD
85
Odynophagia
Painful swallowing Assoc. with esophagitis
86
Dysphagia
Difficulty swallowing Assoc. with esophagitis
87
Infectious esophagitis is MC in what type of patients
Immunosupressed / debilitated
88
Candida esophagitis is MC in what type of patients
Advanced HIV/AIDS
89
Viral esophagitis is MC in what type of patients
Following infection with HSV or CMV
90
Dysphagia, heart burn, “sour brash” taste in mouth are symptoms associated with
GERD
91
Risk factors for GERD
``` Obesity Alcohol Smoking Increased gastric volume Hiatal hernia Pregnancy Age greater than 40 ```
92
What can cause chemical esophagitis
``` Tobacco Alcohol Pill induced Hot liquids Acidic foods Irradiation Chemotherapy ```
93
What microbes can cause infectious esophagitis
Candida esophagitis (fungal) HSV, CMV (viral)
94
Infectious esophagitis MC develops following
An ulcer
95
What is a Mallory Weiss tear
Esophageal laceration Longitudinal at GE junction
96
What type of esophageal laceration Forceful vomiting Hematemsis Uppper GI bleeds
Mallory Weiss tear
97
What type of esophageal laceration is MC
Mallory Weiss tear
98
Which esophageal laceration has most favorable prognosis
Mallory Weiss tear
99
What is boerhaave’s syndrome
Complete penetration of esophageal wall
100
When the stomach protrudes into the thorax due to widened esophageal hiatus
Hiatal hernia
101
MC type of hiatal hernia
Axial AKA sliding “Bell shaped dilation”
102
What type of hiatal hernia Separate portion of the stomach protrudes and patient is prone to strangulation or obstruction
Non-axial AKA rolling
103
What type of hiatal hernia mimics GERD
Non axial AKA rolling
104
What is Barrett esophagus
Esophageal metaplasia where squamous cells of the distal esophagus turn into goblet columnar cells
105
Who is most likely to get Barrett esophagus
Caucasian males aged 40-60 who are obese and/or have a family hx
106
Complications of Barrett esophagus
Esophageal adenocarcinoma Ulceration and strictures
107
Red velvety mucosa that may have bands or “tongues” of the distal esophagus may indicated what condition
Barret esophagus
108
3 types of esophageal tumors
Leiomyoma Adenocarcinoma Squamous cell carcinoma
109
What is a leiomyoma
Benign smooth muscle tumor(s) of the esophagus that can cause dysphagia and/or localized pain
110
MC type of esophageal tumor in USA
Adenocarcinoma
111
Esophageal metaplasia/dysplasia of the distal 1/3 of the esophagus that can cause dysphagia and odynophagia as well as vomiting, cachexia, fatigue and weakness in advanced cases
Adenocarcinoma
112
MC worldwide esophageal tumor
Squamous cell carcinoma
113
Which esophageal tumor is related to GERD
Adenocarcinoma
114
Which kind of esophageal tumor Diffuse flat or raised lesions (exophytic) with possible ulceration
Adenocarcinoma
115
Which esophageal tumor is MC in rural/underdeveloped areas and is 6x MC in African Americans rather than caucasians
Squamous cell carcinoma
116
What part of the esophagus do squamous cell carcinomas MC affect
Middle 1/3
117
Napkin ring deformity (strictures) with possible fistula is assoc with which esophageal tumor
Squamous cell carcinoma
118
What are the prognoses for adenocarcinoma and squamous cell carcinoma tumors of the esophagus with lymphatic mets
Adenocarcinoma - early lymphatic mets - poor prognosis but not the worst (25% at 5 years) SCC - very poor!! - <10% at 5 years
119
What causes hemorrhage of stomach tissue
Mucosal ulceration
120
What is coffee grounds hematemesis
Blood + stomach acid Upper GI bleeding
121
What is melena and what is it caused by
Black tarry feces Upper GI bleeding
122
MC infection of stomach
H. Pylori
123
3 types of gastric inflammatory diseases
Acute gastritis Chronic gastritis Helicobacter pylori gastritis
124
Sudden onset of epigastric pain that is gnawing or burning Nausea, vomiting anorexia Heamtemesis and melena May be caused by NSAIDS, alcohol, smoking, physical trauma, irradiation or chemotherapy
Acute gastritis
125
What is the condition called when acute gastritis results in an ulcer and hemorrhage
Acute erosive hemorrhagic gastritis
126
Less intense but prolonged epigastric pain Nausea and upper abdominal discomfort Usually no hematmesis May be caused by H. Pylori, increased age and/or other stressors
Chronic gastritis
127
Chronic gastritis results in greater risk for
Gastric adenocarcinoma (5x) Peptic ulcer disease
128
