Gastro pt 2
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Questions and Answers

What type of polyp is classified as hamartomatous and typically occurs in children?

  • Hyperplastic polyp
  • Adenomatous polyp
  • Malignant polyp
  • Sporadic polyp (correct)

Which characteristic is true regarding juvenile polyps?

  • They are common in adults.
  • They are typically hamartomatous. (correct)
  • They primarily affect elderly populations.
  • They are always cancerous.

What is the primary population that juvenile polyps affect?

  • Adults over 50
  • Children (correct)
  • Adolescents and young adults
  • Infants and toddlers

Which of the following is a potential feature of juvenile polyps?

<p>Benign growths (A)</p> Signup and view all the answers

How are juvenile polyps generally classified?

<p>Hamartomatous (D)</p> Signup and view all the answers

Which type of colonic polyp is characterized by a serrated pattern on microscopy?

<p>Hyperplastic polyps (B)</p> Signup and view all the answers

What is the most significant risk factor for the progression of an adenomatous polyp to carcinoma?

<p>Polyp size &gt; 2 cm (A)</p> Signup and view all the answers

Which gene mutation is NOT directly associated with the progression from adenomatous polyp to carcinoma?

<p>BRCA1 mutation (C)</p> Signup and view all the answers

What type of inflammation is characteristic of Ulcerative Colitis?

<p>Crypt abscesses with neutrophils (D)</p> Signup and view all the answers

In which condition do patients develop hundreds to thousands of adenomatous polyps and have a high risk of colon cancer?

<p>Familial adenomatous polyposis (FAP) (D)</p> Signup and view all the answers

Which symptom is primarily associated with Crohn's Disease?

<p>Right lower quadrant pain with non-bloody diarrhea (B)</p> Signup and view all the answers

What is the purpose of performing colonoscopy in relation to colorectal polyps?

<p>To remove adenomatous polyps before they progress to carcinoma (C)</p> Signup and view all the answers

Which complication is primarily associated with Ulcerative Colitis after more than 10 years of disease?

<p>Toxic megacolon (B)</p> Signup and view all the answers

What additional condition is associated with familial adenomatous polyposis (FAP)?

<p>Gardner syndrome (A)</p> Signup and view all the answers

What is the primary method of ulcerative colitis effect on the gastrointestinal tract?

<p>Continuous involvement from rectum to cecum (D)</p> Signup and view all the answers

What is a common non-neoplastic proliferation associated with Gardner syndrome?

<p>Fibromatosis (A)</p> Signup and view all the answers

What screening test is commonly used to detect the presence of colonic polyps?

<p>Colonoscopy and fecal occult blood test (A)</p> Signup and view all the answers

Which of the following is a feature of Crohn's Disease regarding its gross appearance?

<p>Cobblestone mucosa and creeping fat (A)</p> Signup and view all the answers

In individuals with Ulcerative Colitis, which extraintestinal manifestation is commonly observed?

<p>Erythema nodosum (A)</p> Signup and view all the answers

Which factor is known to increase the risk of Crohn's Disease?

<p>Cigarette smoking (A)</p> Signup and view all the answers

What type of wall involvement is typically seen in Crohn's Disease?

<p>Full-thickness inflammation with fissures (A)</p> Signup and view all the answers

Which of the following is a characteristic feature of Carcinoid Syndrome?

<p>Bronchospasm (A)</p> Signup and view all the answers

What is the most common cause of acute appendicitis in children?

<p>Lymphoid hyperplasia (A)</p> Signup and view all the answers

Which statement best describes Carcinoid Heart Disease?

<p>It leads to tricuspid regurgitation due to right-sided valvular fibrosis. (C)</p> Signup and view all the answers

In the context of Inflammatory Bowel Disease, which group is most likely to be affected?

<p>Young women aged teens to 30s (D)</p> Signup and view all the answers

What clinical sign is most indicative of an appendiceal rupture?

<p>Guarding and rebound tenderness (C)</p> Signup and view all the answers

Hirschsprung Disease is associated with which of the following?

