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Colon post test

Total questions: 14

Worksheet time: 7mins

Name
Class
Date
1.

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

a)

The parasympathetic innervation to the right and transverse colon is from the vagus nerve.

b)

The rectum is approximately 12-15cm in length.

c)

At S2, the Waldeyer's fascia extends anterior and caudally and attaches to the fascia propria at the anorectal junction.

d)

Anteriorly, Denonvilliers' fascia separates the rectum from the prostate and seminal vesicles in men and from the vagina in women.

2.

What is the most common traumatic cause of incontinence?

a)

Anorectal surgery

b)

Vaginal delivery

c)

Impalement

d)

Pelvic fracture

3.

55/M came in due to hematochezia. Colonoscopy was done revealing a fungating mass 25cm FAV. No enlarged LNs on scan. What is your planned procedure?

a)

Neoadjuvant chemotherapy

b)

Right Hemicolectomy

c)

Transverse Colectomy

d)

Left hemicolectomy

4.

35/M known case of Crohn's disease came in due to abdominal pain and hematochezia. Next step in the management of this patient includes

a)

Bowel rest and antibiotics

b)

CT scan

c)

Barium enema

d)

Colonoscopy possible clipping

5.

Most common site of crohn's disease

a)

Cecum

b)

Small bowel

c)

Colon

d)

Rectum

6.

6/M came in due to bleeding anal mass. On PE, noted 3cm hamartomatous polyp. What is your surgical plan?

a)

Flexible sigmoidoscopy, polypectomy

b)

Flexible sigmoidoscopy, biopsy of polyp

c)

Flexible sigmoidoscopy, transanal excision of mass

d)

Exploratory laparotomy, very low anterior resection

7.

What is the genetic defect associated with Lynch syndrome?

a)

MMR

b)

APC gene mutation

c)

KRAS mutation

d)

Inacivitaion of APC

8.

15/M with family history of FAP was worked up, with noted absence of 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.

What is the single most important prognostic factor in colorectal cancer?

a)

Increased CEA

b)

KRAS mutation

c)

Nodal involvement

d)

Metastatic disease

10.

64/F post low anterior resection for upper rectal cancer revealed the following histopath findings: Tumor extends through the visceral peritoneum with four positive lymph nodes, non metastatic. What is the stage?

a)

Stage IIIA

b)

Stage IIIB

c)

Stage IIIC

d)

Stage IVA

11.

52/M diagnosed with intraanal epidermoid carcinoma measuring 1cm in largest diameter. What is your plan?

a)

Ablation

b)

NIGRO protocol

c)

Wide local transanal excision including the muscle layer

d)

APR

12.

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

a)

Topical imiquimod

b)

Wide local excision

c)

ChemoRT

d)

APR

13.

What is the most common infectious cause of emergency laparotomy in AIDS patients

a)

HPV

b)

CMV

c)

Hep B

d)

Rotavirus

14.

37/F came in 1 week post NSD with episiotomy complaining of fecal discharge per vagina. On physical exam, noted to have low rectovaginal fistula. What is your plan?

a)

Observe for 3-6 months

b)

NPO and IV antibiotics

c)

Diverting colostomy

d)

Endorectal advancement flap