GI POLYPStypes of polyps.1)inflamatory 2)hyperplastic 3)hamartomatous 4)neoplastic1)inflamatory lo ulcerative colitis, segmantal colitis, chrons, diverticulitis and dysenteric colitis3)hamartomatous polyps is imp ra. they asked many times which of the folloing is not hamartomatous polyphamartomatous polyps are peutz jehher syndrome, juvenile polyp and chronchite canada syndrome

Neoplastic polyps are adenomatous polyps and carcinomatp[us polypsyes.

i will explain hemartomatous polyps first.1)juvenile polypsthese are never malignant ra.(very very imp point)commoest polyp in colorectum of infants and childrenNow, juvenile polyp vs juvenile polyposis syndrome

juvenile polyposis syndrome lo juvenile word has nothing to do with age. here juvenile means the size of the polyp is small

and juvenie polyposis syndrome will lead to adenocarcinoma later but juvenile polyp will never turn malignantnow this is the question in aiims 2007 papaer All of the following are premalignant except1-juvenile polyposis syndrome, juvenile polyps, peutz jehger, FAP

one is premalignant, other is notNow peutz jegher syndromepolyps here are common in small intestine(jejunum) but colon polyps also can occur rarely

here melanosis is seen in oral mucosa, lips digits.

in peutz jehger syndrome which is not presentpigmentation of oral mucosa, pigmentation of lips, pigmentation of digits, pigmentation of tongue.

tongue is never pigmented

peutz jehger chusinava?

now chronkite canada syndrome:here polyps are seen in stomach, duodenum and colorectum.mcq: in chronkite canada sundrome, polyps are absent in --stomach, esophagus colon, duodenum (all india)it occurs in females, its premalignant.cachexia,alopecia, onychodystrophy, diarrhoea and pigmentationONYCHODYSTROPHYHamartomatpus polyps are over

now adenoma of colon:adenomas of colon are 3types

tubular, villous and tubulovilloustubular is most common.

villous has poor prognosismalignant potentia untadhi and is determined by 4factorssize, sessile,villous archetecture,dysplasia

now features:

sessile are malignantas they can metastasise

chronic bleeding, anemia etc etc untai telisindhe.prolapse is common in tubular type.diarrhoea common in villous type.tubuar lo tube bayitiki osthadhi.diarrhoea indicates bad prognosis.(villous)diarrhoea is bad

diarhea die arheabad

hypokalemia is the electrolyte abnormalityInv:colonoscopy biopsy

obvious potasium lossRAAS also

Rx colonoscopic polypectomy, sigmoidoscopic diathermy/excision, peranal polypectomy, open abd colostomy nd polypectomy(if big)total colectomy/ segmental resection if many

Now FAP.

FAP:Aut dominant, chromosome 5YOUNGER AGE.(if there is no adenoma at 30years, then it is never FAP)

apc

FAP has high malignant potential., multiple polyps (>100) - mcqscreening of FAP:screen all family members

PJS chromosme 19

pigment spots in retina(CHIRPES)NA tests

STk11 gene

DNAFAP chusinava points.

(>100 polyps)Rx of FAP:

<30 years is key

Proctocolectomy with ileoanal anastomosis with ileal pouchthis procedure is done in 2conditions.1)FAP 2) UC

now associations of FAP (very imp)

associated with 1)duodenal/ampullary carcinoma 2)Gardners syndrome 3)Turcot syndrome 4)Bone sarcomadeenni koncham change chesi mcq laaga ivochu

now a few points about gardners suyndrome.ass with MEN 2babd desmoid tumorsBone osteomasEpidermoid cystsCong hypertrophy of pigment layer or retina***ivanni gardners syndrome points

turcotsTurcots is the only polyposis condition which is autosomal recessive (as per srb)colon polyps +braintumors like medullobastoma and gliomas

So gardners syndrome lo pigment layer hypertrophy is imp ra.

cong hypertrophy of retina is gardners then

and due to this there are pigment spots in retina. wthats the reason ,, in screening of FAP, CHIRPES is done (pigment spots in retinaalong with DNA testsas gardners is ass with FAP

ok so imp things to remember are FAP associations.they are gardners, turcots, Duodenal and ampulary carcinoma, bone sarcomaGardners features: men2b, abd desmoid, bone osteomas, epidermoid cysts cong retina pigment hypertrophy

cowden syndrome:also called multiple hemartoma-neoplasia syndrome)

i remembered it has a cow with a large head, whose age is 20 but will tell it as 10yrs, it has thyroid and breast carcinoma but no GI malignancybut has GI polyps.AD,Macrocephalypnetrance at age 20, pTEN supressor geneGI polyps but no carcinomathyroid carcinomabreast ancer

so till now we got 2 conditions with no GI malignancy potential

juvenilapolyp

now Bannayan - riley-ruvalacaba syndrome

GI HAMARTOMATOUS polyp

strange nemesee features. imagine a person with these features.veelaithe draw a person like this.macrocephaly. mental retardation.hashimotothyroiditisHyperpigmented penile skinNO risk og GI malignancy but hamartomatous polyps seen.

macro is also seen inalexander?

So 3conditions with no GI malignancycowdens, juvenile polyp and this one

so ipudu nenu konni case scenarios cheptha ra. tell me diagnosis and any other points you remember.

females with GI malignancy, polyps in stomach, duodenum colon and onychodystrophyok another point. hamartomatopus polys

FAP

chronkite canada syndrome

stomach is unique hereonychodystrophy also

and no polyps in esophagusautosomal recessive with GI polyps + FAp association+brain gliomas

proctocolectomy with ileoanal anastomosis with ileal pouch is a surgical option for?

FAP?.ok 4 unnai ra.1)juvenile polyp2)peutz jehger3)chronkite canada synd4)bunnayan reiley etc etc syndrome

so juvenile polyp and that bunnayan are not premalignant. in thesealso cowdens is not GI premalignantbut causes thyroid nd breast malignancythyroid disease ass with bunnayan etc etc syndromehashimoto.