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Physical Assessment > Chapter 29, Module 7; Rectal Pain, itching and bleeding > Flashcards

Chapter 29, Module 7; Rectal Pain, itching and bleeding Flashcards

1
Q

Cutting or tearing pain during defecation and gnawing, throbbing discomfort afterward

A

Anal fissure

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2
Q

PHYSICAL FINDINGS OF Anal fissure?

A

Early fissures appear as superficial erosions; more advanced lesions are linear or elliptical breaks in skin; long-standing fissures are deep and indurated; internal fissures are seen when anal sphincter relaxes as examining finger is withdrawn; sentinel tag may be visible at anal verge

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3
Q

DIAGNOSTIC STUDIES OF Anal fissure?

A

Anoscopy

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4
Q

Swelling, throbbing, continuous progressive pain

A

Perirectal abscess

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5
Q

PHYSICAL FINDINGS OF Perirectal abscess?

A

Erythema and swelling in perirectal area; pain may preclude examination

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6
Q

DIAGNOSTIC STUDIES OF Perirectal abscess?

A

Anoscopy, CT SCAN

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7
Q

Sudden, severe, transient pain in rectum often occurring at night; may be accompanied by sweating, pallor, tachycardia; may occur once a year or in waves of 3-4 times/wk

A

Proctalgia fugax

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8
Q

PHYSICAL FINDINGS OF Proctalgia fugax?

A

Normal rectal examination

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9
Q

DIAGNOSTIC STUDIES OF Proctalgia fugax?

A

Diagnosed by clinical history and negative physical examination

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10
Q

Anorectal pain; mucopurulent discharge, tenesmus, constipation with proctitis; also diarrhea, abdominal pain, and fever with proctocoli¬ tis; history of anal intercourse, immunocompromised

A

Proctitis/proctocolitis

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11
Q

PHYSICAL FINDINGS OF Proctitis/proctocolitis?

A

Purulent discharge, inflamed mucopurulent rectal mucosa

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12
Q

DIAGNOSTIC STUDIES OF Proctitis/proctocolitis?

A

Cultures, DNA testing, Gram stain, syphilis testing; stool examination, stool O&P

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13
Q

Pain in sacrum, superior to rectum; history of sedentary occupation

A

Pilonidal disease

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14
Q

PHYSICAL FINDINGS OF Pilonidal disease?

A

Erythema, swelling over sacrum, which can be fluctuant

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15
Q

DIAGNOSTIC STUDIES OF Pilonidal disease?

A

NONE

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16
Q

History of GABHS, local itching, pain

A

Perianal streptococcal cellulitis

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17
Q

PHYSICAL FINDINGS OF Perianal streptococcal cellulitis

A

Erythema, proctitis, blood-streaked stool

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18
Q

DIAGNOSTIC STUDIES OF Perianal streptococcal cellulitis?

A

Culture of perianal area

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19
Q

History of abuse, perianal pain, itching

A

Sexual abuse

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20
Q

PHYSICAL FINDINGS OF Sexual abuse?

A

Large irregular anal fissures, bruising, rectal tone decreased, warts, presence of semen

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21
Q

DIAGNOSTIC STUDIES OF Sexual abuse?

A

Syphilis testing; culture (gonorrhea, Trichomonas vaginalis, herpes); DNA testing, (herpes, Chlamydia, gonorrhea)

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22
Q

Discomfort and itching exacerbated by friction; history of poor anal hygiene or overcleansing

A

Pruritus ani

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23
Q

PHYSICAL FINDINGS OF Pruritus ani?

A

MiId erythema and excoriationover perirectal skin; in laterstages red, raw, oozing, pale, lichenified perirectal skin

24
Q

DIAGNOSTIC STUDIES OF Pruritus ani?

A

NONE

25
Q

Itching, especially at night

A

Pinworms

26
Q

PHYSICAL FINDINGS OF Pinworms?

A

Use flashlight to visualize white- yellow worms 8-13 mm long at night

27
Q

DIAGNOSTIC STUDIES OF Pinworms?

A

Scotch tape test positive for eggs

28
Q

Bright red rectal bleeding with defecation or blood on stool; burning or itching; straining at stool; prolonged sitting; pregnancy and childbirth

A

Hemorrhoids

29
Q

PHYSICAL FINDINGS OF Hemorrhoids?

A

External hemorrhoids.- bluish, skin-covered lumps; internal hemorrhoids: may be visible when patient bears down

30
Q

DIAGNOSTIC STUDIES OF Hemorrhoids?

A

FOBT or FIT; colonoscopy, fecal/stool DNA to exclude carcinoma

31
Q

Painless hematochezia; may have mild abdominal discomfort and cramping often in LLQ; use of aspirin and NSAIDs and a low-fiber diet

A

Diverticular disease

32
Q

PHYSICAL FINDINGS OF Diverticular disease?

A

Brisk rectal bleeding; red, or black stool

33
Q

DIAGNOSTIC STUDIES OF Diverticular disease?

A

Colonoscopy

34
Q

Few symptoms with small lesions;bleeding, discharge, itching, and pain with large lesions

A

Condylomaacuminata

35
Q

PHYSICAL FINDINGS OF Condylomaacuminata?

A

Pink or white warty lesions withpapilliform surface; may extend into anal canal

36
Q

DIAGNOSTIC STUDIES OF Condylomaacuminata?

A

Syphilis testing todistinguish from condyloma lata caused by syphilis

37
Q

Feeling of lump; usually painless; may or may not bleed; may have family or personal history of polyps or colorectal cancer syndromes

A

Cancer of the colon, rectum, anus

38
Q

PHYSICAL FINDINGS OF Cancer of the colon, rectum, anus?

A

Polyp, internal or external mass, ulcers, verrucous growths

39
Q

DIAGNOSTIC STUDIES OF Cancer of the colon, rectum, anus?

A

Colonoscopy

40
Q

Ingestion of maternalblood

A

Newborn

41
Q

PHYSICAL FINDINGS OF Ingestion of maternalblood?

A

Hematemesis

42
Q

DIAGNOSTIC STUDIES OF Ingestion of maternalblood?

A

APT test

43
Q

Infant 0-6 mo, milk formula or breastfeeding mother who has intake of milk

A

Allergic colitis

44
Q

PHYSICAL FINDINGS OF Allergic colitis?

A

Blood-streaked stool

45
Q

DIAGNOSTIC STUDIES OF Allergic colitis?

A

NONE

46
Q

Preterm newborn, infant

A

NEC

47
Q

PHYSICAL FINDINGS OF NEC?

A

Ileus, abdominal distention, gastrointestinal bleeding, bilious vomiting

48
Q

DIAGNOSTIC STUDIES OF NEC?

A

Immediate referral

49
Q

Preschool child, painless Gl bleeding

A

Meckel diverticulum

50
Q

PHYSICAL FINDINGS OF Meckel diverticulum?

A

Black or maroon stool

51
Q

DIAGNOSTIC STUDIES OF Meckel diverticulum?

A

Technetium-99m scan and referral

52
Q

Colicky abdominal pain, vomiting, currant jelly stool

A

Intussusception

53
Q

PHYSICAL FINDINGS OF Intussusception?

A

Sausage-shaped mass may be felt in abdomen

54
Q

DIAGNOSTIC STUDIES OF Intussusception?

A

Refer

55
Q

Painless bleeding with stool, ages 2-5 yr

A

Juvenile polyps

56
Q

PHYSICAL FINDINGS OF Juvenile polyps?

A

NONE

57
Q

DIAGNOSTIC STUDIES OF Juvenile polyps?

A

Colonoscopy

Physical Assessment (27 decks)

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