hey guys it's medicosa's perfect net is where medicine makes perfect sense welcome back to my five minute review playlist in previous videos we talked about nephritic syndrome nephrotic syndrome amniotic fluid embolism Barrett esophagus and in the last video we talked about familial adenomatous polyposis today let's talk about Lynch syndrome unlike familial adenomatous polyposis which literally has thousands of polyps in my colon Lynch syndrome is hereditary non-poliposis colorectal cancer I.E no polyps but Lynch syndrome not only causes colon cancer it can lead to other cancers as well there is a famous investment company called Merrill Lynch every time I read the name of this company I remember macroeconomic I mean micro satellite instability bad joke please watch the videos in this playlist in order first what is cancer cancer is a mass cancer belongs to neoplasia neoplasia could be benign or malignant the benign such as adenoma but the malignant is adenocarcinoma so when I say colonic adenoma it's benign but colon adenocarcinoma is cancer neoplasia was that abnormal Mass so cancer is mass whose growth exceeds and is uncoordinated with that of normal tissue and versus even after cessation of the original stimulus tumors could be benign or malignant the malignant ones could be carcinoma if they are Cancers of the epithelium or sarcomas if they are Cancers of connective tissue carcinomas metastasized lymph sarcomas love to metastasize through the blood cancer is growth with no control growth with no limit no evident cause that's why we say risk factors not causes because correlation is not the same as causation no useful function arise from any type of cell in your body could be non-functioning I.E non-secreting or functioning secreting and those are called perineoplastic syndromes please do not confuse cancer with carcinoid poop emojis in medicine here's the normal stool okay Brown amazing what's that this is pale or clay stool we can see this in obstructive jaundice post hepatic jaundice and in some cases of habitus cellular jaundice as well this stool is greasy and oily and floats on water surface in the toilet bowl this is terria could be caused by a problem in your intestine a problem in your pancreas a problem in your liver because in order for you to digest fat grease you need good bowel good pancreas robust liver and biliary system so any disease in any of these can lead to fatty stool steering and here you're not just losing the fat you're also losing fat soluble vitamins as well such as Vitamin K Vitamin E vitamin D vitamin A Blackstone tool is hemolysis black stool is Melina if it looks like this this is upper GI bleed if it looks like this this is lower GI bleed so colon cancer is here if it's kind of in between this could be coming from upstairs or downstairs the polyps in your colon generally non-malignant and these are some examples sometimes they are malignant especially adenomatous or villus adenomatous polyps and serrated polyps and there are many diseases and syndromes where we have many polyps in the colon and these include familial adenomatous polyposis but exclude Lynch because Lynch is non-polyposis in cases of familial adenomatous polyposis which is an autosomal dominant disease usually due to mutation in the tumor suppressor Gene and when you lose the tumor suppressor Gene you know what you get no suppression of tumor I.E you get tumors you can get cancer these poor patients have thousands of polyps in their colon and there is one chance of developing colorectal cancer put differently almost 100 percent of these patients will develop colorectal cancer it's not a matter of if it's a matter of when usually this disease starts after puberty and then give it some time and it becomes cancer so we do prophylactic colectomy before it becomes cancer we unfortunately have to remove the entire colon it's a very ugly disease Sometimes It's associated with brain tumors so now I have a colon cancer and brain tumor and it's called Turco syndrome how do I remember that Turco turbine turbine head brain there is another one called Gardner syndrome or you have a garden variety of tumors benign soft tissue tumors osteomas of the jaw desmoids Etc doctors have memorized this for years and years and years it's Lord left side obstructs right side bleeds the the left colon or the descending colon when cancer happens here it obstructs giving you the classic napkin ring appears why is that because the descending colon is naturally narrower than the ascending colon so in this descending colon the cancer can grow and then rotate and then squeeze and obstruct here causing the napkin ring appearance giving you constipation colic pain versus the right side or the ascending colon It's very wide it's not going to abstract but for sure it can bleed leading to lots of blood in this tool bright red stool and when you lose blood what do you get anemia the most common cause of iron deficiency anemia in an old person is gastrointestinal bleeding such as cancer until proven otherwise how can we manage colon cancer if it's early stage remove it surgically if it's laid well we gotta give chemo such as the famous full Fox and full Theory regimen now let's compare between familiar real adenomatous polyposis and hereditary non-polyposis colorectal cancer familial adenominus polyposis autosomal dominant how about Lynch syndrome also autosomal dominant familial adenomatos has thousands of polyps but Lynch has no polyps fap is less common but more severe 100 chance of cancer however Lynch syndrome is more common but less severe only 80 percent of patients will develop colon cancer fap is a mutation in the tumor suppressor Gene known as APC on chromosome 5 familial chromosome 5. everything is effed up my colon is effed up I am effed up with 100 chance of cancer the erectum is always involved the rectum is 100 effed up forgive my language this disease usually begins after puberty when I'm ready to use your imagination don't imagine too much also familiar polyposis can be associated with Turco syndrome or Garner syndrome lens syndrome is not a problem with APC tumor suppressor Gene it's usually a problem with DNA mismatch repair when you cannot repair the mismatch of your DNA you develop cancer this is called the micro satellite instability such as msh2 and mlh1 mlh1 and msh2 lens syndrome can also be associated with other Cancers and if you remember my video titled hereditary breast ovarian syndromes I have told you that Lynch syndrome can have colorectal cancer endometrial cancer ovarian cancer skin cancer now it's time to quiz yourself on these hereditary cancer syndromes what's that what's that what's that pause and review I have a video in my pathology playlist titled cancer Basics with the classic mnemonic so please watch it also I've talked about many cancers on this channel if you want to learn about vulvar cancer vaginal cancer cervical cancer uterine cancer ovarian cancer and breast cancer download my OB GYN high yields course at medicosisperfectness.com for more facts about colon cancer skin cancer insulinoma glucagonoma gastrinoma and others download my surgery high yield scores thank you for watching please subscribe hit the bell and click on the join button you can support me here or here go to my website download my courses be safe stay happy study hard this is medicosa's perfect snail is where medicine makes perfect sense