Quiz: SMALL INTESITNE

70-year-old woman has nausea, vomiting, abdominal distention, and episodic, crampy mid abdominal pain. She has no history of previous surgery but has a long history of cholelithiasis for which she has refused surgery. Her abdominal radiograph reveals a spherical density in the right lower quadrant. Correct treatment should consist of

A A- Ileocolectomy B B- Cholecystectomy C C- Ileotomy and extraction D D- Nasogastric tube decompression

Regarding potential complications of Crohn's colitis which of the following statements is true?

A A- Fistulas between the colon and segments of intestine, bladder, vagina, urethra, and skin may develop B B- The occurrence of toxic megacolon is common C C- Perforation occurs in about 25% of patients with similar disease D D- Extra intestinal manifestations including uveitis and erythema nodosum would be exceedingly rare in this patient

complications of diverticular disease are:

A A- diverticulitis B B- pericolic abscess C C- fistula D D- all of the above

Correct statements concerning intussusception in infants include which of the following?

A A- Recurrence rates following treatment are high B B- It is frequently preceded by a gastrointestinal viral illness C C- A 1- to 2-wk period of parenteral alimentation should precede surgical reduction when surgery is required D D- Hydrostatic reduction without surgery rarely provides successful treatment

Which of the following statements is true regarding the effects of colon resection?

A A- Patients who undergo major colon resections suffer little change it their bowel habits following operation B B- Net absorption of water by the rectum has been demonstrated in humans C C- The left colon is better adapted for water absorption than the right colon D D- The role of the ileocecal valve in normal fluid homeostasis is well established

A 55-year-old woman with cancer of the cervix undergoes hysterectomy and is found to have pelvic lymph nodes involved with cancer. She then receives a course of external beam radiation (4500rads). When the physician counsels her prior to her radiation treatment, she should be told of all the possible complications of radiation enteritis. Which of the following is generally not associated with radiation injury?

A A- Malabsorption B B- IntussusceptioN C C- Ulceration D D- Fistulization

During an operation for carcinoma of the hepatic flexure of the colon, an unexpected discontinuous 3-cm metastasis is discovered in the edge of the right lobe of the liver. The surgeon should

A A- Terminate the operation, screen the patient for evidence of other metastases, and plan further therapy after the reevaluation B B- Perform a right hemicolectomy and a right hepatic lobectomy C C- Perform right hemicolectomy & wedge resection of the metastasis D D- Perform a cecostomy and scheduler eoperation after a course of systemic chemotherapy

An 80-year-old man is admitted to the hospital complaining of nausea, abdominal pain, distention, and diarrhea. A cautiously performed transanal contrast study reveals an "apple core configuration in the rectosigmoid. Appropriate management at this time would include

A A- Colonoscopic decompression and rectal tube placement B B- Saline enemas and digital disimpaction of fecal matter from the rectum C C- Colon resection and proximal colostomy D D- Oral administration of metronidazole and checking a Clostridium difficile titer

Which of the following statements regarding stress ulceration is true?

A A- It is true ulceration, extending into and through the muscularis mucosa B B- It classically involves the antrum C C- It frequently involves multiple sites D D- It is seen following shock or sepsis, but for some unknown reason does not occur following major surgery, trauma, or burns

ulcerative colitis is characterized by:

A A- granulated ulcerated mucosa B B- anal lesion in 75% C C- entero-cutaneous fistula D D- all of the above

Which statement regarding absorption by the small intestine is true?

A A- All but the fat in milk is digested and absorbed in humans by the end of the duodenum B B- Complete absorption of carbohydrates in a normal meal occurs in the ileum C C- In short gut syndrome, much of the dietary carbohydrate appears in the stool D D- Aldosterone markedly decrease ssodium transport across the gut mucosa

The least common site for cancer in the alimentary tract is:

A a. Pharynx. B b . Esophagus. C c. Stomach. D d. Small bowel.

The most frequent complication of regional Ilietis is

A a. Abccess formation. B b. Infernal fistulae. C c. Hemorrhage. D d. Perforation.

Among the following statements about Crohn's disease, It is untrue that it:

A a. is commonest in the third decade. B b. Always involves the terminal ileum. C c. is a segmental granulomatous lesion affecting all coats of the bowel and the related mesentry. D d. May be associated with skip areas and anorectal lesions.

Perforated duodenal ulcer is best treated by:

A a. Gastroduodenal suction and antibiotics. B b. Simple closure over an omental patch. C c. Truncal vagotomy. D d. Super selective vagotomy.

The cardinal symptoms of uncomplicated duodenal ulcer do not include:-

A a. Anorexia. B b. Localized midepigastric pain. C c. Hunger pain. D d. Nocturnal pain.

True statements about chronic duodenal ulcers do not! Include that they:

A a. Are never malignant. B b. Occur equally in both sexes. C c. Produce epigastric pain several hours after eating. D d. Have a periodic clinical course.

The common sites of carcinoid tumor in Gi tract are all except:

A a. Appendix. B b. Jejunum. C c. Ileum. D d. Rectum

The following are radiologic finding in TB enteritis:

A a- Sterlin's sign is characteristic of ulcerative type B b- Hypertrophic type always show distortion and elevation of caecum C c- Hypertrophic type always show narrow ileum D d- None of the above

Meckel's diverticulum most commonly presents by:

A A. Gastrointestinal bleeding. B B. Obstruction. C C. Diverticulitis. D D. Intermittent abdominal pain.

Most common complication of Meckel's is:

A a- Diverticulitis B b- Intestinal obstruction C c- Peptic ulceration D d-Littre's hernia

Indications of surgical removal in accidentally discovered Meckel's during laparotomy include the following except:

A a-Narrow mouthed B b- Adhesions C c- Diabetics D d-Young age of patient

As regard Meckel's diverticulum all correct except:

A a- It occurs due to persistence of proximal urachus. B b-It arises from antimesentric border C c-It lies 60 cm (2 feet) from caecum D d-It's 2 inches long

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