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
CROHN DISEASE 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, nonpenetrating 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)