Ileostomy vs IPAA in PSC

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Q)  All are true regarding ileostomy and IPAAA in PSC with UC except? ( # AIIMS GI, # colon

1) PSC UC end ileostomy have risk of peristomal varices

2) IPAA for UC nd PSC-UC have same long term results

3) IPAA for PSC-UC have high chronic pouchitis

Uncomplicated Diverticulitis

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Q). 45 yr old Known case of diverticular disease, presents with left lower abdominal pain , on CT sigmoid wall thickening with fat stranding. All of the following can be done except
a) Admit and iv antibiotic
b) Colonoscopy after resolution
c) Elective colectomy after resolution
d) Out patient oral antibiotic

Fong Score

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Q.Not a Poor risk factor according to Fong score
a) Node +
 b) Disease free interval more than 1 yr
c) 2 Liver Mets

d) Single metastasis 6 cm

Ans b 

Fong score is for Survival after treatment for metastatic colorectal cancer to the liver. It includes 5 variables for which score is alloted to each point

Nodal status of primary

Disease-free interval from the primary to discovery of the liver metastases of <12 months

Number of tumors >1,

Preoperative CEA level >200 ng/ml, and

Size of the largest tumor >5 cm

Prognosis colon cancer

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Q) Out of the following Which is a good prognostic  factor for colorectal cancers
a )Rt side tumor
b) Left side tumor
c) Braf +
d) Kras +

Malignancy risk factors in IBD

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Q) WHich is not a  risk factor for malignancy in inflammatory bowel disease?

a) >50% crohn disease in colon

b) PSC

c) Old age of onset

d) use of Infliximab 

Indication Surgery crohn disease

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Q. Most common indication of surgery in Crohn's disease (#AIIMS GI )    (# Jejunum MCQS) 
a) Fistula
b) intractability
c) abscess
d) obstruction

Ans d Obstruction

Confusion between failure of medical therapy or obstruction as the ans. I have checked Bailey sabiston and Shackelford

2 books mention obstruction on top whereas one mentions failure of medical therapy. However with the improvement of medical management in the past decade, obstruction can be the ans

Crohn’s disease will require surgery at some time durin the course of their illness. Approximately 70% of patients will
require surgical resection within 15 years after diagnosis.

Indications for surgery include failure of medical treatment, bowel obstruction, and fistula or abscess formation. Most patients can
be treated with elective surgery,

Colon Lymphoma

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Q) True about lymphoma of the colon

a) MOre common in females

b) Most common in 3rd and 4th decade

c) Most common site is caecum

d) T cells are most commonly involved

Ans c

Lymphoma is uncommon in the colon/rectum occurring in 0.4% of patients; intestinal lymphoma and can present anywhere between the
second and eighth decades of life.

Most of these lesions are intermediate to high-grade B-cell lymphomas.

Affected men outnumber women about 1.5:1 

The majority of colorectal lymphomas are found in the cecum or ascending colon. More than 70% of colorectal lymphomas are proximal to the hepatic flexure. 

 

Xeloda Regimen

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Q) Xeloda Regimen is 

a) Continuous 5 fU infusion

b) Folfox

c) Folfiri

d) fluropyradmidine and Capecitabine