Q) What is not true about extra levator Abdomino Perineal Resection (APE) (AIIMS 2019)
a) Anal canal dissected from levator
b) Patient in prone jack knife position
c) Specimen is resected en block with sacrum
d) Entire levator is resected along with mesorectum
Q) False regarding FAP
a) Mean age of development of cancer is 40
b)50% population develop gastric polyp and duodenal adenoma
c) 2nd most common cause of death is desmoid
d)
Q) False statement about management of cancer rectum
a) Relative to ERUS, pelvic MRI is more accurate in its ability to detect lymph node involvement
b) Rectal cancers located in the upper third of the rectum are exempt from neoadjuvant treatment.
c) TME is typically performed 2-3 weeks after completion of CRT before fibrosis develop
d) ERAS include early mobilization, transition to oral pain control, and resumption of oral food intake
Q) In juvenile polyposis coli, all true except
a) SMAD 4 mutation
b) No risk of cancer
c) Polyps most common in ileum
d) Autosomal Dominant with high penetrance
Q) Which of the following is Not a risk factor for pouchitis post IPAA in ULcerative colitis
A) Smoking
B ) NSAIDs use post op
C) Elderly patients
D) UC with extra intestinal manifestation
Ans a
Pouchitis is the complication of Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative colitis. The incidence of pochitis for the same proedure for familial Adenomatous polyposis is less than 10% but for ulcerative colitis can go as high as 50%.
Risk factors for development of pouchitis are
5. Other reported factors that may associate with pouchitis include extent of UC, thrombocytosis,and PPI use with NSAId
Ref - https://onlinelibrary.wiley.com/doi/full/10.1111/den.12744
Q ) Which of the following group of lymph nodes do lymphatics of the colon first drain to?
a) Paracolic
b) Epicolic
c) Nodes along SMA/IMA
d) Para aortic
Answer to 37
37) b
Lymphatics first drain to epicolic group along the bowel wall
Then paracolic group along the marginal artery
Intermediate group along the named vessels SMA/IMA
Finally to par aortic
Colon and upper 2/5 of rectum --- Para aortic
Lower 1/5 of rectum and anal canal - Superficial inguinal lymph nodes
Ref Sabiston-1317
Q) All are true regarding complete mesorectal excision except
a) Introduced by Hobeninger
b) It is based on ligation of central artery
c) Increases yield of lymph nodes and has decreased recurrence
d) Line of resection is below Toldt's fasica
Become a premium member to see the answer and explanation IT is Q 22 from AIIMS Nov
Q) In radiation proctitis surgery is needed in all except
a) Pain Abdomen
b) Rectal stricture
c) Haemorrhage
d) Vesical Fistula
Free Question on management of raiation proctiitis
Q) . Management of Rectal Prolapse with constipation
a) Ripstein's repair
b) Resection rectopexy
c) Altemeier procedure.
d) Thiersch
Answer to
Q) Which of the following is a Perineal procedure in rectal prolapse
A. Delorme
B. Ripstein
C. Resection rectopexy
D. Frykman Goldberg procedure