Transcript MCQ ASSESSMENT M62 Course 2005 Answers Association of Coloproctology

MCQ ASSESSMENT
M62 Course 2005
Answers
Association of Coloproctology
of Great Britain and Ireland
M62 - MCQ 1
A healthy adult presents acutely with prolapsed gangrenous
haemorrhoids. Which of the following statements is true
(choose the best answer)
A) One week of non-operative treatment is necessary before
attempting surgery
B) Urgent operation has an unacceptable rate of postoperative anal
stricture
C) Urgent operation has an unacceptable rate of postoperative
spetic pylephlebitis
D) Urgent operation has a five fold greater risk of postoperative
bleeding than elective haemorrhoidectomy
E) Duration of pain and disability is minimised by urgent
haemorrhoidectomy
M62 - MCQ 1
A healthy adult presents acutely with prolapsed gangrenous
haemorrhoids. Which of the following statements is true
(choose the best answer)
E) Duration of pain and disability is
minimised by urgent haemorrhoidectomy
M62 - MCQ 2
In patients with Bowen’s disease or Paget’s disease of the
perianal skin:-
A) Only Bowen’s begins as a localised intra-epidermal malignancy
B) The two conditions are easily distinguished on clinical grounds
C) Invasive Bowen’s disease is best managed by abdoperineal
excision of the rectum.
D) Wide local excision can be definitive treatment in both
conditions
E) Occupation is an important aetiological factor
M62 - MCQ 2
In patients with Bowen’s disease or Paget’s disease of the
perianal skin:-
D) Wide local excision can be definitive
treatment in both conditions
M62 - MCQ 3
Regarding perineal procedures for rectal prolapse the
following are all true EXCEPT;
A) Delorme’s procedure decreases rectal compliance
B) Delorme’s procedure produces virtually no change in
sphincter pressure
C) Recurrence after Delorme’s procedure reaches a
plateau at 8 years follow up
D) Altemeier’s operation includes a sutured coloanal
anastomosis
E) Perineal procedures are most suited to the elderly
and frail
M62 - MCQ 3
Regarding perineal procedures for rectal prolapse the
following are all true EXCEPT;
C. Recurrence after Delorme’s procedure
reaches a plateau at 8 years follow up
M62 - MCQ 4
In the management of anal fissures, all of the following
are true EXCEPT;
A) Placebo treatments are associated with 35% healing rate
B) Botulinum toxin injection into the internal sphincter cannot
be repeated
C) Surgery is more effective than medical therapy in curing
fissure
D) GTN therapy is significantly more likely to be associated
with headache than placebo
E) Calcium channel blockers achieve healing rates similar to
GTN
M62 - MCQ 4
In the management of anal fissures, all of the following
are true EXCEPT;
B. Botulinum toxin injection into the internal
sphincter cannot be repeated
M62 - MCQ 5
In the management of polyp cancer the following are true
EXCEPT:
A) Lymphatics in the colon wall do not penetrate the muscularis mucosae
B) Sessile polyps with a focus of invasive cancer can be managed by snare
excision
C) Carcinoma limited to the head of a pedunculated polyp can be managed
by snare excision
D) Carcinoma limited to the head of a pedunculated polyp does not mandate
colonic resection if poorly differentiated
E) Carcinoma limited to the head of a pedunculated polyp does not mandate
colonic resection if associated with vascular or lymphatic invasion
M62 - MCQ 5
In the management of polyp cancer the following are true
EXCEPT:
A) Lymphatics in the colon wall do not penetrate
the muscularis mucosae
M62 - MCQ 6
With regard to Solitary Rectal Ulcer Syndrome (SRUS) all of the
following are true EXCEPT
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
M62 - MCQ 6
With regard to Solitary Rectal Ulcer Syndrome (SRUS) all of the
following are true EXCEPT
E) Rectopexy is associated with symptom
resolution in more than 90% of patients
M62 - MCQ 7
All of the following statements regarding “colitis” are true
EXCEPT:A) CMV infection is a recognised complication of IBD that does
not alter patient prognosis
B) Clostridium associated diarrhoea may present as an acute
abdomen
C) Pseudomembranous colitis may require colectomy
D) Entamoeba histolytica is responsible for amoebic colitis
E) In the UK and other developed countries most cases of
bacillary dysentery (>90%) are due to S. sonnei
M62 - MCQ 7
All of the following statements regarding “colitis” are true
EXCEPT:-
A) CMV infection is a recognised complication
of IBD that does not alter patient prognosis
M62 - MCQ 8
In patients with anal carcinoma the following are true EXCEPT:-
A) Nearly all cases are of the epidermoid type
B) Combined modality therapy (radiotherapy, fluorouracil
and mitomycin) has no advantage over radiotherapy alone.
