37 Anal and Rectal
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Questions and Answers

What is the arterial supply to the anus?

  • External hemorrhoid artery
  • Middle rectal artery
  • Superior rectal artery
  • Inferior rectal artery (correct)

Which plexus is responsible for the venous drainage above the dentate line?

  • Superior hemorrhoid plexus
  • Internal hemorrhoid plexus (correct)
  • Middle hemorrhoid plexus
  • External hemorrhoid plexus

What can cause pain in external hemorrhoids?

  • Bleeding
  • Straining (correct)
  • Itching
  • Prolapse

What type of innervation do internal hemorrhoids have?

<p>Autonomic innervation (D)</p> Signup and view all the answers

What is the recommended treatment for thrombosed external hemorrhoids if the condition has persisted for more than 72 hours?

<p>Lance open (C)</p> Signup and view all the answers

What is the surgical indication for resecting external hemorrhoids?

<p>Large external component (B)</p> Signup and view all the answers

What is the most common symptom of anal melanoma?

<p>Rectal bleeding (C)</p> Signup and view all the answers

Which anal cancer requires standard postoperative chemo/XRT similar to rectal cancer?

<p>Adenocarcinoma (A)</p> Signup and view all the answers

What is the recommended treatment for pilonidal cysts?

<p>Drainage and packing followed by surgical resection (C)</p> Signup and view all the answers

What is the most common cancer in patients with AIDS?

<p>Kaposi's sarcoma (B)</p> Signup and view all the answers

Which type of anal incontinence has no good treatment?

<p>Neurogenic incontinence (A)</p> Signup and view all the answers

What is the precursor for anal squamous cell carcinoma (SCCA)?

<p>Anal intra-epithelial neoplasm (AIN) III (B)</p> Signup and view all the answers

Which type of cancer is associated with HPV, HIV, XRT, and immunosuppression?

<p>Squamous cell carcinoma below the dentate line (C)</p> Signup and view all the answers

What is the most common site for melanoma?

<p>Rectum (C)</p> Signup and view all the answers

What is the primary treatment for anal margin squamous cell carcinoma if it involves the sphincter or if there are positive nodes?

<p>Chemotherapy only (B)</p> Signup and view all the answers

What is the primary drainage and packing followed by surgical resection recommended for?

<p>Pilonidal cysts (A)</p> Signup and view all the answers

What should be considered for biopsy to rule out cancer and diagnose anal problems?

<p>Inguinal nodes (B)</p> Signup and view all the answers

What is the surgical treatment for rectal prolapse in older and frail patients?

<p>Transabdominal posterior suture rectopexy (B)</p> Signup and view all the answers

What is the primary medical treatment for anal fissure?

<p>Bulk (psyllium) (C)</p> Signup and view all the answers

Which condition can be a contraindication to sphincterotomy for anal fissure?

<p>Incontinence after botulinum injection (C)</p> Signup and view all the answers

What is the recommended surgical treatment for lateral or recurrent anal fissures?

<p>Lateral subcutaneous internal sphincterotomy (A)</p> Signup and view all the answers

Which type of anorectal abscess may form a horseshoe abscess?

<p>Intersphincteric abscess (D)</p> Signup and view all the answers

What percentage of patients with fistula-in-ano eventually develop a fistula-in-ano?

<p>30% (B)</p> Signup and view all the answers

What is Goodsall's rule used for in the context of fistula-in-ano?

<p>Identifying the type of fistula based on location (A)</p> Signup and view all the answers

What is the recommended treatment if less than 1/4 of the external anal sphincter is involved in a fistula-in-ano?

<p>Fistulotomy (B)</p> Signup and view all the answers

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