benign ano-rectal disease

Question 1

epi of abscess fistula disease

Answer 1

• very common
• M>F
• painful mass around anus

Question 2

MOA of abscess

Answer 2

crypts in anus get blocked

• bacteria can’t drain
• expands into potential spaces

Question 3

4 possible locations

Answer 3

1. perianal
2. ischiorectal
3. supralevator
4. horseshoe

Question 4

treat of anal abscess

Answer 4

incision and drainage in ER or OR

- many dev. fistula

Question 5

def. of fistula

Answer 5

abnormal connection b/w 2 epitelialized structues

Question 6

2 types of hemorrhoids

Answer 6

1. internal

2. external

Question 7

features of internal

Answer 7

• BRBPR
• drips, not mixed with stool
• PAINLESS
• diagnosis of exclusion until colonoscopy

Question 8

path of hemm

Answer 8

straining or hard stoll leads to prolapsed tissues

Question 9

3 treatments by increasing grades

Answer 9

1. fibre
2. banding
3. ectomy

Question 10

Sx of external

Answer 10

1. PAIN - due to thrombosis

2. itch - due to skin tags

Question 11

treatment of external

Answer 11

get better in 4 days

Question 12

DDx of external

Answer 12

always rule out Ca

Question 13

def. fissures

Answer 13

• small linear tear usually in post. midline

Question 14

Sx of fissures

Answer 14

• pain with def.

- maybe blood on stool

Question 15

3 treatments

Answer 15

1. oitment - diltiazem or nitro
2. botox
3. sphycterectomy

Question 16

epi. of pruritis ani

Answer 16

1-5%
M>F
20-50

Question 17

MOA of ass itch

Answer 17

itch > scratch > irritates > worse

Question 18

2 etiology of itch

Answer 18

1ry - 90% unknown
2ry
- anal pathology that can be malig
- surgery
-- dermatitis

Question 19

3 investigations for itch

Answer 19

1. inspect
2. DRE
3. rigid sigmoiscopy

Question 20

mgmt of itch

Answer 20

1. diet
2. hygene - less is more
3. always follow-up for malig