Disorders of the Anus and Rectum

Question 1

A 64 year old male presents with bloody stools. Digital rectal exam reveals a step off at Bulmer’s shelf. What is your diagnosis?

Answer 1

rectal cancer

Question 2

A 45 year old female presents with painful defecation, pruritus of the anus and occasional blood. What is your diagnosis?

Answer 2

internal hemorrhoids

Question 3

What is the recommended treatment for a perianal cyst?

Answer 3

surgical drainage

Question 4

Significant rectal pain, and pruritus but no bleeding. Affects the lower 1/3 of anus (below dentate line)

Answer 4

external hemorrhoids

Question 5

A 55 year old patient with rectal bleeding and tenesmus (a feeling of incomplete emptying after a bowel movement). What must you consider?

Answer 5

Anorectal cancer

Whenever rectal bleeding occurs, even in patients with obvious hemorrhoids or known diverticular disease, coexisting cancer must be ruled out

Question 6

Tearing rectal pain and bleeding which occurs with or shortly after defecation, bright red blood on toilet paper

Answer 6

anal fissures

Question 7

What type of hemorrhoids are usually painless?

Answer 7

internal hemorrhoids

Question 8

Treatment for fecal impaction?

Answer 8

Digital rectal /manual disimpaction - Diet with fiber stool softeners/laxatives for prevention

Question 9

Rectal mass rectal bleeding and tenesmus?

Answer 9

Rectal cancer (solitary tenesmus may occur with anal inflammation)