Q) In Regression of tumour after Neoadjuvant CTRT for rectal cancer are all except
A) Decrease in size
B) Nodal regression
C) Mucosal venous invasion in mri
D) Depth change
Rectum
Perioperative steroid management in IBD
Q) All are true regarding perioperative management Of IBD on steroid except
a) Minor procedure needs only routine steroidal dose supplementation
b) Major procedures needs Hydrocort 100-150 mg tds
3.Chronic steroid use causing adrenal failure that presents with hypotension, vomiting, fever, lethargy
4.All cases of UC need supraphysiological dose of steroid.
ELAPE (Extra Levator Abdomino perineal Excision)
Q) What is not true about extra levator Abdomino Perineal Resection (APE) (AIIMS 2019)
a) Anal canal dissected from levator
b) Patient in prone jack knife position
c) Specimen is resected en block with sacrum
d) Entire levator is resected along with mesorectum
FAP
Q) False regarding FAP
a) Mean age of development of cancer is 40
b)50% population develop gastric polyp and duodenal adenoma
c) 2nd most common cause of death is desmoid
d)
Cancer lower rectum
Q) False statement about management of cancer rectum
a) Relative to ERUS, pelvic MRI is more accurate in its ability to detect lymph node involvement
b) Rectal cancers located in the upper third of the rectum are exempt from neoadjuvant treatment.
c) TME is typically performed 2-3 weeks after completion of CRT before fibrosis develop
d) ERAS include early mobilization, transition to oral pain control, and resumption of oral food intake
Juvenile Polyposis Coli
COLORECTAL SURGERY MCQ | NEET SS
Juvenile Polyposis Syndrome
A 12-year-old boy presents with recurrent episodes of painless rectal bleeding and anemia. Colonoscopy reveals multiple juvenile hamartomatous polyps throughout the colon. Which of the following statements regarding this syndrome is FALSE?
A. It may be associated with a SMAD4 mutation.
B. It is associated with an increased risk
of gastrointestinal malignancy.
C. The polyps are most commonly located in
the ileum.
D. It is inherited in an autosomal dominant pattern.
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Juvenile Polyposis Syndrome: Important Exam Notes
Juvenile polyposis syndrome is an inherited gastrointestinal polyposis condition characterized by multiple juvenile hamartomatous polyps. Patients may present with rectal bleeding, anemia, abdominal symptoms, or complications related to polyp burden.
Genetics and inheritance
The principal genes associated with juvenile polyposis syndrome include SMAD4 and BMPR1A. The syndrome usually follows an autosomal dominant inheritance pattern.
Malignancy risk
JPS is associated with an increased risk of gastrointestinal malignancy, particularly colorectal cancer. Gastric cancer risk may also be increased. Appropriate surveillance and specialist assessment are important parts of management.
NEET SS exam takeaway
When a question describes a child with recurrent rectal bleeding and multiple juvenile hamartomatous polyps, consider juvenile polyposis syndrome. Remember the association with SMAD4 and BMPR1A, autosomal dominant inheritance, and increased gastrointestinal cancer risk.
Pouchitis after IPAA in ulcerative colitis
Free Question: NEET SS Surgery
Q: Which of the following is NOT a risk factor for pouchitis post-IPAA in ulcerative colitis?
Explanation Ans A :
Pouchitis is a common complication of Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative Colitis, with an incidence up to 50%.
✅ Smoking is protective against pouchitis.
Risk factors include: - Extra-intestinal manifestations (e.g. arthritis) - ANCA positivity - NOD2insC mutation - NSAIDs and PPI use post-op - Extent of colitis and thrombocytosis
🔗 Ref: Wiley Journal Article
Pouchitis is a common complication of Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative Colitis, with an incidence up to 50%.
✅ Smoking is protective against pouchitis.
Risk factors include: - Extra-intestinal manifestations (e.g. arthritis) - ANCA positivity - NOD2insC mutation - NSAIDs and PPI use post-op - Extent of colitis and thrombocytosis
🔗 Ref: Wiley Journal Article
lymphatics of colon
Q ) Which of the following group of lymph nodes lymphatics of the colon first drain to?
a) Paracolic
b) Epicolic
c) Nodes along SMA/IMA
d) Para aortic
Technique of CME
Q) All are true regarding complete mesorectal excision except
a) Introduced by Hobeninger
b) It is based on ligation of central artery
c) Increases yield of lymph nodes and has decreased recurrence
d) Line of resection is below Toldt's fasica