Colorectal Surgery and Perianal Conditions Quiz

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Questions and Answers

What is the most common cause of perianal fistulas?

Ulcerative Colitis

Chronicization of acute suppurations (correct)

Tuberculosis

Actinomycosis

What is the primary treatment for perianal abscesses?

Observation and monitoring

Antibiotics only

Surgical intervention (correct)

Anti-infective vaccination

Which of the following are characteristics of superficial abscesses?

Fluctuating swellings in the anus-rectal submucosa (correct)

Extensive bulging and redness

Deeply located in the ischiorectal space

Absence of pain on palpation

Which of the following can complicate untreated perianal abscesses?

Fistula formation (C) Signup and view all the answers

What is the name of the space where ischiorectal phlegmon develops?

Ischiorectal space (D) Signup and view all the answers

What is a characteristic feature of ischiorectal phlegmon?

Extensive bulging and redness of the integument (B) Signup and view all the answers

What type of fistula has two orifices?

Complete fistula (A) Signup and view all the answers

Which of the following conditions can sometimes cause perianal fistulas?

Ulcerative Colitis (C) Signup and view all the answers

Which of the following is a key advantage of hydrosonography for colorectal cancer?

Is non-invasive and cost-effective, allowing for potential screening. (B) Signup and view all the answers

What is the primary use of abdominal ultrasound in the context of colorectal cancer?

To identify potential lymph node involvement or metastases. (C) Signup and view all the answers

Which of the following tumor markers is commonly used for post-operative monitoring in rectal cancer patients?

CEA (C) Signup and view all the answers

Which of the following conditions is NOT mentioned as a differential diagnosis of rectal cancer?

Gastritis (B) Signup and view all the answers

What is the primary aim of curative (radical) surgical interventions for rectal cancer?

To remove the entire tumor and affected lymph nodes. (C) Signup and view all the answers

Which surgical procedure is mainly used for tumors located at the recto-sigmoid junction?

High anterior resection (B) Signup and view all the answers

Which of the following statements is TRUE regarding scheduled surgical treatment for rectal cancer?

It can involve radical-vis surgery for curative purposes. (D) Signup and view all the answers

What is the main limitation of intra-rectal ultrasound in the context of rectal cancer?

It cannot accurately determine the extent of local invasion. (C) Signup and view all the answers

What is the initial conservative treatment approach for rectal prolapse in children?

Observation and management (C) Signup and view all the answers

Which procedure is suitable for elderly patients with associated hard tissues in the treatment of rectal prolapse?

Thiersch procedure (B) Signup and view all the answers

What is the peak incidence age range for rectal cancer?

60-69 years (C) Signup and view all the answers

Which of the following is NOT considered a protective dietary factor against carcinogenesis in rectal cancer?

Red meat proteins (C) Signup and view all the answers

What type of cancer is recognized as a separate entity from colon cancer?

Rectal cancer (A) Signup and view all the answers

Which geographical region has the highest incidence of rectal cancer?

Romania (C) Signup and view all the answers

Which genetic condition is associated with a higher risk of developing hereditary nonpolyposis colorectal cancer?

Lynch syndrome (D) Signup and view all the answers

What factor contributes to increased carcinogenesis in patients who have undergone cholecystectomy?

Increased bile acid levels (A) Signup and view all the answers

What is primarily associated with grade IV hemorrhoidal prolapse?

Hemorrhoidal thrombophlebitis with mucosal ulceration (B) Signup and view all the answers

Which symptom is NOT typically associated with grade IV hemorrhoidal prolapse?

Hemorrhoidal thrombosis without anus swelling (A) Signup and view all the answers

What is a common complication of untreated hemorrhoidal prolapse?

Anal fissures (C) Signup and view all the answers

Which of the following is part of the prophylactic treatment for hemorrhoids?

Avoiding a sedentary lifestyle (D) Signup and view all the answers

What type of fistulas connect the rectum to the integument after passing through the ischiorectal fossa?

Ischiorectal fistulas (C) Signup and view all the answers

What is a common clinical sign of a perianal fistula?

Perianal purulent discharge (C) Signup and view all the answers

What type of surgery is NOT mentioned as a surgical option for complicated hemorrhoids?

Hernia repair (B) Signup and view all the answers

What is the primary method for exploring fistulas?

