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Surgery > Block 6 - Stomach, Small Intestines, Colon, Rectum, and Anus > Flashcards

Block 6 - Stomach, Small Intestines, Colon, Rectum, and Anus Flashcards

1
Q

The most accurate evaluation procedure in the study of colon and rectum.

A

A. Endoscopy

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2
Q

Characterized by polyps carpeting the entire colon

A

A. Juvenile polyposis coli

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3
Q

Elderly and malnourished patients are susceptible to this condition

A

Pseudomembranous colitis

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4
Q

This condition commonly occurs in elderly individuals

A

A. Ischemic colitis

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5
Q

Characterized by bright red, painless rectal bleeding

A

A. Internal hemorrhoids

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6
Q

Located above the dentate line

A

A. Internal hemorrhoids

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7
Q

The rule which guides the location of the internal sphincter in Fistula-in-ano is

A

A. Goodsall’s rule

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8
Q

The most common location of colorectal cancer is

A

A. Recto-sigmoid

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9
Q

Which of the ff. is characterized by an outpouching of the entire wall of the colonic wall?

A

A. True diverticulum

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10
Q

The ff. is/are cause of lower GI bleeding

A

A. Diverticulosis

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11
Q

Which of the ff. is a precancerous lesion?

A

A. Adenomatous polyp

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12
Q

Inverted U or bent inner tube sign on abdominal X-ray of a patient with abdominal pain and distension is a characteristic of

A

A. Volvulus

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13
Q

The findings of plaques on proctoscopy in a patient with watery diarrhea is a characteristic of

A

A. Pseudomembranous colitis

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14
Q

Characterized by remission and exacerbation of symptoms

A

A. Ulcerative colitis

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15
Q

Which portion of the rectum drains into the portal system?

A

A. Superior rectum

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16
Q

Surgery may be indicated in the ff.

A

A. Complicated diverticulitis
B. Recurrent attacks of diverticulitis

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17
Q

Massive lower GI bleed is commonly caused by the ff. except

A

A. Angiodysplasia
B. Diverticular disease
C. Colon cancer
D. None of the above- answer

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18
Q

A 60 year old male was diagnosed A 60 year old male was diagnosed to have fungating middle 3rd rectal lesion. Biopsy showed poorly differentiated adenocarcinoma. Which subsequent procedure is/are options?

A

A. Do cancer staging

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19
Q

The most accurate diagnostic procedure for the diagnosis of colorectal diseases is

A

A. Endoscopy

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20
Q

The etiologic agent of Pseudomembranous colitis is

A

A. Clostridium difficile

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21
Q

Follows after exposure of 5000 rads or more

A

A. Radiation enterocolitis

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22
Q

True regarding rectal cancer except:

A

A. Transverse colon is the most commonly affected

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23
Q

The ff. is/are true regarding Amebic colitis:

A

A. Can complicate into hepatic abscess
B. Treated with Metronidazole

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24
Q

Occurs below the dentate line

A

A. External hemorrhoids

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25
Q

Presents with pain in the anal area:

A

A. External hemorrhoids

C. Perianal abscess

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26
Q

Has external and internal opening

A

A. Fistula-in-ano

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27
Q

The prolapsing mucosa is concentric

A

A. Rectal prolapse

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28
Q

Often times diagnosed as acute appendicitis

A

A. Meckel’s diverticulitis

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29
Q

“Collar bone ulcers”

A

A. Ulcerative colitis

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30
Q

Most common caustic agent ingested

A

A. Alkali

31
Q

Cause/s of GERD

A

A. Incompetent esophageal sphincter

32
Q

Best diagnostic tool in esophageal diseases

A

A. Endoscopy

33
Q

Best initial approach to manage swallowing of caustic substance

A

A. Neutralize the acid or alkali

34
Q

Transformation of epithelial lining in the lower esophagus

A

A. Barrett’s esophagus

35
Q

Risks factors for esophageal cancer:

A

A. Alcohol
B. Smoking
C. Papilloma virus

36
Q

Substernal pain and crepitus in the neck area after upper GI endoscopy suggests

A

A. Esophageal perforation

37
Q

Full thickness caustic injury to the gastroesophageal wall follows

A

A. Alkali ingestion

38
Q

Characterized by external and internal opening

A

A. Fistula-in-ano

39
Q

Timing of endoscopy after caustic ingestion is

A

A. 12-48 hours

40
Q

Smell of food stimulates gastric acid production by secreting

A

A. Acetylcholine

41
Q

The gastro-esophageal junction is supplied by what artery?

A

A. Left gastric

42
Q

The Criminal Nerve of Grassi is a branch of

A

A. Posterior vagus

43
Q

Helicobacter pylori contributes to the development of peptic ulcers by inhibiting?

A

A. D cells

44
Q

76 year old/M, slightly pale, complained of epigastric pain, your primary clinical impression is?

A

A. Peptic ulcer disease

45
Q

Patient admitted because of diffuse board like abdomen, to help confirm impression you request?

A

Chest Xray upright

46
Q

Which part of ulcer surgery will address gastrin stimulus?

