Case 6 Path2

Front 1

Abdominal pain or discomfort at least 3 days per month over 3 months, improvement with defectation, a change in stool frequency or form

Back 1

IBS

Front 2

Chronic condition resulting from inappropriate mucosal immune activation

Back 2

Inflammatory Bowel Disease

Front 3

What two disorders comprise IBD

Back 3

Crohn disease and ulcerative cholitis

Front 4

This is a severe ulcerating inflammatory disease limited to the colon and rectum and only extends into the mucosa and submucosa

Back 4

Ulcerative Cholitis

Front 5

Aka Regional enteritis, this is an inflammatory condition that can involve any area of the GI tract

Back 5

Crohn's Disease

Front 6

This is a susceptibility gene in Crohn's disease (is often mutated)

Back 6

NOD2

Front 7

This is the mainstay of inflammatory bowel disease treatment

Back 7

Immunosuppression

Front 8

Polymorphisms in EM1 gene are associated with (ulcerative colitis or crohns)

Back 8

Ulcerative Colitis

Front 9

Most common sites of Crohn's disease

Back 9

Terminal ileum, ileocecal valve, cecum

Can be anywhere though

Front 10

Earliest Crohn Disesae lesion

Back 10

Aphthous Ulcer

Front 11

Hallmark of Crohn disease found in about 35% of cases

Back 11

Noncaseating granulomas

Front 12

Skip lesions are seen in ____ and not seen in ____

Back 12

Crohn's, UC

Front 13

UC is limited to the ___ and ___

Back 13

Colon and Rectum

Front 14

Toxic megacolon is a common problem secondary to

Back 14

Ulcerative Colitis

Front 15

T or F Ulcerative Colitis involves all levels of the mucosa

Back 15

F

It is generall limited to the mucosa

Front 16

Saccharomyces cerevisiaeHallmark of Crohn disease found in about 35% of cases

Back 16

Noncaseating granulomas

Front 17

Skip lesions are seen in ____ and not seen in ____

Back 17

Crohn's, UC

Front 18

UC is limited to the ___ and ___

Back 18

Colon and Rectum

Front 19

Toxic megacolon is a common problem secondary to

Back 19

Ulcerative Colitis

Front 20

T or F Ulcerative Colitis involves all levels of the mucosa

Back 20

F

It is generall limited to the mucosa

Front 21

Hallmark of Crohn disease found in about 35% of cases

Back 21

Noncaseating granulomas

Front 22

Skip lesions are seen in ____ and not seen in ____

Back 22

Crohn's, UC

Front 23

UC is limited to the ___ and ___

Back 23

Colon and Rectum

Front 24

Toxic megacolon is a common problem secondary to

Back 24

Ulcerative Colitis

Front 25

T or F Ulcerative Colitis involves all levels of the mucosa

Back 25

F

It is generall limited to the mucos

Front 26

The most striking feature of diversion colitis is the development of of numerous

Back 26

Mucosal lymphoid follicles

Front 27

Where are colonic diverticulae most common

Back 27

in the sigmoid colon

Front 28

1. Polyps with stalks are considered _____
2. Polyps that are small elevations of the mucosa are reffered to as _____

Back 28

1. Pedunculated
2. Sessile

Front 29

_____ polyps occur sporadically

Back 29

Hamartomous

Front 30

Focal malformations of the mucosal epithelium and lamina propria - the vast majority of which occuring in kids less than 5 yo

Back 30

Juvenile Polyposis

Front 31

The majority of of juvenile polyps are located in the______ and are sessile/pedunculated

Back 31

rectum
Pedunculated

Front 32

Common mutation of Juvenile Polyposis

Back 32

SMAD4

Front 33

Common mutation of Peutz-Jeghers syndrome

Back 33

LKB1

Front 34

Common mutation of Cowden syndrome, Bannayan-Ruvalcaba-Riley syndrome

Back 34

PTEN

Front 35

This dx is assoc. with increased risk of malignancy and consists of multiple GI polyps and mucocutaneous hyperpigmentation

Back 35

Peutz-Jeghers Syndrome

Front 36

The most common site of Peutz-Jeg. polyps

Back 36

Small intestine

Front 37

Dx characterized by macrocephaly, intestinal hamartomous polyps,and benign skin polyps

Back 37

Cowden Syndrome

Front 38

How is the difference between Bannayan-etc syndrome and Cowden syndrome distinguished

Back 38

Bannayan is the only one that includes mental deficiencies and developmental delays

Front 39

The only non-hereditary hamartomatous polyposis syndrome found in people ofver 50 with tons of polyps that resemble juvenile polyposis

Back 39

Cronkhite-Canada Syndrome

Front 40

Hyperplastic polyps are commonly found in the ____ colon

Back 40

LEFT COLON

Front 41

The most common and important neoplastic polyps are ________; benign polyps that are precursors to colorectal adenocarcinomas

Back 41

Colonic adenomas

Front 42

Colorectal adenomas are characterized by the presence of _______ _______

Back 42

Epithelial Dysplasia!!!!!

Front 43

What characteristic of neoplastic polyps most importantly correlates with risk of malignancy

Back 43

Size

Front 44

Dx is an autosomal dominant one in which patients develop numerous colorectal adenomas as teenagers - It's caused by mutations of what gene?

Back 44

FAP! Familial Adenomatous Polyposis

It's caused by mutations of the APC gene (adenomatous polyposis coli gene)

Front 45

Colorectal adenocarcinoma develops 100% of people with untreated ____

Back 45

FAP

Front 46

A specific mutation in the APC gene causes ____ syndrome which, in addition to polyps includes osteomas of mandible skull and long bones

Back 46

Gardner

Gardner is boney

Front 47

Another disease caused by a variant mutation of APC that is rare and characterized by intestinal adenomas and tumors of the CNS

Back 47

Turcot syndrome

Front 48

In patients with this cancer also known as Lynch syndrome get colon cancers at younger ages and are often located in the right colon

Back 48

HNPCC

Hereditary Non-polyposis colorectal cancer

Front 49

Gene commonly mutated in HNPCC

Back 49

MSH2, MLH2

Michigan State is a cancerous school

Front 50

Are adenocarcinomas more commonly found in the colon or the small intestine

Back 50

The Colon

Front 51

Consider colorectal carcinogenesis:

APC is a normal inhibitor of WHAT, which, in absence of APC, accumulates and translocates to the nucleus

Back 51

Beta-catenin

Front 52

In patients with DNA mismatch repair deficiency (such as those with HNPCC), the main accumulation and issue is a condition known as

Back 52

Microsattelite Instability

Front 53

What are most cecal and other right sided colon cancers most frequently called to clinical attention for

Back 53

Fatigue and weakness due to IRON DEFICIENCY ANEMIA

Front 54

Two most important prognostic factors of colorectal cancers are

Back 54

1. Depth of invasion
2. Presence or absence of lymph node metastases

Front 55

Most common site of colorectal cancer metasteses

Back 55

Liver

Front 56

Most frequent predisposing influences on gettin hemorrhoids! (3

Back 56

Straining when trying to go poo when constipated
Venous stasis of pregnancy