<p>Failure of ganglion cells to descend (A)</p> Signup and view all the answers

Which of the following correctly describes a complication of an appendiceal rupture?

<p>Periappendiceal abscess (B)</p> Signup and view all the answers

Which diagnostic method is crucial for confirming Hirschsprung Disease?

<p>Rectal suction biopsy (C)</p> Signup and view all the answers

Which condition is primarily associated with wall stress due to straining and constipation?

<p>Colonic Diverticula (A)</p> Signup and view all the answers

What is the most common presenting symptom of ischemic colitis?

<p>Postprandial pain (C)</p> Signup and view all the answers

What complication can occur from diverticulitis?

<p>Colovesicular fistula (B)</p> Signup and view all the answers

Which condition is an acquired malformation that typically presents as hematochezia in older adults?

<p>Angiodysplasia (A)</p> Signup and view all the answers

Which area of the colon is most commonly affected by angiodysplasia?

<p>Cecum and right colon (B)</p> Signup and view all the answers

What symptom is NOT typical of irritable bowel syndrome?

<p>Identifiable pathologic changes (B)</p> Signup and view all the answers

What is the root cause of most cases of ischemic colitis?

<p>Atherosclerosis of the superior mesenteric artery (B)</p> Signup and view all the answers

Which factor is NOT typically associated with the development of colonic diverticula?

<p>Chronic diarrhea (D)</p> Signup and view all the answers

Flashcards

Hyperplastic polyps

The most common type of colon polyps, appearing serrated on microscope, usually in the left colon, and are benign.

Adenomatous polyps

Neoplastic polyps that may become cancerous. Second most common, premalignant.

Adenoma-carcinoma sequence

Progression from normal colon cells to adenomatous polyps to cancer. Genetic mutations increase the risk.

Familial Adenomatous Polyposis (FAP)

Genetic disorder causing hundreds of colon polyps. Almost guaranteed cancer without prevention.

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APC gene mutation

A mutation in the APC gene increases the risk of colon polyps, a key factor in FAP.

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Colon Polyp Screening

Using colonoscopy and fecal occult blood tests to detect polyps in the colon. Helps find and remove polyps before malignancies form.

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Colon polyp risk factors

Polyp size larger than 2 cm, sessile growth, or villous histology increases the likelihood of progression to cancer.

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Prophylactic removal

Surgical removal of the colon and rectum to prevent cancer if FAP is present.

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Ulcerative Colitis (UC) location

Starts in the rectum and extends proximally up to the cecum, it is continuous involvement.

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Crohn's Disease location

Can occur anywhere from mouth to anus, often skipping sections (skip lesions).

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UC wall involvement

Affects the mucosal and submucosal layers.

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Crohn's wall involvement

Full-thickness inflammation.

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UC symptom

Left lower quadrant pain, bloody diarrhea.

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Crohn's symptom

Right lower quadrant pain, non-bloody diarrhea.

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UC inflammation

Crypt abscesses with neutrophils.

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Crohn's inflammation

Lymphoid aggregates with granulomas.

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Juvenile Polyp

A benign polyp common in children, characterized by a hamartomatous growth (abnormal tissue development).

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Carcinoid Syndrome

A collection of symptoms caused by excessive serotonin release from a tumor, including bronchospasm, diarrhea, and flushing of the skin.

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Carcinoid Heart Disease

Right-sided heart valve damage caused by serotonin buildup, leading to tricuspid regurgitation and pulmonary valve stenosis. Left-sided valves aren't affected due to serotonin breakdown in the lungs.

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Hamartomatous Polyp

A polyp formed due to abnormal tissue development, usually benign and doesn't turn cancerous easily.

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Sporadic Polyp

A polyp that occurs randomly, not due to a genetic predisposition or family history.

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Acute Appendicitis

Inflammation of the appendix, usually due to blockage by lymphoid hyperplasia (children) or a fecalith (adults).

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McBurney Point

The location of pain in the right lower quadrant of the abdomen, a classic sign of acute appendicitis.

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Where do Juvenile Polyps occur?