Usually asymptomatic risks include poor childhood sanitation and hygiene And is associated with carcinogenic dysplasia and metaplasia What type of gastritis
Helicobacter pylori gastritis
129
What type of dysplasia and metaplasia is helicobacter pylori gastritis associated with
Gastric adenocarcinoma (MC) MALT lymphoma
130
What condition Small, shallow ulcerations of the stomach and duodenum Results in nausea and coffee ground hematemesis Follows gastric/duodenal ischemia that may be due to hypotension or reduced GI blood flow Heals within few days/weeks
Stress related mucosal disease (acute peptic ulcerations)
131
Causes of stress related mucosal disease
Severe physiologic stress (shock, sepsis, head injury or other trauma, burns) High doses of NSAIDs Intracranial disease (vagus nerve)
132
What condition Antibodies form against parietal cells and intrinsic factor MC effects elderly females Chronic gastritis causes gastric atrophy Anemic features
Autoimmune gastritis (autoimmune strophic gastritis)
133
Complication of autoimmune gastritis
Complicates erythropoiesis - pernicious anemia (no IF—> no B12–> less RBCs) - megaloblastic anemia (RBCs larger than normal)
134
What condition Solitary “punched out” ulceration Patient has pin point pain MC proximal duodenum 2nd MC gastric antrum Hemorrhage present but won’t see in stool
Peptic ulcer disease
135
Multifactorial risks of PUD
Increased acidity is ulcerogenic NSAIDs H pylori
136
Gastric vs. duodenal PUD
Duodenal - posprandial relief (Dairy) then pain returns in 1-3 hrs Gastric - worse postprandial (after eating) Shared features: - eating influences pain - relieved by alkaline substance or vomiting - worse at night
137
Mass projecting from gastric mucosa
Gastric polyp
138
3 types of gastric polyps
Inflammatory and hyper plastic polyps Fundic gland polyp Gastric adenomas
139
What type of gastric polyp is precancerous
Gastric adenoma
140
MC type of gastric polyp and size/risk factors
Inflammatory and hyper plastic 1 cm Age 50-60, H pylori
141
2nd MC type of gastric polyp and risk factors
Fundic gland polyp PPI use or FAP (Proton pump inhibitors)
142
Least MC type of gastric polyp and risk factors
Gastric adenoma MALES, increased age 1/3 —> adenocarcinoma (precancerous)
143
Fecal occult blood vs. frank blood
Fecal occult - not obvious - smaller amounts of blood - gastric adenoma, gastric CA, PUD Frank blood - colon, rectum, anus (lower GI) - obvious blood - high volume of bleeding - colorectal CA, ulcerative colitis, Crohn’s disease,
144
MC type of stomach CA
Adenocarcinoma (glandular) from dysplasia adenomas
145
Signet ring cell is associated with what condition
Stomach CA (MC adenocarcinoma)
146
Who MC gets stomach CA
Males age 55 with chronic inflammation (H pylori, EBV) Japan 20x!
147
Symptoms of advanced stomach CA
``` Gastritis Altered bowels Nausea/anorexia Weight loss Hemorrhage Anemia ```
148
Pyloric stenosis
Hypertrophy or narrowing of pyloric sphincter
149
Dx shortly after birth (1-5 weeks) Hyperperistalis and projectile vomiting that is not bile stained Sunken eyes, lack of tears, sunken fontanels, dark or lack of urine, failure to thrive
Pyloric stenosis
150
Risks of pyloric stenosis
Family hx Caucasian males Turner syndrome
151
Types of mechanical intestinal obstructions
Hernia Adhesions Intussusception Volvulus
152
Hernia
Abdominal wall defect that allows a segment of intestine to protrude and cause inflammation
153
MC type of intestinal hernia
Inguinal hernia MC in males
154
What type of mechanical intestinal obstruction Swelling and localized aching with exercise No pain with palpating but enlarge via valvsalva
Hernia
155
What type of mechanical intestinal obstruction Chronic inflammation that leads to visceral fibrosis due to tumors, surgical scarring or infection May cause two areas of intestines to stick together
Adhesions
156
What type of mechanical intestine all obstruction Proximal segment telescopes into a distal segment Causes frank blood MC in infants and at junction of ileum and cecum
Intussusception
157
Classic triad of intussusception
Vomiting Abdominal pain Blood in stool
158
What type of mechanical intestinal obstruction Twisting of a loop of bowel that causes frank blood MC in sigmoid colon and cecum Ischemia
Volvulus
159
Congenital outpouching of the small intestine approx 2 inches long MC asymptomatic
Meckel diverticulum
160
