the butttt

Question 1

where are the majortiy of anal fissures

Answer 1

posterior midline

Question 2

what is a skin tag

Answer 2

Anal skin tags are benign skin growths around the anus. These are generally caused by various pathologies of the anus, most commonly hemorrhoids and anal fissures.

Question 3

secondary causes of anal fssures

Answer 3

chrones diseases
malignancy like leukemia

Question 4

acute .chronic anal fissure

Answer 4

6 weeks

chronic divided into A B C

its deeper than acute
A- raised lumpy borders
B- skin tag distal to tear
C- hypertophied papillae proximal to tear

Question 4

acute .chronic anal fissure

Answer 4

6 weeks

chronic divided into A B C
A- raised lumpy borders
B- skin tag distal to tear
C- hypertophied papillae proximal to tear

Question 5

rf

Answer 5

1.!! contsipation

pregnancy
anal cancer
psoarias , chrones

Question 6

rf

Answer 6

1.!! contsipation

pregnancy

Question 7

Management of anal fissures
Treatment of constipation – laxatives/fibre in diet
Topical analgesics – lidocaine cream / jelly
Topical vasodilators e.g. nifedipine or nitroglycerine
Second line treatments include topical calcium channel blockers (diltiazem), or oral nifedipine / diltiazem.

Answer 7

Treatment of constipation laxatives/fibre in diet
Topical analgesics – lidocaine cream / jelly
Topical vasodilators e.g. nifedipine or nitroglycerine
Second line treatments include topical calcium channel blockers (diltiazem), or oral nifedipine / diltiazem.

Question 8

what kind of blood in anal fissure

Answer 8

fresh bright red

Question 9

defintion OF ANAL FISSURE

Answer 9

A painful tear in the squamous lining of the lower anal canal below the pectinate line

Anal fissure is an ulcer in the lower portion of the anal canal.- NOV

Question 10

complication of hemmorhoid- NOV

Answer 10

thrombosis of the hemorrhaid which can be very painful

anemia- chronic blood loss

Bleeding, inflammation, thrombosis, strangulation and necrosis.

Question 11

rf for piles

Answer 11

spicy foods
constipation

portal hypertnsion

sitting for long periods of time
straining during bowel movements
obesity
pregnancy
low fibre

Question 12

rf for piles

Answer 12

spicy foods
sitting for long periods of time
straining during bowel movements
obesity
pregnancy
anal sex + low fibre

Question 13

management of piles conservative

Answer 13

sitz bath - warm water

topical CS to alleviate the itching

band ligation good for 2 + 3

laxatives to soften the stool
diety - increase fiber

injection of sclerosant (only for internal so 1+2)

Question 14

surgical options piles

Answer 14

hemmoridectomy

LORDS

Internal sphincter is stretched widely , resulting in dilation _ disruption of fibers

BARONS

bands are applied at the neck of hemmoroids which undergo healing by fibrosis

Question 14

surgical options piles

Answer 14

LORDS

Internal sphincter is stretched widely , resulting in dilation _ disruption of fibers

BARONS

bands are applied at the neck of hemmoroids which undergo healing by fibrosis

Question 15

what do we divide hemorrhoids into

Answer 15

internal(arise from superior hemoroidal plexus)

and external (arise from inferior hemorroidal plexus)

Question 16

difference between internal and external hemorrhoids

Answer 16

intenral - very little pain, but more bleeding in compariosn

external - more painful less bleeding

Question 17

difference between internal and external hemorrhoids

Answer 17

intenral - very little pain, but more bleeding in compariosn

external - more painful less bleeding

Question 18

novs def of hemorrhoids

Answer 18

Haemorrhoids are the angorgement of the hemorrhoidal vascular plexuses with redundancy of
their coverings. The word ‘piles’ is an alternative name for haemorrhoids.

Question 18

novs def of hemorrhoids

Answer 18

Haemorrhoids are the angorgement of the hemorrhoidal vascular plexuses with redundancy of
their coverings. The word ‘piles’ is an alternative name for haemorrhoids.

Question 19

symptoms

Answer 19

patients are systemically well!!!

bleeding on defecation - typically painless

can feel a lump (if thrombosed)

itchy- due to excessive mucus production

patients will compain of mucous discharge

pain is not typical except if an external thrombosed hemorrhoid

Question 20

what is the criteria for a thrombosed h

Answer 20

it has to have been protruded to get thrombosed and it changes colour

Question 21

what is the criteria for a thrombosed h

Answer 21

it has to have been protruded to get thrombosed and it changes colour

Question 22

managemnt of thrombosed H

Answer 22

hrombosed haemorrhoids (which present as a painful purple protrusion) can be managed conservatively with ice packs, laxatives, and lidocaine gel. Patients require haemorrhoidectomy if conservative measures fail.

Question 23

what medications can worsen the bleeding

Answer 23

heprain
wrafarin
aspirin (anti-platelet)
nsaids

Question 23

what medications can worsen the bleeding

Answer 23

heprain
wrafarin
aspirin (anti-platelet)
nsaids

Question 24

investigations for hemorrhoids- nOV

Answer 24

anoscope exam
protecotscopy

Question 24

investigations for hemorrhoids

Answer 24

anoscope exam

Question 25

protcoscopy

Answer 25

looks at rectum + anus

Question 26

Y