Colon And Rectum: Appendicitis

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  • 1/32 Questions

    A patient presents with periumbilical pain that moves to the RLQ over 24 hrs. the pain is exacerbated by walking, coughing, or a car ride. The patient presents with nausea, vomiting, and a low grade fever of less than 38C or 100.4. What is the suspected diagnosis?

    • Acute appendicitis
    • Ovarian cyst
    • Volvulus
    • Acute pancreatitis
    • Acute cholecystitis
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About This Quiz

Explore the anatomy of the lower digestive tract with this focused quiz on the colon and rectum. Topics include the structure and blood supply of the cecum, rectum, and anal canal, enhancing understanding for medical students and professionals.

Colon And Rectum: Appendicitis - Quiz

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  • 2. 

    What is the treatment for appendicitis?

    • Surgical removal of inflamed appendix before it ruptures

    • Pain control and antibiotics

    • Pain control

    • Antibiotics and observation

    Correct Answer
    A. Surgical removal of inflamed appendix before it ruptures
    Explanation
    The correct answer is surgical removal of inflamed appendix before it ruptures. Appendicitis is the inflammation of the appendix, and if left untreated, it can lead to a rupture, causing a life-threatening condition. The most effective treatment for appendicitis is the surgical removal of the inflamed appendix, known as an appendectomy. This procedure is typically performed before the appendix ruptures to prevent complications and ensure a faster recovery. Pain control and antibiotics may be used as part of the treatment plan, but the primary intervention is the surgical removal of the inflamed appendix.

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  • 3. 

    A MANTRELS score of over 8 indicates

    • Very probable appendicitis

    • Probable appendicitis

    • Appendicitis less likely

    • Possible appendicitis

    Correct Answer
    A. Very probable appendicitis
    Explanation
    A MANTRELS score is a scoring system used to assess the likelihood of appendicitis. A score of over 8 indicates a higher probability of appendicitis. Therefore, the correct answer "very probable appendicitis" suggests that a MANTRELS score of over 8 strongly indicates the presence of appendicitis.

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  • 4. 

    What vein carries venous blood from the intestines to the liver?

    • Portal vein

    • Iliac veins

    • Middle colic vein

    • Inferior mesenteric vein

    • Superior mesenteric vein

    Correct Answer
    A. Portal vein
    Explanation
    The portal vein carries venous blood from the intestines to the liver. This vein is responsible for transporting nutrient-rich blood from the digestive system to the liver, where it is processed and detoxified before entering the systemic circulation. The other options listed are not involved in this specific function of carrying blood from the intestines to the liver.

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  • 5. 

    The _____________  is 3-4 cm long, starts at the dentate line, is supported by the internal and external anal sphincters, and composed of sensitive squamous epithelium.

    • Rectum

    • Anal Canal

    • Colon

    • Anal sphincter canal

    Correct Answer
    A. Anal Canal
    Explanation
    The anal canal is a part of the digestive system that is approximately 3-4 cm long. It begins at the dentate line and is supported by the internal and external anal sphincters. The anal canal is composed of sensitive squamous epithelium.

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  • 6. 

    The __________ extends from the rectosigmoid junction to the anal canal and is composed of insensitive columnar epithelium.

    • Anal Canal

    • Rectum

    • Colon

    • Large bowel

    Correct Answer
    A. Rectum
    Explanation
    The rectum extends from the rectosigmoid junction to the anal canal and is composed of insensitive columnar epithelium. This means that it is the correct answer to the question. The anal canal, colon, and large bowel are not the correct answers because they do not fit the description given in the question.

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  • 7. 

    The superior mesenteric artery supplies blood to which part of the GI tract?

    • Small intestine (other than duodenum) and proximal colon

    • Mid-transverse colon to rectum

    • Duodenum

    • Cecum

    • Rectum only

    Correct Answer
    A. Small intestine (other than duodenum) and proximal colon
    Explanation
    The superior mesenteric artery supplies blood to the small intestine (other than duodenum) and proximal colon. This artery is a major branch of the abdominal aorta and provides oxygenated blood to these specific regions of the gastrointestinal tract. The duodenum, cecum, and rectum are supplied by different arteries.

