Clinical Exam - Prostate, Rectum, Anus

Front 1

which part of anal canal is supplied by somatic sensory nerves?

Back 1

lower half

Front 2

where do anal glands empty?

Back 2

crypts between the anal columns (of Morgagni)

Front 3

inflammation in anal crypts can lead to what?

Back 3

fissure or fistula formation

Front 4

which part of the prostate do you palpate during rectal exam?

Back 4

posterior

Front 5

in infants, involuntary control of both sphincters is due to what?

Back 5

myelination of spinal cord is incomplete

Front 6

what causes retention of stool in elderly?

Back 6

degeneration of afferent neurons in rectal wall

Front 7

risk factors for colorectal CA (10)

Back 7

> 50, fam hx, personal hx of colon CA/IBD/polyps/Gardner, personal hx of ovarian/endometrial/breast CA, Ashkenazi Jew, diet high in animal fat/low in fiber, obesity, smoking, physical inactivity, alcohol

Front 8

risk factors for prostate CA (7)

Back 8

> 50, black, from N Am and NW Europe, fam hx, diet high in animal fat, cumulative exposure to androgens, physical inactivity

Front 9

pilonidal are =

Back 9

sacrococcygeal area

Front 10

Dx: perianal irritation (2)

Back 10

fungal infection, pinworm infection

Front 11

12 o'clock refers to which part of the anus?

Back 11

anterior wall

Front 12

Dx: lax sphincter

Back 12

neurologic deficit

Front 13

Dx: extremely tight sphincter (4)

Back 13

scarring, spasticity caused by fissure, inflam, anxiety

Front 14

size of healthy prostate

Back 14

4 cm with 1 cm intrusion into rectum

Front 15

Dx: rubbery, boggy prostate

Back 15

BPH

Front 16

Dx: stony hard nodular prostate (3)

Back 16

carcinoma, calculi, chronic fibrosis

Front 17

Dx: fluctuant softness of prostate

Back 17

abscess

Front 18

DRE and PSA should be done once a year beginning at what age?

Back 18

50, 40 with + fam hx or are black

Front 19

what are shelf lesions?

Back 19

nodules of peritoneal metastases that are palpable above prostate or cul-de-sac

Front 20

Dx: very light tan or gray stool

Back 20

obstructive jaundice

Front 21

Dx: tarry black stool

Back 21

upper GI bleed

Front 22

Dx: intermittent pencil like stool

Back 22

spasmotic contraction of rectum

Front 23

Dx: persistent pencil like stool

Back 23

permanent stenosis from scarring or pressure of malignancy

Front 24

Dx: pipestream and ribbon stools

Back 24

lower rectal stricture

Front 25

Dx: large amount of mucus in stool

Back 25

intestinal inflam and mucous colitis

Front 26

Dx: small flecks of blood stained mucous in liquid feces

Back 26

amebiasis

Front 27

Dx: fatty stools

Back 27

pancreatic disorders, malabsorption

Front 28

Dx: aluminum color stool

Back 28

tropical sprue, carcinoma of hepatopancreatic ampulla, sulfonamide tx (due to mixture of melena and fat)

Front 29

Dx: shrunken buttocks

Back 29

chronic debilitating disease

Front 30

Dx: asymmetric creases of buttocks

Back 30

congential dislocation of hip

Front 31

Dx: perirectal redness, irritation (3)

Back 31

pinworms, candida, other irritants

Front 32

Dx: hemorrhoids in child

Back 32

portal HTN

Front 33

Dx: small flat flaps of skin around rectum

Back 33

syphilis

Front 34

Dx: sinuses, tufts of hair, dimpling in pilonidal area

Back 34

lower spinal deformities

Front 35

Dx: no evidence of stool in newborn (3)

Back 35

rectal atresia, Hirschsprung, CF

Front 36

description of newborn meconium

Back 36

greenish black, viscous, contains occult blood, sterile

Front 37

description of 3-6 day old stool

Back 37

thin, slimy, brown to green

Front 38

description of breast fed stool

Back 38

mushy, loose, golden yellow, nonirritating to skin

Front 39

description of formula fed stool

Back 39

light yellow, irritating to skin

Front 40

Dx: lax sphincter in infant (4)

Back 40

lesion of peripheral nerve, lesion of spinal cord, Shigella infection, previous fecal impaction

Front 41

Dx: palpable prostate in preadolescent boys

Back 41

precocious puberty or virilizing disease

Front 42

effects of Fe supplements on stool appearance

Back 42

dark green or black color, diarrhea or constipation

Front 43

Dx: dimple with a sinus tract superifical to coccyx and lower sacrum

Back 43

pilonidal cyst or sinus

Front 44

Dx: pink to whitish growth on anus

Back 44

anal warts (condyloma acuminata)

Front 45

what causes anal warts?

Back 45

papilloma virus

Front 46

2nd most common cause of anal cancer

Back 46

adenocarcinoma

Front 47

Dx: area of swelling, erythema, painful, tender, fever

Back 47

perianal and perirectal abscesses

Front 48

where does a tear in the anal mucosa (fissure) most often occur?

Back 48

posterior midline

Front 49

what often accompanies anal fissure?

Back 49

sentinel skin tag at lower edge

Front 50

inflam tract that runs from anus/rectum to open onto surface of perianal skin/other tissue

Back 50

anorectal fistula

Front 51

chronic inflam of perianal skin causes what? (3)

Back 51

excoriation, thickening, pigmentation

Front 52

Dx: blue shiny mass at the anus

Back 52

thrombosed hemorrhoid

Front 53

what is a common sx of polyp?

Back 53

rectal bleeding

Front 54

Dx: polypoid mass with nodular raised edges and area of ulceration

Back 54

rectal CA

Front 55

most common sx of rectal CA

Back 55

bleeding

Front 56

most common type of rectal CA

Back 56

adenocarcinoma

Front 57

Dx: rectal prolapse in child

Back 57

CF

Front 58

Dx: asymmetric enlarged prostate, urethral discharge, fever

Back 58

prostatitis

Front 59

Dx: boggy, enlarged, tender, fibrosed palpate

Back 59

chronic prostatitis

Front 60

when do rectal/colon parasites lay eggs?

Back 60

at night, onto perianal skin