Q56). Ulcerative Colitis with malignancy
a) Has a better prognosis than Carcinoma Colon alone
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
Q61. Toxic Megacolon is associated with all except
a) Ulcerative colitis
b) Crohn's Disease
c) Pseudomembranous Colitis
d) Shigella
Answers
56/c
Carcinoma colon in ulcerative colitis is related to the duration of the disease. More is the duration of the disease, higher the incidence of malignancy
57) a
Total proctocolectomy with brooke's ileostomy removes almost all of the diseased segment.
IRA and IPAA 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 It is mostly not malignant and no endoscopic screening is required but risk of malignancy at extra gi sites is more.
JPC is 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.
61) d
In Toxic megacolon bacterial infection of the wall of colon creates dilatation of the wall which further progresses to imminent perforation.
Necrotic thin walled colon in which pneumatosis can be seen radiographically
