MCQ ASSESSMENT M62 Course 2005 Answers

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MCQ ASSESSMENT M62 Course 2005Answers
Association of Coloproctology of Great Britain
and Ireland
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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
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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
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M62 - MCQ 2
In patients with Bowens disease or Pagets
disease of the perianal skin-
A) Only Bowens begins as a localised
intra-epidermal malignancy B) The two conditions
are easily distinguished on clinical grounds C)
Invasive Bowens 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
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M62 - MCQ 2
In patients with Bowens disease or Pagets
disease of the perianal skin-
D) Wide local excision can be definitive
treatment in both conditions
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M62 - MCQ 3
Regarding perineal procedures for rectal prolapse
the following are all true EXCEPT
A) Delormes procedure decreases rectal
compliance B) Delormes procedure produces
virtually no change in sphincter pressure C)
Recurrence after Delormes procedure reaches a
plateau at 8 years follow up D) Altemeiers
operation includes a sutured coloanal
anastomosis E) Perineal procedures are most
suited to the elderly and frail
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M62 - MCQ 3
Regarding perineal procedures for rectal prolapse
the following are all true EXCEPT
C. Recurrence after Delormes procedure reaches a
plateau at 8 years follow up
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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
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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
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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
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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
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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
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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
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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 (gt90) are due to S. sonnei
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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
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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
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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.
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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
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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
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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
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M62 - MCQ 10
Complications of radiation injury to the rectum
include all of the following EXCEPT (Choose the
best answer)
D) Colitis cystica profunda
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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.
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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.
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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
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M62 - MCQ 12
Regarding chemotherapy for colorectal cancer the
following statements are true, EXCEPT
B) All Dukes B patients benefit from adjuvant
chemotherapy
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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
intra-epithelial 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
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M62 - MCQ 13
In the management of HIV infection and the anus,
the following are true EXCEPT
C) The incidence and progression of anal
intra-epithelial neoplasia is unrelated to HIV
status
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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
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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.
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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
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M62 - MCQ 15
In the management of pruritus ani following are
true EXCEPT
D) Patch testing for contact dermatitis is not
helpful
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M62 Course Feedback
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M62 - MCQ Hotshots
THE WINNERS
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M62 COLOPROCTOLOGY COURSEhttp//www.m62course.org
March 30-31st 2006