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GI: Key Information > Anal Diseases > Flashcards

Anal Diseases Flashcards

1
Q

define perianal disease

A

thesis recurrent abscess formation, leading to pain and leakage

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2
Q

diagnosis of perianal disease

A

PR examination

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3
Q

management of perianal disease

A

surgical drainage

antibiotics

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4
Q

define haemorrhoids

A

enlarged vascular cushions in the lower rectum and anal canal

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5
Q

presentation of haemorrhoids

A

painless bleeding

itch

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6
Q

diagnosis of haemorrhoids

A

PR examination
proctoscopy
sigmoidoscopy

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7
Q

management of haemorrhoids

A

only if symptomatic
grade I- III= sclerosation or rubber banding
grade IV= haemorrhoidectomy
HALO/THD procedure (locates artery supplying haemorrhoid and ties it off)

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8
Q

define a rectal prolapse

A

rectum loses its normal attachments inside the body (can be partial or complete)

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9
Q

presentation of a rectal prolapse

A

protruding mass from the anus (particularly after defecation)
PR bleeding and mucus

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10
Q

diagnosis of rectal prolapse

A

PR shows poor anal tone

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11
Q

management of rectal prolapse

A

rectoplexy (reattachment of rectum)
Derlome’s procedure (mucosa and muscle removed)
anterior resection (removal of that part of rectum)
too frail for surgery = bulking agents and manual reduction education

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12
Q

define an anal fissure

A

this is a tear in the anal margin, due to a constipated stool

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13
Q

what does multiple fissures indicate?

A

Crohn’s

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14
Q

presentation of an anal fissure

A

acute pain following an episode of constipation (can b up to 1/2 hour after)
PR bleeding

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15
Q

management of an anal fissure

A

dietary advice
stool softener e.g. docusate
GTN cream and diltiazem to relax sphincters
sphincterotomy or botox injection

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16
Q

define an anal fistula

A

abnormal communication between two epithelial surfaces

17
Q

presentation of an anal fistula

A

recurrent abscess, pain, itch, PR bleeding

18
Q

diagnosis of an anal fistula

A

examination
proctoscopy
sigmoidoscopy

19
Q

management of an anal fistula

A 
insertion of seton (suture if high fistula)
LIFT procedure (closure and removal of infected tissue)
20
Q

classification of haemorrhoids

A

1st degree= no prolapse
2nd degree= prolapse when straining and return on relaxation
3rd degree= can be pushed back
4th degree= permanent prolapse

21
Q

topical therapies for haemorrhoids

A

anusol and germoloid creams

22
Q

score for major lower GI bleeds for discharge planning

A

Oakland score

23
Q

what causes an anorectal abscess?

A

infection originating in cryptoglandular epithelium lining the anal canal that spreads to soft tissues with abscess formation

24
Q

location of anorectal absccesses

A

ischiorectal
intersphincteric
supralevator
perianal

25
Q

what to expect if extreme pain in haemorrhoids

A

blood supply strangulation

26
Q

what is a perianal haematoma cause?

A

rupture of perianal subcutaneous blood vessel

27
Q

presentation of perianal haematoma

A

blue/ black bulge at anal margin

28
Q

classification for anal fistula

A

Park’s classification

29
Q

what is Goodsall’s rule?

A

transverse line through the anus in lithotomy position. Fistula with opening anterior to this will follow a straight line to the anus. Fistulae with an opening posterior will follow a curved line

30
Q

what is the pilonidal sinus?

A

hair containing sinus that can cause inflammation

31
Q

management of pilonidal sinus

A

hygiene
shaving
surgery - incision and drainage, WLE and flap

32
Q

RF for anal carcinoma

A

HPV

receptive anal intercourse

33
Q

most common anal carcinoma

A

squamous cell

34
Q

management of anal carcinoma

A

radiotherapy +/- chemotherapy

GI: Key Information (24 decks)

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