Sos: Pathology of Large Intestine Flashcards
(134 cards)
1
Q
RLQ pain
+ McBurney’s sign
A
acute appendicitis
2
Q
Lumen obstruction > wall compression from continued mucus formation > wall necrosis > acute inflammation > perforation
A
acute appendicitis pathophys
3
Q
pt has fever
N/V
RLQ pain
A
acute appendicitis
4
Q
A
acute appendicitis
5
Q
common chronic disorder involving large intestine w/ unknown cause
A
IBS
6
Q
control sx’s of this w/ stress reduction, diet management, and healthy lifestyle choices
A
IBS
7
Q
No histopathologic findings of this syndrome or increase chance of colorectal adenocarcinoma
A
IBS
8
Q
chronic inflammation of GI tract resulting in permanent damage possibly leading to adenocarcinoma
A
IBD
9
Q
2 types of IBD
A
Ulcerative colitis
Crohn’s disease
10
Q
chronic inflammation of intestines that can lead to cancer
A
IBD
11
Q
20s and 60s
starts in rectum and progresses to cecum in a linear fashion
A
Ulcerative colitis
12
Q
large intestine lose haustra and contains pseudopolyps
A
Ulcerative colitis
13
Q
normal mucosa surrounded by erosion
A
pseudopolyps
14
Q
“lead pipe” appearance on imaging
A
ulcerative colitis
15
Q
inflammation restricted to mucosa and submucosa
A
UC
16
Q
contains crypt abscesses
A
UC
17
Q
pt presents w/ LLQ abdominal pain and bloody diarrhea
A
ulcerative colitis
18
Q
associated w/ primary sclerosing cholangitis and pANCA
A
ulcerative colitis
19
Q
can develop toxic megacolon and adenocarcinoma if disease progresses
A
ulcerative colitis
20
Q
A
L: normal
middle: UC
R: UC
21
Q
lead pipe (loss of haustra)
A
ulcerative colitis
22
Q
A
ulcerative colitis
23
Q
A
pseudopolyp
24
Q
2 ways to describe large intestine on histology
A
test tubes and daisy fields
25
test tubes (large intestine)
26
crypt abscess on daisy field (large intestine)
27
crypt abscess
28
15 to 35 yrs
lesions found anywhere on GI tract (from oral cavity to anus---->rectum sparing)
Crohn's disease
29
most common site for Crohn's disease
Ileum
30
least common site for Crohn's disease
rectum
31
contains skip lesions and strictures
Crohn's disease
32
in Crohn's disease, wall can become so thick that mesenteric fat wraps around serosa
"creeping fat"
33
mucosal "cobblestone" appearance
Crohn's disease
34
people with this disease can develop malabsorption w/ nutritional deficiency and fistula formation
Crohn's disease
35
sx's of this focus on RLQ abdominal pain and non-bloody diarrhea
Crohn's disease
36
cobblestone mucosa
Crohn's disease
37
string sign of Kantor (Crohn's disease)
38
Crohn's disease
39
can be associated with internal or external fistulas
Crohn's disease
40
"blue balls in the wall"
Crohn's disease
41
"granuloma in mucosa"
Crohn's disease
42
dysplasia to adenocarcinoma by what 2 IBDs
UC and Crohn's
43
C. difficile overgrowth, within days, due to antibiotic treatment during hospital stay
Pseudomembranous colitis
44
Symptoms include watery diarrhea, abdominal cramps/pain, fever, nausea and dehydration
pseudomembranous colitis
45
Rx C.diff
Vancomycin or Fidaxomicin
46
pseudomembranous colitis
47
mushroom exudate living on top of mucosa
pseudomembranous colitis
48
pseudomembranous colitis
49
Thinning and dilation of the abdominal aorta caused by smoking, diet and hypertension increasing atherosclerosis of the wall
Abdominal Aortic Aneurysm (AAA)
50
Atherosclerosis and increased inflammation destroys the elastic properties of the wall allowing for both dilation and obstruction
AAA
51
Typically asymptomatic until rupture which is often quickly fatal
Symptoms include back and naval pain, sharp extreme pain during rupture
AAA
52
____ can cause IMA obstruction or insufficiency
AAA
53
AAA
54
Caused by atherosclerosis or hypoperfusion commonly at the splenic flexure due to the SMA being occluded
Ischemic Colitis
55
Sudden or gradual onset of Abdominal pain
Bright red blood in stool
Nausea/vomiting
Ischemic Colitis
56
portal vein has huge clot
Ischemic colitis
57
Ischemic colitis
58
most common type of colorectal polyp that CAN become cancer
tubular adenoma
59
common type of colorectal polyp that does NOT become cancer
Hyperplastic polyp
60
hyperplastic glands (polyp)
61
polyp most often found in rectosigmoid region
hyperplastic polyp
62
Due to lack of apoptosis of cells at the surface of the glands causing cells to push into the lumens of the glands appearing sawtooth in pattern
hyperplastic polyp
63
hyperplastic polyp
64
3rd most commonly diagnosed cancer
colorectal cancer
65
85% of colorectal cancer is due to what
chromosomal instability (adenoma to adenocarcinoma)
66
adenoma to adenocarcinoma following genetic mutations
colorectal cancer
67
tubular adenoma
68
tubular adenoma
69
forms from a stalk
tubular adenoma
70
25% risk of malignant potential
Tubulovillous adenoma
71
tubulovillous adenoma
72
40% risk of malignant potential
Villous Adenoma
73
can be polyps (15%) or sessile (85%)
villous adenoma
74
Villous Adenoma
75
Right?