A

A. Antrectomy

47
Q

Patient is diagnosed to have gastric carcinoma with an intraoperative findings of a 3 cm mass at the antrum, no lymph nodes noted, surgical procedure should be?

A

A. Radical subtotal gastrectomy

48
Q

Which bleeding artery of the stomach would require surgery once seen by endoscopy?

A

A. Mucosal artery

49
Q

Patient is diagnosed to have Patient is diagnosed to have massive upper GI bleed, endoscopy showed a bleeding mucosal vessel at the proximal body, your diagnosis is?

A

A. Dieulafoy’s lesion

50
Q

Which ulcer surgery will preserve the GI function?

A

Proximal gastric vagotomy

51
Q

Patient was diagnosed to have gastric adenocarcinoma, with a 5 cm epigastric mass, and left supraclavicular lymph node. No other signs of organ metastasis. Stage is?

A

A. III

52
Q

Patient presented with gastric outlet obstruction, with a resectable gastric adenocarcinoma with liver metastasis, you recommend?

A

A. Gastric bypass

53
Q

10 years after Billroth II surgery for PUD, patient had melena and weight loss, your diagnosis is?

A

A. Recurrent peptic ulcer disease

54
Q

The longest portion of the duodenum is?

A

A. Descending

55
Q

H. pylori infection increases acid secretion in the stomach through the?

A

A. Inhibitory effect on antral D cells

56
Q

The largest part of the stomach is the?

A

A. Body

57
Q

Highly selective vagotomy means cutting the?

A

Anterior vagus nerve

58
Q

Which epithelial cell at the mucosal crypts is responsible for the secretion of growth factors?

A

A. Paneth cells

59
Q

A 30 year old male who had a history of ruptured appendicitis 10 years ago was admitted because of vomiting and absence of bowel movement for three days. PE: tachycardic, distended abdomen with slight tenderness at the epigastric area. What diagnostic procedure will help you in your diagnosis?

A

Scout film of the abdomen

60
Q

How would you manage the above mentioned case?

A

Start total parenteral nutrition

61
Q

A 28 year old female complaining of recurrent abdominal pain and diarrhea. Upper GI endoscopy revealed a superficial ulcer with surrounding erythema at the antrum. You recommend?

A

A. H. pylori regimen

62
Q

After exploratory laparotomy for a trauma, a greenish, foul-smelling discharge amounting to 300 ml per day and a CT scan finding of complex mass at the right lower quadrant. The recommended management would be?

A

A. Surgical exploration

63
Q

70 year old female was admitted because of a 15 day history of moderate to high grade fever and sudden severe abdominal pain. Your primary clinical impression is?

A

A. Perforated typhoid ileitis

64
Q

A 65 year old male uncontrolled diabetic was admitted because of a right lower quadrant mass, he had a previous history of an epigastric pain radiating to the right lower quadrant. On physical examination, he was febrile with episodes of hypotension and direct and rebound tenderness on the right lower quadrant. Your recommendation would be?

A

A. Surgical drainage

65
Q

A 25 year old male undergoing exploratory laparotomy for trauma had an incidental finding of a non-obstructing 4x4 mass at the jejunum, you will?

A

A. Leave the mass and do close monitoring and follow up

66
Q

The most common benign symptomatic tumor of the small intestine is?

A

A. Leiomyoma

67
Q

A 26 year old G1P1 on her first trimester of pregnancy was admitted because of a right lower quadrant pain. PE showed vital signs stable, low grade fever, and direct tenderness at the right lower quadrant. You recommend?

A

A. Appendectomy (Laparoscopic)

68
Q

A 35 year old male was scheduled for emergency exploratory laparotomy for massive lower GI bleeding. Intraoperatively an diverticulum was noted 2 feet proximal to the ileocecal valve, you proceed with?

A

A. Segmental ileal resection

69
Q

Meissner’s plexus is located in the

A

A. Submucosa

70
Q

30 year old male with history of surgical exploration presented with abdominal distention, vomiting, and absence of flatus for three days. On PE, he is afebrile, tachycardic, and normotensive. Abdominal exam revealed distended abdomen and a bulging mass at the previous incision site. You recommend?

A

Conservative treatment

71
Q

On the seventh post-operative day, a clear yellow non-foul smelling discharge was noted on the incision site. Your initial impression is?

A

A. Seroma

72
Q

Patients diagnosed with enterocutaneous fistula should undergo nutritional support by giving

A

A. High protein oral supplements
B. High caloric milk formulas by NGT
C. Elemental diet
D. Total parenteral nutrition

73
Q

Patient is diagnosed to have post-operative adhesions and was treated conservatively upon admission. On the second hospital day, NGT drainage was 1.5 L greenish, non-tender abdomen with no passage of flatus. Repeat abdominal film showed no air-fluid levels, thickened inter-serosal folds, and string of pearl gas pattern. Your management is?

A

A. Start oral liquids

74
Q

During surgery, you noted an 8 cm submucosal mass at the ileum. You proceed with?

A

A. Frozen section biopsy

Surgery (9 decks)

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