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  • 8. 

    What is the primary cause of appendicitis?

    • Obstruction of the lumen between the cecum and appendix

    • Inflammation due to an immune response

    • Constipation

    • Overuse of antibiotics

    Correct Answer
    A. Obstruction of the lumen between the cecum and appendix
    Explanation
    Appendicitis is primarily caused by the obstruction of the lumen between the cecum and appendix. When the opening of the appendix gets blocked, it can lead to the buildup of mucus, bacteria, and stool, resulting in inflammation and infection. This obstruction can occur due to various factors such as fecal matter, enlarged lymphoid tissue, or tumors. Inflammation due to an immune response, constipation, and overuse of antibiotics are not the primary causes of appendicitis.

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  • 9. 

    What is the blind sac that is in the RLQ below the ileocecal valve?

    • Cecum

    • Appendix

    • Transverse colon

    • Ascending colon

    Correct Answer
    A. Cecum
    Explanation
    The blind sac that is in the RLQ below the ileocecal valve is called the cecum. The cecum is a pouch-like structure that is the first part of the large intestine. It is located in the lower right quadrant of the abdomen and serves as a site for the absorption of water and electrolytes. The appendix is a small, finger-like projection that extends from the cecum. The transverse colon is a part of the large intestine that runs horizontally across the abdomen, while the ascending colon is the part of the large intestine that travels upward on the right side of the abdomen.

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  • 10. 

    What 3 major branches of the aorta supply blood to the intestines?

    • Celiac artery, superior mesenteric artery, inferior mesenteric artery

    • Celiac artery, superior mesenteric artery, and right and left gastric artery

    • Superior mesenteric artery, inferior mesenteric artery, and internal and external iliac arteries

    • Common iliac artery, superior mesenteric artery, inferior mesenteric arteries

    Correct Answer
    A. Celiac artery, superior mesenteric artery, inferior mesenteric artery
    Explanation
    The correct answer is celiac artery, superior mesenteric artery, inferior mesenteric artery. These three major branches of the aorta supply blood to the intestines. The celiac artery supplies blood to the upper abdominal organs, including the stomach and liver. The superior mesenteric artery supplies blood to the small intestine and the first half of the large intestine. The inferior mesenteric artery supplies blood to the second half of the large intestine.

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  • 11. 

    What are some possible causes of an obstructed appendix?

    • Inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber- fecaliths, parasites, fb, and neoplasms

    • Infection, fecal stasis, calcium salts or undigested fiber-fecaliths, parasites, FB, and neoplasms, diarrhea

    • Fecal stasis, fecaliths, FB, gastric ulcer, infection, calcium salts or undigested fiber- fecaliths, parasites,and neoplasms

    • Suppositories, FB, neoplams, undigested fiber and calcium salts, calcium salts or undigested fiber-fecaliths, infection, fecal stasis, parasites

    Correct Answer
    A. Inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber- fecaliths, parasites, fb, and neoplasms
    Explanation
    The possible causes of an obstructed appendix include inflammatory bowel disease, infection, fecal stasis, calcium salts or undigested fiber- fecaliths, parasites, foreign bodies (fb), and neoplasms. These factors can lead to blockage or inflammation of the appendix, resulting in appendicitis.

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  • 12. 

    While examining a patient with suspected appendicitis, you would expect to find pain (with or without) gaurding, (with or without) rebound tenderness, pain (with or without) passive flexion of R hip, pain (with or without) passive flexion of L hip, and a postitive or negative obturator sign?

    • Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a positive obturator sign

    • Pain: without gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a postivie obturator sign

    • Pain: without gaurding, with rebound tenderness, with passive flexion of R hip, with passive flexion of L hip, and a positive obturator sign

    • Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, with passive flexion of L hip, and a positive obturator sign

    Correct Answer
    A. Pain: with gaurding, with rebound tenderness, with passive flexion of R hip, without passive flexion of L hip, and a positive obturator sign
    Explanation
    The correct answer suggests that while examining a patient with suspected appendicitis, one would expect to find pain with guarding, rebound tenderness, and passive flexion of the right hip. However, there would not be pain with passive flexion of the left hip. Additionally, a positive obturator sign would be present.