Juvenile polyps are most commonly found in the small intestine and the colon.

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Juvenile Polyp vs. Hyperplastic Polyp

Juvenile polyps are hamartomatous, while Hyperplastic polyps are more common and usually benign.

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Inflammatory Bowel Disease (IBD)

A chronic, relapsing inflammation of the bowel, possibly due to an abnormal immune response to gut bacteria.

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Hirschsprung Disease

A condition where nerve cells in the colon are missing, preventing proper bowel function and causing constipation.

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Myenteric (Auerbach) Plexus

A network of nerves located between the muscle layers of the colon, responsible for controlling bowel movements.

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Submucosal (Meissner) Plexus

A network of nerves located beneath the inner lining of the colon, regulating blood flow, secretions, and absorption.

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Colonic Diverticula

Outpouchings of the colon's inner lining through the muscle layer, often caused by straining and low fiber diet.

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Diverticulitis

Inflammation of diverticula, usually due to trapped stool, causing pain in the lower left abdomen, similar to appendicitis.

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Angiodysplasia

Abnormal blood vessel clusters in the colon, often in the cecum, leading to bleeding.

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Hereditary Hemorrhagic Telangiectasia

Inherited disorder causing thin-walled blood vessels in the mouth and digestive tract, causing bleeding.

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Ischemic Colitis

Damage to the colon due to reduced blood flow, often at the splenic flexure, causing pain and bloody diarrhea.

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Irritable Bowel Syndrome (IBS)

Recurrent abdominal pain, bloating, gas, and altered bowel habits, often in middle-aged women, without identifiable changes in the colon.

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Colovesicular Fistula

An abnormal connection between the colon and the bladder, often caused by a ruptured diverticulum, leading to air or stool in the urine.

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What is the common location for colonic diverticula?

The sigmoid colon is the most frequent location for colonic diverticula due to its vulnerability to pressure during bowel movements.

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Study Notes

Colon Polyps

  • Colon polyps are raised protrusions of the colonic mucosa
  • Most common types are hyperplastic and adenomatous polyps
  • Hyperplastic polyps are due to hyperplasia of glands (often in the left colon)
  • Adenomatous polyps are due to neoplastic proliferation of glands
  • Most common type of polyp: hyperplastic; usually in the left colon
  • Benign polyps, but have malignant potential
  • Adenomatous polyps are the second most common type of colon polyp
    • Benign, but may progress to adenocarcinoma
    • Adenoma-carcinoma sequence: describes the molecular progression from normal colonic mucosa to adenomatous polyp to carcinoma
      • Increase risk for formation of polyp: APC gene mutations (sporadic or germline)
      • K-ras mutation leads to formation of polyp
      • p53 mutation and increased expression of COX allow for progression to carcinoma
  • Screening for polyps is performed by colonoscopy and testing fecal occult blood
    • Goal is to remove hyperplastic and adenomatous polyps before progression
    • Polyps are removed and examined microscopically
    • Greatest risk for progression from adenoma to carcinoma is related to size of polyp (>2 cm), sessile growth, and villous histology

Familial Adenomatous Polyposis (FAP)

  • Autosomal dominant disorder characterized by 100s to 1000s of adenomatous colon polyps
  • Due to inherited APC mutation (chromosome 5)
  • Increases propensity to develop adenomatous polyps throughout colon and rectum
  • Colon and rectum are removed prophylactically; otherwise, almost all patients develop carcinoma by 40 years of age
  • Gardner syndrome is FAP with fibromatosis and osteomas
    • Fibromatosis is a non-neoplastic proliferation of fibroblasts
    • Osteoma is a benign tumor of bone that usually arises in the skull
  • Turcot syndrome is FAP with CNS tumors (medulloblastoma and glial tumors)

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Description

This quiz covers the essential characteristics of colon polyps, including types, risks, and their potential for malignancy. It discusses hyperplastic and adenomatous polyps, the adenoma-carcinoma sequence, and screening methods. Test your knowledge on the pathology and clinical significance of these lesions.

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