SURG 6 Flashcards by Abby David

What is the most common presenting feature of an acute abdomen?

A. Abdominal distention
B. Abdominal pain
C. Diarrhea
D. Vomiting

B. Abdominal pain

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Which of the following statements about pain in acute abdomen is true?

A. Gradually worsening pain is felt for a perforated viscus
B. Continuous pain is of obstructed pathology
C. Colicky pain is associated with solid organ pathology
D. Referred pain is due to similar innervation

D. Referred pain is due to similar innervation

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Which of the following visceral stimulation when stimulated will result to abdominal pain?

A. Traction and torsion
B. Compression
C. Stretching
D. All of the above

D. All of the above

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Which of the ff locations of gastric ulcer causing perforations is associated with increased acid production:

A. Cardia
B. Fundus
C. Body
D. Pylorus

C. Body

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Which is the most common cause of appendiceal obstruction leading to acute appendicitis?

A. Fecalith
B. Lymph node
C. Fruit seeds
D. Parasite

A. Fecalith

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What is the embryonic origin of the appendix?

A. Foregut
B. Midgut
C. Hindgut
D.Tailgut

B. Midgut

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A 45-year-old seaman was admitted for RUQ pain, ultrasound confirmed acute cholecystitis. IV antibiotics, analgesia, and bed rest were initiated. What is the right time for cholecystectomy?

A. Urgent
B. Within 1-3 days
C. 2 weeks
D. 1 month

B. Within 1-3 days

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Which of the ff is true in the pathogenesis of Acute Appendicitis?

A. Obstruction of the lumen due to fecaliths or hypertrophy of lymphoid tissue is proposed as the main etiologic factor
B. The base of the appendix is the part that suffers the most thus is the on that perforates
C. Arterial vessels are occluded first than venous drainage
D. The mucosa of the appendix is not susceptible to impairment to blood supply

A. Obstruction of the lumen due to fecaliths or hypertrophy of lymphoid tissue is proposed as the main etiologic factor

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A 35 year old female consulted at the ER due to vague periumbilical pain which is converted to sharp, prominent pain at RLQ area. This RLQ localization of pain is due to

A. Inflammation of serosa and parietal peritoneum due to inflamed appendix
B. Vascular compromise due to obstruction of appendiceal lumen
C. Stasis and Bacterial Proliferation
D. Stimulation of visceral nerve fibers

A. Inflammation of serosa and parietal peritoneum due to inflamed appendix

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Which of the following statements best characterize the supply to the colon?

A. Ileocolic artery is a branch of the superior mesenteric artery which supplies the hepatic flexure
B. Left colic flexure is a branch of the inferior mesenteric artery that supplies the descending colon
C. Right colic artery communicates with left colic artery at the splenic flexure
D. Middle colic artery is a direct branch of aorta which supplies transverse colon.

B. Left colic flexure is a branch of the inferior mesenteric artery that supplies the descending colon

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Parasympathetic innervation of the sigmoid colon comes from:

A. Vagus nerve
B.T6-T12
C.L1-L2
D.S2-S4

D.S2-S4

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What causes shift in location of pain in acute appendicitis?

A. C4 mediated irritation is due to the irritation of the overlying peritoneum at Mcburney’s point
B. Visceral pain shifts to parietal pain localized at the RLQ when the parietal peritoneum is directly inflamed
C. Visceral pain is elicited when the inflamed appendix is distended
D. Direct innervation of somatic when Mcburney’s point is distended

B. Visceral pain shifts to parietal pain localized at the RLQ when the parietal peritoneum is directly inflamed

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What supplies blood to the stomach?

A. Right gastroepiploic artery
B. Left gastroepiploic artery
C. Left gastric artery
D. AOTA

D. AOTA

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A 48-year old man underwent emergency exploratory laparotomy. A gangrenous appendicitis and a 1.5 mass at the base of the appendix was found intraoperatively. What is the best surgical option?

