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minor surg/proctology > proctology > Flashcards

proctology Flashcards

(101 cards)

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1
Q

the rectum and anal canal start at level ___ and is ___cm in length

A

S3; 12-15cm

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2
Q

the midpoint of the anal canal has an undulating demarcation known as

A

dentate line

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3
Q

the dentate line is __cm from the anal verge

A

2

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4
Q

the dentate line takes a ___ appearance

A

pleated

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5
Q

T/F: the anal canal consists of epithelium of different types at different levels

A

true

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6
Q

there are 6-14 folds within the dentate line known as

A

columns of morgagni

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7
Q

between the columns of morgagni at the lower end there is a small pocket known as

A

crypts

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8
Q

___ are of surgical significance as foreign material may lodge in them, obstructing the ducts of the anal gland and result in abscesses

A

crypts

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9
Q

what are 5 muscles of the rectum

A

internal sphincter, conjoined longitudinal muscle, external sphincter, and levator ani, puborectalis

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10
Q

___ muscle is at the anorectal ring, this muscle coats the rectum and is joined by fibers from the levator ani and puborectalis muscles. It descends between the internal and external anal sphincters. Function is to affix the anal canal and evert the anus during defecation

A

conjoined longitudinal muscle

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11
Q

Lowest portion of the external sphincter is below and lateral to the internal sphincter. There is a palpable groove at this level and is referred to as the

A

intersphincteric groove.

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12
Q

____ is a broad thin muscle that forms the greater part of the floor of the pelvic cavity and is innervated by S4

A

levator ani

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13
Q

___ is the standard position when discussing anorectal disease and treatment

A

left lateral sims

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14
Q

____is a small tear in the thin, moist tissue (mucosa) that lines the anus.

A

anal fissure

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15
Q

___ are Areas of hypertrophied cutaneous tissue located adjacent to the anus, MC posterolateral quadrants of the anus

A

skin tags

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16
Q

___ is an unpleasant cutaneous sensation (various degrees of itching). Men MC 4:1. Perianal skin becomes thin, friable, tender, blistered, ulcerated, and weeping. In later stages, the skin is raw, red, and oozing or pale and thickened (lichenified)

A

pruritus ani

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17
Q

T/F pruritus ani can be caused by antibiotics/ overuse of topical steroids

A

true

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18
Q

T/F pruritus ani can be caused by diet

A

true: coffee, chocolate, tomatoes, spicy food, citrus

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19
Q

There are areas in the anal canal that are highly vascular masses of thick submucosa with smooth muscle and elastic connective tissue (cushions). ____are a sliding downward of this part of the anal canal lining.

