Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
10 Cards in this Set
- Front
- Back
|
what are 5 causes of anal pain without any swelling? |
anal fissure, anal herpes, ulcerative proctitis, tenasmus, proctalgia fugax (levator ani spasm), solitary rectal ulcer (Murtaghs) |
|
|
what can be done about a perianal hameatoma (caused by a ruptured external haemmorhoid) in the first (a) 24hrs (b) 24hrs to 5 days and (c) day 6 onwards? |
(a) aspirate the haematoma as it is still fluid, dont need LA (according to Murtagh!!) (b) deroof haematoma with scissors under LA (c) leave it alone unless very painful, it should resolve and leave a skin tag (Murtaghs) |
|
|
CAuses of anal discharge (a) continent of faeces (5 causes) (b) incontinent of faeces (2 causes) (c) partially continent (2 causes) |
a) anal fistula, pilonidal sinus, STI's, solitary rectal ulcer syndrome, cancer of anal margin b) minor incontinence - weakness of internal sphincter. Severe incontinence - weakness of levator ani and puborectalis muscle c) faecal impaction, rectal prolapse (Murtaghs) |
|
|
Causes of the follow rectal bleeding: a) bright red on toilet paper b) blood on underwear c) bloods and mucous mixed with faeces d) mucous and faeces, no blood |
a) fissure, anal cancer, warts, internal haemmorhoids b) anal cancer, ulcerated perianal haematoma c) colorectal cancer, proctitis, IBD, ischaemic colitis d) villous papilloma of rectum or colon (Murtaghs) |
|
|
Pruritis ani - 6 ddx |
piles,, fissures, arts, pinworms, diarrhoea, diabetes, cadidaisis, eczema, zealous hygeine, contact dermatitis (from toilet paper, soap, powder, clothing), excessive sweating (Murtaghs) |
|
|
a) outline treatment for anal fissure . b) what medication can be used? what is a precaution of this medication and what side effect do you need to warm the patient about? |
a) avoid hard stools (may need laxatives), salt baths after passing bowel motions, medication as below, may need lateral sphincterotomy if becomes chronic b) GTN 0.2% ointment - 1cm stripe applied with gloved finger to inside anus 3-4 times/day, for 2 weeks. advise against using it if pt has had phosphodiesterase inhibitor (eg. viagra) in past 24hrs. Warm pt of headache and hypotension. (eTG) |
|
|
James is 43yrs and healthy. Lately he has been waking up at night due to sharp stabbing pain felt in his anus. this has also occured in the daytime on occassion. He has no pain between episodes and no red flag symptoms. What is a common cause of these symptoms? how can this condition be managed? |
proctalgia fugax, caused by pelvic floor muscle spasm. Management - reassurance and explanation that the episodes are brief and self-limiting. Other strategies include local warmth, immediate ingestion of food or drink, and firm pressure to the perineum. For patients with severe, debilitating symptoms, anecdotal evidence suggests the following drugs may be beneficial: inhaled salbutamol, antispasmodic drugs, calcium channel blockers, clonidine and glyceryl trinitrate. (eTG) |
|
|
what should you advise for management of haemmorhoids? |
1. ensure adequate fibre and fluids to avoid constipation 2. avoid straining on the loo 3. wait for the urge to defecate rather than trying to force it 4. OTC products can help relief itch or discomfort 5. persistent bleeding is best treated with rubber band ligation (eTG) |
|
|
How do you treat mild, moderate and severe diverticulitis? |
mild - can first try to manage clear fluids only (bowel rest) moderate - those who fail conservative tx, give augmentin duo forte (875/125mg) BD x 5days severe - unwell, peritonism - IV Amp/Gent/Metronidazole (eTG) |
|
|
a) how would you manage someone with mildly symptomatic diverticular disease? b) should you do a colonoscopy after diverticulitis? How long afterwards? |
a) high fibre diet, plenty of fluids, simple analgesia b) yes - 6 weeks after resource - Australian Doctor from 2004, couldnt find more recent article... |