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  • 13. 

    A MANTRELS score of less than five indicates that:

    • Appendicitis is less likely

    • Possible appendicitis

    • Probable appendicitis

    • Very probable appendicitis

    Correct Answer
    A. Appendicitis is less likely
    Explanation
    A MANTRELS score is a scoring system used to assess the likelihood of appendicitis. A score of less than five indicates that the likelihood of appendicitis is low. Therefore, the correct answer is "appendicitis is less likely."

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  • 14. 

    What 3 arteries supply the anorectum? (click all that apply)

    • Superior rectal artery

    • Middle rectal artery

    • Inferior rectal artery

    • Inferior mesenteric artery and its branches

    • Superior mesenteric artery and its branches

    Correct Answer(s)
    A. Superior rectal artery
    A. Middle rectal artery
    A. Inferior rectal artery
    Explanation
    The correct answer is superior rectal artery, middle rectal artery, and inferior rectal artery. These three arteries supply the anorectum. The superior rectal artery is a branch of the inferior mesenteric artery, while the middle rectal artery is a branch of the internal iliac artery. The inferior rectal artery is a branch of the internal pudendal artery, which itself is a branch of the internal iliac artery.

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  • 15. 

    The celiac artery supplies blood to which part of the GI tract?

    • Duodenum

    • Jejunum

    • Small intestine and proximal colon

    • Mid-transverse colon to rectum

    • Cecum

    Correct Answer
    A. Duodenum
    Explanation
    The celiac artery supplies blood to the duodenum, which is the first part of the small intestine. This artery is a major branch of the abdominal aorta and provides oxygenated blood to various organs in the abdominal region, including the stomach, liver, spleen, and parts of the small intestine.

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  • 16. 

    The superior rectal artery supplies blood to which part of the GI tract?

    • The rectum

    • The upper and middle rectum

    • Lower rectum

    • Anal sphincters and rectum

    • Anal sphincters only

    Correct Answer
    A. The upper and middle rectum
    Explanation
    The superior rectal artery supplies blood to the upper and middle rectum. This artery is a branch of the inferior mesenteric artery and plays a crucial role in providing oxygenated blood to this part of the gastrointestinal tract.

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  • 17. 

    The inferior mesenteric artery supplies blood to which part of the GI tract?

    • Mid-transverse colon to rectum

    • Colon and anal canal

    • Descending colon and rectum

    • Colon and rectum

    • Colon, cecum, and rectum

    Correct Answer
    A. Mid-transverse colon to rectum
    Explanation
    The correct answer is mid-transverse colon to rectum. The inferior mesenteric artery is responsible for supplying blood to the mid-transverse colon, descending colon, sigmoid colon, and rectum. It does not supply blood to the cecum or the anal canal.

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  • 18. 

    During the rectoanal inhibitory reflex, the internal sphincter ________  allowing the contents into the anal canal, then the external sphincter ____________ and contents are pushed back into the rectum. This occurs up to 7 times daily.

    • Relaxes, relaxes

    • Contracts, contracts

    • Relaxes, contracts

    • Contracts, relaxes

    Correct Answer
    A. Relaxes, contracts
    Explanation
    During the rectoanal inhibitory reflex, the internal sphincter relaxes, allowing the contents into the anal canal. Then, the external sphincter contracts, pushing the contents back into the rectum. This reflex occurs multiple times daily, up to 7 times.

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  • 19. 

    A MANTRELS score of 5-6 indicates:

    • Possible appendicitis

    • Probable appendicitis

    • Appendicitis is less likely

    • Very probable appendicitis

    Correct Answer
    A. Possible appendicitis
    Explanation
    A MANTRELS score of 5-6 indicates possible appendicitis. This means that based on the MANTRELS scoring system, which evaluates various symptoms and signs associated with appendicitis, a score of 5-6 suggests that there is a possibility of the patient having appendicitis. However, further diagnostic tests and evaluations are required to confirm the diagnosis.

