Anus and prostate Flashcards
What is pain with defecation indicative of?
Hemorrhoids
What is the cause of the black coloration of melena?
protein
What are the other causes of black stool? (3)
Iron
Black licorice
Bismuth salts
What is the cause of hematochezia? (4)
colon CA
polyps
Diverticulitis
Hemorrhoids
What is screening?
Testing without symptoms
What is the second leading cause of death in men over 50?
Prostate CA
At what age does the risk of prostate cancer increase?
50
How is prostate cancer different in african americans? (2)
Earlier age
More advanced
What are the three requirements to screen anything?
Pose a risk
No symptoms
Have an intervention
What is the D grade for screening?
D for “don’t do it”
What are the two screening methods for prostate ca?
PSA
Digital exam
When does colorectal CA screening begin?
at 50
What is lynch syndrome?
HNPCC
What is the recommendation grade for colorectal CA?
A
What are the three tumor “mimics” for female colon CA (things that feel like a mass, but is part of normal anatomy)?
Cervix
Retroverted uterus
Tampon
Why should you always look before doing a prostate exam?
See perianal abscesses and other things
What should you tell your pt before performing a digital rectal exam?
That they may have a feeling of urgency
What do you offer pts after the DRE?
Toilet paper
What are the three common findings with the prostate on a DRE?
Prostatitis
BPH
CA
What are the five common findings with the rectum on a DRE?
Anal fissures polyps CA Hemorrhoids Prolapse
What are the symptoms of prostatitis?
Dysuria Frequency nocturia Hesitancy Suprapubic pain Painful ejaculation Flu like symptoms
Why do you not do a DRE if you suspect prostatitis?
Spread the gram negative bacteria’s toxins
What are the signs/symptoms of BPH?
Urgency
Frequency
Hematuria
(no dysuria)
Is a DRE useful for BPH?
Yes
What are the signs of BPH?
Enlarged prostate
No TTP
Hard
Symmetric
Is PSA useful for BPH?
No
What is the difference between prostate CA or BPH?
lack of symmetry
What is the cause of an anal fissure?
Straining, or constipation
What is the cause of an anal fistula?
infected anal gland, producing a chronic draining abscess
What is a bowel prolapse?
protrusion of the anal canal through the anus
True of false: biopsy is mandatory for anal polyps?
True
What is a anal pap?
Anal screening for HPV
What does a guaiac test, test for?
Heme–NOT iron
How sensitive/specific is DRE for prostate CA?
59% sensitive
94% specific
