Gi: Peterson: Neoplastic Colon & Appendix

Front 1

Sessile polyp

Back 1

Polyp in the beginning stage of growth that is more of an elevation that grows without a stalk

Front 2

Pedunculated Polyp

Back 2

Polyp with a stalk

Front 3

Name 3 types of non-neoplastic types of polyps

Back 3

Hyperplastic, Inflammatory, Hamartomatous (Peutz-Jeghers)

Front 4

Name 3 types of neoplastic polyps (Adenomatous)

Back 4

Tubular, Tubulovillous, Villous

Front 5

MC non-neoplastic polyp

Back 5

Hyperplastic

Front 6

Simple mucinous glands with sawtooth pattern

Back 6

Hyperplastic polyps

Front 7

Where do you find most hyperplastic polyps?

Back 7

Rectosigmoid (NO malignant potential)

Front 8

Type of polyp assoc with Solitary Rectal Ulcer Syndrome

Back 8

Inflammatory Polyps

Front 9

Where do you find an inflammatory polyp in Solitary Rectal Ulcer Syndrome

Back 9

Anterior rectal wall

Front 10

Cause of inflammatory polyps

Back 10

impaired relaxation of the rectal sphinter which causes abrassion of the anterior wall.

Front 11

Entrapment in the fecal stream is common leading to mucosal prolapse

Back 11

Inflammatory Polyps

Front 12

see fibromuscular hyperplasia in the lamina propria, inflammatory infiltrates, ulceration, and erosion. (type of polyp)

Back 12

Inflammatory

Front 13

Type of polyp in Juvenile polyp

Back 13

Hamartomatous

Front 14

Where do most hamartomatous polyps of Juvnenile polyps occur?

Back 14

rectum and cause bleeding

Front 15

In the genetic form of juvenile polyps, muts are found in what?

Back 15

SMAD4 (encodes the cytoplasmic intermediary of the TGF-B pathway); BMPR1A muts may also be seen

Front 16

Transmission of Peutz-Jeghers and median age of presentation

Back 16

AD; age 11

Front 17

multiple polyps and mucocutaneous hyperpigmentations (blue to brown macules on the mouth, eyes, nostrils, buccal mucosa, palms, genitals, and perianal region

Back 17

Peutz-Jeghers

Front 18

Peutz-Jeghers is a syndrome is associated with an increased risk for carcinoma of what?

Back 18

colon, pancreas, breast, lung, ovaries, uterus and testicles

Front 19

What germ-line heterozygous gene mut, a LOF mut, is present in 50% of Peutz-Jeghers

Back 19

LKB1 (STK11) gene mut (encodes a kinase involved in cell polarization growth; 2 hit hypothesis)

Front 20

Type of polyps in Peutz-Jeghers

Back 20

Hamartomatous; pedunculated

Front 21

What type of polyps do you see in Cowden Syndrome (Bannayan-Ruvalcaba-Riley Syndrome)?

Back 21

Hamartomatous

Front 22

Cowden Syndrome (Bannayan-Ruvalcaba-Riley Syndrome)
are AD syndrome associated with a loss of function muts in what?

Back 22

PTEN (encodes a lipid phosphatase that is a tumor suppresor)

Front 23

characterized by macrocephaly, intestinal hamartomatous polyps, and benign skin tumors (Cowden or BRR?)

Back 23

Cowden

Front 24

Cowden pts have an > risk for what?

Back 24

breast carcinoma, follicular carcinoma of the thyroid, and endometrial carcinoma

Front 25

How is Bannayan-Ruvalcaba-Riley syndrome separated from Cowdens?

Back 25

Cowdens has the presence of mental deficiencies and developmental delays

Front 26

Type of polyps found in Cronkite Canada Syndrome

Back 26

Hamartomatous

Front 27

Where are polyps of Cronkite Canada Syndrome found?

Back 27

stomach, SI and colon; in pts over 50

Front 28

Neoplastic Polyps are precursors to what?

Back 28

colorectal adenocarcinoma

Front 29

Hallmark of adenomatous polyp

Back 29

dysplasia (nuclear hyperchromasia, elongation and stratification)

Front 30

When does intraucosal carcinoma occur from an adenomatous polyp?

Back 30

when the dysplastic cell breaches the BM

Front 31

What constitues invasive carcinoma and has met potential of an adenomatous polyp?

Back 31

Invasion beyond the muscularis mucosa

Front 32

Most important RF for malignant potential of an adenomatous polyp

Back 32

SIZE (Carcinoma is rare in polyps < 1cm. If greater than 4 cm, 40% have cancer)

Front 33

MC location of FAP

Back 33

left; onset in teens, cancer by 20-3-

Front 34

Name some extracolonic finding of FAP

Back 34

retinal pigment hypertrophy, Gardner and Turcot syndrome

Front 35

thyroid tumors, desmoid tumors, epidermal cysts, and dental abnormalities + FAP

Back 35

Gardner Syndrome

Front 36

FAP + tumors of the CNS

Back 36

Turcot Syndrome

Front 37

HNPCC or Lynch syndrome is the inherited loss (AD) of one normal allele of the ____ or _____ gene

Back 37

MSH2 or MLH1 gene

Front 38

Difference of HNPCC/Lynch and FAP

Back 38

HNPCC/Lynch <100, smaller flat polyps; cancer at 40-50 years

Front 39

Pts with HNPCC or Lynch are at increased risk for what?

Back 39

Endometrial, ovarian cancer (stomach, ureters, brain, small bowel, hepatobiliary tract and skin cancer too)

Front 40

Location of microsatellite Instability expression of HNPCC/Lynch

Back 40

Right side

Front 41

When Beta catenin accumulates (due to loss of both APC copies), what does it activate?

Back 41

Activates the transcription genes for MYC and cyclin D1

Front 42

Most improtant factors of Sporadic Colon Cancer

Back 42

Depth of invasion and node status

Front 43

Using Classic Duke's Classificaiton of sporadic colon cancer: mucosa limited

Back 43

A

Front 44

Using Classic Duke's Classificaiton of sporadic colon cancer: Inasive but not penetrating to serosa

Back 44

B1

Front 45

Using Classic Duke's Classificaiton of sporadic colon cancer: invasive and penetrating to serosa but NO node involvement

Back 45

B2

Front 46

Using Classic Duke's Classificaiton of sporadic colon cancer: Invasive and penetrating to serosa and node involvement

Back 46

C2

Front 47

Using Classic Duke's Classificaiton of sporadic colon cancer: Invasive but NOT penetrating to serosa and node involvement

Back 47

C1

Front 48

Using Classic Duke's Classificaiton of sporadic colon cancer: distant mets to liver/lungs

Back 48

D

Front 49

Lipofuscin is deposited into cells within the lamina propria; often caused by the abuse of laxatives

Back 49

Melanosis coli

Front 50

Benign tumor of the appendix

Back 50

Mucoceal