MC malformation of GI tract
Meckel diverticulum
161
MC cause of acute abdomen
Acute appendicitis
162
Early periumbilical/epigastric discomfort Later RLQ Leukodyosis MC in male adolescents and young adults
Acute appendicitis
163
Acute abdomen can be caused by
``` Acute appendicitis Ectopic pregnancy Salpingitis Pancreatitis Peptic ulcer disease Colorectal CA Diverticulitis Cholecystitis Ischemic bowel disease IBS IBD AAA Ruptured spleen Etc... ```
164
appendix tumors
MC Carcinoid - neuroendocrine CA - rarely adenocarcinoma **possible site for mucocele
165
Tenesmus
Sensation of inadequate bowel movement
166
Risks for sigmoid diverticulitis
Age > 60 Refined foods Constipation Decreased fiber
167
What arteries are assoc with ischemic bowel disease
Superior mesenteric Inferior mesenteric Celiac
168
What types of ischemia are assoc. with ischemic bowel disease
Hypotension or occlusion Mucosal infarction Thrombosis Arterial embolism
169
Non occlusive ischemic bowel disease can be caused by
Heart failure AAA hemorrhage Shock Dehydration Vasoconstrictive meds
170
How does chronic ischemic bowel disease mimic IBD
Insidious Episodic blood diarrhea
171
Symptoms of acute ischemic bowel disease
Severe abdominal pain and rigidity Nausea, vomiting Frank blood in stool
172
2 types of angiodsyplasia
Vascular lesions | Dilated hemorrhoidal venous plexus
173
Submucosal and mucosal vessels are tortuous and dilated MC cecum but can also occur in ascending colon Melena or fecal occult blood Follows mechanical stress (constipation)
Vascular angiodysplasia
174
MC GI vascular disorder
Dilated hemorrhoidal venous plexus (angiodysplasia)
175
2 types of hemorrhoids
Internal = upper anorectal line External = lower anorectal line
176
Asymptomatic or very painful Perianal itching (pruritus) Frank blood in stool Due to straining from constipation or severe venous congestion due to liver cirrhosis MC effects adults 50+ or females in advanced pregnancy
Hemorrhoids
177
diarrheal diseases are AKA
Enterocolitis | Coloenteritis
178
Malabsorption in US caused by
Celiac disease Crohn’s disease Pancreatic insufficiency (in cystic fibrosis patients)
179
Steatorrhea
Excessive fat in feces Bulky, frothy, greasy, yellow/gray diarrhea
180
Dysentery
Bloody diarrhea following infection (painful)
181
Features of malabsorption
Weight loss / muscle wasting Borboygmus (stomach rumbling) and flatulence Abdominal distension Anorexia
182
Consequences of malabsorption
``` Vitamin deficiencies Iron deficiency anemia Osteopenia Tetany Amenorrhea, impotence, infertility Hyperkeratosis, edema Neuropathies ```
183
Immune mediated reaction to gliadin Villous atrophy Crypt hyperplasia Increased risk of intestinal adenocarcinoma
Celiac disease
184
What antibodies are involved in celiac disease
IgA = against tissue transglutaminase IgG = against delaminated gliadin (stays in blood 3-6 months after exposure)
185
Gliadin + glutenin
Gluten
186
Dermatitis herpetiformis
Celiac disease manifesting on the skin Similar appearance to herpes vesicles
187
Cycles of mucosal injury, malnutrition and inflammation
Environmental enteropathy
188
Hypotheses regarding environmental enteropathy
Autoimmune = villus flattening (lymphocyte attack on small intestine) Infectious = because responds to antibiotics but no microbe found
189
Who gets environmental enteropathy
Children age 2-3 Either living in tropics or a recent visit
190
Acquired reduced or absent lactase brush border enzyme Bloating, cramps, gas, diarrhea 30 min postprandial Dx via breath hydrogen test
Lactose intolerance
191
Microbial infection —> inflammation —> diarrhea Abdominal pain Urgency/incontinence Perianal discomfort Hemorrhage Bacterial, viral, protozoal microbes
Infectious enterocolitis
192
Acute onset of vomiting and rice water diarrhea Gram neg bacteria Caused by fecal-oral contaminated H20
Cholera
193
Microbe that causes cholera
Vibrio cholerae
194
Enterotoxgenic E. Coil microbe is MC cause Caused by fecal-oral contaminated food or water Unformed or loose stools within 24 hours Acute onset with recovery in 7-10 days Fever, nausea/vomit, abdominal cramps
Traveler’s diarrhea
195
MC enteric pathogen in US
Campylobacter jejuni
196
Campylobacter jejuni microbe Enterotoxins —> dysentery and fever May initiate reactive arthritis or GBS
Campylobacter enterocolitis
197
Snakes lizards and salamanders may carry what pathogen to cause what condition