A. Appendectomy
B. Limited Right Hemicolectomy
C. Right Hemicolectomy
D. Extended Right Hemicolectomy

C. Right Hemicolectomy

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Which of the following is retroperitoneal?

A. Pancreas
B. Gallbladder
C. Spleen
D. Liver

A. Pancreas

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Which of the following is not true of the HIDA scan?

A. Highly sensitive and specific for acute cholecystitis
B. Lack of filling of the gallbladder indicates a cystic duct obstruction
C. Normal HIDA scan does not rule out Acute cholecystitis
D. It is helpful in atypical cases of acute cholecystitis

C. Normal HIDA scan does not rule out Acute cholecystitis

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What is the manifestation of intestinal obstruction due to strangulation?

A. Abdominal pain
B. Obstruction
C. Feculent vomitus
D. Fever

D. Fever

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A 52-year-old patient with RUQ pain and jaundice underwent biliary exploration. Intraoperatively, a 2 cm stone impacted in the infundibulum of the gallbladder was noted causing extraluminal obstruction of the bile duct. This condition is called:

A. Hydrops gallbladder
B. Mirizzi syndrome
C. Fitz-Hugh-Curtis Syndrome
D. Courvoisier gallbladder

B. Mirizzi syndrome

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Murphy sign is associated with

A. Acute appendicitis
B. Acute pancreatitis
C. Acute cholecystitis
D. Acute gastritis

C. Acute cholecystitis

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Which of the following radiographic findings is NOT part of triad suggestive of small bowel obstruction?

A. Small bowel diameter >3cm
B. Pneumatosis intestinalis
C. Air fluid level
D. Paucity of air in colon

B. Pneumatosis intestinalis

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True of the embryological development of the appendix:

A. Appendix and cecum appear as outpouching at 8 weeks AOG
B. Acheive vermiform appendix at 5th month
C. Both are true Incorrect
D. Neither true

B. Acheive vermiform appendix at 5th month

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What Hinchey classification is described when there is a 5-cm pericolic abscess confined at the left lower quadrant area as seen on CT scan but is determined to have perforated with an opening big enough to spill fecal material to the upper quadrants of the abdomen?

A. III
B. I
C. II
D. IV

D. IV

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W GA, a 60-year-old man, with a history of chronic constipation, consulted at the ER due to progressive abdominal distention noted three hours ago. On physical examination, vital signs were stable, and he had a markedly distended abdomen with hyperactive BS, tympanitic, non-tender but with no palpable mass. Radiographs of the abdomen were taken which revealed a markedly dilated bowel segment with omega loop sign with its apex pointing to the right upper quadrant. What is your diagnosis?

A. Sigmoid Volvulus
B. Intussusception
C. Cecal Volvulus
D. Hirschsprung’s disease

A. Sigmoid Volvulus

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A 21-year-old professional motorcycle rider was brought to the ER after a crash. His BP is 80/50, HR is 125, RR is 30 and he is anxious. What does the ABCs in trauma management include?

A. B for Breathing
B. A for allergies
C. A for Acute injury
D. C for Cervical spine protection

A. B for Breathing

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What is the most common presentation of a complicated diverticular disease? A. Obstruction B. Abscess C. Perforation D. Fistula

B. Abscess

Which of the following statements is associated with the Carcinoid Tumor? A. Less aggressive than appendiceal carcinoid tumor B. Arise from enterochromaffin cells predominantly the duodenum C. Tumor debulking of metastatic lesions has no role D. Carcinoid syndrome will manifest mostly in patients with liver metastases.

