Gastro 1 - Anorectal

Question 1

Perianal abscess

Answer 1

Collection of purulent material that arises from glandular crypts in the anus or rectum

Question 2

Hemorrhoids - Medical treatment

Answer 2

Topical Astringents, Topical Hydrocortisone, Topical anesthetics, Hydrocortisone suppositories

Question 3

Infectious Proctitis - Etiologies

Answer 3

STI’s

Question 4

Hemorrhoids - Further treatment (Internal)

Answer 4

Rubber band ligation, Sclerotherapy, Electrocoagulation

Question 5

Anal fissure - causes

Answer 5

Trauma during defecation- Straining - Constipation- High internal sphincter tone

Question 6

Hemorrhoids - Presentation

Answer 6

bright red rectal bleeding Perianal itching, Mucoid discharge with stool, Pain if external Hemorrhoids

Question 7

Anal fissure locations

Answer 7

Posterior 75% Anterior 24%

Question 8

Perianal Abscess - PE

Answer 8

DRE req

Question 9

Infectious Proctitis - STI presentations

Answer 9

Syphilis - chancre
Herpes - grouped vesicles
Gonorrhea - mucopurulent discharge
Chlamydia - slight discharge – may be asymptomatic

Question 10

Carcinoma of the Anus Higher risk patients

Answer 10

Anoreceptive intercourse, Anal warts

Question 11

Anal fissures no located on midline suspect (6)

Answer 11

Crohn Disease, HIV/AIDS, Tuberculosis, Syphilis, Carcinoma, Trauma

Question 12

NL anal vasculature

Answer 12

Contribute to normal anal pressures and ensure a water-tight closure of the anal canal

Question 13

Hemorrhoids - PE

Answer 13

Internal may prolapse upon valsalva DRE

Question 14

Perianal Abscess - Treatment of simple

Answer 14

Outpatient - incise & drain

Question 15

Internal hemorrhoids (2)

Answer 15

Located proximal to the dentate line

Arise from the superior hemorrhoidal veins - Associated with mucous production

Question 16

Carcinoma of the Anus points (3)

Answer 16

Rare, Squamous cell cancers are the majority, CT or MRI

Question 17

Carcinoma of the Anus - presentation

Answer 17

Often confused with hemorrhoids, Most common symptoms:, Bleeding, pain, local mass

Question 18

Anal fissure

Answer 18

a tear in the anoderm distal to the dentate line

Question 19

Anal fissure - Presents (2)

Answer 19

Acute tearing pain (Self induced constipation) Mild hematochezia Sentile pile (skin tag on edge)

Question 20

Condylomata Acuminata is

Answer 20

Anal warts, Must distinguish from cancer

Question 21

Condylomata Acuminata - S&S

Answer 21

May c/o itching, bleeding or pain

Question 22

Surgical Anal fissure treatment

Answer 22

Fissurectomy

Lateral internal sphincerotomy

Question 23

Chronic anal fissure - treatment

Answer 23

Topical Vasodilators

Question 24

T/F - Perform DRE on pt w/ anal fissure

Answer 24

F

Question 25

Perianal Abscess - Presentation

Answer 25

Constant severe pain not associated with defecation Fever & Malaise

Question 26

Infectious Proctitis - S&S

Answer 26

Anorectal discomfort, Tenesmus, Constipation, Mucus or bloody discharge

Question 27

Perianal Abscess - Treatment of complex

Answer 27

Inpatient - Surgical drianage

Question 28

Fistula is

Answer 28

Epithelialized track can form connecting the abscess in the anus or rectum with the perirectal skin
Can result in chronic purulent drainage

Question 29

Perianal abscess - Complications

Answer 29

Fistula formation - Req surgery

Question 30

Internal hmorrhoids grades

Answer 30

I - Bleeding, no prolapse II. - Prolapse, goes back in on its own III. - Prolapse, maually pushed in

Question 31

External hemorrhoids

Answer 31

Located distal to the dentate line - Arise from inferior hemorrhoidal veins

Question 32

Hemorrhoids - General treatment

Answer 32

High fiber diet, Increase fluid intake, Wet wipes

Question 33

Hemorrhoid - Pathogenesis

Answer 33

Straining at stool, Constipation, Prolonged sitting, Pregnancy, Obesity, Low-fiber diet

Question 34

Anal fissure - treatment

Answer 34

Sitz bath Fiber & fluid Stool Softeners

Question 35

Thrombosed Hemorrhoids

Answer 35

Int or Ext (painful & req surgery)