Rectal Disorders Flashcards
A pt presents because he noticed blood while wiping after pooping this morning and he has had perianal pruritis. What diagnostic procedures could be used to confirm his Dx?
Hemorrhoid
Visualization
Anoscopy
Rectoflexion
A pt presents with BRBPR and pruritis. Anoscopy shows an internal hemorrhoid. What treatment do you reocommend?
Stool softeners, avoid straining
Benzocaine/topical pain relief
Anusol HC, banding, excision
A pt presents with BRBPR and PE shows a non-thrombosed external hemorrhoid. What treatment do you recommen?
Preparation H
Analpram
Sitz baths
“Tucks” Pads
A pt presents with a thrombosed external hemorrhoid. What is the most appropriate treatment?
Thrombectomy
A pt comes in because of burning pain with defecation. He noticed blood while wiping and perianal pruritis. What do you suspect? What treatment do you recommend?
Anal Fissure > 90% heal w/o Tx Good hygiene Manage constipation, avoid trauma Topical steroids, NTG Severe: surgery
A pt presents with pain, constipation, and a fever. Exam shows a closed abscess. What is your diagnosis?
Perirectal abscess
A pt presents with aching, stabbing knife-like pain that lasted for 15 min. He doesn’t believe it was related to his bowel movements. What do you suspect? What is the etiology of this disease?
Proctalgia Fugax
Spasm of the levator ani muscle
How do you treat pruritus ani?
Talc powder
A pt presents with hematochezia, maroon stools, abdominal pain, and diarrhea. Rectal exam and colonoscopy suggest an acute lower GI bleed. What treatment do you recommend?
Transfusion PRN
Stop anicoagulation, reversal in needed
Lower endoscopy if stable
A 75 yo woman with CRF and aortic stenosis presents with painless maroon stools and cramping. What do you suspect? How do you treat?
Angiodysplasia/AVM
Electrocautery
Argon plasma coagulation
