GI Pathology IV: Large Intestine Flashcards Preview

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Flashcards in GI Pathology IV: Large Intestine Deck (38)
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1
Q

True Diverticulum

A

Involves all 3 wall layers - Mekcel’s

2
Q

False Diverticulum

A

Only involves the mucosa and submucosa

3
Q

Diverticulitis

A

Inflammation of the diverticula that can cause pain

4
Q

Hernia

A

Serosal lined outputting of peritoneum - with loops of intestines trapped within the hernia sac

5
Q

What are the symptoms of ischemic bowel disease?

A
  • Sudden severe abdominal pain
  • Bloody diarrhea
  • Tenderness
  • Shock
6
Q

What is the pathogenesis of ischemic bowel disease?

A

Caused due to hypoxic injury and is worsened with the reperfusion injury

7
Q

Where is the ischemic bowel disease often the worst?

A

In water shed areas - furthest from circulation - splenic flexure

8
Q

What is the range of damage seen on the gross findings of ischemic bowel disease?

A

Can range from mucosal hemorrhage to transmural necrosis of the bowel wall

9
Q

Internal Hemorrhoids

A

They are above the pectinate line and are NOT painful

10
Q

External Hemorrhoids

A

Below the pectinate line and ARE painful

11
Q

Inflammatory Polyp (Solitary Rectal Ulcer Syndrome)

A

Sharp angle in the rectum undergoes recurrent abrasion and ulceration that leads to the formation of polyp.

12
Q

What is the histologic pattern seen with an inflammatory polyp?

A

Fibromuscular hyperplasia in the lamina propria with some inflammation present

13
Q

Juvenile Polyp

A

Most are found in children younger than 5 yrs and if solitary, then it is benign, if multiple then there is increased risk of adenocarcinoma

14
Q

Peutz-Jeghers Syndrome

A

Multiple benign hamartomas throughout the GI tract with hyper pigmentation of the lips, genitals and hands.

The polyps do NOT have malignant potential but patients are at increased risk of colorectal cancer.

15
Q

Hyperplastic Polyp

A

Asymptomatic. Look like adenomas with proliferation of mature goblet cells that pile up on each other giving it a serrated appearance.

16
Q

What are the types of Adenomatous Polyps?

A
  • Sessile

- Pedunculated

17
Q

What is the histology of sessile adenomatous polyps?

A

Villous

18
Q

What is the histology of pendunculated adenomatous polyps?

A

Tubular

19
Q

Sessile Serrated Adenoma

A

Adenomatous polyp occurring predominantly in the right colon and has malignant potential

20
Q

Adenomatous Dysplasia

A

Neoplastic epithelium which lines the glands leading to disordered cells with or without mucin production and cells have increased N/C ratio

21
Q

What is the gene mutation in Familial Adenomatous Polyposis?

A

Autosomal dominant defect in APC gene on Ch5q21

22
Q

Gardner Syndrome

A

Autosomal dominant with polyps similar to FAP but with osteomas

23
Q

Turcots Syndrome

A

Intestinal adenomas with tumors of the CNS - most have APC mutations

24
Q

Hereditary Nonpolyposis Colorectal Cancer (Lynch Syndrome)

A

Autosomal dominant mutation of DNA mismatch repair genes that will have a lower number of polyps but with cancer occurring at younger ages than sporadic cancer

25
Q

What is the function of the APC gene?

A

APC is an inhibitor of B catenin and mutation in APC will cause B catenin to accumulate and active MYC and cyclin D1 leading to the promotion of proliferation

26
Q

What cancers do mutations in the DNA mismatch repair cause?

A

HNPCC

SSA

27
Q

What cancers do mutations in APC cause?

A

FAP

Sporadic CRC

28
Q

Right Sided CRC

A

Asymptomatic for a long period of time with signs of iron deficiency anemia from ulceration and blood loss

29
Q

One what side is the colon larger?

A

Right

30
Q

Left Sided CRC

A

The narrower lumen causes tumors that lead to bowel obstruction with possible blood in the stool

31
Q

What is the most common type of rectal cancer?

A

Adenocarcinoma

32
Q

What is the most common type of anal cancer?

A

Squamous Cell Carcinoma

33
Q

Acute Appendicitis

A

Obstruction from fecal matter leads to impair blood flow and bacterial contamination with transmural inflammation that leads to RLQ pain

34
Q

What is seen on histology of appendicitis?

A

Transmural inflammation full of neutrophils

35
Q

Mucocele

A

Benign dilatation of the lumen by mutinous secretions

36
Q

Mucinous Cystadenoma

A

Proliferation of benign neoplastic cells with dilatation of the lumen by mutinous material and it may rupture

37
Q

Mucinous Cystadenocarcinoma

A

Invasion of neoplastic cells

38
Q

Pseudomyxoma peritonei

A

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

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