D. Carcinoid syndrome will manifest mostly in patients with liver metastases.

What is the most common neoplasm found in the small bowels? A. Adenocarcinoma B. Gastrointestinal Stromal Tumor (GIST) C. Lymphoma D. Carcinoid Tumor

A. Adenocarcinoma

What is the most common site of the bowels affected by Diverticulosis? A. Descending Colon B. Cecum C. Sigmoid Colon D. Ascending Colon

C. Sigmoid Colon

A 55-year-old man consulted at the clinic complaining of a palpable mass at the periumbilical area. Patient denies of any changes in bowel movement nor weight loss. Physical examination showed a non-distended abdomen, normoactive bowel sounds with a soft, nontender, 10 cm palpable mass at the periumbilical area. The mass is hard, movable, non-tender with well-defined borders. What would be the initial diagnostic examination appropriate for this patient? A. Ultrasound B. Colonoscopy C. Water soluble contrast enema D. CT scan of the abdomen with contrast

D. CT scan of the abdomen with contrast

What is the characteristic finding on endoscopy of patients with sigmoid volvulus? A. Whirl sign B. Coffee bean sign C. Bird's beak sign D. Pin wheel sign

D. Pin wheel sign

One of the following is not a manifestation of Carcinoid syndrome. A. Diarrhea B. Tachycardia C. Flushing D. Hypertension

D. Hypertension

HG is a 60-year-old female who presented with left lower quadrant pain associated with fever. Physical examination revealed a slightly distended hypoactive abdomen with direct and rebound tenderness at the left lower quadrant area. The admitting impression is a complicated Sigmoid Diverticulitis. What is the imaging modality of choice for this patient? A. MRI of the Abdomen B. Ultrasound C. Water soluble contrast enema D. CT scan of the abdomen with contrast

D. CT scan of the abdomen with contrast

Intraoperative findings for a drive who was brought in because of a head on vehicular crash revealed hemoperitoneum approximately 1.5 L secondary to a splenic hilar vessel laceration causing 40 % devascularization. What is grade of the splenic injury? A. III B. IV C. V D. II

B. IV

A 52-year-old male underwent an emergency Exploratory laparotomy for a complete bowel obstruction. Intraoperatively, small bowels were dilated due to an obstructing bulky mass at the hepatic flexure. The liver is grossly normal with no other lesions that would signify distant metastasis. What is the most common type of malignancy at the hepatic flexure? A. Carcinoid tumor in small intestine and appendix B. Gastrointestinal Stromal Tumor C. Lymphoma D. Adenocarcinoma

D. Adenocarcinoma

Which of the following statements is related to the Gastrointestinal Stromal Tumor (GIST)? A. Express KIT assessed by CD 117 antigen B. Spread via lymphatics, Hematogenous and direct extension C. The size of the tumor has no significance on the prognosis. D. Arise from enterochromaffin cells predominantly in the ileum

A. Express KIT assessed by CD 117 antigen

What specific arteries supplying the colon should be ligated in performing cancer surgery for a right hemicolectomy? A. Ileocolic Artery, right colic artery, right and left branches of middle colic artery B. Ileocolic Artery, right colic artery, right branch of middle colic artery C. Ileocolic Artery, right colic artery, right and left branches of middle colic artery, left colic artery D. Ileocolic Artery, right colic artery

B. Ileocolic Artery, right colic artery, right branch of middle colic artery

MJ a 55-year-old female came in with signs of colonic obstruction. What is the definitive treatment if the primary impression is a sigmoid volvulus? A. Double set-up Flexible sigmoidoscopy B. Observe for 48 hrs. C. Exploratory laparotomy D. Bowel rest and IV antibiotics

A. Double set-up Flexible sigmoidoscopy

What is the minimum parameter to establish invasive carcinoma in colorectal tumor? A. Muscularis Propria B. Muscularis mucosa C. Submucosa D. Serosa

C. Submucosa

UT, a 56-year-old female was explored because of a stercoral perforation, or a proximal rectal tumor that has perforated. What is the definitive procedure in the management of this patient? A. Exploratory laparotomy, Hartmann's procedure B. Exploratory laparotomy, sigmoidectomy C. CT guided Percutaneous drainage of abscess if accessible D. Observe

