Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Rectum Problems > Flashcards

Rectum Problems Flashcards

1
Q

What are the symptoms of haemorrhoids (vascular cushions that enlarge due to increased pressure)

What are symptoms of external thrombosis (strangulation)

A 
Fresh painless bleeding after defaecation
Itchy
Mucous discharge
Pruritus 
Lump in anus
Anaemia may occur

Signifcant pain
Purple / oedematous
PR impossible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the RF for haemorrhoids

A 
Obese
Age
Pregnant
Weight lifting
Excessive straining due to constipation 
Lack of fibre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you Dx haemorrhoids

A

For all rectal bleed - Digital rectal exam, abdominal exam + colonoscopy to exclude malignancy if >50
DRE
May need proctoscopy for internal

Grade 
1 = not out of canal
2 = prolapse on defaecation
3 = manually reduce
4 = cannot reduce

Assess for red flags e.g. weight loss / change in bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you treat haemorrhoids

A

Increase fibre/ fluid / laxatives to often
Topical LA / analgesia
Topical steroid for short term only

Surgery 
US ligation of vessels
Band litigation
Miligan Morgan open Haemorrhoidectomy - gold standard 
Excise within 72 hours if thrombose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are differentials for haemorrhoids

A 
IBD 
Peri-anal haematoma
Malignancy 
Fissure
Abscess 
Unlikely to be abscess or fissure as painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the risks of surgery

A 
Bleeding 
Fistula 
Infection 
Incontinene 
Stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes anal fissue

A 
Constiption = most common 
Trauma
IBD - Chron's 
Malignnacy
STI - Syphillis 
Nicorandil - ulceration
Haemorrhoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the symptoms of anal fissue

A

Pain
Bleeding after defection
Itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you Dx fissue

A

Digital rectal exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you treat fissue

A

Laxatives / High fibre diet to bulk stool
Lubricant / Ointment
Topical anaesthetic
Steroid = no help

If no improvement / chronic
Continue above
Topical GTN
Topical NO / CCB

If no improvement after 8 weeks - refer 2
Botilum toxin
Sphincterotomy to losen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is sphincter laparoscopy CI

A

Women of child bearing age as leads to incontinece

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What causes peri-anal abscess

A 
Anal tissue infected
IBD
STI
Blocked anal gland 
E.coli / S.Aureus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of abscess

A 
Swelling 
Pain - constant 
Skin irritation 
Discharge 
Constipation 
Previous anal rectal condtions
Fever + severe pain differentiate from fissure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are general RF for abscess / bowel conditions

A

IBD
Diverticulitis
PID

DM
Steroids
Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you diagnose abscess

A

Digital rectal exam
Colonoscopy for underlying cause
MRI / USS if part of IBD etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you treat abscess

A

Drain abscess
Pain relief
Ax not usually needed
Broad spec if DM

17
Q

What are the complications of abscess

A

FIstula

18
Q

What causes fistula in ano

A 
Abscess = most common
Chrons
Diverticulitis
HIV
TB
Cancer
Surgery
19
Q

What are the symptoms of fistula

A 
Pain 
Skin irritation
Smelly discharge
Passing pus or blood in stool
Bowel incontinece
High output = ideal / jejunal
Nutritional deficiency
20
Q

How do you Dx fistula

A 
Digital rectam exam
Proctoscopy
EUA
USS
MRI - see course 
CT
Infection screen
21
Q

How do you treat fistula (need to close primary opening before outer hole closes as abscess will form)

A

Conservative if no IBD / distal obstruction as should heal
Protect skin with stoma bag
TPN / nutrition if high volume
Octreoide - reduce volume of pancreatic secretions
Fistulotomy if superficial
Seton suture
FIstula plug
Permacol paste
Emergency if acutely unwell but better to investigate and know course

22
Q

What causes solitary rectal ulcer

A

Constipation
Straining
Ulceration

Need to endoscopy + biopsy to exclude malignancy

23
Q

What do you do for puriruts of anus

A

Check not related to bowel habit e.g. diarrhoea
Look for worms
Proctosigmoidoscopy for other cause
Exclude cancer
SUpportive
Mild topical corticosteroid if inflammation (max 2 weeks)

24
Q

What causes pruritus and

A 
Soiled anus / incontinence / poor hygiene 
Fissure
Fistula
Threadworm
Lischen scloeriss
Contact dermatitis

GI (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions