MCQ ANSWERSMCQ ANSWERSM62 Course 2004M62 Course 2004

Association of Coloproctology

of Great Britain and Ireland

Regarding the management of faecal incontinence, all of the following are true EXCEPT

M62 - MCQ 1M62 - MCQ 1

A) The role of biofeedback is not proven for faecal incontinence

B) Enema use can be useful if faecal soiling is a problem

C) Loperamide can be of value

D) Prolonged PNTML carries a poor prognosis

E) Topical phenylephrine gel may have a role in management

Regarding the management of faecal incontinence, all of the following are true EXCEPT

M62 - MCQ 1M62 - MCQ 1

D) Prolonged PNTML carries a poor prognosis

The successful operative treatment of patients with moderate to severe symptoms due to an anterior rectocoele has been shown to correlate best with:-

M62 - MCQ 2M62 - MCQ 2

A) physical examination identifying a >2cm rectocoele

B) MRI identifying a >2cm rectocoele

C) Defaecographic identification of a >2cm rectocoele

D) Anal incontinence as a presenting complaint

E) Duration of symptoms

The successful operative treatment of patients with moderate to severe symptoms due to an anterior rectocoele has been shown to correlate best with:-

M62 - MCQ 2M62 - MCQ 2

C) Defaecographic identification of a >2cm rectocoele

Regarding irritable bowel syndrome:

M62 - MCQ 3M62 - MCQ 3

A) The Rome criteria are a useful clinical tool

B) No association with chronic fatigue, fibromyalgia, bladder or gynaecological symptoms is seen

C) May be explained by peripheral visceral hypersensitivity or central hypervigilance

D) Cannot be induced by Campylobacter infection

E) May occur without disturbance in defaecation

Regarding irritable bowel syndrome:

M62 - MCQ 3M62 - MCQ 3

C) May be explained by peripheral visceral hypersensitivity or central hypervigilance

With regard to Solitary Rectal Ulcer Syndrome (SRUS) all of the following are true EXCEPT

M62 - MCQ 4M62 - MCQ 4

A) Ulceration is due to trauma to the leading edge of an internal intussusception

B) Biofeedback can be initially helpful in up to 30% of patients

C) Defaecating proctography is useful in patient assessment.

D) Colitis cystica profunda is a recognised variant.

E) Rectopexy is associated with symptom resolution in more than 90% of patients

With regard to Solitary Rectal Ulcer Syndrome (SRUS) all of the following are true EXCEPT

M62 - MCQ 4M62 - MCQ 4

E) Rectopexy is associated with symptom resolution in more than 90% of patients

All of the following statements regarding FOBT population screening for colorectal cancer are true EXCEPT:-

M62 - MCQ 5M62 - MCQ 5

A) Targeted population is aged 45 to 65 years

B) The most widely used kit is a guaiac based test for peroxidase activity

C) Population compliance is about 60%

D) Less than 2% of returned tests are positive.

E) Colonoscopy of the FOB positive population demonstrates a cancer in 10%

All of the following statements regarding FOBT population screening for colorectal cancer are true EXCEPT:-

M62 - MCQ 5M62 - MCQ 5

A) Targeted population is aged 45 to 65 years

All of the following statements regarding Colonic Volvulus are true EXCEPT:-

M62 - MCQ 6M62 - MCQ 6

A) Percutaneous sigmoid colostomy can be useful in selected cases

B) Endoscopic decompression is successful as initial therapy in up to 90% of patients

C) Sigmoid colectomy for sigmoid volvulus can be associated with a recurrence rate of 30% or more

D) The recurrence rate after sigmoid colectomy for volvulus is unaffected by the preoperative presence of megacolon

E) Caecal volvulus is less common than sigmoid volvulus

All of the following statements regarding Colonic Volvulus are true EXCEPT:-

M62 - MCQ 6M62 - MCQ 6

D) The recurrence rate after sigmoid colectomy for volvulus is unaffected by the preoperative presence of megacolon

Lipomas of the colon:

M62 - MCQ 7M62 - MCQ 7

A) Are mostly subserosal

B) Are most commonly found in the sigmoid

C) Cannot be differentiated from cancer on imaging studies

D) Are the most common benign intramural colon tumour

E) Are best treated by snare excision

Lipomas of the colon:

M62 - MCQ 7M62 - MCQ 7

D) Are the most common benign intramural colon tumour

Regarding campylobacter enteritis:

M62 - MCQ 8M62 - MCQ 8

A) It is a rare cause of infectious diarrhoea in this country

B) The organism Campylobacter jejuni are gram positive cocci seen in clusters on a stool smear

C) Transmission occurs through a faecal-oral route through contaminated water and fruit

D) Treatment of choice is penicillin orally for mild cases or parenterally for severe cases

E) Toxin production does not occur

Regarding campylobacter enteritis:

M62 - MCQ 8M62 - MCQ 8

C) Transmission occurs through a faecal-oral route through contaminated water and fruit

Pneumatosis cystoides intestinalis

M62 - MCQ 9M62 - MCQ 9

A) Usually presents with abdominal pain and pneumoperitoneum

B) May involve cysts in both the submucosa and the subserosa of the bowel

C) Is treated effectively with IV antibiotics and nitrous oxide

D) Has a low concentration of hydrogen in the cysts

E) Has no known aetiology

Pneumatosis cystoides intestinalis

M62 - MCQ 9M62 - MCQ 9

B) May involve cysts in both the submucosa and the subserosa of the bowel

Regarding chemotherapy for colorectal cancer the following statements are true, EXCEPT:

M62 - MCQ 10M62 - MCQ 10

A) 5 FU/FA has been the mainstay of therapy for metastatic CRC for 40 years

B) All Dukes B patients benefit from adjuvant chemotherapy

C) 5 FU/FA adjuvant chemotherapy is standard practice after curative resection of lymph node positive CRC

D) NICE guidelines allow capecitabine use as first line therapy for metastatic CRC

E) NICE guidelines allow irinotecan use as second line therapy for metastatic CRC

Regarding chemotherapy for colorectal cancer the following statements are true, EXCEPT:

M62 - MCQ 10M62 - MCQ 10

B) All Dukes B patients benefit from adjuvant chemotherapy

Regarding the operation of anterior resection for full thickness rectal prolapse, all of the following are true EXCEPT:-

M62 - MCQ 11M62 - MCQ 11

A) The rectum is mobilised completely to the coccyx

B) The large majority of patients are female

C) The cumulative recurrence rate at 10 years is 9.6%

D) Anterior resection for prolapse predictably improves anal continence.

E) Approximately 20cm of rectum and sigmoid is resected on average.

Regarding the operation of anterior resection for full thickness rectal prolapse, all of the following are true EXCEPT:-

M62 - MCQ 11M62 - MCQ 11

D) Anterior resection for prolapse predictably improves anal continence.

Ileaoanal pouch construction in is associated with all of the following EXCEPT:-

M62 - MCQ 12M62 - MCQ 12

A) An overall excision rate of less than 5%

B) Metronidazole and Ciprofloaxcin are the most effective agents in managing pouchitis.

C) A postulated reduction in female fertility

D) Reduced sphincter injury if the double stapled technique is used

E) No functional difference between J and W pouches at 12 months follow up

Ileaoanal pouch construction in is associated with all of the following EXCEPT :-

M62 - MCQ 12M62 - MCQ 12

A) An overall excision rate of less than 5%

In the management of postoperative small bowel obstruction the following are true except:-

M62 - MCQ 13M62 - MCQ 13

A) The presence of peritonitis is not an absolute indication for laparotomy

B) Water soluble contrast studies require administration of 100mls of contrast solution orally or via the NG tube.

C) Small bowel obstruction requiring laparotomy is accurately predicted by failure of contrast to reach the caecum at 4 hours

D) Immediate postoperative obstruction would be expected to resolve with conservative measures in 80-90% of patients

E) Obstruction after APER often mandates laparotomy

In the management of postoperative small bowel obstruction the following are true except:-

M62 - MCQ 13M62 - MCQ 13

A) The presence of peritonitis is not an absolute indication for laparotomy

Regarding peri-operative nutrition in Colorectal Surgery all of the following are true EXCEPT :-

M62 - MCQ 14M62 - MCQ 14

A) SGA is highly predictive of malnutrition in surgical patients

B) Short preoperative course of TPN (5-10 days) may reduce postoperative morbidity in malnourished surgical patients

C) TPN should be started after 5 – 10days of postoperative ileus

D) Early postoperative oral feeding may be associated with an increased risk of anastomotic breakdown

E) Oral intake of clear fluids 2 to 3 hours before anaesthesia is safe in patients with normal gastric emptying

M62 - MCQ 14M62 - MCQ 14

D) Early postoperative oral feeding may be associated with an increased risk of anastomotic breakdown

Regarding peri-operative nutrition in Colorectal Surgery all of the following are true EXCEPT :-

In patients with Fulminant Colitis the following are true EXCEPT:-

M62 - MCQ 15M62 - MCQ 15

A) Can be precipitated by Clostridium difficle infection

B) Low division of the rectal stump at colectomy facilitates subsequent reconstructive surgery.

C) Optimal management is based on joint care – gastroenterologist, surgeon and specialist nurses

D) Primary restorative procedure at the time of urgent colectomy is not advisable

E) Fulminant colitis is the first presenation of up to one third of patients

In patients with Fulminant Colitis the following are true EXCEPT:-

M62 - MCQ 15M62 - MCQ 15

B) Low division of the rectal stump at colectomy facilitates subsequent reconstructive surgery.

M62 – Course FeedbackM62 – Course Feedback

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M62 - MCQ HotshotsM62 - MCQ Hotshots

136 – Rowena Sheldon

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M62 COLOPROCTOLOGY COURSEM62 COLOPROCTOLOGY COURSE24th – 2524th – 25thth March 2005 March 2005

http://www.m62course.ohttp://www.m62course.orgrg