Colorectal Surgery Practice Questions

Q: Which chromosome is associated with familial polyposis coli?

Chromosome 5. **Explanation:** **Familial Adenomatous Polyposis (FAP)**, also known as Familial Polyposis Coli, is an autosomal dominant condition characterized by the development of hundreds to thousands of adenomatous colorectal polyps. 1. **Why Chromosome 5 is Correct:** The genetic defect in FAP is a germline mutation in the **APC (Adenomatous Polyposis Coli) gene**, which is located on the **long arm of chromosome 5 (5q21)**. The APC gene is a tumor suppressor gene that regulates the Wnt signaling pathway. Loss of this gene leads to the accumulation of β-catenin, resulting in uncontrolled cellular proliferation and polyp formation. 2. **Why Other Options are Incorrect:** * **Chromosome 6:** Associated with the HLA complex and Hemochromatosis (HFE gene). * **Chromosome 11:** Associated with the WT1 gene (Wilms tumor) and the MEN1 gene (Multiple Endocrine Neoplasia type 1). * **Chromosome 13:** Associated with the RB1 gene (Retinoblastoma) and the BRCA2 gene. **High-Yield Clinical Pearls for NEET-PG:** * **Inheritance:** Autosomal Dominant. * **Clinical Feature:** >100 polyps are required for diagnosis. Malignant transformation to colorectal cancer is **100%** by age 40-50 if a prophylactic total proctocolectomy is not performed. * **Gardner Syndrome:** FAP + Extra-colonic manifestations (Osteomas of the mandible/skull, desmoid tumors, and sebaceous cysts). * **Turcot Syndrome:** FAP + Central Nervous System tumors (typically Medulloblastoma). * **Screening:** Annual sigmoidoscopy starting at age 10–12 years for at-risk family members.

Question 1

A 60-year-old male presented with bleeding per rectum. On digital rectal examination, a growth was palpable at the tip of the index finger. Sigmoidoscopy revealed an ulcero-proliferative growth located 6 cm from the anal verge. CECT showed no involvement of the liver or lungs. Following chemoradiation, what is the next best step in management?

Accepted Answer

Low anterior resection

Answer

Observation and follow-up

Answer

Abdominoperineal resection

Answer

Haman's procedure

Question 2

Which of the following statements regarding colon carcinoma is true?

Accepted Answer

Right-sided colon carcinoma is associated with younger individuals.

Answer

The most common site for colon carcinoma is the sigmoid colon.

Answer

Right-sided colon carcinoma often presents as chronic anemia.

Answer

Right-sided colon has a better prognosis than left-sided colon.

Question 3

A 72-year-old male presents with complete rectal prolapse and a 10-year history of constipation. What is the recommended management for this patient?

Accepted Answer

Delorme procedure

Answer

Well's resection

Answer

Abdominal Rectopexy

Answer

Resection Rectopexy

Question 4

All of the following are true about rectal cancer EXCEPT:

Accepted Answer

Dissection lateral to the endopelvic fascia investing the mesorectum causes local recurrence.

Answer

The most common symptom is hematochezia.

Answer

Precise location of the tumor is determined with rigid proctosigmoidoscopy.

Answer

The radiation dose is 60 Gray.

Question 5

Which chromosome is associated with familial polyposis coli?

Accepted Answer

Chromosome 5

Answer

Chromosome 6

Answer

Chromosome 11

Answer

Chromosome 13

Colorectal Surgery — MCQs

Colorectal Surgery — MCQs

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