NMS Q&A Family Medicine

Surgical Issues of the Gastrointestinal Tract 97bloody mucous stools. Deep palpation reveals asausage-like mass in the supraumbilical area of themidline abdomen. Which of the following is the mostlikely cause of these findings?(A) Meconium plug(B) Hirschsprung disease(C) Carcinoma of the colon(D) Shigellosis(E) Intussusception15 A 45-year-old female patient has just been told thather brother, who is 3 years older than she, has beendiagnosed with colorectal cancer (CRC). She has nosymptoms or change in bowel habits, blood in thestool, or any abdominal discomfort. She wishes toknow what measures she should take to avoid anencounter with the disease. First, you explain to herthat the lifetime risk of carcinoma of the colon isabout 2.5% for the average American. What would bethe corresponding risk figure for her, a person whohas a first-degree relative with colon cancer?(A) 2.5% to 3%(B) 7% to 7.5%(C) 10%(D) 15%(E) 20%16 Regarding the patient in Question 15, you performflexible sigmoidoscopy and excise a polyp that turnsout histologically to be an adenomatous polyp of thetubular type. What is your next advice and dispositionfor her medical care?(A) Fecal occult blood testing every year, three stools,two samples per stool, beginning at age of 50 years(B) Dual-contrast barium enema annually startingat 50 years(C) Flexible sigmoidoscopy every 5 years starting at50 years(D) Colonoscopy now and every 3 years if findingsare negative(E) No need to worry, considering the odds areoverwhelmingly in her favor