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41 In pseudomembranous colitis, what is the first treatment of choice, metronidazole or vancomycin?

42 Is Crohn's disease considered as an autoimmune disease. If it is, are there other predisposing factors to it other than genetics? If it is not, what is its nature?

43 Why does carcinoma of the ascending colon cause more anaemia than obstruction, and carcinoma of the descending colon more obstruction features and less anaemia?

44 Can you explain why a patient with colorectal carcinoma might present with diarrhoea and abdominal pain?

45 What causes the blood to be altered in the presentation of melaena: is it intestinal juice?

46 What is the differential diagnosis of multiple rectal ulcers in an 18-yearold female?

47 What is the best surgical technique in a chronic (2-3 years) painful anal fissure that is located sagittally posteriorly?

48 Can I make a diagnosis of irritable bowel syndrome (IBS) in a 40-year-old female patient without doing gastrointestinal investigations?

49 What is the cause of abdominal bloating, which is often a symptom in patients with irritable bowel syndrome (IBS)?

50 1. Where is the Traub's area situated anatomically? 2. What does it mean if it is dull on percussion? 3. What is the proper way to percuss this area?