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Colon rectum anus pretest

Total questions: 15

Worksheet time: 15mins

Name
Class
Date
1.

Which of the following statements are true regarding the anatomy of the colon, rectum, and anus?

a)

The intraperitoneal colon and proximal one third of the rectum are covered by serosa; the mid and lower rectum lack serosa

b)

The cecum is the most vulnerable to perforation and obstruction

c)

The sigmoid colon is the narrowest part of the large intestine and is extremely mobile

d)

The marginal artery of Drummond is complete in only 15% to 20% of people

2.

Name the three muscles that form the levator ani muscle of the pelvic floor

(a)  

3.

The following arteries are ligated in right colectomy except

a)

Ileocolic artery

b)

Right colic artery

c)

Right branch of the middle colic artery

d)

Middle colic artery

4.

Which of the following is an elective indication for surgery in patients with Ulcerative colitis?

a)

Massive hemorrahge

b)

Toxic megacolon

c)

Fulminant colitis

d)

Intractability

5.

55/M known case of Crohn’s disease came in due to perianal pain. On rectal exam, noted skin tag and mucosal break at the posterior portion of the anus. What is your plan?

a)

Pain meds and high fiber diet

b)

Excision of skin tag

c)

Excision fo skin tage and sphincterotomy

d)

Sphincterotomy only

6.

75/M came in due to fever and left lower quadrant pain. On PE, stable VS but with direct tenderness, LLQ and hypogastric region. WAB CT scan done revealing fluid collection at the pelvis around 3cm in widest diameter. What is your plan?

a)

Bowel rest and IV antibiotics

b)

Bowel rest and IV antibiotics and percutaneous drainage

c)

For diagnostic laparoscopy, drainage of abscess

d)

For exploratory laparotomy

7.

32/M with noted polyp on the small bowel, colon, and rectum. On further physical exam, noted melanin spots on the lips. What is your diagnosis?

a)

Hyperplastic Polyposis

b)

Peutz-Jeghers syndrome

c)

Cowden syndrome

d)

Lynch syndrome

8.

15/M with family history of FAP was worked up, with noted APC gene mutation. When would you recommend to start flexible sigmoidoscopy?

a)

Annual flex sig at age 10

b)

Annual flex sig at age 20

c)

Annual flex sig at age 40

d)

Annual flex sig at age 50

9.

20/F with a family history of Lynch syndrome, with youngest diagnosed relative at 40yo came in for screening. When would you advise the screening to start?

a)

Screening colonoscopy at 20yo, TVS with biopsy at 25yo

b)

Screening colonoscopy at 30yo, TVS with biopsy at 30yo

c)

Screening colonoscopy and TVS at 35yo

d)

Screening colonoscopy and TVS at 40yo

10.

53/M post descending colon resection revealed the following histopath findings: Tumor involves the muscularis propria, with 2 positive nodes, non metastatic. What is the stage?

a)

Stage IIA

b)

Stage IIb

c)

Stage IIIA

d)

Stage IIIB

11.

48/M diagnosed with rectal carcinoid measuring 1.5cm in largest diameter. What is your plan?

a)

Ablation

b)

NIGRO protocol

c)

Wide local transanal excision including the muscle layer

d)

APR

12.

37/F ECOG 1 with rectal prolapse came in for surgical consult. What will be your planned procedure?

a)

Ripstein Rectopexy

b)

Delorme procedure

c)

Altemeier procedure

d)

Anal encirclement

13.

45/M diagnosed with Anal intraepithelial neoplasia 2cm in widest diameter, no nodal involvement. What is your planned procedure?

a)

Topical imiquimod

b)

Wide local excision

c)

ChemoRT

d)

APR

14.

60/M diagnosed with Anal Invasive Paget’s disease 1.5cm widest diameter, no nodal involvement. What is your planned procedure?

a)

Topical imiquimod

b)

Wide local excision

c)

ChemoRT

d)

APR

15.

47/M diagnosed with Anal Melanoma 1.5cm widest diameter, no nodal involvement. What is your planned procedure?

a)

Topical imiquimod

b)

Wide local excision

c)

ChemoRT

d)

APR