Haemorrhoids+Acute abdo Flashcards
1
Q
what are they?
A
venous vascular cushions that have become enlarged due to increased pressure
2
Q
classification?
A
- 1st degree: no prolapse
- 2nd degree: prolapse when straining and return on relaxing
- 3rd degree: prolapse when straining, do not return on relaxing but can be pushed back
- 4th degree: prolapsed permanently
3
Q
aetiology?
A
anything which increases intra-abdo pressure
4
Q
presentation?
A
- can be asymptomatic
- painless PR bleeding (bright red)
- sore/itchy anus
- feeling a lump around anus
- constipation
5
Q
how does a thrombosed haemorrhoid present?
A
- can be extremely painful
- PR exam will be impossible due to pain
- appear as purple, v tender swollen lumps around anus
6
Q
Ix?
A
- PR exam
- proctoscopy required for proper visualisation and inspection
- if suspicious symptoms –> colonoscopy / flexible sigmoidoscopy
7
Q
Mx?
A
- symptomatic
- local anaesthetic, topical steroids
- band ligation
- haemorrhoidectomy
- consider DDx of rectal bleeding
8
Q
rectal bleeding DDx?
A
9
Q
presentation of anal fissures?
A
classically lead to severe pain on passing faeces
10
Q
what is angiodysplasia and what is it associated with?
A
- AVM in submucosa
- assoc w Aortic Stenosis
11
Q
Acute abdo DDx (just some)
A
MEDIC CURSES A MOP
Mesenteric Adenitis
Enteritis
Diverticulitis
Ischaemic colitis
Cholecystitis
Ulcers
Renal Colic
Salpingitis
Ectopic pregnancy
SBO
Appendicitis
Meckel’s diverticulum
Ovarian cyst
Pancreatitis
12
Q
acute abdo by 9 regions
A