Fistulography (D) Signup and view all the answers

What is the purpose of rectal curettage in the examination of hemorrhoids?

To reveal soft masses inside the anal canal (B) Signup and view all the answers

Which of these is a curative treatment option for hemorrhoids?

Mild laxatives (B) Signup and view all the answers

Which treatment is typically performed for uncomplicated fistulas?

Surgical excision of the exact area (D) Signup and view all the answers

What is the nature of rectal prolapse?

Descent of the upper rectum through the anus (C) Signup and view all the answers

What is a consequence of repeated bleeding from hemorrhoidal prolapse?

Anemia (A) Signup and view all the answers

Which factor is NOT incriminated in the etiopathogenesis of rectal prolapse?

Chronic diarrhea (C) Signup and view all the answers

What distinguishes mucosal rectal prolapse from other types?

Only the rectal mucosa leaves its position (B) Signup and view all the answers

What happens to a fistula without treatment?

It has no tendency to heal (B) Signup and view all the answers

What is a key procedure that must be performed during surgeries on rectal cancer involving Denonvilliers fascia?

Dilaceration of the constituent lamellae of Denonvilliers fascia (D) Signup and view all the answers

Which is a goal of palliative surgery in advanced stages of rectal cancer?

To prevent possible complications (B) Signup and view all the answers

Local surgery procedures for rectal cancer are performed under what conditions?

Low tumors without invasion of the rectal wall (A) Signup and view all the answers

What is the aim of adjuvant radiotherapy in rectal cancer treatment?

To sterilize remaining tumor material after surgery (B) Signup and view all the answers

What is a characteristic of radical radiotherapy for rectal cancer?

Effective for small tumors less than 5 cm (B) Signup and view all the answers

Which is a common unwanted effect of chemotherapy in the treatment of rectal cancer?

Stomatitis (A) Signup and view all the answers

Why is chemotherapy considered less effective as an adjuvant treatment compared to radiotherapy in rectal cancer?

Tumors develop resistance to chemotherapy quickly (C) Signup and view all the answers

What type of local technique can be utilized in the treatment of rectal cancer?

Electrocoagulation (B) Signup and view all the answers

Study Notes

Ano-rectal Surgical Pathology

Rectum Anatomy: 15-25 cm, extends from S3 vertebra to the anocutaneous line, with multiple curves and a dilated rectal vault. The anal canal is ~3 cm long with vertical folds (Morgagni columns).
Vascularization: Supplied by superior, middle, and inferior hemorrhoidal arteries, with venous plexuses connecting portal and caval systems.

Hemorrhoids

Definition: Varicose veins in hemorrhoidal plexuses (internal, external, mixed). Caused by factors like constipation, HTP, and chronic pressure.
Grade IV: Complete prolapse outside defecation, often with thrombophlebitis.
Symptoms: Itching, bleeding, pain, anemia.
Diagnosis: Visual inspection, anoscopy, rectoscopy.
Treatment: Medical for mild cases (laxatives, anti-inflammatories), surgery for severe cases (electroresection, ligation, excision).

Anal Fissure

Definition: Ulceration in the anal canal, typically due to sphincter spasm.
Treatment: Topical ointments for recent cases, surgery (sphincterotomy) for chronic ones.

Ano-Rectal Discharge

Causes: Abscesses, phlegmons, fistulas.
Symptoms: Pain, fever, possible complications (sepsis, fistula).
Treatment: Surgical drainage and excision of infected tissues.

Rectal Prolapse

Definition: Protrusion of rectal tissue through the anus.
Causes: Weak tissues, excessive intra-abdominal pressure.
Treatment: Conservative in children, surgery (resections, perineal tightening) in adults.

Rectal Cancer

Epidemiology: Most common in older adults (60-69 years), with higher incidence in some regions (e.g., France).
Etiology: Environmental (red meat, alcohol) and genetic factors (FAP, Lynch syndrome).
Diagnosis: Colonoscopy, CT, X-rays, and biopsy.
Treatment: Surgical resection (curative or palliative), chemotherapy, radiotherapy.

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Description

Test your knowledge on colorectal surgery and the management of perianal conditions. This quiz covers topics such as perianal fistulas, abscesses, and related surgical procedures. Perfect for medical students and healthcare professionals looking to brush up on their expertise.