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15 Cards in this Set
- Front
- Back
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Hematemesis |
defined as vomiting of blood, can be bright red if it is vomited immediately but has a coffee ground appearance after exposure to gastric acid |
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Melena |
stools that are black and tarry due to upper GI bleeds |
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Hematochezia |
passage of red blood per rectum that indicates it is a lower GI bleed
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occult bleeding |
blood in the stool can be tested for hemoglobin peroxidase which can prove bleeding when other findings a unremarkable |
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Lesion types |
tubular or pedunculated adenoma = stalk like mucosal tumor
sessile or villous adenoma = increased growth and thickness of the mucosal but without a stalk and flat with the layer of the mucosa |
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Adenoma-carcinoma sequence |
normal route for all colorectal cancers including both sporadic and familial
larger amount of villous tissus, greater size, and presence of high grade dysplasia all increase risk |
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Hyperplastic polyps |
most common type of non-neoplastic colonic polpy are small and multiple
have saw tooth epithilelial pattern and serrated infolding |
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Sessile serrated adenomas |
involved in a microsattelite instability
benign hyperplastic polyp to neoplastic sessile serrated adenoma SSA to sessit serrated adenoma with dysplasia to colorectal carcinoma
abberant promoter region methylation and inactivation of DNA mismatch repair genes such as hMLH1, micro instability, mutations in BRAF oncogene, and p21
may occur with sporadic right sided mucinous colon cancers |
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Juvenile polyps |
non neoplastic hamartomatous
when multiple may be associated with autosomal dominant juvenile polyposis syndrome
may be at higher risk for adenomatous poylps |
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Peutz- Jeghers |
mutation in STK11 gene
hamartomas that occur throughout the entire GI tracts |
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FAP |
autosomal dominant disorder in APC pathway
gardner's syndrome = variant of FAP with mutliple colorectal adenomas and multiple osteomas
Turcots is autorecessive adenomatous polyposis coli and brain tumors |
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Complications of adenocarincomas |
perforations and peritonitis with disease in the left and right colon |
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Sx |
rectal bleed
abdominal pain
perofration
tenesmus and change in bowel habits
weight loss and fatigue with iron deficiencyer
metastases |
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Three major routes to colorectal cancer |
FAP
HNPCC
BRAF oncogenes and silencing of tumor supressor genes due to CpG island hypermethylation |
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Rx |
staging then surgery
most impt prognostic facors is the stage of the tumors at the time of diagnsosi
TNM classification system |
