Rectal and anal conditions.
Which of the following statements is INCORRECT concerning paediatric rectal prolapse.
Rectal prolapse is most common under 4yrs of age with the highest incidence in children < 1year. It is worth remembering that rectal prolapse is the presenting symptom of Cystic Fibrosis in up to 1/3 of patients.
What is the most common rectal foreign body?
Apparently glass bottles win. They make up 42% of all rectal foreign bodies.
Below is a link explaining one method of removing rectal foreign bodies.
There are 4 grades of haemorrhoids. Which of the following best describes Type 3 haemorrhoids?
Answer 1 is a Grade 4.
Answer 2 is a Grade 1.
Answer 3 is a Grade 3.
Answer 2 is a Grade 2.
A 56yr old man presents at 3am with a severely painful thrombosed haemorrhoid present for the last 16hrs. You are working in a small rural ED. Which is the ideal option for his treatment?
You can then refer the patient to the surgeon as an outpatient for follow up. Print out a patient info sheet to give to him.
Haemorrhoids are dilated venous vascular cushions (there are 3 of them that lie at 3, 7 and11oclock positions). They lie below the dentate line. The real pain comes from when they thrombose.
Excising and removing a clot is normally only recommended in the first 3 days.
Which of the following actors who were in the 1976 hit TV series "Charlies Angels" died of anal cancer?
Farrah Fawcett died of anal cancer, aged 62yrs
Which of these cancers has the worst overall 5 year survival rate?
Lung 5 yr survival has doubled since the early 90s but is still only about 20%.
Bowel is just over 70%
Breast is over 90% but a little behind Melanoma.
Which is NOT a recognised complication of a perianal abscess?
Essentially they need incision and drainage.
If a patient develops "saddle paresthesia" and urinary retention what would you be concerned for?
Cauda Equina syndrome occurs when there is dysfunction of the lower lumbar and sacral nerve roots. Overall the most common cause is a large herniated disc although there are multiple other causes from tumours through to trauma.
One of the following statements is INCORRECT concerning anal fissures.
It is not a pre cancerous condition but rather occasionally anal cancer can mimic the appearance of an anal fissure.
What anal problem do pin worms cause in children.
If a child has pin worms "enterobius vermicularis" they emerge from the anal canal at night and early morning where they lay their eggs around the anus. This makes the anus itchy.
Diagnose it by using sticky tape peri anally in the morning. The eggs stick to the tape.
Treatment is using drugs like Pyrantel (Combantrin) orally.