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  • 20. 

    A MANTRELS score of 7-8 indicates

    • Probable appendicitis

    • Appendicitis less likely

    • Possible appendicitis

    • Very probable appendicitis

    Correct Answer
    A. Probable appendicitis
    Explanation
    A MANTRELS score of 7-8 indicates probable appendicitis. This means that based on the scoring system used, the patient's symptoms and clinical findings suggest a high likelihood of appendicitis. The score falls within the range that is typically associated with a high probability of the condition.

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  • 21. 

    The inferior rectal artery supplies blood to which part of the rectum?

    • The internal and external anal sphincters

    • The lower rectum

    • The uppper, middle, and lower rectum

    • The external sphincter only

    • The internal sphincter only

    Correct Answer
    A. The internal and external anal sphincters
    Explanation
    The inferior rectal artery supplies blood to the internal and external anal sphincters. These sphincters are located at the opening of the anus and are responsible for controlling the passage of stool. The blood supply is important for maintaining the health and function of these muscles.

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  • 22. 

    What type of tissue is the appendix made up of?

    • Lymphatic

    • Connective

    • Fibrinous

    • Intestinal mucosa

    Correct Answer
    A. Lymphatic
    Explanation
    The appendix is made up of lymphatic tissue. The lymphatic tissue is a part of the immune system and helps in the production of white blood cells and antibodies. The appendix contains lymphoid follicles, which are clusters of lymphatic tissue that play a role in immune responses. This makes the lymphatic tissue the correct answer for the type of tissue that makes up the appendix.

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  • 23. 

    What best explains what happens to the appendix when it is obstructed?

    • The inflamed tissue becomes infected and dies from lack of blood supply and eventually bursts

    • The inflamed tissue dies from lack of blood supply causing the appendix to burst

    • The obstruction causes pressure to build up and eventually causes the appendix to burst

    • The obstruction hardens the appendix eventually causing it to burst

    Correct Answer
    A. The inflamed tissue becomes infected and dies from lack of blood supply and eventually bursts
    Explanation
    When the appendix is obstructed, the inflamed tissue inside it becomes infected and starts to die due to a lack of blood supply. As the infection progresses, the pressure builds up inside the appendix, eventually causing it to burst. This can lead to the release of the infected contents into the abdominal cavity, resulting in a serious condition called peritonitis.

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  • 24. 

    What percentage of people have appendicitis in their lifetime?

    • 10%

    • 20%

    • 30%

    • 50%

    Correct Answer
    A. 10%
    Explanation
    In the given question, the correct answer is 10%. This means that approximately 10% of people will experience appendicitis at some point in their lifetime. Appendicitis is a condition characterized by inflammation of the appendix, a small organ located in the lower right abdomen. It is a relatively common condition that often requires surgical removal of the appendix. By stating that 10% of people will have appendicitis, it suggests that this condition is not extremely rare, but also not overly prevalent in the general population.

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  • 25. 

    What does a left shift mean in the MANTRELS score?

    • Bands have over 75% neutrophils

    • The patient lays down on left side

    • The patient has pain on left side

    • The leukocytes are increasing in number

    Correct Answer
    A. Bands have over 75% neutrophils
    Explanation
    A left shift in the MANTRELS score refers to the presence of bands (immature neutrophils) in the blood that make up over 75% of the total neutrophil count. This indicates an increase in the number of immature neutrophils, which can be a sign of an infection or inflammation in the body.

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  • 26. 

    The middle rectal artery supplies blood to which part of the rectum?

    • The lower rectum

    • The middle rectum

    • The anal sphincters

    • Upper and middle rectum

    Correct Answer
    A. The lower rectum
    Explanation
    The middle rectal artery supplies blood to the lower rectum.

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  • 27. 

    What stimulates the contraction of propulsive waves that move stool distally from the cecum?

