30 Questions
What is typically seen at the outer end of a chronic anal fissure?
A sentinel tag
What is the primary cause of pain in an anal fissure?
The spasm of the anal sphincter
What is the purpose of a lateral sphincterotomy?
To abolish the spasm of the anal sphincter
What is the Classification of an abscess located in the region of the anal canal?
Perianal
What is the recommended treatment for a chronic anal fissure?
All of the above
Where are the glands located that can cause an abscess in the region of the anal canal?
In the intersphincteric plane
What is typical of the history of an anorectal fistula?
A pattern of discharge followed by healing and then further discharge
During examination, what is typically found adjacent to the anus?
A pit or granulating hole in the skin
What is the preferred type of anaesthetic for anorectal fistula examination?
One that preserves the tone of the anal muscles
What is the purpose of Goodsall's rule during the examination?
To locate the internal opening of the fistula
What is the typical location of the anorectal fistula in relation to the anorectal ring?
Below the anorectal ring
What is a possible cause of an anorectal fistula that communicates between the rectum and the skin through the levator ani?
Pelvic sepsis
What is the main objective of treating an anal fistula?
To core out the fistula track from below through the levator ani
What is a rare cause of fistula-in-ano?
Tuberculosis
What is the purpose of performing a histological examination on tissue removed in recurrent or problematical fistulae?
To identify the underlying cause of the fistula
What is a common feature of rectal prolapse?
It is usually reducible
How can a prolapse be produced during examination?
By asking the patient to strain
What is a treatment option for minor degrees of mucosal prolapse?
Injections of haemorrhoids
What is usually performed if the lesion is more than 5 cm from the anus and not very large?
Anterior resection with anastomosis on the descending colon to the lower rectum
Why is the use of a mechanical stapling device helpful in an anterior resection?
It makes the very low anastomosis more feasible, especially in males
What is the resulting consequence of an abdominoperineal excision of the rectum?
Permanent colostomy
When is a Hartmann's procedure usually performed?
When the tumour is not resectable
What is the purpose of staging in adenocarcinomas of the gastro-intestinal tract?
To classify the tumour
What is the characteristic of Stage A in the Duke's classification?
The tumour is confined to the bowel wall
What is the recommended follow-up for vinous adenomas?
Regular sigmoidoscopies
What is the commonest site for carcinoma of the large bowel?
Rectosigmoid junction
What is thought to increase the exposure of the mucosa to carcinogenic influences?
A contemporary, Western, low-residue, constipating diet
What type of carcinoma may occur in the anal canal?
Squamous cell carcinoma
What is the characteristic of polyps with a diameter of greater than 2 cm?
They have a high chance of being malignant
What is the initial pattern of spread of rectal carcinoma?
Local through the wall into neighbouring tissues
This quiz covers the diagnosis and treatment of anal fissures, including symptoms, examinations, and surgical procedures. Learn about the causes of pain and the different approaches to relieve suffering.
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