H&P Final Exam: Anus, Rectum, & Prostate

Question 1

What is BPH?

Answer 1

Benign prostatic hypertrophy

Question 2

What does BPH cause?

Answer 2

Irritation (urgency, frequency, nocturia)

Obstruction (decreased stream, incomplete emptying, straining)

Question 3

How common is BPH?

Answer 3

> 50% of all men by 50 yo

Question 4

What causes hemorrhoids?

Answer 4

Straining during bowel movements
Constipation
Sitting for long periods of time
Anal infections
Certain diseases like cirrhosis

Question 5

When are hemorrhoids most common?

Answer 5

During pregnancy and after childbirth

Question 6

Which anal sphincter is voluntary?

Answer 6

External anal sphincter

Question 7

Which anal sphincter is involuntary?

Answer 7

Internal anal sphincter

Question 8

Where is the prostate located relative to rectal structures?

Answer 8

In between the middle and inferior transverse rectal folds.

You can palpate the median sulcus and lateral lobe.

Question 9

What are external hemorrhoids?

Answer 9

Dilated hemorrhoidal veins that originate below the pectinate line and are covered with skin.

Question 10

What causes external hemorrhoids to actually hurt?

Answer 10

Thrombosis.

Note:
Will appear as a tender, swollen, bluish, ovoid mass.

Question 11

What do internal hemorrhoids look like?

Answer 11

Enlargements of normal vasculature above the pectinate line.

Usually not palpable.

Question 12

What do internal hemorrhoids cause when ruptured?

Answer 12

Bright-red bleeding during defecation.

Question 13

What are prolapsed hemorrhoids?

Answer 13

Reddish, moist, protruding masses when a patient bears down.

Question 14

What does a rectal prolapse look like?

Answer 14

A doughnut of red tissue.

Question 15

What do I check during a DRE in men?

Answer 15

Prostate also at the 12oclock position.

Question 16

When does sphincter tightness occur?

Answer 16

Anxiety
Inflammation
Scarring

Question 17

When does sphincter laxity occur?

Answer 17

Neurologic distress

Question 18

When does induration occur?

Answer 18

Inflammation
Scarring
Malignancy

Question 19

What is 12 oclock on the rectum?

Answer 19

Pointing towards the penis

Question 20

What does an anal fissure suggest?

Answer 20

Large, hard stools
IBD
STIs
Anal trauma

Question 21

Where is an anal fissure most commonly found?

Answer 21

Midline posteriorly

Question 22

What is an anal abscess?

Answer 22

Tender, purulent, red mass with fever and chills.

Question 23

What is an anorectal fistula?

Answer 23

Inflammatory tract/tube that opens into the anus or rectum and out the skin.

Often oozes blood, pus, and feculent mucus.

Question 24

What is a rectal polyp called when it is on a stalk?

Answer 24

Pedunculated

Question 25

What is a rectal polyp called when it is on the mucosal surface?

Answer 25

Sessile

Question 26

How can you differentiate a rectal polyp from benign or malignant?

Answer 26

Proctoscopy and biopsy is required. They are soft and normally difficult to palpate.

Question 27

What is a firm/hard surface in the rectum called?

Answer 27

Rectal shelf

Question 28

Where does a rectal shelf develop in a woman?

Answer 28

Rectouterine pouch

Question 29

What is the size and texture of a prostate?

Answer 29

Golf ball/walnut Rubber, nontender

Question 30

What suggests prostate cancer?

Answer 30

Hardness in the prostate. But not 100% accurate.