14 - Colon, Rectum, and Anus

Question 1

Most common site of metastasis of colorectal cancers:

Answer 1

liver

Question 2

Most common type of neoplastic colonic polyp:

Answer 2

tubular adenoma

Question 3

Identify: types of inflammatory bowel disease: -which of these is more related to the development of colorectal cancer than the other?

Answer 3

-ulcerative colitis -Crohn’s disease -ulcerative colitis

Question 4

Age at which screening for colorectal cancer is started:

Answer 4

45 years

Question 5

Most common genetic defect leading to sporadic colorectal cancer is:

Answer 5

APC

Question 6

What week does embryonic GI tract begin developing

Answer 6

4th week of gestation

Question 7

Most common bacteria in the colon

Answer 7

B. Fragilis

Question 8

Diagnostic test used if perforation or leak is suspected in the colon

Answer 8

Gastrografin - water soluble contrast agent

Question 9

How can ultrasound differentiate a benign polyp from invasive tumor?

Answer 9

Based on integrity of the submucosal layer

Question 10

Most common traumatic cause of incontinence

Answer 10

Injury to the anal sphincter during vaginal delivery

Question 11

Most common site of diverticulosis

Answer 11

sigmoid colon

Question 12

Most common fistula of diverticulitis

Answer 12

colovesical fistula (5%)

Question 13

hinchey staging for complicated diverticulitiys

Answer 13

I - pericolic abscess II - pelvic abscess III - purulent peritonitis IV - fecal peritonitis

Question 14

Diagnostic test for diverticulitis

Answer 14

CT scan

Question 15

Treatment of uncomplicated diverticulitis

Answer 15

1. out patient 2. broad spectrum antibiotic 7 to 10 days 3. low residue diet 4. failure to improve in 48 to 72 hours indicates abscess formation

Question 16

Treatment of complicated diverticulitis

Answer 16

Elective sigmoid colectomy

Question 17

What gene is mutated in familial aadenomatous polyposis

Answer 17

APC gene - chromosome 5

Question 18

Multiple polyps in the intestine associated with melanin spots in the buccal mucosa and lips

Answer 18

Peutz Jegher Syndrome

Question 19

Characteristic of Cronkite Canada Syndrome

Answer 19

1. polyposis 2. alopecia 3. cutaneous pigmentation 4. atrophy of fingernails and toenails

Question 20

Characteristic of Cowden Syndrome

Answer 20

1. GI polyps 2. facial trichilemoas 3. breast cancer 4. thyroid disease

Question 21

What type of adenoma has the highest cancer risk

Answer 21

Villous adenoma (50%)

Question 22

Most common form of spread of colorectal carcinoma

Answer 22

lymphatics

Question 23

Duke’s staging of colorectal cancer

Answer 23

A - mucosa and submucosa B - muscularis propria C - lymph node D - distant metastases

Question 24

Treatment of colorectal cancer

Answer 24

1. LAR - tumor within 5 to 10 cm from anal verge 2. APR - tumor less than 5 cm from anal verge or recurrent cancer

Question 25

Triad of carcinoid tumor

Answer 25

1. flushing - bradykinin 2. diarrhea - serotonin 3. vascular heart disease (mitral valve) - serotonin

Question 26

Diagnostic test of caarcinoid tumor

Answer 26

24 hour 5 -HIAA test

Question 27

This refers to squamous cell carcinoma in situ

Answer 27

Bowen's disease (anal intraepithelial neoplasia)

Question 28

This disease is seen as bent inner tube or coffee bean appearance with loop convexity lying in the RUQ

Answer 28

sigmoid volvulus

Question 29

This diease is seen as kidney shaped, air filled structuree in the LUQ

Answer 29

cecal volvulus

Question 30

Treatment of sigmoid volvulus

Answer 30

1. fluid resuscitation 2. endoscopic detorsion

Question 31

Treatment of cecal volvulus

Answer 31

1. surgical exploration

Question 32

most common complication of hemorrhoidectomy

Answer 32

urinary retention

Question 33

most common location of anal fissure

Answer 33

posterior midline

Question 34

Medical management of anal fissure

Answer 34

1. lubricant 2. hot sitz bath 3. bulk laxatives

Question 35

surgical management of anal fissure

Answer 35

Lateral subcutaneous partial internal sphincterectomy

Question 36

most common type of anorectal abscess

Answer 36

perianal abscess

Question 37

most common type of fistula in ano

Answer 37

intersphincteric

Question 38

It is a class of fistula in ano where in it tracks through the distal internal sphincter and intersphincteric space to an external opening near the anal verge

Answer 38

intersphincteric

Question 39

it is a class of fistula in ano where in it results fro an ischiorectal abscess and extends through bot the internal and external sphincter

Answer 39

transsphincteric

Question 40

it is a class of fistula in ano where in it originates in the intersphincteric plane and tracks up around the entire external sphincter

Answer 40

suprasphincteric

Question 41

it is a class of fistula in ano where in it originates in the rectal wall

Answer 41

extrasphincteric

Question 42

Treatment of fistuala in ano

Answer 42

fistulotomy with drainage or seton placement

Question 43

What is important in maintaining the integrity of colonic mucosa

Answer 43

short chain fatty acids