colon rectum anus

Question 1

What week does embryonic GI tract begin developing

Answer 1

4th week of gestation

Question 2

Most common bacteria in the colon

Answer 2

B. Fragilis

Question 3

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

Answer 3

Gastrografin - water soluble contrast agent

Question 4

How can ultrasound differentiate a benign polyp from invasive tumor?

Answer 4

Based on integrity of the submucosal layer

Question 5

Most common traumatic cause of incontinence

Answer 5

Injury to the anal sphincter during vaginal delivery

Question 6

Most common site of diverticulosis

Answer 6

sigmoid colon

Question 7

Most common fistula of diverticulitis

Answer 7

colovesical fistula (5%)

Question 8

hinchey staging for complicated diverticulitiys

Answer 8

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

Question 9

Diagnostic test for diverticulitis

Answer 9

CT scan

Question 10

Treatment of uncomplicated diverticulitis

Answer 10

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 11

Treatment of complicated diverticulitis

Answer 11

Elective sigmoid colectomy

Question 12

What gene is mutated in familial aadenomatous polyposis

Answer 12

APC gene - chromosome 5

Question 13

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

Answer 13

Peutz Jegher Syndrome

Question 14

Characteristic of Cronkite Canada Syndrome

Answer 14

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

Question 15

Characteristic of Cowden Syndrome

Answer 15

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

Question 16

What type of adenoma has the highest cancer risk

Answer 16

Villous adenoma (50%)

Question 17

Most common form of spread of colorectal carcinoma

Answer 17

lymphatics

Question 18

Duke’s staging of colorectal cancer

Answer 18

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

Question 19

Treatment of colorectal cancer

Answer 19

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 20

Triad of carcinoid tumor

Answer 20

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

Question 21

Diagnostic test of caarcinoid tumor

Answer 21

24 hour 5 -HIAA test

Question 22

This refers to squamous cell carcinoma in situ

Answer 22

Bowen’s disease (anal intraepithelial neoplasia)

Question 23

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

Answer 23

sigmoid volvulus

Question 24

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

Answer 24

cecal volvulus

Question 25

Treatment of sigmoid volvulus

Answer 25

1. fluid resuscitation | 2. endoscopic detorsion

Question 26

Treatment of cecal volvulus

Answer 26

1. surgical exploration

Question 27

most common complication of hemorrhoidectomy

Answer 27

urinary retention

Question 28

most common location of anal fissure

Answer 28

posterior midline

Question 29

Medical management of anal fissure

Answer 29

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

Question 30

surgical management of anal fissure

Answer 30

Lateral subcutaneous partial internal sphincterectomy

Question 31

most common type of anorectal abscess

Answer 31

perianal abscess

Question 32

most common type of fistula in ano

Answer 32

intersphincteric

Question 33

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 33

intersphincteric

Question 34

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 34

transsphincteric

Question 35

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 35

suprasphincteric

Question 36

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

Answer 36

extrasphincteric

Question 37

Treatment of fistuala in ano

Answer 37

fistulotomy with drainage or seton placement

Question 38

What is important in maintaining the integrity of colonic mucosa

Answer 38

short chain fatty acids