Gastrointestinal Disorders Quiz

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Questions and Answers

What advantage does colonoscopy have over rectosigmoidoscopy?

  • Colonoscopy requires no preparation.
  • Colonoscopy is less invasive.
  • Colonoscopy can only identify polyps.
  • Colonoscopy visualizes the entire colon. (correct)

Which type of polyp requires surgical intervention?

  • Benign polyps that are asymptomatic
  • Broad-based implantation polyps
  • Polyps without any signs of cancer
  • Polyps with signs of malignant degeneration (correct)

Which syndrome is associated with gastrointestinal polyposis and perioral hyperpigmentation?

  • Juvenile polyposis
  • Gardner syndrome
  • Peutz-Jeghers syndrome (correct)
  • Familial adenomatous polyposis

What is ulcerative colitis also known as?

<p>Ulcerative-haemorrhagic colitis (B)</p> Signup and view all the answers

What is a characteristic of ulcerative colitis?

<p>It can be localized or affect the entire colon. (B)</p> Signup and view all the answers

What is the primary age range during which the condition is most commonly observed?

<p>24 - 45 years (C)</p> Signup and view all the answers

Which factor is NOT recognized in the onset and development of the disease?

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

What is a significant concern regarding the long-term effects of this condition?

<p>It is considered a precancerous state for recto-smoid cancer. (D)</p> Signup and view all the answers

Which of the following is a characteristic of the severe clinical form of the disease?

<p>Localized extensively (C)</p> Signup and view all the answers

What type of findings are initially observed in the mucosa during the pathological examination?

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

What is the most common complication associated with the condition mentioned in the text?

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

Which of the following is NOT a factor considered when determining the type of surgery performed?

<p>Age and general condition of the patient (A)</p> Signup and view all the answers

What is the primary surgical intervention mentioned in the text?

<p>Surgical removal of the lesion (D)</p> Signup and view all the answers

Which of the following is a type of palliative surgery mentioned in the text?

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

What is the main focus of the last paragraph of the text?

<p>The anatomy of the rectum and anus (B)</p> Signup and view all the answers

What percentage of colon cancers are located in the sigmoid area?

<p>75% (C)</p> Signup and view all the answers

Which paraclinical diagnostic method can show a complete stop in occlusive forms of colon cancer?

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

What clinical manifestation is most commonly associated with tumors located in the left colon?

<p>Feces with streaks of blood (B)</p> Signup and view all the answers

Which imaging technique provides a finer diagnosis compared to ultrasound for colon cancer?

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

Which of the following is a clinical feature of low localizations of colon cancer?

<p>Pencil-shaped stools (A)</p> Signup and view all the answers

What is the recommended dosage of prednisone for patients requiring corticoid therapy?

<p>20 mg/day followed by 10 mg/day for 1-2 months (D)</p> Signup and view all the answers

Which dietary factor is considered a protective factor against colon cancer?

<p>Cellulosic fibers (B)</p> Signup and view all the answers

At what age group is colon cancer most commonly observed?

<p>60-70 years old (D)</p> Signup and view all the answers

Which type of tumor typically has an increased risk of malignancy?

<p>Villous tumors (C)</p> Signup and view all the answers

Which type of colon cancer develops endolumenally and evolves into colon obstruction?

<p>Cancer vegetant (B)</p> Signup and view all the answers

What is the main characteristic of diffuse infiltrative cancer?

<p>Poorly demarcated edges and grainy surface (C)</p> Signup and view all the answers

Which of the following conditions is considered a precancerous inflammatory lesion?

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

What is the significance of genetic load in colon cancer etiology?

<p>It indicates inherited aggregated disorders that may increase risk. (D)</p> Signup and view all the answers

What is the primary role of mucus secretion in the colon?

<p>To protect the colonic mucosa and facilitate feces passage (A)</p> Signup and view all the answers

Which artery primarily vascularizes the right colon?

<p>Superior mesenteric artery (C)</p> Signup and view all the answers

Which of the following is NOT an absorbed substance in the colonic lining?

<p>Digestive enzymes (B)</p> Signup and view all the answers

What is the most common complication associated with colonic diverticulosis?

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

Which symptom is NOT commonly associated with diverticulitis?

<p>Intermittent abdominal pain (B)</p> Signup and view all the answers

What is the most likely age demographic affected by diverticulosis?

<p>Adults over 60 (C)</p> Signup and view all the answers

Which of the following structures collects lymph from the colon?

<p>Subserosal plexus (C)</p> Signup and view all the answers

What examination is REQUIRED at the slightest suspicion of colic cancer?

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

What characterizes diverticula in diverticulosis?

<p>Can vary in size from 1 mm to 7 cm (B)</p> Signup and view all the answers

Which of the following best describes the pain associated with diverticulitis?

