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Surgery > Large Intestine > Flashcards

Large Intestine Flashcards

1
Q

In order to avoid complications, output from an ileostomy should be kept below

A. 500 mL/day
B. 1000 mL/day
C. 1500 mL/day
D. 2000 mL/day

A

C

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2
Q

An internal hemorrhoid that prolapses past the dentate line with straining is a

A. First-degree hemorrhoid
B. Second-degree hemorrhoid
C. Third-degree hemorrhoid
D. Fourth-degree hemorrhoid

A

A

First-degree hemorrhoids bulge into the anal canal and may prolapse beyond the dentate line on straining.
Second-degree hemorrhoids prolapse through the anus but reduce spontaneously.
Third-degree hemorrhoids prolapse through the anal canal and require manual reduction.
Fourth-degree hemorrhoids prolapse but cannot be reduced and are at risk for strangulation.

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3
Q

In patients with inflammatory bowel disease, erythema nodosum

A. Is seen more commonly in men
B. May occur near a stoma
C. Usually occurs on the lower legs
D. All of the above

A

C

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4
Q

Lymphoma of the colon is most commonly found in the

A. Cecum
B. Transverse colon
C. Sigmoid colon
D. Rectum

A

A

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5
Q

Which of the following is the first test that should be performed in a patient with lower gastrointestinal bleeding?

A. Nasogastric aspiration
B. Anoscopy
C. Proctoscopy
D. Colonoscopy

A

A

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6
Q

Which of the following is the procedure of choice for a patient with Crohn’s colitis involving the left colon who has rectal sparing?

A. Left colectomy with primary anastomosis
B. Left colectomy with colostomy
C. Total colectomy with primary anastomosis
D. Total colectomy with ileostomy

A

A

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7
Q

Approximately 5% of patients with complicated diverticulitis develop a fistula to an adjacent organ. The most commonly involved organ is

A. Small bowel
B. Skin
C. Bladder
D. Vagina

A

C

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8
Q

Azathioprine (which can be used in the treatment of inflammatory bowel disease)

A. Decreases the efficacy of leucocytes
B. Can be used instead of steroids in patients who are steroid refractory
C. Has an onset of action of 6-12 weeks
D. Requires intravenous administration

A

C

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9
Q

The most common infectious cause for emergency laparotomy in a patient with AIDS is

A. Cytomegalovirus
B. Toxoplasmosis
C. Salmonella
D. Herpes simplex

A

A

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10
Q

Which of the following is often effective in the treatment of a desmoid tumor of the mesentery in a patient with familial adenomatous polyposis?

A. Tamoxifen
B. Methotrexate
C. Steroids
D. Radiotherapy

A

A

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11
Q

Treatment of Ogilvie’s syndrome includes

A. Proctoscopy
B. Sigmoid colectomy
C. Intravenous neostigmine
D. Saline enemas

A

C

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12
Q

Which of the following has the lowest recurrence rate after reduction and repair of a rectal prolapse?

A. Perineal reefing of the rectal mucosa (Delorme procedure)
B. Abdominal rectopexy (Ripstein procedure)
C. Perineal rectosigmoidectomy (Altemeier procedure)
D. Reduction of the perineal hernia and closure of the cul-de-sac (Moschcowitz procedure)

A

B

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13
Q

A 2-cm invasive cancer of the toproximal transverse colon carcinoma should be treated with which of the following procedures?

A. Ileocecectomy
B. Ascending colectomy
C. Right hemicolectomy
D. Extended right hemicolectomy

A

D

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14
Q

Anal fissures in Crohn’s disease are most commonly

A. Anterior
B. Posterior
C. Lateral
D. None of the aboveóthe distribution is equal

A

C

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15
Q

The risk of colon cancer in a patient who was diagnosed with ulcerative colitis 20 years ago is approximately

A. 8%
B. 18%
C. 28%
D. 38%

A

A

2% after 10 years, 8% after 20 years, and 18% after 30 years

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16
Q

The most common complication following hemorrhoidectomy is

A. Fecal impaction
B. Bleeding
C. Urinary retention
D. Infection

A

C

17
Q

Which of the following is an extraintestinal manifestation of familial adenomatous polyposis?

A. Arthritis
B. Uveitis
C. Central nervous system tumors
D. Erythema nodosum

A

C

18
Q

Which of the following is characterized by hamartomas formed from all three embryonic layers?

A. Familial juvenile polyposis
B. Peutz-Jeghers syndrome
C. Cronkite-Canada syndrome
D. Cowden syndrome

A

D

19
Q

How many distinct layers of the rectal wall can be seen on endorectal ultrasound?

A. 2
B. 3
C. 4
D. 5

A

D

20
Q

The initial treatment of symptomatic pouchitis includes

A. Oral antibiotics
B. Intravenous antibiotics
C. Probiotic enemas
D. Steroid enemas

A

A

21
Q

Which of the following is produced by the appendix?

A. T cells
B. B cells
C. IgG
D. IgA

A

D

22
Q

Lymphoid tissue in the appendix

A. Is present at birth
B. Steadily increases in amount throughout life
C. Is maximally present during puberty
D. Disappears by the 5th decade of life

A

C

23
Q

The luminal capacity of a normal appendix is

A. 0.1 mL
B. 1 mL
C. 5 mL
D. 10 mL

A

A

24
Q

Appendectomy may decrease the risk of developing which of the following diseases?

A. HIV
B. Burkitt’s lymphoma
C. Ulcerative colitis
D. Colon cancer

A

C

25
Q

Cultures should be taken at the time of surgery

A. For all patients with appendicitis
B. For all (but only) patients with perforated appendicitis
C. For immunocompromised patients with appendicitis
D. Never

A

C

26
Q

Which of the following is indicated in a patient with pseudomyxoma peritonei of appendiceal origin?

A. Right hemicolectomy
B. Hysterectomy with bilateral salgingo-oophorectomy
C. Abdominal XRT
D. Systemic chemotherapy

A

B

27
Q

The treatment for lymphoma confined to the appendix is

A. Appendectomy alone
B. Appendectomy with systemic chemotherapy
C. Right hemicolectomy alone
D. Right hemicolectomy with systemic chemotherapy

A

A

28
Q

Divides endoderm and ectoderm

A

Dentate line

29
Q

Transverse appendectomy incision

A

Rocky-davis

30
Q

If phlegmon is present in appendicitis, what is the treatment?

A

Delay resection and start antibiotics then interval appendectomy

31
Q

Most common location of carcinoid tumor

A

Small intestine (ileum)

32
Q

Used to localize carcinoid tumor

A

Octreotide scan

33
Q

Treatment of carcinoid tumor if > 2 cm, associated with metastatic disease, or involving the terminal ileum or appendiceal base

A

right hemicolectomy

34
Q

Pseudo obstruction of the colon

A

Ogilvie’s syndrome

Air in the rectum

Surgery (10 decks)

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