Large Bowel

Question 1

Microscopic colitis biopsy findings

Answer 1

lymphocytic or collagenous colitis

Question 2

Layers of the bowel impacted by UC (2)

Answer 2

mucosa
submucosa

Question 3

Chemo for colorectal cancer

Answer 3

FOLFOX

Question 4

Components of FOLFOX (3)

Answer 4

5-fluorouracil
leucovorin
oxaliplatin

Question 5

Antibiotics for uncomplicated diverticulitis (2)

Answer 5

ciprofloxacin + metronidazole

Question 6

IBS-C fiber recommendations

Answer 6

increase intake

Question 7

IBS-D fiber recommendations

Answer 7

decreased intake

Question 8

Rome IV IBS criteria

Answer 8

1) symptoms lasting at least 6 months
2) occurring at least 1 day/week
3) for the past 3 months

Question 9

Chronic diarrhea duration

Answer 9

> 4 wks

Question 10

Serum ferritin indicative of anemia in chronic disease

Answer 10

> 100

Question 11

Number of recurrences to consider FMT

Answer 11

2-3

Question 12

Success rate of FMT

Answer 12

> 90%

Question 13

Polyp size to use snare polypectomy

Answer 13

< 1 cm

Question 14

Components for Mayo score (4)

Answer 14

stool frequency
rectal bleeding
endoscopic findings
physician global assessment

Question 15

Mayo score

Answer 15

Stool Frequency:
0: Normal
1: 1-2 stools more than normal
2: 3-4 stools more than normal
3: ≥5 stools more than normal

Rectal Bleeding:
0: None
1: Streaks of blood in stool
2: Obvious blood in stool
3: Passing blood alone

Endoscopic Findings:
0: Normal or inactive disease
1: Mild disease (erythema, decreased vascular pattern, mild friability)
2: Moderate disease (marked erythema, lack of vascular pattern, friability)
3: Severe disease (spontaneous bleeding, large ulcers)

Physician’s Global Assessment:
0: Normal
1: Mild disease
2: Moderate disease
3: Severe disease

Question 16

Polyp size that EMR is indicated

Answer 16

> /= 2 cm

Question 17

Diagnosis of toxic megacolon

Answer 17

colonic dilation > 6 cm on x-ray w/ systemic toxicity

Question 18

Toxic megacolon treatment

Answer 18

IV steroids
cipro + flagyl
surgery if no improvement in 24-48 hours

Question 19

UC vs Crohn’s histology

Answer 19

UC - crypt abscesses, mucosal inflammation
Crohn’s - noncaseating granulomas, transmural inflammation

Question 20

FAP surgical management

Answer 20

colectomy by age 25 if multiple polyps

Question 21

Genetic testing for Lynch Syndrome (3)

Answer 21

MLH1
MSH2
MSH6

Question 22

Peutz-Jeghers genetic mutation

Answer 22

STK11 gene

Question 23

TNF inhibitor indicated for FISTULIZING Crohn’s

Answer 23

infliximab (remicade)

Question 24

FAP inheritance pattern

Answer 24

autosomal dominant

Question 25

Peutz-Jeghers inheritance pattern

Answer 25

autosomal dominant

Question 26

FAP genetic mutation

Answer 26

APC

Question 27

Test for chronic inflammation

Answer 27

ESR

Question 28

Test for acute inflammation

Answer 28

CRP

Question 29

Most common site of colonic neoplasms

Answer 29

descending colon

Question 30

Absorption at transverse colon (3)

Answer 30

water electrolytes small-chain fatty acids