Chapter 17 Part 9

Question 1

What type of cancer is found below and above the pectinate line?

Answer 1

below - squamous cell carcinoma

above - adenocarcinoma

Question 2

Anal canal cancer spreads to which lymph nodes?

Answer 2

superficial inguinal lymph nodes

Question 3

Hemorrhoids develop secondary to what circulatory condition in the rectum?

Answer 3

-persistently elevated venous pressure within the rectal venous plexus (hemorrhoidal plexus)

Question 4

Are hemorrhoids above and the below the pectinate line painful or painless?

Answer 4

above - painless unless complication

below - painful

Question 5

True or False: the appendix is a normal true diverticulum of the cecum

Answer 5

True; majority are located retrocecally

Question 6

In what age group is appendicitis most common?

Answer 6

adolescents and young adults

males slightly more often than females

Question 7

What other conditions would be on a differential with appendicitis?

Answer 7

• Meckel diverticulum
• mesenteric lymphadenitis
• acute salpingitis
• ectopic pregnancy, ovarian torsion
• mittelschmirtz

Question 8

True or False: appendicitis is easy to diagnose at the extremes of age

Answer 8

False, because other causes of abdominal emergencies are prevalent in these populations and they are more likely to have atypical presentation

Question 9

What causes the majority of overt luminal obstruction in appendicitis?

Answer 9

fecaliths

less commonly are gallstones, tumors, or masses of worms

Question 10

What is the clinical presentation of acute appendicitis?

Answer 10

-periumbilical pain that localizes to the RLQ
-N/V
-fever
mildly elevated peripheral white count

Question 11

What is pseudomyxoma peritonei?

Answer 11

-progressive intraperitoneal accumulation of mucinous ascites related to a mucin-producing neoplasm, most commonly a tumor of the appendix

Question 12

What is spontaneous bacterial peritonitis?

Answer 12

• develops in the absence of an obvious source of contamination
• seen most often in cirrhotic patients

Question 13

Ruptured dermoid cysts cause what?

Answer 13

• release of keratins

- induction of intense granulomatous rxn

Question 14

What are the characteristics of sclerosing retroperitonitis (idiopathic retroperitoneal fibrosis), of which a subset of cases appear to be a manifestation of IgG4-related disease?

Answer 14

• back and abdominal pain
• male predominance
• bilateral ureter impingement
• ARF
• elevated ESR and CRP

Question 15

True or False: almost all peritoneal mesotheliomas are associated with significant asbestos exposure

Answer 15

True

Question 16

What is the most common soft tissue tumor within the peritoneum?

Answer 16

• desmoplastic small round cell tumor

- -aggressive tumor in children and young adults

Question 17

What is the most common metastasis in the peritoneum?

Answer 17

peritoneal carcinomatosis