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07. Year 2: Alimentary System > Anorectal Conditions > Flashcards

Anorectal Conditions Flashcards

1
Q

What are the 2 broad categories of ano-rectal abnormalities?

A

Congenital

Acquired

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2
Q

What is the common presentation of ano-rectal abnormalities?

A

Pain

Haemorrhage

Dysfunction

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3
Q

What is a haemorrhage?

A

Escape of blood from a ruptured blood vessel

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4
Q

What are the different classifications of ano-rectal abnormalities?

A

Inflammation

Infection

Malignancy

Trauma

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5
Q

What are examples of ano-rectal congenital abnormalities?

A

Imperforate anus

Uro-Genital Fistulae

Hirschprung’s Myenteric Plexus Deficiency

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6
Q

What are examples of acquired ano-rectal abnormalities?

A

Haemorrhoids

Fissure

Abscess

Fistula-in-ano

Ulceration

Cancer

Control of continence

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7
Q

What should be considered when investigating haemorrhoids?

A

History

Site

Stage

Treatment

Complications

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8
Q

What is the treatment for haemorrhoids?

A

Stapled anopexy

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9
Q

What is stapled anopexy?

A

Procedure for Prolapse and Haemorrhoids (PPH), circular stapling instrument is inserted through the anus into the rectum which pulls the swollen and prolapsed blood vessels of the haemorrhoids back into their normal position

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10
Q

What is an anal fissure?

A

Break or treat in the skin of the anal canal

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11
Q

When investigating an anal fissure what should be considered?

A

History

Site

Stage

Treatment

Complications

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12
Q

How can the internal anal sphincter be relaxed?

A

Medical

Surgical

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13
Q

What medicine can be given to relax the internal anal sphincter?

A

Topical nitric oxide

0.2% glyceryl trinitrate paste

2% diltiazem calcium blocker

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14
Q

What surgical procedure can be done to relax the internal anal sphincter?

A

Internal lateral sphincterotomy

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15
Q

What is a peri-anal abscess?

A

Collection of pus develops near the anus

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16
Q

What are most peri-anal abscess’ the result of?

A

Infection from small anal glands

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17
Q

What should be considered when investigating peri-anal abscess’?

A

History

Site

Category

Treatment

Complications

18
Q

What is the treatment for peri-anal abscess?

A

Incision and drainage

Try to avoid complications

19
Q

What is fistula-in-ano?

A

Abnormal communications between the epithelialised surface of the anal canal and usually the perianal skin

20
Q

What should be considered when investigating fistula-in-ano?

A

History

Site

Category

Treatment

Complications

21
Q

What is the treatment for fistula-in-ano?

A

Lay open by fistulotomy (if superficial)

Trans-sphincteric, aim to close primary opening

22
Q

What is anorectal cancer?

A

Malignant (cancer) cells form in the tissues of the anus

23
Q

What should be considered when investigating anorectal cancer?

A

History

Site

Category/stage

Treatment

Complications

Follow up

Genetics

Screening

24
Q

What are different colorectal cancer sites?

A

Left colon (36%)

Right colon (27%)

Rectum (16%)

Transverse colon (10%)

Anus (3%)

Others (8%)

25
Q

What is the most common site of colorectal cancer?

A

Left colon

26
Q

What are different kinds of imaging used to investigate colorectal cancer?

A

Colonoscopy

CT colonoscopy

MRI guided colonoscopy

27
Q

What is a colonoscopy?

A

Videoscope (flexible thin tube with camera at the end) view with or without x-ray screening

28
Q

What does anorectal cancer treatment depend on?

A

The histology (anal squamous cancer or rectal adenocarinoma)

29
Q

What are the 2 main histological types of anorectal cancer?

A

Anal squamous cancer

Rectal adenocarcinoma

30
Q

What is the treatment for anal squamous cancer?

A

Radiotherapy

31
Q

What is the treatment for rectal adenocarcinoma?

A

Neo-adjuvant chemotherapy and radiotherapy

Laparoscopic resection

32
Q

What is used to stage anorectal cancer?

A

Duke’s stage

33
Q

What does each Duke’s stage correspond to?

A
34
Q

What can anal ulceration be caused by?

A

Crohn’s disease

Malignancy

Syphilis

Nicrorandil

35
Q

What is continence?

A

The ability to control movements of the bowels and bladder

36
Q

What can control of continence be impacted by?

A

Congenital and acquired conditions

37
Q

What is the treatment of lack of continence?

A

Sacral nerve root stimulator implant

38
Q

What does a sacral nerve root stimulator implant do?

A

Stimulates the actions of the sacral nerve to alleviate faecal and/or urinary incontinence

39
Q

How is a sacral nerve stimulator implant inserted?

A

Objective anorectal manometry and endoanal ultrasound

40
Q

What is done before a sacral nerve root stimulator implant is permenently inserted?

A

Implant trial

07. Year 2: Alimentary System (41 decks)

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