Colon 51-60

Colon Surgery Questions

Q51) Not a significant factor for prognosis in colorectal metastasis?

a) Involved lymph node in primary

b) Metachronous  lesion

c) Synchronous lesion

d) Size more than 5 cm

Q52) WHich of the following is not a histological feature of Crohn disease of the bowel

a) Stricture

b) Granuloma

c) Crypt Abscess

d) Goblet cell atrophy

Q53 ) 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 53) 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. 

Q54.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 54) 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

Q 55.Not include in Montreal classification of Crohn Disease?
a) Site
b) Behavior
c) Age
d) Endoscopy

Ans d Endoscopy

Age at diagnosis (A)

Location (L) Upper Gastrointestinal (GI)
modifier (L4)
L1 Terminal ileum L1 + L4 (terminal ileum and
upper GI)
L2 Colon L2 + L4 (colon and upper GI)
L3 Ileum and colon L3 + L4 (ileocolic and upper GI)
L4 Upper GI —
Behavior (B) Perianal disease modifier (p)
B1 Nonstricturing,
B1p (nonstricturing,
nonpenetrating and perianal)
B2 Stricturing B2p (stricturing and perianal)
B3 Penetrating B3p (penetrating and perianal)

Q 56)  All are true regarding ileostomy and IPAAA in PSC with UC except?

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

4) IPAA for PSC-UC associated with low risk of anastomotic varices

Ans is 2

26% of patients with PSC develop Peristomal varices with end ilesotomy as compared to none with IPAA ( SKF page 1382) 

Cumulative risk of pouchitis at 10 years after IPAA was 61% for patients with PSC and CUC, as compared with
36% for patients with CUC alone ( so B is false SKF page 1382) 

c is true

d is true