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Jaspie - Surgery > 14 - Colon, Rectum, and Anus > Flashcards

14 - Colon, Rectum, and Anus Flashcards

1
Q

Most common site of metastasis of colorectal cancers:

A

liver

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2
Q

Most common type of neoplastic colonic polyp:

A

tubular adenoma

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3
Q

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

A

-ulcerative colitis -Crohn’s disease -ulcerative colitis

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4
Q

Age at which screening for colorectal cancer is started:

A

45 years

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5
Q

Most common genetic defect leading to sporadic colorectal cancer is:

A

APC

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6
Q

What week does embryonic GI tract begin developing

A

4th week of gestation

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7
Q

Most common bacteria in the colon

A

B. Fragilis

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8
Q

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

A

Gastrografin - water soluble contrast agent

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9
Q

How can ultrasound differentiate a benign polyp from invasive tumor?

A

Based on integrity of the submucosal layer

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10
Q

Most common traumatic cause of incontinence

A

Injury to the anal sphincter during vaginal delivery

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11
Q

Most common site of diverticulosis

A

sigmoid colon

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12
Q

Most common fistula of diverticulitis

A

colovesical fistula (5%)

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13
Q

hinchey staging for complicated diverticulitiys

A

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

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14
Q

Diagnostic test for diverticulitis

A

CT scan

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15
Q

Treatment of uncomplicated diverticulitis

A
  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
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16
Q

Treatment of complicated diverticulitis

A

Elective sigmoid colectomy

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17
Q

What gene is mutated in familial aadenomatous polyposis

A

APC gene - chromosome 5

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18
Q

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

A

Peutz Jegher Syndrome

19
Q

Characteristic of Cronkite Canada Syndrome

A
  1. polyposis 2. alopecia 3. cutaneous pigmentation 4. atrophy of fingernails and toenails
20
Q

Characteristic of Cowden Syndrome

A
  1. GI polyps 2. facial trichilemoas 3. breast cancer 4. thyroid disease
21
Q

What type of adenoma has the highest cancer risk

A

Villous adenoma (50%)

22
Q

Most common form of spread of colorectal carcinoma

A

lymphatics

23
Q

Duke’s staging of colorectal cancer

A

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

24
Q

Treatment of colorectal cancer

A
  1. LAR - tumor within 5 to 10 cm from anal verge 2. APR - tumor less than 5 cm from anal verge or recurrent cancer
25
Q

Triad of carcinoid tumor

A
  1. flushing - bradykinin 2. diarrhea - serotonin 3. vascular heart disease (mitral valve) - serotonin
26
Q

Diagnostic test of caarcinoid tumor

A

24 hour 5 -HIAA test

27
Q

This refers to squamous cell carcinoma in situ

A

Bowen’s disease (anal intraepithelial neoplasia)

28
Q

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

A

sigmoid volvulus

29
Q

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

A

cecal volvulus

30
Q

Treatment of sigmoid volvulus

A
  1. fluid resuscitation 2. endoscopic detorsion
31
Q

Treatment of cecal volvulus

A
  1. surgical exploration
32
Q

most common complication of hemorrhoidectomy

A

urinary retention

33
Q

most common location of anal fissure

A

posterior midline

34
Q

Medical management of anal fissure

A
  1. lubricant 2. hot sitz bath 3. bulk laxatives
35
Q

surgical management of anal fissure

A

Lateral subcutaneous partial internal sphincterectomy

36
Q

most common type of anorectal abscess

A

perianal abscess

37
Q

most common type of fistula in ano

A

intersphincteric

38
Q

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

A

intersphincteric

39
Q

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

A

transsphincteric

40
Q

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

A

suprasphincteric

41
Q

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

A

extrasphincteric

42
Q

Treatment of fistuala in ano

A

fistulotomy with drainage or seton placement

43
Q

What is important in maintaining the integrity of colonic mucosa

A

short chain fatty acids

Jaspie - Surgery (18 decks)

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