Villous Adenoma
76
villous adenoma
77
90% of adenomas will have ____ mutations
APC
78
what gene mutation would be identified in these cells if they show a POLYP?
APC
79
APC to KRAS to ____ mutation for carcinoma
p53
80
what is the most common mutation in this LESION
p53
81
uncontrolled cell growth without differentiation
APC mutation
82
system stays on; TF’s constantly being produced for cell growth and can migrate or metastasize
KRAS mutation
83
most common mutation in carcinomas
p53 mutation
84
triggers both mitochondrial and death receptor induced apoptotic pathways
p53
85
cancer cell survives if _____ is mutated
p53
86
these make up 96% of the neoplasms for colorectal cancer
adenocarcinomas
87
commonly tested for colorectal cancer recurrence
carcinoembryonic antigen (CEA)
88
elderly patient with iron deficiency anemia, blood in stool; what to rule out
colorectal carcinoma
89
Feces is reshaped to “pencil-thin” in descending colon due to what
adenocarcinoma
90
apple core sign
adenocarcinoma
91
colon mass
92
metastatic lymph nodes
93
normal colon
94
adenocarcinoma
95
adenocarcinoma
96
cancer going all the way into fat (high stage)
97
neural invasion (painful)
98
what to stain for adenocarcinoma
IHC: cytokeratin
99
No polyps present or polyps at early age before cancer;
Autosomal dominant, family member with colon cancer before age of 50
Lynch syndrome
100
due to mutations in DNA repair genes
Lynch syndrome
101
Increased risk of cancer of uterus and ovaries, gastrointestinal tract, urinary tract and kidneys
Lynch syndrome
102
60% risk of uterine cancer by 70 yrs
Lynch syndrome
103
80% risk of colorectal cancer by 70 yrs
Lynch syndrome
104
autosomal dominant disorder characterized by colorectal cancer due to APC mutation
familial adenomatous polyposis (FAP)
105
1000s of polyps identified, usually start to develop in their teens
Familial adenomatous polyposis (FAP)
106
teeth and soft tissue tumors associated with FAP
Gardner syndrome
107
APC, MLH1, PMS2 mutations
Turcot syndrome
108
FAP w/ CNS tumors
Turcot syndrome
109
hamartomatous polyps
pigmentation of lips and tongue area
Peutz-Jeghers syndrome
110
Peutz-Jeghers syndrome
111
left?
Peutz-Jeghers syndrome
112
elderly
most common vascular malformation of the intestines
Angiodysplasia
113
Angiodysplasia
114
intestines
angiodysplasia
115
innervated by parasympathetic NS and made of smooth muscle
internal anal sphincter
116
under conscious control
made of skeletal muscle
external anal sphincter
117
The inability to correctly tighten and relax the pelvic floor muscles to have a bowel movement
Pelvic Floor Dysfunction
118
can have urine or stool leakage
age contributes to this
pelvic floor dysfunction
119
best position to defecate
squatting
120
below pectinate line (aka dentate line)
painful and itchy
external hemorrhoids
121
above pectinate line
painless but pressure
internal hemorroids
122
tears in mucosa around anus
fissures
123
blood in stool think what
fissures
hemorrhoids
scope for cancer or IBD
124
above pectinate line receive ____innervation and not painful
visceral
125
below pectinate line receive ___innervation and are painful
somatic
126
tear in anal mucosa (fissure) area innervated by what nerve
Pudendal
127
artery and vein supplying area above pectinate line
superior rectal a and v
128
superior rectal a. is branch of what
IMA
129
artery and vein supplying area below pectinate line
inferior rectal a and v
130
inferior rectal a. is a branch of what
internal pudendal a.
131
anal warts associated with HPV
Condyloma acuminata
132
most common cancer of anus often found in advanced stage in older people
anal SCC
133
risk factor for anal SCC
HPV
134
anal wart
Condyloma
