Polyps

Question 1

4 parts of large intestine

Answer 1

ascending
transverse
descending
sigmoid

Question 2

Fxn of large intestine

Answer 2

remove water, salt and form stool

Question 3

Clinical polyps

Answer 3

• asymptomatic
• bright red blood per rectum
• rectal tenesmus
• change in bowel habits (severe)

Question 4

sessile

Answer 4

base attached to colonic wall

Question 5

pedunculated

Answer 5

mucosal stalk between polyp and wall

Question 6

flat

Answer 6

height is less than the base of the diameter

Question 7

depressed

Answer 7

depression into colonic wall

Question 8

5 types of non-neoplastic polyps

Answer 8

mucosal
inflammatory pseudopolyps
hyperplastic
submucosal
hamartamous

Question 9

Mucosal polyp

Answer 9

• small <5mm

- resembles adjacent tissue and is histologically normal

Question 10

Inflammatory pseudopolyps

Answer 10

• irregularly shaped islands of intact mucosa due to ulcerations and regeneration
• commonly seen in patients with IBD

Question 11

Hyperplastic polyp

Answer 11

most common non-neoplastic polyp

Question 12

Submucosal polyp

Answer 12

• lipoma is most common; yellow and soft; pillow sign

Question 13

Hamartamous polyps

Answer 13

• grow in disorganized fashion

- non-neoplastic but certain syndromes can cause them to become CRC

Question 14

Adenomatous polyps

Answer 14

• 2/3 of colonic polyps
• benign tumor of glandular tissue
• take 7-10yrs to become adenocarcinoma

Question 15

RF for adenomatous polyps

Answer 15

• old age
• increased BMI
• lack of physical activity
• men
• smoking

Question 16

prevention for adenomatous polyps

Answer 16

• low fat diet, high in fruit, veggies, fiber
• normal body weight and exercise
• decrease in alcohol (beer)
• aspirin daily
• COX-2 agents

Question 17

Tubular adenoma

Answer 17

80% of colonic adenoma and small risk of developing into CRC

Question 18

Villous adenoma

Answer 18

highest risk of developing into crc

Question 19

Characteristics associated with increase CRC risk

Answer 19

1. villous histology
2. high grade dysplasia
3. number and size- more than 1 over 1cm or more than 3 any size

Question 20

Diagnosis adenomatous polyps

Answer 20

Fecal Occult Blood Testing
Double Contrast Barium Enema
CT colonography
Flexible Sigmoidoscopy
Colonoscopy

Question 21

Gold standard for adenomatous polyps

Answer 21

colonoscopy

Question 22

Pro and Con to colonoscopy

Answer 22

Pro
-direct visualization and can remove polyps visualized
Con
-perforation
-significant bleeding
-intolerance to sedation
-dehydration/electrolyte imbalance in elderly

Question 23

Tx adenomatous polyps

Answer 23

polypectomy