A. Exploratory laparotomy, Hartmann's procedure

GA, a 60-year-old man, with a history of chronic constipation, consulted at the ER due to progressive abdominal distention noted three hours ago. On physical examination, vital signs were stable, and he had a markedly distended abdomen with hyperactive BS, tympanitic, non-tender but with no palpable mass. At the ER, which one of the following is the priority management for this patient? A. IV antibiotics is not needed if no signs of sepsis. B. Allow diet if tolerated. C. Adequate hydration/fluid resuscitation D. Fleet enema to facilitate bowel movement

C. Adequate hydration/fluid resuscitation

What are the regions involved in Focused Assessment with Sonography in trauma (FAST)? A. Pelvis B. Perisplenic C. Perihepatic D. AOTA

D. AOTA

What is the most common organ injured following a blunt abdominal trauma? A. Kidney B. Spleen C. Pancreas D. Liver

D. Liver

What procedure would you explain to a relative who calls you up saying that your 70-year-old uncle is in the operating room and was determined to have a malignancy of the hepatic flexure? A. Left Hemicolectomy B. Right Hemicolectomy C. Transverse colectomy D. Extended Right Hemicolectomy

D. Extended Right Hemicolectomy

What radiologic sign is evident on computed tomography scan for a patient with Sigmoid volvulus? A. Coffee bean sign B. Whirl sign C. Pin wheel sign D. Bird's beak sign

B. Whirl sign

When the histopathologic report reveals that the cancer invades at the level of the submucosa and only one out of 18 pericolic lymph nodes is positive of tumor cells, what is the pathologic stage of the disease? A. Stage IIB B. Stage IIA C. Stage IIIB D. Stage IIIA

D. Stage IIIA

Which of the following is TRUE in relation to the anatomic division of the abdomen? A. Four quadrants dividing through the anterior median line and transverse line traversing the xiphoid process B. Two vertical lines and two transverse lines dividing the abdomen into 9 regions C. The adrenal glands are located in the intraperitoneal space D. Nerve that supply in the anterior and lateral abdominal wall is L2-L5

B. Two vertical lines and two transverse lines dividing the abdomen into 9 regions

Which of the following statements related to pain of acute abdomen is true? A. Gradually worsening pain may be suggestive of a perforated anus B. Colicky pain is likely associated with solid organ pathology C. Pain that is continuous in nature is likely related to obstructive process D. Referred pain beyond site of the disease is due to shared innervation

D. Referred pain beyond site of the disease is due to shared innervation

Which is associated with visceral pain in acute appendicitis? A. Mediated by both C and A delta nerve fibers B. Acute, sharp and persistent C. Worse with movements D. Localized in mid-abdomen

D. Localized in mid-abdomen

A 25 yo male consulted at the ER due to vague periumbilical pain which later became sharp and prominent at the RLQ area. The pain is likely due to A. inflammation of serosa and parietal pneumoperitoneum due to inflamed appendix B. vascular compromise due to obstruction of appendiceal lumen C. stasis and bacterial proliferation D. Stimulation of visceral nerve fiber

A. inflammation of serosa and parietal pneumoperitoneum due to inflamed appendix

Shifting pain in acute appendicitis is due to? A. C4 mediated nerve is stimulated due to irritation of overlying peritoneum at the McBurney’s point B. Visceral pain is due to distention of the appendix, which later becomes a sharper parietal pain in the RLQ when the overlying peritoneum becomes directly inflamed C. Visceral pain is most often felt in the McBurney’s point following the distention of the inflamed appendix D. Direct irritation of the somatically innervated visceral peritoneum caused by the distention of the inflamed appendix

B. Visceral pain is due to distention of the appendix, which later becomes a sharper parietal pain in the RLQ when the overlying peritoneum becomes directly inflamed

What is the largest blood supply of the stomach? A. Left gastroepiploic artery B. Right gastroepiploic artery C. Left gastric artery D. Right gastric artery

C. Left gastric artery

Which of the following locations of gastric ulcer causing perforations is associated with increased acid production? A. Cardia B. Fundus C. Body D. Pylorus

