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  #1  
Old 07-31-2011
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Question Diagnose the colonoscopic finding

A 70-year-old previously healthy man notes blood-streaked stool and sees his physician. On physical examination his stool is positive for blood, though a lesion cannot be palpated by digital rectal examination. There are no palpable abdominal masses or organomegaly. There is no abdominal tenderness and bowel sounds are active. An appendectomy scar is present in the right lower quadrant. A colonoscopy is performed, and there is an area of obstruction from an encircling mass with superficial ulceration that is located at 20 cm above the anal verge. Which of the following risk factors was most likely to have been present for development of this lesion?

A Human papillomavirus infection

B Crohn disease

C High fat diet

D Diverticulosis

E Prior abdominal surgery
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Old 08-01-2011
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B Crohn disease
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  #3  
Old 08-01-2011
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Ans C = High Fat ( possibly low fiber diet) ???
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Old 08-01-2011
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I agree

crohns disease
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Old 08-01-2011
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I am with C. high fat diet.
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Old 08-01-2011
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c. High fat diet - May be risk factor for adenocarcinoma, Circling mass is typical of descending colon cancer.
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Old 08-01-2011
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i'm also thinking C
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Old 08-01-2011
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i'm thinking d
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Old 08-01-2011
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D?
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Old 08-01-2011
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A Human papillomavirus infection--- >nothing to do with ulcer

B Crohn disease-> it would be ulceration extending all three layers of GIT

C High fat diet-> increase risk for diverticulosis

D Diverticulosis---> it can get infected and produce superficial uleration

E Prior abdominal surgery---> nothing to do with GIT ulcer
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Old 08-01-2011
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Quote:
Originally Posted by usmle2011 View Post
A 70-year-old previously healthy man notes blood-streaked stool and sees his physician. On physical examination his stool is positive for blood, though a lesion cannot be palpated by digital rectal examination. There are no palpable abdominal masses or organomegaly. There is no abdominal tenderness and bowel sounds are active. An appendectomy scar is present in the right lower quadrant. A colonoscopy is performed, and there is an area of obstruction from an encircling mass with superficial ulceration that is located at 20 cm above the anal verge. Which of the following risk factors was most likely to have been present for development of this lesion?

A Human papillomavirus infection

B Crohn disease

C High fat diet

D Diverticulosis

E Prior abdominal surgery
the ans is E
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Old 08-01-2011
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its either c or e not sure but i ll go with c
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Old 08-01-2011
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C) High fat diet;
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  #14  
Old 08-01-2011
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[QUOTE=usmle2011;57517]A 70-year-old previously healthy man notes blood-streaked stool and sees his physician. On physical examination his stool is positive for blood, though a lesion cannot be palpated by digital rectal examination. There are no palpable abdominal masses or organomegaly. There is no abdominal tenderness and bowel sounds are active. An appendectomy scar is present in the right lower quadrant. A colonoscopy is performed, and there is an area of obstruction from an encircling mass with superficial ulceration that is located at 20 cm above the anal verge. Which of the following risk factors was most likely to have been present for development of this lesion?

A Human papillomavirus infection

B Crohn disease

C High fat diet

D Diverticulosis

E Prior abdominal surgery[/iUOTE]

i think its due to adhesion formation due to prior surgery causing partial obstruction n ischemic changes leading to supeficial necrosis
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Old 08-02-2011
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Default Explanation

(A) Incorrect. HPV infection affects squamous epithelium, and could be responsible for dysplasias and carcinomas of the anorectal region.

(B) Incorrect. This cancer is unlikely to be related to inflammatory bowel disease at his age.

(C) CORRECT. This is a colonic adenocarcinoma. At his age, this is likely a sporadic type of colon cancer, not an inherited condition nor a complication of inflammatory bowel disease, particularly in view of no past history of bowel disease. Increased fat intake and obesity are controversial as risk factors for cancer, but probably play a role. Reducing fat intake and maintaining an ideal body weight are good ways to help prevent cancers in general.

(D) Incorrect. Diverticulosis is common, but there is no long term risk for cancer.

(E) Incorrect. Prior abdominal surgery predisposes to formation of adhesions that can increase the risk for bowel obstruction, but not carcinoma.
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