MCQ - Small intestine - Neoplasm

  1. MC tumor of small bowel?
    LeiomyomaQ >AdenomaQ
  2. MC tumor of small bowel in children?
    LymphomaQ
  3. MC malignant tumor of small bowel?
    Carcinoid >AdenocarcinomaQ
  4. MC site of small bowel malignancy, carcinoids, lymphoma?
    IleumQ
  5. Treatment of small bowel malignancy?
    Often, surgical resection for cure is not possible. Therefore, palliative resection should be performed to prevent further complications of bleeding, obstruction, and perforationQ
  6. Cause of obstruction in benign and malignant lesions of small bowel?
    • CA - due to tumor infiltration and adhesionsQ
    • Benign lesions - due to intussusceptionsQ
  7. MC splenic neoplasm?
    NHLQ
  8. Primary GI lymphomas occur more frequently in?
    • • Chronic gastritis caused by H. pyloriQ
    • • Chronic sprueQ like syndromes
    • • Natives of the Mediterranean regionQ
    • • Congenital immunodeficiency statesQ
    • • HIV infectionQ
    • • Following organ transplantation with immunosuppressionQ
  9. Distribution of Carcinoid Tumors?
    Bronchus> Ileum > Rectum > Appendix > Colon > Stomach – BIRACS
  10. Cell of origin of carcinoid tumors?
    From enterochromaffin cellsQ at the base of the crypts of Lieberkuhn
  11. Most important peptide produced by carcinoids?
    • SerotoninQ
    • Foregut carcinoids produce low levels of serotoninQ (5-hydroxytryptamine) but may secrete 5-hydroxytryptophan or adrenocorticotrophic hormone.
    • Hindgut carcinoids rarely produce serotoninQ
  12. MC symptom of Small bowel carcinoid?
    Intermittent intestinal obstructionQ
  13. Common symptoms and signs of carcinoid syndrome?
    Cutaneous flush (80%)Q; diarrhea (76%); hepatomegaly (71%); cardiac lesions (70%); asthma (25%).
  14. MC cardiac lesions in carcinoid syndrome?
    Tricuspid insufficiency (TR), pulmonary stenosis (PS), tricuspid stenosis. (TR>PS>PR>TS)Q
  15. Diagnosis of carcinoid tumors?
    • Elevated urinary levels of 5-HIAAQ - highly specificQ.
    • Plasma concentration of chromogranin A is 100% specificQ
  16. Provocation test for carcinoid tumors?
    Provocative tests using pentagastrin, calcium, or epinephrine are used to reproduce the symptoms of carcinoid tumors. The administration of pentagastrin is the safest and most reliable and the most frequently usedQ
  17. In which layer of bowel, is the carcinoid tumor located?
    Submucosal location
  18. Surgical tumor of carcinoid tumors?
    • Carcinoid tumors of the jejunum and ileum: segmental resection and en-bloc lymphadenectomyQ.
    • Resection of the primary tumor regardless of metastasis, to avoid complications from growth of the primary tumor in terms of bleeding, obstruction and abdominal pain especially with midgut carcinoids because of their propensity to cause intense fibrosing reactionQ
  19. Medical therapy for carcinoid tumors?
    • Chemotherapy and biological agents such as somatostatin analogs and interferon alphaQ.
    • Chemotherapy: Dacarbazine, epirubicin and 5-FU (DEF)Q.
    • Octreotide administration leads to reduction of symptoms, including flushing and diarrhea.
    • Newer treatment includes In111-Octreotide and I124-labeled MIBG (metaiodobenzylguanide)Q.
  20. Prognosis of Carcinoid tumors?
    They have the best prognosis of all small bowel tumors, whether the disease is localized or metastaticQ.
  21. Least and most malignant carcinoid tumor location?
    • Least malignant potential: Rectum followed by bronchus and lungQ.
    • Maximum malignant potential: Pancreatic carcinoid followed by small intestineQ
  22. What is Enteroclysis (Small Bowel Enema)?
    • Contrast in injected directly through Frekas tube directly into distal duodenum, filling the small bowel loopsQ.
    • The opacified small bowel loops can be imaged then using X-rays (Barium enteroclysis), CT (CT enteroclysis) or MRI (MRI enteroclysis).Q
  23. Indications of Enteroclysis? \
    • • Partial, intermittent small intestinal obstructionQ
    • • Crohn’s diseaseQ
    • • Small intestinal diverticulaQ
  24. Diseases that can be diagnosed by small intestine biopsy?
    • Whipple's diseaseQ - Lamina propria contains macrophages containing PAS + material
    • AgammaglobulinemiaQ - No plasma cells; either normal or absent villi ("flat mucosa")
    • AbetalipoproteinemiaQ - Normal villi; epithelial cells vacuolated with fat postprandially
Author
surgerymaster
ID
335022
Card Set
MCQ - Small intestine - Neoplasm
Description
Small intestine
Updated