Colorectal

Question 1

Stoma: Ileostomy

Location:
Spouted or non-spouted:
Output:

Answer 1

Right illiac fossa
Spouted
Liquid

Question 2

Stoma: Colostomy

Location:
Spouted or non-spouted:
Output:

Answer 2

Usally left side of abdomen
Non-spouted
Solids

Question 3

Mx. Acute mesenteric ischaemia:

Answer 3

Immediate LAPAROTOMY

Question 4

80% of anal cancers are:

causes:

Answer 4

Squamous cell carcinomas (adenocarcinoma in rectum)

HPV, smoking

Question 5

Haemorrhoids location:

Answer 5

3,7,11 oclock.

Question 6

Commonest location of colorectal cancer:

Answer 6

Rectum

Question 7

Colorectal cancer procedures:

Caecal, ascending or promximal transverse colon:

Anastamosis

Answer 7

Right hemicolectomy

ileocolic

Question 8

Colorectal cancer procedures:

Distal transverse descending colon:

Anastamosis:

Answer 8

Left hemicolectomy

Colo-colon

Question 9

Colorectal cancer procedures:

Sigmoid colon:

Anastamosis:

Answer 9

High anterior resection

Colorectal

Question 10

Colorectal cancer procedures:

Upper rectum

Answer 10

Anterior resection (TME) -

colorectal w/ or w/out defunctioning stoma

Question 11

Colorectal cancer procedures:

Low rectum

Answer 11

Anterior resection (low TME)

Question 12

Colorectal cancer procedures:

Anal verge:

Answer 12

Abdomino-perineal excision of rectum

Question 13

What is the name of the procedure in which a sigmoid resection is carried out with an end colostomy fashioned:

Answer 13

Hartmann’s procedure

Question 14

FIT tests:
offered as screening to:
Also used when:

Answer 14

50-74 years

Pts. with new symptoms do not fit the 2 week wait criteria

Question 15

Diverticular disease - pts. advised to increase what in their diet:

Answer 15

FIbre

Question 16

Diverticulitis tx.
Mild cases:
If symptoms do not settle within 72 hours or severe:

Answer 16

Oral antibiotics, liquid diet and analgesia

Admit for IV antibiotics

Question 17

Investigations for Large bowel obstruction:

Answer 17

Abdominal X-ray still used first-line

CT scan

Question 18

Tx. Large bowel obstruction:

Answer 18

NBM, IV fluids, NG tube w/ free drainage

Question 19

Peri-anal abscess:

causative organism:

Answer 19

E.coli

Question 20

Gold-standard investigations for peri-anal abscess:

Answer 20

MRI but rarely used unless complications

Question 21

All patients presenting with rectal bleeding should get

Answer 21

Digital rectum exam

Procto-sigmoidoscopy as minimal baseline

Question 22

If PR bleeding and presenting with other symptoms of inflammatory bowel disease

Answer 22

Colonscopy

Question 23

Fissure in ano mx.

Answer 23

GTN ointment or DILTIAZEM cream topically
Botox if failure to respond
If fail botox - internal sphincterotomy

Question 24

Haemorrhoids tx.

Answer 24

Lifestyle advice
injection sclerotherapy or rubber band ligation
if external consider haemorrhoidectomy

Question 25

Fistulating Crohn's:

Answer 25

Seton stitches

Question 26

Caecal volvulus management:

Answer 26

Usually operative - right hemicolectomy is often needed

Question 27

Sigmoid volvulus:

Answer 27

Rigid sigmoidoscopy with rectal tube insertion

Question 28

Gosrelin is a GnRH ___

Answer 28

Agonist - used in prostate cancer