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37 Cards in this Set
- Front
- Back
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What are the common colonic polyps?
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Neoplastic, haramatomas, inflammatory, or misc
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Neoplastic colon polyps are commonly what type of tumor?
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Adeonomas
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What are the 3 types of neoplastic polyps?
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Tubular Adenoma
Tubulovillous Adenoma Villous Adenoma |
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List the 3 neoplastic colon polyps in order of greatest malignant potential to least malignant potential?
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Villous Adenoma (greatest)
Tubulovillous Tubular Adenoma (smallest) |
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What is the mean age of patients with polyps?
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55 years
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Where do polyps mostly occur?
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Sigmoid/Rectum
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What is the most common presenting complaint?
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Intermittent rectal bleeding
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If invasive adenocarcinoma is found, is a colectomy mandatory?
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No as long as gross and microscopic margins are clear.
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Abundant polyps throughout the colon and rectum beginning at puberty
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Familial Polyposis Syndrome
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What gene is inovlved in Familial Polyposis Syndromes and how is it inherited?
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APC gene, autosomal dominant
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What syndrome consists of polyposis, desmoid tumors, osteomalacia of mandible or skull, & sebaceous cysts
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Gardner's Syndrome
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What syndrome consists of polyposis with medulloblastoma or glioma?
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Turner's Syndrome
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Presence of what predicts FAP with 97% sensitivity?
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Congenital hypertrophy of retinal pigment epithelium
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Nonneoplastic hamartomatous polyps in stomach, small intestine, & colon, skin & mucous membrane hyperpgimentation, particularly on lips
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Peutz-Jeghers Syndrome
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With Peutz-Jeghers Syndrome, one has a risk of developing what in other tissues?
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CA
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Herniation involving the full bowel wall thickness
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True diverticula
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Where are true diverticula found?
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Cecum, ascending colon
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Only mucosal herniations through muscular wall?
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False diverticula
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Where are false diverticula mostly found?
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Sigmoid colon
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Recurrent abdominal pain in LLQ & changes in bowel habits, few pts present with lower GI hemorrhage that can be massive
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Diverticulosis
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LLQ pain, diarrhea, constipation, fever, anorexia, leukocytosis
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Diverticulitis
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Bleeding is more consistent with what?
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Diverticulosis or diverticulitis?
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What is the most common fistula associated with diverticulitits?
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Colovesicular (presenting with recurrent UTI)
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Bright red blood per rectum
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Usually points to bleeding in the distal small bowel or colon
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What is the most common site for a large-intestine obstruction?
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Sigmoid Colon
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What are the common causes of large-intestine obstruction?
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Adenocarcinoma, scarring secondary to diverticulitis, & volvulus--consider adhesions if pt had previous abdominal surgery
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What does X-ray show for a large intestine obstruction?
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Distended proximal colon, air-fluid levels, no gas in rectum.
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To diagnoses a large intestine obstruction, what are you supposed to do?
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Do NOT give barium orally with suspected obstruction
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What is another name for pseudo-obstruction?
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Ogilvie's Syndrome
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Presence of massive right-sided colon dilatation with no evidence of obstruction
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Pseudo-obstruction (Ogilivie's Syndrome)
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Rotation of the large intestine along its mesenteric axis--twisting can promote ischemic bowel, gangrene, & subsequent perforation
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Volvulus
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What are the two most common sites for a volvulus?
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Sigmoid, cecum
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What does one see on x-ray for volvulus?
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Dilated loops of bowel with loss of hayseed with a kidney bean appearance.
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What does one see on barium enema for volvulus?
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A narrowing mimicking a "bird's beak" or "ace of spades" picture, with point of beak pointing to site of bowel obstruction
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An autosomal dominant predisposition to colorectal cancer with right sided predominance (70% proximal to the splenic flexure)
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HNPCC Lynch Syndrome I
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Shows all of the features of Lynch Syndrome I & also causes extracolonic cancers, particularly endometrial carcinoma, carcinoma of the ovary, small bowel, & pancreas, & transitional cell CA of the ureter & renal pelvis
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HNPCC Lynch Syndrome II
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What tumor marker will be elevated before any physical evidence of disease?
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CEA
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