Colorectal

Question 1

What is rectal prolapse?

Answer 1

Associated with childbirth and rectal intussceception. May be internal or external

Question 2

Features of an anal fissure?

Answer 2

Typically presents with painful rectal bleeding
Location: midline 6 (posterior midline 90%) & 12 o’clock position. Distal to the dentate line
Chronic fissure > 6/52: triad: Ulcer, sentinel pile, enlarged anal papillae

Question 3

Dukes classifciation for the spread of colorectal cancer?

Answer 3

A- Confined to mucosa
B- Invafing bowel wall
C- Lymph node metastases
D- Distant metastases

Question 4

Most common type of colorectal cancer?

Answer 4

Adenocarcinoma

Question 5

Management of chronic anal fissures?

Answer 5

topical glyceryl trinitrate (GTN) is first-line treatment for a chronic anal fissure

if topical GTN is not effective after 8 weeks then secondary care referral should be considered for surgery (sphincterotomy) or botulinum toxin

Question 6

What is a Hartmann’s procedure?

Answer 6

type of colectomy that removes part of the colon and sometimes rectum

Question 7

What is volvulus?

Answer 7

occurs when a loop of intestine twists around itself and the mesentery that supports it, causing bowel obstruction. Symptoms include abdominal distension, pain, vomiting, constipation, and bloody stools

Question 8

What are diverticula?

Answer 8

medical term used to describe the small bulges that stick out of the side of the large intestine (colon). Diverticula are common and associated with ageing.

Question 9

What is diverticulitis?

Answer 9

infection of a diverticulum, an out-pouching of the intestinal mucosa.

Question 10

What are anal fissures?

Answer 10

longitudinal or elliptical tears of the squamous lining of the distal anal canal

Question 11

Management of sigmoid volvulus?

Answer 11

rigid sigmoidoscopy with rectal tube insertion

Question 12

What is a perianal abscess?

Answer 12

collection of pus within the subcutaneous tissue of the anus that has tracked from the tissue surrounding the anal sphincter.

Question 13

Presentation of thronbosed haemorrhoids?

Answer 13

significant pain and a tender lump

Question 14

Examination findings in thrombosed haemorrhoids?

Answer 14

purplish, oedematous, tender subcutaneous perianal mas

Question 15

What is an anal fistula?

Answer 15

a small tunnel that develops between the end of the bowel and the skin near the opening of the bottom (anus)
caused by an infection near the anus, which results in a collection of pus (abscess) in the nearby tissue. When the pus drains away, it can leave a small channel behind.

Question 16

What is an anal fissure?

Answer 16

tear or open sore (ulcer) that develops in the lining of the large intestine, near the anus.

Question 17

What is CEA used to monitor?

Answer 17

Response to treatment of colon cancer

Question 18

What is AFP used as a tumour marker for?

Answer 18

Hepatocellular carcinoma

Question 19

Emergency presentations of poorly controlled colitis that fails to respond to medical therapy should usually be managed with what?

Answer 19

Sub total colectomy
Excision of the rectum is a procedure with a higher morbidity and is not generally performed in the emergency setting

Question 20

What is the most commonly performed operation for rectal tumours, except in lower rectal tumours

Answer 20

Anterior resection

Question 21

When is a loop ileosotomy done?

Answer 21

Defunctioning of colon e.g. following rectal cancer surgery
Does not decompress colon (if ileocaecal valve competent)

Question 22

Colonic tumour resection pitcure

Answer 22

Question 23

Management of acute mesenteric ischaemia?

Answer 23

immediate laparotomy is usually required, particularly if signs of advanced ischemia e.g. peritonitis or sepsis
poor prognosis, especially if surgery delayed

Question 24

Faecal occult blood is used to screen for what?

Answer 24

bowel cancer but is not used for diagnosis in patients presenting with symptoms or signs of bowel cancer.

Question 25

What is anterior resection in colorectal cancer?

Answer 25

remove a tumour in the upper or middle part of the rectum (back passage)

Question 26

Frimann Dahl’s sign

Answer 26

diagnostic sign demonstrated when three dense lines, representing the sigmoid walls, are seen converging to the site of obstruction in sigmoid volvulus and associated with empty rectal gas

Question 27

Grading of internal haemorrhoids?

Answer 27

Question 28

Where are diverticula most commonly found?

Answer 28

Sigmoid colon

Question 29

Where do most anal fissures occur?

Answer 29

Posterior midline

Question 30

What is an end colostomy?

Answer 30

end of the colon is brought through the abdominal wall, where it may be turned under, like a cuff. The edges of the colon are then stitched to the skin of the abdominal wall to form an opening called a stoma

Question 31

Antibiotics in hospital for diverticulitis if oral doesnt work- Which ones?

Answer 31

IV ceftriaxone and metronidazole

Question 32

Management of thrombosed haemorrhoids?

Answer 32

stool softeners, ice packs and analgesia.

Question 33

Most common cause of large bowel obstruction?

Answer 33

Bowel cancer

Question 34

Perfered diagnostic test for chronic pancreatits?

Answer 34

CT pancreas