C. Body

Which is the intraperitoneal finding of perforated peptic ulcer disease related to acid hypersecretion? A. Perforation at the prepyloric area with duodenal scarring B. Perforation at the area near the cardia C. Perforation at the gastric fundus D. Perforation at the prepyloric area in a person taking aspirin for 3 months

A. Perforation at the prepyloric area with duodenal scarring

A 76 yo male was rushed to the ER due to generalized abdominal pain. The pain started 2 days ago as an excruciating epigastric pain, persisted and became generalized. PE findings was febrile with icteric sclerae. BP 90/60 HR 110 RR 25. Patient was then subjected to OR for fluid resuscitation. Intraoperative finding was Interloop abscess collection at perigastric area with 1-cm perforation at the prepyloric area. What is the appropriate management? A. Graham’s patch with highly selective vagotomy B. Biopsy of the ulcer edge, Graham’s patch perforation repair C. Graham’s patch + truncal vagotomy + gastrojejunostomy D. Digital gastrectomy

B. Biopsy of the ulcer edge, Graham’s patch perforation repair

A 60-year-old man with a history of chronic constipation consulted into the ER due to abdominal distension which was noted to be progressive over the last 3 days. On PE, vital signs are stable, markedly distended abdomen, hyperactive bowel sounds, tympanitic, nontender, no palpable masses. After adequate management in the ER, what is the next step in the treatment? A. Exploratory laparotomy B. Double set-up flexible sigmoidoscopy C. Bowel rest and IV antibiotics D. Observe for 48 hours

B. Double set-up flexible sigmoidoscopy

Which is TRUE about normal transmit constipation? A. The stool moves through the colon at a slow rate B. Lack of coordination of the pelvic floor during defecation C. Abdominal pain and bloating relieved by defecation D. It is otherwise called as abdominal constipation

C. Abdominal pain and bloating relieved by defecation

What is the optimal diagnostic modality in detecting colorectal cancer? A. Colonoscopy B. Contrast enema C. CT colonography D. Intra-operative colonoscopy

A. Colonoscopy

What is the most common cause of small bowel obstruction? A. Postoperative adhesions B. Tumor C. Volvulus D. Foreign body ingestion

A. Postoperative adhesions

A 32-year-old male was consulted to the ER due to vomiting associated with constipation. History revealed that the patient underwent exploratory laparotomy for ruptured appendicitis 5 years ago. Patient’s vital signs are stable with a soft distended with hypoactive bowel sounds and minimal tenderness. X-ray revealed dilated small bowel with air fluid levels. What is the appropriate management for this patient? A. Do explorative laparotomy after adequate hydration B. Hydration, bed rest and observe for 48 hours C. Give laxative to aid evacuation D. Refer to gastroenterologist for colonoscopy

B. Hydration, bed rest and observe for 48 hours

Which of the following is NOT considered part of intestinal series in the diagnostic imaging of small bowel obstruction? A. Chest x-ray upright B. Abdominal x-ray lateral C. Abdominal x-ray supine D. Abdominal x-ray upright

B. Abdominal x-ray lateral

Which of the following statements is related to the Gastrointestinal Stromal Tumor (GIST)? A. Expressed KIT assessed by CD 117 antigen B. Spread via lymphatics, hematogenous and direct extension C. The size of the tumor has no significance on the prognosis D. Arise from enterochromaffin cells predominantly in the ileum

A. Expressed KIT assessed by CD 117 antigen

Which among the following is NOT a manifestation of carcinoid syndrome? A. Diarrhea B. Flushing C. Hypertension D. Tachycardia

C. Hypertension

What is TRUE of Meckel’s diverticulum? A. It is a true diverticulum B. It has 2:1 female predominance C. Pancreatic acini most common heterotopic mucosa D. It is a rare congenital anomaly of the GIT