<p>Constant, intense pain in the left iliac fossa (D)</p> Signup and view all the answers

Flashcards

Colonic Diverticulosis

A condition characterized by small, pouch-like bulges that form in the lining of the colon, most commonly in the sigmoid colon.

Diverticula

Small, pouch-like bulges in the lining of the colon, caused by herniation of mucosa and submucosa between circular muscle fibers.

Diverticulitis

Inflammation of the diverticula, often caused by fecal stasis and involvement of the lymphatic system.

Colon Secretion

The role of the colon in protecting itself from mechanical and chemical irritation through mucus secretion.

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Colon Absorption

The process by which the colon absorbs water, electrolytes, vitamins, ammonium, bile salts, urea, and medications.

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Superior Mesenteric Artery

The superior mesenteric artery supplies blood to the right colon, including the cecum and ascending colon, and the right half of the transverse colon.

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Inferior Mesenteric Artery

The inferior mesenteric artery and sigmoid arteries (superior, middle, and inferior) supply blood to the remaining parts of the colon.

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Lymph Collection in Colon

The network of lymphatic vessels and nodes that drain the colon, contributing to its overall immune function.

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Lower Hemiabdomen Pain

A common symptom of diverticulosis, often felt as intermittent pain in the lower abdomen.

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Abdominal Distension

A common symptom of diverticulosis, characterized by a feeling of fullness, bloating, and discomfort in the abdomen.

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Rectosigmoidoscopy

A procedure using a flexible tube with a camera to view the rectum and sigmoid colon.

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Colonoscopy

A procedure using a longer flexible tube with a camera to view the entire colon.

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Colonic Polyps

Small growths or abnormal tissue protrusions in the colon.

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Familial Adenomatous Polyposis (FAP)

A condition characterized by widespread polyps throughout the colon, often with familial inheritance.

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Ulcero-Hemorrhagic Rectocolitis

An inflammatory bowel disease that primarily affects the rectum and colon, causing ulcers and bleeding.

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Ulcerative Colitis

A digestive disorder most common between the ages of 24 and 45, but can occur earlier or later, affecting both men and women equally.

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Etiology of Ulcerative Colitis

The exact cause of ulcerative colitis is unknown, but there are many potential factors that may contribute to its development, including bacterial, allergic, immune, enzymatic, and psychosomatic factors.

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Prevalence of Ulcerative Colitis

Ulcerative colitis is more prevalent in economically developed countries, with an increasing frequency and more severe forms in developing nations.

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Macroscopic Findings of Ulcerative Colitis

Ulcerative colitis is characterized by initial mucosal changes such as redness, swelling, and pinpoint bleeding, followed by ulcerations of varying sizes with a hemorrhagic base, eventually leading to scarring and sclerosis.

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Clinical Forms of Ulcerative Colitis

Ulcerative colitis has three clinical forms: benign, average, and severe, each with varying degrees of severity and localization within the colon.

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Vegetant Cancer

A type of colonic cancer characterized by a bulky, endolumenally growing tumor with areas of softening and hemorrhage, often leading to colon obstruction.

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Ulcerative Cancer

A type of colonic cancer caused by ischemic necrosis of the tumor, resulting in a bleeding crater and potential evolution into a vegetative form.

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Schiros Cancer

A type of colonic cancer where the tumor infiltrates the colonic wall circularly, leading to luminal stenosis and a rigid, colic-induced feeling.

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Mucyocarcinoma

A type of colonic cancer characterized by a voluminous, soft, gelatinous, hemorrhagic, and often infected tumor.

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Papillary Adenocarcinoma

A type of colonic cancer that arises from the malignant transformation of a villous tumor, presenting as a soft, friable tumor with wide implantation and potential circumferential invasion.

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Diffuse Infiltrative Cancer

A rare type of colonic carcinoma that infiltrates diffusely, resembling plastic linnet, with poorly demarcated edges and multiple exulcerations.

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Genetic Load in Colon Cancer

Inherited conditions that increase the risk of colon cancer.

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Environmental Factors in Colon Cancer

Factors related to a person's environment that influence their risk of developing colon cancer.

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Left Colon Cancer

A type of colon cancer located in the sigmoid colon, which is the most common location for this type of cancer.

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Irigography

A diagnostic test that uses X-rays to visualize the colon, aiding in the detection of polyps, tumors, and other abnormalities.

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Abdominal Ultrasound

A medical imaging technique that uses sound waves to create images of internal organs, including the colon and surrounding structures.

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Carcinoembryonic Antigen Assay

A blood test that measures the levels of a protein called carcinoembryonic antigen (CEA), which can be elevated in certain cancers, including colon cancer.

