1. Which answers are true? In contrast to ulcerative colitis, Crohn's disease of the
colon:
A. Is not associated with increased risk of colon cancer.
B. Seldom presents with daily hematochezia.
C. Is usually segmental rather than continuous.
D. Has a lower incidence of perianal fistulas.
E. Never develops toxic megacolon.
Answer: BC
2. Which answers are true? Options to consider when operating for Crohn's disease
of the large intestine include:
A. Colectomy and ileorectostomy.
B. Colectomy, closure of the rectal stump, and ileostomy.
C. Colectomy and continent ileostomy (Kock pouch).
D. Proctocolectomy and ileostomy.
E. Proctocolectomy and ileal pouch–anal canal anastomosis.
Answer: ABD
3. Crohn's disease:
A. Is caused by Mycobacterium paratuberculosis.
B. Is more common in Asians than in Jews.
C. Tends to occur in families.
D. Is less frequent in temperate climates than in tropical ones.
E. Is improved by smoking.
Answer: C
4. Recurrence after operation for Crohn's disease:
A. Occurs after operations for ileal Crohn's but not colonic Crohn's.
B. Is usually found just proximal to an enteric anastomosis.
C. Rarely requires reoperation.
D. Occurs in 1% of patients at risk per year during the first 10 years after the
operation.
E. Is prevented by maintenance therapy with corticosteroids.
Answer: B
5. Excision rather than bypass is preferred for surgical treatment of small
intestinal Crohn's because:
A. Excision is safer.
B. Bypass does not relieve symptoms.
C. Excision cures the patient of Crohn's disease but bypass does not.
D. Fewer early complications appear with excision.
E. The risk of small intestine cancer is reduced.
Answer: E
6. Which statements about anorectal Crohn's disease are true?
A. It may be the only overt manifestation of Crohn's disease.
B. It accompanies large intestine Crohn's more often than small-intestine Crohn's.
C. It subsides when associated small intestinal Crohn's is excised.
D. It should not be treated operatively.
E. It may subside in response to metronidazole, 250 mg. q.i.d.
Answer: ABE
7. The most common indication for operation in Crohn's disease of the colon is:
A. Obstruction.
B. Chronic debility.
C. Bleeding.
D. Perforation.
E. Carcinoma.
Answer: B
8. Which of the following statements about surgical anatomy of the colon and
rectum is/are correct?
A. The cecum has the largest inner diameter of all segments of the colon (13 to 15
cm.).
B. The rectosigmoid junction is situated at approximately 15 to 18 cm. from the anus.
C. The rectum is entirely an intraperitoneal organ.
D. The ileocolic, right colic, and middle colic arteries are branches from the inferior
mesenteric artery.
E. The arterial arcade created by communicating vessels at 1 to 2 cm. from the
mesenteric is called the artery of Drummond. Answer: BE
2 http://medcosmossurgery.blogspot.com
Edit by: Dr. Aimen yahia /Al-yarmook teaching hospital e-mail: aimenalkhadi@yahoo.com
, Medicosmos Surgery MCQ LARGE INTESTINE MCQs
9. Which of the following statements about surgical procedures on the colon and
rectum is/are correct?
A. Successful healing of colonic anastomoses depends on the adequacy of the blood
supply.
B. In excising part of the colon containing cancer, the lymphatics should be avoided
by dividing the mesentery close to the wall of the colon.
C. Despite complete removal of the colon and rectum, transanal fecal flow can be
preserved by means of an ileal pouch–anal anastomosis.
D. When a colostomy is created it cannot be reversed.
E. Colostomy can be life saving in patients with colonic perforation or obstruction.
Answer: ACE
10. Which of the following statements about colon physiology is/are correct?
A. Colonic recycling of urea is accomplished by the splitting of urea by bacterial
ureases.
B. Fermentation by colonic bacteria may rescue malabsorbed carbohydrates.
C. The preferred fuel of the colonic epithelium is glucose.
D. Absorption by the colonic mucosa is a passive process.
E. Insoluble fibers create bulk in the stool.
Answer: ABE
11. Which of the following statements about colonic motility is/are true?
A. Mass contractions involve only the rectum.
B. “Antiperistaltic” contractions occur in the descending colon.
C. The rectum can accommodate stool by receptive relaxation.
D. Stool in the colon is propelled by tonic contractions.
E. Defecation involves both sensory and motor pathways.
Answer: ADE
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