    • Distention of the colonic wall

    • Distention of the small intestinal wall

    • The fermenting vat located in the cecum

    • Distention of the cecum wall

    Correct Answer
    A. Distention of the colonic wall
    Explanation
    The contraction of propulsive waves that move stool distally from the cecum is stimulated by the distention of the colonic wall. When the colonic wall becomes distended, it triggers the muscular contractions necessary for propelling stool through the colon and towards the rectum. This distention acts as a signal for the muscles in the colon to contract and move the stool along the digestive tract.

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  • 28. 

    What part of the colon propels retrograde waves of contraction to allow the cecum to retain liquid feces and act as a 'fermenting vat'?

    • Mid-transverse colon

    • Entire transverse colon

    • Ascending colon

    • Descending colon

    • Ileum

    Correct Answer
    A. Mid-transverse colon
    Explanation
    The mid-transverse colon is responsible for propelling retrograde waves of contraction to allow the cecum to retain liquid feces and act as a 'fermenting vat'.

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  • 29. 

    What are diagnostic features of acute appendicitis? click all that apply

    • Low grade fever less than 100.4F/38C

    • Moderate leukocytosis (10,000-20,000)

    • Ultrasound

    • CT (with contrast depending on body habitus)

    • CT (helpful if perforation is suspected to diagnose periappendiceal abscess)

    Correct Answer(s)
    A. Low grade fever less than 100.4F/38C
    A. Moderate leukocytosis (10,000-20,000)
    A. Ultrasound
    A. CT (with contrast depending on body habitus)
    A. CT (helpful if perforation is suspected to diagnose periappendiceal abscess)
    Explanation
    The diagnostic features of acute appendicitis include low-grade fever less than 100.4F/38C, moderate leukocytosis (10,000-20,000), ultrasound, and CT (with contrast depending on body habitus). CT is also helpful if perforation is suspected to diagnose periappendiceal abscess. These features can help in the diagnosis of acute appendicitis.

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  • 30. 

    During defecation, movement of feces into the rectum initiates (click all that apply)

    • Rectoanal inhibitory reflex

    • Voluntary relaxation of the pelvic floor and external sphincter mechanism

    • Voluntary increase in intra-abdominal pressure

    • Voluntary contraction of external sphincter

    Correct Answer(s)
    A. Voluntary relaxation of the pelvic floor and external sphincter mechanism
    A. Voluntary increase in intra-abdominal pressure
    Explanation
    During defecation, the movement of feces into the rectum triggers the voluntary relaxation of the pelvic floor and external sphincter mechanism. This allows for the passage of feces through the anus. Additionally, there is a voluntary increase in intra-abdominal pressure, which helps to push the feces out of the rectum and through the anal canal. These two mechanisms work together to facilitate the process of defecation.

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  • 31. 

    Name 4 (positive) findings on a physical exam of someone has acute appendicitis

    Correct Answer(s)
    RLQ pain with guarding
    rebound tenderness
    psoas sign
    obturator sign
    Explanation
    The four positive findings on a physical exam of someone with acute appendicitis are RLQ pain with guarding, rebound tenderness, psoas sign, and obturator sign. RLQ pain with guarding refers to pain in the right lower quadrant of the abdomen that worsens with pressure and is accompanied by muscle tension. Rebound tenderness is when there is pain upon releasing pressure from the abdomen. The psoas sign is positive when flexing the hip against resistance causes pain in the RLQ. The obturator sign is positive when internal rotation of the hip causes pain in the RLQ. These findings help in diagnosing acute appendicitis.

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  • 32. 

    What two symptoms are worth 2 points in the MANTRELS scoring method?

    Correct Answer(s)
    RLQ tenderness, shift left
    Explanation
    In the MANTRELS scoring method, RLQ tenderness and shift left are worth 2 points each as symptoms. RLQ tenderness refers to tenderness or pain in the right lower quadrant of the abdomen, which may indicate inflammation or infection in the appendix. Shift left refers to the presence of abnormal white blood cells in a blood test, indicating an infection or inflammation in the body. These two symptoms are given a higher point value because they are commonly associated with appendicitis, a condition that requires immediate medical attention.

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  • Mar 21, 2023
    Quiz Edited by
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  • Oct 26, 2009
    Quiz Created by
    Nsched

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