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50 Cards in this Set
- Front
- Back
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External colorectal anatomy defining transition from colon to rectum . . .
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Broadening of taenia coli
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Two named arteries providing collateral flow between the SMA and IMA . . .
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1. Marginal artery of Drummond
2. Arc of Riolan |
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Blood supply to the rectum (arteries and origins) . . .
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1. Superior rectal - IMA
2. Middle rectal - internal iliac 3. Inferior rectal - pudendal |
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Venous drainage of the rectum (veins and destination) . . .
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1. Superior rectal - IMV
2. Middle rectal - IMV 3. Inferior rectal - internal iliac |
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Most abundant fecal anaerobe and aerobe respectively . . .
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Bacteroides fragilis and E. coli.
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External and internal anal sphincters are continuations of which muscles respectively . . .
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levator ani (striated) and circular muscle of muscularis propria (smooth)
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Treatment for sigmoid volvulus . . .
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Decompressive colonoscopy (50% recurrence) followed by bowel prep and sigmoid colectomy if not toxic
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Typical patient population for sigmoid volvulus . . .
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Debilitated/psychiatric patients, neurologic dysfunction, laxative abuse
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Success rate of decompressive colonoscopy for cecal vs sigmoid volvulus . . .
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20% vs 80%
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Typical age group for cecal volvulus . . .
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20-30
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Must be ruled out before diagnosis of Ogilvie's can be made . . .
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Colonic obstruction
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Diagnosis of Hirschsprung's disease is based on . . .
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Rectal biopsies (aganglionosis)
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Enterocolitis following chemotherapy . . .
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Typhlitis
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Finding on sigmoidoscopy with C. difficile colitis . . .
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Pseudomembranes
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Test of choice for bright red rectal bleeding following AAA repair . . .
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Sigmoidoscopy (rule out ischemic colitis secondary to IMA ligation)
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Most common location of colonic angiodysplasia . . .
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Right side
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Type of bleeding found with angiodysplasia vs diverticulosis . . .
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Venous vs arterial
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Most common cause of lower gastrointestinal bleeding . . .
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Diverticulosis
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Treatment of choice for patient with unresponsive hypotension and non-localized lower gastrointestinal bleeding . . .
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Subtotal colectomy
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Bleeding rate required for arteriography and tagged RBC scan respectively . . .
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>0.5 mL/min and >0.1 mL/min
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Most common location of colonic perforation . . .
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Cecum
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Three characteristics of polyps that are associated with increased risk of cancer:
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1. >2 cm
2. sessile 3. villous |
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Most common neoplastic polyp type . . .
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tubular (5% cancer risk)
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Innervation of the pelvic nerves . . .
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parasympathetic (S2-4)
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Primary nutrients of colonocytes . . .
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Short-chain fatty acids (butyrate)
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Name for fascia anterior and posterior to the rectum respectively . . .
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Denonvillier's and Waldyer's
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When does carcinoma in situ become carcinoma?
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When it crosses the basement membrane (into the submucosa) -- T1
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Most important prognostic factor for colorectal cancer . . .
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Nodal status
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Top 2 sites of colorectal cancer metastasis . . .
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Liver and lung
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By what route does colorectal cancer metastsize to the spine?
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Batson's (venous) plexus
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Minimal margin for resection for colon cancer . . .
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2 cm
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Best method for detecting intrahepatic metastases . . .
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Intraoperative ultrasound
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Number for nodes needed for N2 colorectal cancer
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4
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Rate of recurrence and rate of second primary after successful treatment for colorectal cancer . . .
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20% (mostly within 3 years) and 5%
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Gene and penetrance of FAP . . .
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APC gene and 100% (by age 40)
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When should a total colectomy be performed?
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Age 20
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Most common cause of death in FAP patients (hint: not directly related to their colon cancer) . . .
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Duodenal tumors
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Types of tumors (besides colon) seen in Gardner's and Turcot's syndromes respectively . . .
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desmoid tumors and brain tumors
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Gene and inheritance pattern of HNPCC . . .
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DNA mismatch repair gene and autosomal dominant
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Amsterdam criteria . . .
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3 first-degree relatives
2 generations 1 cancer before age 50 |
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Other types of cancer (besides colon) found in Lynch II . . .
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ovarian, endometrial, bladder, stomach
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Type of IBD that only involves the colon, nearly always involves the rectum and presents with bleeding . . .
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Ulcerative colitis
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Pathologic finding in Crohn's disease that differentiates it from ulcerative colitis . . .
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Granulomas
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IBD that involves the anus . . .
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Crohn's disease
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Two extraintestinal manifestations of ulcerative colitis that do not improve after colectomy . . .
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1. primary sclerosing cholangitis
2. ankylosing spondylitis |
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Low rectal carcinoids <2cm can be treated by . . .
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wide local excision with negative margins (vs APR)
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Colon perforation is most likely to occur where and why?
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Cecum (law of LaPlace: tension = pressure x diameter)
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Where do bleeding diverticuli more often occur?
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On the right side of the colon.
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Anatomical marker dividing the upper and lower GI tract . . .
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ligament of Treitz
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Rate of bleeding detectable by arteriography vs tagged RBC scan . . .
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0.5 mL/min vs 0.1 mL/min
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