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22 Cards in this Set
- Front
- Back
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Are small bowel malignancies common?
If the sm. bowel neoplasm is malignant, is it more likely to be asymptomatic or symptomatic? |
no, only 1 to 2 percent of GI maligs arise from the sm. bowel
symptomatic, though not always. |
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What are the three benign small bowel tumors?
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adenoma, leiomyoma, lipoma
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What are the two types of sm. bowel adenoma? Which are more common in the duodenum? Which have low malignant potential?
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tubular, villous
tubular, tubular |
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Do Leiomyomas grow inside the bowel lumen?
Lipomas? |
No, they grow in the submucosal layer.
No, they arise from serosal fat or submucosal adipose. |
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What are the 4 malignancies seen in the small bowel?
Which constitute 50% of the malignancies seen? Gender predominance? Frequent site? |
adenocarcinoma
carcinoid lymphoma leiomyosarcoma adenocarcinoma Male Proximal small bowel |
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Celiac sprue
Crohn's dz FAP ...all are associated with which small bowel malignancy? |
adenocarcinoma
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What is a carcinoid tumor?
- sx? - freq site? - 10% associated with which syndrome? freq site when association present? |
Rare, neuroendocrine tumors
- usually asx. - ileum - carcinoid syndrome: 5HT producing malignant tumors arising from enteroendocrine cells + midgut |
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What are the sx of carcinoid syndrome?
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flushing, diarrhea, dyspnea, telelangectasias, hypotension, tachycardia
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Which type of lymphoma is more commonly associated with celiac sprue when found in the sm. bowel?
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T-cell
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Are Leiomyosarcomas vascularized? What does this mean re: sx? dx?
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yes
may present w/ bleeding can be found with arteriograms --> contrast "blurring"/extravasation --> "tumor blush" |
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Do large bowel tumors tend to present w/ or w/o sx?
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w/o = asymptomatic
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When do malignant tumors of the large bowel tend to show sx? Name some possible sx.
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later in the dz process
Asymptomatic Obstruction Constipation Occult GI Bleeding Gross GI Bleeding Anemia Weight Loss |
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Hyperplastic polyps
Juvenile polyp Peutz-Jeghers syndrome Adenoma Lipoma Leiomyoma ...all are what? |
Benign Colon Tumors
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What is the most common benign tumor of the distal colon and rectum? Do they have malignant potential? Do they increase the risk of a more proximal colon neoplasm?
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hyperplastic polyps
No No. |
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What are Hamartomas?
- ages? - are multiples seen often? - when are multiples seen? |
juvenile polyps of the large bowel
- 4-14y - rarely - genetic abnormalities localized to the long arm of chromosome 10 |
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What is Peutz-Jegher's Syndrome?
- inheritance? - linked to chromosome...? |
Hamartomas in association with mucocutaneous hyperpigmentation (dark dots around lips, or in mouth)
- autosomal dominant - chromosome 19 |
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What is the second leading cause of cancer death in the US?
- is age a risk factor? - gender? |
CRC
- yes; most common in pts over 50 - males are slightly more @ risk |
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Age > 50
Colon adenoma personal CRC hx relatives w/ adeomas / CRC FAP Cigarette smoking Being a fat ass eating red meat crohn's dz UC .... all of these are risk factors for... |
CRC
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Most CRC arise from what? Over what kind of time frame does this happen? Is this a single-hit process?
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Adenomas
usually 10-15 years No, multi-hit/sequential. |
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What are some protective measures that can be taken against CRC?
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screening
Calcium Aspirin (GI bleed risk goes up tho'; not routinely recommended) Cox-2 inhibitors (Cardiac risks --> not recommended) |
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How do we screen for CRC? (5)
Which is based upon the rx of Hb-derived peroxidase and H2O2? Is it sensitive/specific? - does evidence suggest that it is effective? |
FOBT, stool DNA testing, flex sig, colonoscopy, CT, colonography.
FOBT - not too much of either, but more sens than spec. - yes |
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What is the difference between a flex sig and a colonoscopy?
Does screening save lives re: CRC? |
Sigmoidoscopy is limited to the distal third of the colon
Colonoscopy examines the entire length of the colon Yes! |