A

Hemorrhoids

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20
Q

T/F hemorroids are still a problem even if no symptoms

A

false

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21
Q

what are 4 types of hemorroids

A

internal, external, mixed or strangulated

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22
Q

75% of frank bleeding from bowel is due to what condition

A

internal hemorrhoids

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23
Q

what does 1st degree internal hemorrhoids look like

A

no protrusion but bulge into lumen of rectal canal

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24
Q

2nd degree internal hemorrhoids do what

A

protrude at stool & reduce spontaneously

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25
3rd degree internal hemorrhoids protrude at stool like 2nd degree, but...
must be manually reduced
26
4th degree hemorrhoids also protrude at stool, but..
can not be reduced
27
treatment of hemorrhoids include
diet, education, stool softener, suppositories, hot sitz baths.. can also use rubber band ligation
28
___ is a painful linear ulcer situated in the anal canal and extends below the dentate line to the margin of the anus. Very common Symptoms: pain for 30min-hours after defecation, frank bleeding, constipation, dysuria Affects men and women with most located mid-line posterior
fissure in ano
29
a lateral fissure can be indicative of ___
severe systemic disease
30
___ can mimic any condition- often confused with cancer and crohns
Schistosomiasis
31
___ is a sexually transmitted disease of the anorectum that is due to papilloma virus. Cauliflower like masses that are often soft, friable, and bleed easily. 1-6mo incubation period and transmittable. Bleeding and pruritus ani may be only symptoms. Definitive dx made by dark field exam that will demonstrate spirochetes. Treatments include: podophyllin, surgical excision, electro desiccation, cryotherapy, and US.
Condylomata acuminata
32
T/F: any chronic unhealed ulcer should be considered as potentially squamous cell carcinoma
true
33
____ is an abnormal communication between the anal canal and perianal skin
fistula in ano
34
90% of fistula in ano originate in ___ with greatest conc of this area located in posterior aspect of anal canal
crypts of morgagni
35
___ is an acute manifestation while the fistula is a chronic situation. Will have acute pain and swelling. Pain increased with sitting, movement, defecation, coughing, sneezing. Usually history includes diarrhea. Symptoms also include malaise and pyrexia
abscess
36
MC benign condition of the large bowl is..
polyps
37
T/F neoplastic polyps are found with carcinoma
true
38
MC complaint area of IBS
lower GI
39
MC lesion that exists between the anus and isch tub
abscess
40
complication of keesay method
bleeding
41
what is keesay method treatment for
internal hemorroid
42
3 common tests for GI
spect, colonoscopy, manual inspection
43
another name for the dentate line
pectinate line
44
what does the pectinate line divide
the upper 2/3 from the lower 1/3 rectum
45
HPV treatment options
electrosurgery / excision, freezing, topicals
46
what is the purpose of the prostate
makes fluid that combined with sperm cells from the testicles makes semen
47
what are s/s of pinworm
pinworm MC in kids (5-10yo) and easily spread. S/S= itching pain rash and presence in stool
48
what is tenesmus
recurrent inclination to evacuate bowels, pain/cramping- feeling urge even after defication
49
what causes tenesmus
inflammatory bowel disease MC: Chrons and UC
50
what can you palpate on DRE
prostate, uterus, ovaries, and sometimes the bladder
51
if the prostate feels boggy, soft, non-tender, might have
BPH
52
if prostate is painful with palpation could be
prostatis
53
if prostate feels rock hard what is a likely dx
cancer
54
what is the median sulcus
on prostate and separates the 2 lateral lobes
55
another name for the median sulcus is
longitudinal groove
56
what does the prostate encircle
the urethra
57
where is the prostate location in relation to the bladder
just inferior
58
diabetes can cause what condition/complication with relation to the anus
puritis ani -> bleeding and anal fissures -> abcess??
59
patients require transrectal US guided biopsy if have one of these 3 scenarios (relation to PSA lvls and DRE findings)
1. PSA 4-10ng/ml with abnormal DRE 2. PSA >10ng/ml- regardless DRE 3. palp nodule on DRE regardless of PSA
60
normal feel of a prostate with DRE
rubbery and walnut sized
61
DRE of prostatitis is pain but could also feel how
soft and boggy
62
what is prostatitis
inflammation of the prostate (25% GU concerns from young-mid age men)
63
is prostatitis symptomatic? *
acute- yes; chronic can be asymptomatic.... MC LBP
64
what is a risk factor for prostatitis (another health condition)
diabetes
65
T/F: bacterial prostatitis has SUDDEN onset
yes
66
what causes bacterial prostatitis and most UTIs
escherichia coli
67
____ has S/S like prostatitis, can be due to msl spasm and like nerve entrapment
prostadynia
68
what is another name for chronic pelvic pain syndrome (CPPS)
prostadynia
69
what is BPH
benign prostate hyperplasia
70
T/F BPH can lead to prostate cancer
no; its benign... but they can co-exist (does not increase risk)
71
where does BPH happen
in transitional zone
72
do patients with BPH have symptoms
20% do
73
what are some symptoms of BPH
can block lower urinary tract, interrupt stream, cause hesitation, and urgency
74
what can cause an increased PSA besides cancer?
BPH, recent DRE (for 2 days!), and prostatitis
75
what does PSA stand for
prostate specific antigen
76
a PSA of 0-4 is considered...
normal*
77
PSA level 4-10 is considered
slightly increased; 10-20 moderately
78
what PSA level is considered severe increase
20-35
79
T/F PSA varies with age
yes; it increases- so there will be different norms per age gp *
80
what is finasteride
a treatment used for BPH
81
another name for finasteride
PROSCAR
82
what is the difference between finasteride and alpha blocker that can also be used to treat BPH
finasteride will decrease size of prostate as well as help with symptoms. alpha blocker has no effect on size
83
what are 3 surgery options available for BPH
TURP (core out), laser, prostatectomy
84
what are some risk factors for developing prostate cancer
over 50yo; african american, family hx, smoking, diet/weight, and vasectomy might
85
what is a supplemental option that can treat BPH without affecting PSA levels
saw palmetto
86
____ causes prostate to feel like "pebble"
cancer
87
T/F: prostate cancer can cause urinary obstruction
false
88
why doesn't prostate cancer affect urinary tract like BPH?
cancer usually is peripheral, not central
89
what are some S/S of prostate cancer
blood in urine/semen, pain in back, hips, and thighs
90
what percent of prostate cancer is asymptomatic
47%
91
why is prostate cancer so serious
can met to bone
92
what is bisphosphonates (fosamax) used to treat
helps increase bone density and slows loss of bone density
93
what medication can be used to help decrease risk of fracture from met to bone
fosamax
94
T/F cyrosurgery is an option for prostate cancer
yes
95
MC type of prostate cancer
adenocarcinoma
96
____ is a score used to evaluate tissue samples from a tumor and determine how progressed the tumor is/malignant
Gleason score
97
T/F: gleason score of 1-5 is bad
false- it is low risk; over 10 is increased risk
98
finestride (used to treat BPH) can also be used to treat,,,
prostadynia
99
T/F: penile cancer and prostate cancer are related
no
100
another name for hemorroids
piles
101
what are hemorroids
swelling of veins in the lower part of the rectum

minor surg/proctology (2 decks)

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