Salmonella Acute self limited colitis
198
Acute self limited colitis can be caused by what pathogens
Campylobacter Shigella E. coli Salmonella
199
Campylobacter vs. E. coli acute self limited colitis
Campylobacter = neutrophils, crypt abscess E. coli = neutrophils, normal crypts
200
Clostridium difficult is AKA
Pseudo membrane colitis
201
Enterotoxins —> inflammation and necrosis Pseudomembranes in large intestine composed by dead/injured enteropathy, leukocytes, inflammatory exudate ``` Fever Diarrhea Dehydration Abdominal pain Leukocytosis ```
Pseudomembranous colitis (C diff)
202
1/2 of all gastroenteritis cases Infection—>inflammation—>diarrhea Effects stomach or small intestine Nausea Vomiting Diarrhea Malabsorption
Viral gastroenteritis
203
Two pathogens that cause viral gastroenteritis
Rotavirus = children | Norovrius = adults Contaminated food/H2O
204
Two types of parasitic diseases that affect >1/2 world population
Ascaris lumbricoides Giardia lamblia
205
What parasitic disease Large nematode up to 14 inches 1/6 of world population infected but asymptomatic ``` Symptoms: Diarrhea Malnutrition Stunted growth Spread to stool and lungs ```
Ascaris lumbricoides
206
Beaver fever
Giardiasis
207
What parasitic disease Flagellated protozoa that resists cold and chlorine Fecal oral 1-2 week latency Alters small intestinal enzymes Malabsorption diarrhea Anorexia Cramps
Giardia lamblia
208
Altered bowel habits with NO INFLAMMATION
IBS
209
IBS mostly effects
Females with psychological stress | Dx of exclusion
210
Features of IBD
``` Abnormal host immune response Abdominal pain Genetic predisposition Diarrhea Intestinal epithelial dysfunction Blood in stool Relapsing episodes of inflammation Weight loss ```
211
Types of IBDs
Crohn’s disease | Ulcerative colitis
212
Crohn’s vs. ulcerative colitis
Crohn’s - entire GI tract but MC ileum - trans mural Ulcerative colitis - rectum, distal colon - mucosa and submucosa - frank blood in stool
213
Regional inflammation and fissures lead to fibrosis and narrowing T cell mediated reaction but no known cure Melena Mild episodic diarrhea Fever Abdominal pain (RLQ) Skip lesions, non-caseating granulomoas, ulcerations, strictures, fissures, creeping mesenteric fat —> cobblestone appearance Terminal ileum, ileocecal valve, cecum
Crohn’s disease
214
Superficial inflammation and mucosal ulcerations Always begins in rectum and moves proximally Pseudopolyps No granuloma or skip lesions Not transmural Smoking is inhibitory Assoc. with toxic megacolon Stool is grossly bloody and mucous Lower abdominal cramping Frank blood in stool Relapsing episodes (“attacks”) Risk for adenocarcinoma
Ulcerative colitis
215
Types of colon polyps and tumors
- hamartomas (min risk, mature cells, benign) - inflammatory (min risk, blood in stool) - hyperplastic (resemble dysplasia, sigmoid colon or rectum) - adenomas (benign neoplasm)
216
MC colon polyp
Adenoma If dysplasia —> adenocarcinoma
217
Benign tumor Onset around age 40 FOB, possible iron deficient anemia Malignant until proven otherwise CA rare if <1cm
Colonic adenomas
218
100+ adenomas Autosomal dominant CA syndrome (APC gene) Teen onset - 100% develop CA before age 30 FOB, anemia
Familial adenomatous polyposis
219
Hereditary cancer syndrome - inherited mutations later DNA mismatch repair - autosomal dominant Adenocarcinoma without traditional adenomatous polyps Risk for various CAs at younger onset - colorectal and SI - gastric - brain - skin - endometrial (MC!) - ovarian - uterine
Lynch syndrome
220
Lynch syndrome AKA
Hereditary nonpolyposis colorectal CA (HNPCC)
221
MC malignancy of GI tract
Colorectal adenocarcinoma
222
Mets of colorectal CA is most commonly to
Liver But also to nodes, lungs, marrow
223
MC location for small intestine CA
Duodenum
224
___ are adenocarcinomas and ___ carcinoids in small intestine cancer
Half and half
225
Congenital aganglionic megacolon
Hirschsprung disease
226
Lack of neurologic ganglia in rectum (may involve sigmoid colon) Due to defective neural crest cell migration Constipation Inflammation Peritonitis/sepsis Bowel obstruction More severe in females Familial association
Hirschsprung disease
227
How is hirschsprung disease dx
Failure to pass meconium (48 hrs) Severe dilation of proximal bowels

Systems Pathology II (2 decks)

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