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1)       Strength of anastomosis is derived from which layer

a)      Mucosa

b)      Submucosa

c)       Muscularis propria

d)      Serosa


2)       Most cephalad border of ischiorectal fossa?

a)      Puborectalis

b)      Pubic tubercle

c)       Levator ani

d)      External sphincter

e)      Pubic ramus


3)       Patient presents with Ischiorectal Abscess. Which of the following is most true:

a)      Most improve with IV ampicillin

b)      I&D when diagnosis made

c)       I&D when fluctuance appears

d)      Drain transrectally

e)      Need to rule out rectal cancer


4)       26 year old male, acute onset of pain at anus after straining for stool. On exam, small tender blue swelling. Diagnosis?

a)      Sentinel pile (Anal fissure)

b)      Perianal abscess

c)       Prolapsed external haemorrhoid

d)      Strangulated internal haemorrhoid

e)      Thrombosed external haemorrhoid


5)        Which of the following is an indication for 1 stage fistulotomy:

a)       anterior transphincteric fistula in a female

b)       extrasphincteric fistula in a crohn's patient

c)       lateral suprasphincteric fistula in a male

d)       posterior transphincteric fistula in anyone

e)      fistula secondary to radiation


6)         What is the number one complication of not putting a stoma through the rectus muscle?

a)       prolapse

b)       fistula

c)       hernia

d)       retraction

e)      stenosis


7)        What is the most frequent problem with abdominal repair of  rectal prolapse

a)       urinary retention

b)       constipation

c)       rectal incontinence

d)       rectal bleeding


8)        With respect to chronic anal fissure, which is true?

a)       sublingual nitro is proven

b)       lat EXTERNAL sphincterotomy is proven

c)       botox and topical nitro are effective

d)      fissurectomy is treatment of choice


9)        POD # 3 sigmoidectomy.  Pt. Unwell, temp, and incisional pain with brownish watery non-feculent discharge.  What to do?

a)       C&S of discharge

b)       Blood culture

c)       Gram stain discharge

d)       Gastrograffin enema

e)      U/S abdomen


10)    Polypectomy is carried out for a 2.5 cm pedunculated rectal polyp.  Path shows well diff. Tumour, no lymphovascular invasion and negative margins. Best treatment:

a)       anterior resection

b)       transanal excision

c)       no follow-up

d)       colonoscopy in one year

e)      repeat endoscopy in 4-6 months for first year


11)    How should a patient who had Dukes C colon cancer two years previously be followed for recurrence of liver mets?

a)       liver enzymes

b)       CEA

c)       U/S

d)       CT

e)      Radionuclide imaging


12)     Post op 36 hrs banding external hemorroids.  Pt now complains of pain, fever, difficulty voiding.  What next?

a)       prescribe sitz baths over phone

b)       prescribe oral antibiotics over phone

c)       set up appointment in future

d)      see patient as soon as possible


13)     Woman with incontinence to gas and liquid since birth of last child 10 yrs ago.  Decreased squeeze pressure and palpable anterior defect.  Best treatment:

a)       Artificial sphincter

b)       Gracillis repair

c)       Overlapping sphincteroplasty

d)       Parks post repair

e)       colostomy



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