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Multiple Choice Questions (MCQ)

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Category: Surgery--->Colon, Rectum, and Anus
Page: 3

Question 11#Print Question

A previously healthy 46-year-old woman with a history of rectal adenocarcinoma, first discovered on colonoscopy 1 year ago who is status post low anterior resection with a diverting loop ileostomy returns to clinic 3 months after her low anterior resection for a preoperative appointment for her ileostomy reversal. Over the past 3 months she has had good ileostomy output as well as occasional loose stools per rectum. What workup does she need to have prior to ileostomy reversal?

a. A digital rectal examination to palpate the anastomosis and check for patency
b. No examination is needed as this was a simple diversion and she has continued to pass stool per rectum
c. A flexible sigmoidoscopy or contrast enema to check for patency
d. A colonoscopy to evaluate for polyps not previously seen on previous colonoscopy


Question 12#Print Question

A 75-year-old woman undergoes a right hemicolectomy and end ileostomy for right-sided perforated diverticulitis. What is the most concerning adverse outcome in the short term of this procedure and will require revision?

a. Skin breakdown caused by succus entericus
b. Stoma necrosis above the level of the fascia
c. Stoma necrosis below the level of the fascia
d. Stomal retraction below the level of the fascia


Question 13#Print Question

A 19-year-old man with medically refractor ulcerative colitis undergoes a total colectomy with J-pouch creation. What are some of the late complications of ileal pouchanal reconstruction? 

a. More than eight bowel movements per day
b. Nocturnal incontinence
c. Pouchitis
d. Small bowel obstruction
e. All of the above


Question 14#Print Question

A 50-year-old woman who underwent a total colectomy with ileal pouch-anal reconstruction 5 years ago presents to the emergency room with diarrhea, fever, 2 weeks of malaise, and severe abdominal pain. What is the most appropriate differential diagnosis?

a. Parasitic infection, ulcerative colitis of the remaining rectal cuff, undiagnosed Crohn disease
b. Bacterial or viral infection, undiagnosed Crohn disease, and pouchitis
c. Rectal cancer of remaining rectal cuff, bacterial or viral infection, and undiagnosed Crohn disease
d. Parasitic infection, bacterial or viral infection, and pouchitis


Question 15#Print Question

A 68-year-old man is undergoing a right hemicolectomy for a cecal mass. He asks what the current research has shown about decreasing postoperative infection after this procedure. When should antibiotics always be used for this procedure?

a. Oral antibiotics should be used in combination with bowel preparation
b. Parenteral antibiotic prophylaxis at the time of surgery after the skin incision is made and redosed as needed during the procedure
c. Parenteral antibiotic prophylaxis at the time of surgery before the skin incision is made
d. Oral antibiotics should be used postoperatively to decrease risk of anastomosis leak




Category: Surgery--->Colon, Rectum, and Anus
Page: 3 of 8