C) Randomised trials of best therapy demonstrate 3 to 5
year survival rates of 56-76%
D) 90% of local treatment failures occur within 36 months
E) Salvage anorectal excision can produce cure in about
50% of patients
M62 - MCQ 8
In patients with anal carcinoma the following are true
EXCEPT:-
B) Combined modality therapy (radiotherapy,
fluorouracil and mitomycin) has no
advantage over radiotherapy alone.
M62 - MCQ 9
The management of a high transphincteric fistula might
include any of the following EXCEPT (Choose the best
answer)
A) Draining seton
B) Immediate division of the external sphincter
C) Cutting seton
D) Advancement flap
M62 - MCQ 9
The management of a high transphincteric fistula might
include any of the following EXCEPT (Choose the best
answer)
B) Immediate division of the external
sphincter
M62 - MCQ 10
Complications of radiation injury to the
rectum include all of the following EXCEPT
(Choose the best answer)
A) Diarrhoea
B) Fistulation
C) Rectal stricture
D) Colitis cystica profunda
M62 - MCQ 10
Complications of radiation injury to the
rectum include all of the following EXCEPT
(Choose the best answer)
D) Colitis cystica profunda
M62 - MCQ 11
Regarding abdominal operations for full thickness
rectal prolapse, all of the following are true EXCEPT:-
A) The rectum is mobilised completely to the
coccyx
B) Most patients are female
C) Mesh rectopexy may be associated with severe
constipation
D) Anterior resection for prolapse predictably
improves anal continence.
E) In anterior resection for prolapse approximately
20cm of rectum and sigmoid is resected.
M62 - MCQ 11
Regarding abdominal operations for full thickness
rectal prolapse, all of the following are true EXCEPT:-
D) Anterior resection for prolapse predictably
improves anal continence.
M62 - MCQ 12
Regarding chemotherapy for colorectal cancer the following
statements are true, EXCEPT:
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
M62 - MCQ 12
Regarding chemotherapy for colorectal cancer the
following statements are true, EXCEPT:
B) All Dukes B patients benefit from
adjuvant chemotherapy
M62 - MCQ 13
In the management of HIV infection and the anus, the
following are true EXCEPT:
A) 5% of all HIV/AIDS patients will see a proctologist
B) Perianal pain and/or mass are common presenting
symptoms in HIV/AIDS
C) The incidence and progression of anal intraepithelial neoplasia is unrelated to HIV status
D) HPV serotypes 6 and 11 are associated with
genital/anal warts
E) HPV serotypes 16 and 18 are onocogenic
M62 - MCQ 13
In the management of HIV infection and the anus, the
following are true EXCEPT:
C) The incidence and progression of anal intraepithelial neoplasia is unrelated to HIV status
M62 - MCQ 14
In the prevention of DVT after colorectal surgery
A) Heparins reduce the incidence of DVT and PE when
compared to no treatment
B) Unfractionated heparin and low molecular weight heparins
are equally effective
C) Enoxaparin can be given 2 hours before surgery if an
epidural is planned.
D) Graded compression stockings with low dose heparin are
more effective than low dose heparin alone
E) There is insufficient evidence for the role of intermittent
pneumatic compression in colorectal DVT prevention
M62 - MCQ 14
In the prevention of DVT after colorectal surgery
C) Enoxaparin can be given 2 hours before
surgery if an epidural is planned.
M62 - MCQ 15
In the management of pruritus ani following are true
EXCEPT:
A) Intradermal injection of methylene blue can be
effective in relieving symptoms
B) Topical capsaicin [a natural alkaloid extracted from
red chili peppers] produces significant relief of pruritus
ani symptoms
C) Attention to personal hygiene is important
D) Patch testing for contact dermatitis is not helpful
E) Topical corticosteroids can be useful
M62 - MCQ 15
In the management of pruritus ani following are true
EXCEPT:
D) Patch testing for contact dermatitis is not
helpful
M62 – Course Feedback
FEEDBACK
Facilities
9
8
7
6
5
4
3
2
1
0
Location
Car Park
Food
Accomodation
A-V
3-D Column 6
FEEDBACK
Relevance
80
70
60
50
40
No
Yes
30
Very
20
10
0
FEEDBACK
Change Practice
90
80
70
60
50
40
30
20
10
0
No
Yes
FEEDBACK
Further M62 Course ?
90
80
70
60
50
40
30
20
10
0
No
Yes
M62 - MCQ Hotshots
THE WINNERS
15 / 24 / 42 (NW)
45 (GW)/ 50 / 141 / 18 (KC)
M62 COLOPROCTOLOGY COURSE
http://www.m62course.org
March 30-31st 2006