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Bowel Occlusion

The narrowing of the bowel lumen, often due to scar tissue or tumor growth, making it difficult for food to pass through.

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Bowel Hemorrhage

Excessive bleeding from the bowel, often a serious complication of inflammatory bowel diseases, diverticulitis, and colorectal cancer.

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Bowel Perforation

The perforation of the bowel wall, allowing intestinal contents to leak into the abdominal cavity, leading to serious infection.

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Segmental Colectomy

A surgical procedure to remove a segment of the colon, typically when there's a tumor or other obstruction.

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Colostomy

A surgical procedure to create an artificial anus, bypassing the rectum and colon, to allow for drainage of waste.

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Study Notes

. ### Surgical Pathology of the Colon and Rectum - Short Notes

Colon Anatomy

  • Length: Approx. 1.5 meters.
  • Diameter: Cecum (8 cm), tapering to 4-5 cm at rectosigmoid junction.
  • Parts: Cecum, ascending, right colic flexure, transverse, left colic flexure, descending, iliac, pelvic colon.

Embryological Division

  • Right Colon: Cecum, ascending colon, right half of transverse colon.
  • Left Colon: From splenic flexure to pelvic diaphragm.

Topographical Division

  • Divided into ascending, transverse, descending, sigmoid, and pelvic colon.

Physiological/Radiological Division

  • Cannon’s Sphincter: Divides colon into right, left, pelvic sections.
  • Right Colon: Digestion and absorption.
  • Left Colon: Passage.
  • Pelvic Colon: Stasis area.

Mobility and Fixity

  • Mobile: Transverse and sigmoid colon.
  • Fixed: Ascending, descending, and flexures.

Ileocecal Valve (Check)

  • Location: Right iliac fossa.
  • Size: 6-7 cm.
  • Function: Regulates passage from ileum to cecum, associated with the appendix.

Colon Parts

  • Ascending Colon: 12-15 cm, from cecum to hepatic flexure.
  • Transverse Colon: 45-50 cm, between hepatic and splenic flexures.
  • Descending Colon: 25 cm, from splenic flexure to iliac fossa.
  • Sigmoid Colon: 40 cm, from iliac fossa to rectum, most mobile.

Colon Physiology

  • Digestion: Absorbs water, electrolytes, and bacterial digestion products.
  • Movements: Peristalsis (2-3/min), segmental contractions for mixing.
  • Secretion: Alkaline mucus for lubrication and protection.
  • Absorption: Water, electrolytes, bile salts, vitamins, and medications.

Vascularization

  • Superior Mesenteric Artery (SMA): Supplies right colon.
  • Inferior Mesenteric Artery (IMA): Supplies left colon.
  • Veins: Drain into respective veins, eventually to the portal system.

Lymphatic System

  • Lymphatic drainage to epicolic, paracolic, and mesenteric lymph nodes.

Colonic Diverticulosis

  • Location: Commonly in sigmoid colon, herniation of mucosa and submucosa through muscle.
  • Prevalence: Affects over 1/3 of those over 60 years.
  • Complications: Diverticulitis (10-15%), GI bleeding (20-30%).

Diverticulitis

  • Symptoms: Left iliac fossa pain, fever, constipation, abdominal distension.
  • Diagnosis: Radiography, endoscopy, angiography for bleeding.

Complications

  • Fistulas (e.g., colo-vesical), bowel obstruction, peritonitis, abscess formation.

Colon Cancer

  • Treatment: Surgical resection, chemotherapy, or radiotherapy depending on stage.

Polyps

  • Types: Sessile, pedunculated. Adenomas (tubular, villous).
  • Risk: Villous adenomas have higher cancer risk.

Symptoms: Diarrhea, colic, blood/mucus in stool.

Diagnosis: Colonoscopy, biopsy, radiography.

Treatment: Removal via colonoscopy for benign polyps, surgery for malignant ones.


Ulcerative Colitis

  • Definition: Non-specific inflammation of the colon, primarily affecting the rectosigmoid.
  • Forms: Acute, chronic, and intermittent.
  • Symptoms: Bloody diarrhea, tenesmus, pain, fever, anemia, weight loss.
  • Diagnosis: Rectosigmoidoscopy, biopsy, imaging.
  • Complications: Perforation, cancer, abscesses, fistulas.

Treatment: Medical (steroids, immunosuppressants), surgical (colectomy in severe cases).


General Treatment Notes

  • Surgical Procedures: Segmental colectomy, hemicolectomy, colectomy with stoma formation.
  • Preoperative Preparation: Mechanical bowel preparation, electrolyte management.
  • Postoperative Care: Monitoring for infection, hemorrhage, and anastomotic leaks.

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