Surgery Multiple Choice Questions
MCQ SURGERY Questions on stomach and duodenum
Questions on colon, large bowel with Refrences and explanations
Q56). Ulcerative Colitis with malignancy
a) has a better prognosis than Ca Colon
b) Is related to disease activity
c) is related to duration of ulcerative colitis
d) Malignancy is more in ano rectal ulcerative colitis
Q57) In ulcerative coilitis with toxic megacolon
lowest recurrence is seen in
a) complete proctocolectomy and brook's ileostomy
b) Ileo rectal anastomosis
c) koch's pouch
d) Ileo anal pull through procedure
Q58) All are premalignant except
a) Turcot syndrome
b) cowden syndrome
c) Juvenile polyposis coli
d) none
Q59) Colonic polyps are seen to regress with
a) Azathioprine
b) streptozocin
c) Sulindac
Q60) All are precancerous for carcinoma colon except
a. crohn's disease
b. Bile acids
c. Fats
d. carotene
Answers
56) c
The two most important risk factors for developing malignany in Ulcerative colitis are duration of the disease and extent of the disease .Disease activity is not a determinant of malignancy.
57) a
Total proctocolectomy with brooke's ileostomy removes almost all of the diseased segment.
IRA (Ileo rectal anastomosis) and IPAA (Ileal Pouch Anal Anastomosis) leave behind rectal mucosa which may or may not be diseased
58) d
Turcot syndrome Turcot et al first described an association between colonic polyps and tumors. The colonic/rectal polyps are adenomatous, usually multiple, and 1-30 mm in diameter. Most central nervous tumors are supratentorial glioblastoma with occasional medulloblastoma. Other reported abnormalities include sebaceous cysts, papillary carcinoma of the thyroid, leukemia, and spinal cord tumors. They are definately premalignant PN
Cowden syndrome is a rare disorder that is inherited in autosomal dominant manner with intra-familial and inter-familial differences in the expressivity of symptoms Ii is mostly not malignant and no endoscopic screening is reuired but risk of malignancy at extra gi sites is morer.
JPCis premalignant Patients with polyps should undergo endoscopic surveillance every 1-3 year. Colectomy is recommended for patients who have numerous polyps in the colon; however, surveillance of the ileal pouch should be continued because of the risk of malignant change.
59)c
60) d
Carotene, Vit C and Calcium reduce the risk of colonic malignancy.