A. It is a true diverticulum

Which of the following is associated with carcinoid tumors? A. Carcinoid syndrome will mostly manifest in patients with liver metastases B. Arise from interstitial cells of Cajal C. Less aggressive than appendiceal carcinoid tumors D. Tumor metastases of bulking lesions has no role in management

A. Carcinoid syndrome will mostly manifest in patients with liver metastases

Which statement is true of bowel obstruction? A. Abdominal distention is prominent in distal bowel obstruction B. Fecaloid NGT output is consistent only with distal Too far away from colon bowel obstruction C. Bilious vomiting is prominent in distal bowel D. Abdominal distention is prominent in proximal

A. Abdominal distention is prominent in distal bowel obstruction

A 60-year-old female presents with left lower quadrant pain with fever. What is the initial diagnostic examination appropriate for this patient? A. Ultrasound B. Colonoscopy C. Water soluble contrast enema D. CT scan with abdominal contrast

D. CT scan with abdominal contrast

What is the common location of the volvulus? A. Transverse colon B. Cecum C. Proximal jejunum D. Sigmoid colon

D. Sigmoid colon

What sign in acute appendicitis is pain elicited at McBurney’s point upon palpation of the left lower quadrant? A. Iliopsoas sign B. Murphy’s sign C. Rovsing’s sign D. Obturator sign

C. Rovsing’s sign

Which of the following radiographic findings is not part of the triad suggestive of small bowel obstruction? A. Pneumatosis intestinalis B. Diameter of small bowel >3 cm C. Air-fluid level D. Paucity of air in the colon

A. Pneumatosis intestinalis

Which of the following features of intestinal obstruction indicate bowel strangulation? A. Obstipation B. Abdominal pain C. Feculent vomitus D. Fever

D. Fever

Which part of the colon is commonly affected by diverticulosis? A. Ascending B. Descending C. Sigmoid D. Cecum

C. Sigmoid

Which of the following is associated with the formation of colorectal cancer? A. Activation of p53 gene B. Activation of the K-ras gene C. Activation of the APC gene D. Activation of the DDC gene

B. Activation of the K-ras gene

A 45-year-old man underwent an emergency right hemicolectomy for an obstructing cecal mass. Final histopathologic report revealed well differentiated adenocarcinoma invading the submucosa, with two out of 20 lymph nodes positive. No distant metastasis noted on work up. What is the stage of the disease? A. Stage IIA B. Stage IIB C. Stage IIIA D. Stage IIIB

C. Stage IIIA

What is the minimum criteria to establish invasive carcinoma in colon or rectal polyp? Involvement of the A. muscularis propria B. muscularis mucosa C. submucosa D. serosa

C. submucosa

What is the most common type of colon cancer that causes obstruction? A. Lymphoma B. Adenocarcinoma C. Carcinoid tumor D. GIST

B. Adenocarcinoma

A 60-year-old female consulted at the ER for a LLQ pain associated with fever. CT scan of the abdomen showed a 5-cm pericolic abscess and 3-cm pelvic abscess. What is the Hinchey stage of this patient? A. I B. II C. III D. IV

B. II

An 85-year-old female underwent emergency exploratory laparotomy for a perforated sigmoid diverticulitis – Hinchey IV. What is the appropriate surgical procedure for this patient? A. Sigmoidectomy B. Hartmann’s procedure C. Anterior resection D. Left hemicolectomy

B. Hartmann’s procedure

A 60-year-old man presents with obstipation and abdominal distention but with stable vital signs. A single-shot water soluble contrast enema showed a “bird’s beak appearance”. What is the next step in the management of this patient? A. Exploratory laparotomy B. Flexible sigmoidoscopy C. Bowel rest and IV antibiotics D. Observe for 48 hours

B. Flexible sigmoidoscopy

Which of the following is a true option in the screening for colorectal cancer? A. FOBT with flexible sigmoidoscopy every 5 years in individuals with familial adenomatous polyposis B. Colonoscopy at 50 years old in individuals with family history of colon cancer C. Colonoscopy every 5 years starting at 21 years old in patients with Lynch syndrome D. Annual FOBT in average risk individuals

D. Annual FOBT in average risk individuals

What endoscopic finding is suggestive of sigmoid volvulus? A. Pinwheel sign B. Bird beak sign C. Coffee bean sign D. Bent inner tube sign

A. Pinwheel sign

Which of the following is/are measures of adequate urine output? A. Adult = 0.5 ml/kg/hr B. Child = 1 ml/kg/hr C. <1 year old = 2 ml/kg/hr D. AOTA

D. AOTA

A 52-year-old female with left lower quadrant pain came to consult. Computed tomography (CT) scan revealed a 5-cm pericolic abscess along the left lateral gutter. She had a previous sigmoid diverticulitis. What is the next step in the management of this patient? A. Ex-lap, Hartmann’s procedure B. Ex-lap, Hartmann’s procedure C. CT scan guided percutaneous drainage of abscess if accessible D. NGT, bowel rest observe

C. CT scan guided percutaneous drainage of abscess if accessible

One of the following is an example of an intramural cause of intestinal obstruction A. Tumor B. Santol seed C. Gallstone D. Adhesion

A. Tumor

What are the ABCs in trauma management? A. A for Allergies B. B for Breathing C. C for Cervical spine protection D. All of the above

B. B for Breathing

In a patient where the FAST exam was done, examination revealed fluid collection at perisplenic region. What is the estimated blood loss of the patient? A. 500 ml B. 900 ml C. 1800 ml D. 2100 ml

C. 1800 ml

What is the most common organ injured following blunt abdominal trauma? A. Liver B. Spleen C. Kidney D. Pancreas

A. Liver

What is the most common malignant neoplasm in the jejunum? A. Carcinoid tumor B. GIST C. Adenocarcinoma D. Lymphoma

C. Adenocarcinoma

A 56-year-old male underwent right hemicolectomy for a nearly obstructing cecal tumor and a biopsy of few peritoneal nodules on the right lateral gutter. Final histopathologic finding revealed a well differentiated adenocarcinoma with a tumor invading the muscularis propria. 1/20 lymph nodes positive for cancer. Peritoneal nodules also revealed the same type of cancer. What is the type of pathologic staging? A. IIIC B. IVA C. IVB D. IVC

D. IVC

In the treatment of slow transmit constipation, which of the following is an example of a stimulant laxative? A. Psyllium B. Lactulose C. Bisacodyl D. Polyethylene glycol

C. Bisacodyl

What arteries should be ligated in doing right hemicolectomy for cancer surgery? A. Ileocolic artery and right colic artery B. Ileocolic artery, right colic artery, and right branch of middle colic artery C. Ileocolic artery, right colic artery, right and left branches of middle colic artery, left colic artery D. Ileocolic artery, right colic artery, right and left branches of middle colic artery, left colic artery

B. Ileocolic artery, right colic artery, and right branch of middle colic artery

The following is/are true with slow transmit constipation A. Lack of coordination of the pelvic floor during defecation B. Results in excessive straining, needs digital manipulation with incomplete evacuation C. Wireless motility capsule is the most common study utilized D. Management should always begin with appropriate counseling, including listening to and validating patient’s complaints

D. Management should always begin with appropriate counseling, including listening to and validating patient’s complaints

Which of the following is a finding on water-soluble contrast enema with sigmoid diverticulitis? A. Pinwheel sign B. Bird’s beak sign C. Coffee bean sign D. Bent inner tube sign

B. Bird’s beak sign

A 34-year-old went to OPD with a chief complaint of irregular bowel movement. She is asking if her case can be considered constipation. According to Rome III criteria, which of the following can define the functional constipation? A. Straining during at least 55% of defecation B. Hard stools at least 45% of defecation C. Sensation of incomplete evacuation at least 35% of defecation D. Manual maneuver to facilitate at least 25% of defecation

D. Manual maneuver to facilitate at least 25% of defecation

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