Anorectal Disease Flashcards

1
Q

What are haemorrhoids?

A

Swollen vessels, usually veins, in/around the rectum and anus

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2
Q

Painful bleeding usually occurs with haemorrhoids. True/False?

A

False
Classically painless bleeding

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3
Q

Is there usually weight loss + change in bowel habit associated with haemorrhoids?

A

No

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4
Q

List investigations for haemorrhoids

A

PR exam
Rigid sigmoidoscopy
Flexible sigmoidoscopy in pts older than 50

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5
Q

List treatment for symptomatic haemorrhoids

A

Scleroant therapy
Ice packs, gel, cream
Band ligation
Haemorrhoidectomy
Artery ligation

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6
Q

Why is haemorrhoidal artery ligation essentially pain-free?

A

Little/no sensory neurones in lower rectum

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7
Q

What is rectal prolapse?

A

Protruding mucosal mass from anus, usually during defecation

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8
Q

Rectal prolapse causes loss of anal tone. True/False?

A

True

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9
Q

Most patients are unable to undergo surgery for rectal prolapse. True/False?

A

True

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10
Q

What are anal fissures?

A

Tear in the anal margin during passage of (constipated) stool

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11
Q

Anal fissures are most commonly associated with ulcerative colitis. True/False?

A

False
More likely to be with Crohn’s disease

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12
Q

How do anal fissures classically present?

A

Acute onset of anal pain following passage of constipated stool
Feels like shitting a shard of glass

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13
Q

List treatment for anal fissure

A

Stool softener, diet advice
Pharmacological sphincterotomy (relax sphincter using diltiazem)

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14
Q

What is fistula in ano?

A

Abnormal epithelial connection between anal canal + peri-anal skin

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15
Q

Which conditions have a rare association with anal fistulas?

A

Tuberculosis
Crohn’s disease
Carcinoma

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16
Q

How does fistula in ano classically present?

A

Abscess formation

17
Q

List treatment for fistula in ano

A

Cut it open
Seton stitch
Drainage
Fistulotomy