ABSITE – ANORECTAL QUESTIONS WITH CORRECT ANSWERS 2025/2026

ABSITE – ANORECTAL QUESTIONS WITH
CORRECT ANSWERS 2025
Anus Blood Supply - CORRECT ANSWER -artery - inferior rectal artery

vein, proximal to dentate - internal hemorrhoid plexus

vein, below dentate - external hemorrhoid plexus



Hemorrhoids - CORRECT ANSWER -hemorrhoid plexuses - left lateral, right anterior, right posterior

- radial appearance

*straining



- tx - fiber, stool softeners, fluids

- Sitz baths



External Hemorrhoids - CORRECT ANSWER -- thrombosis --> pain

- swelling, itching



- tx <72 hrs --> lance

- tx >72 hrs --> elliptical excision



Internal Hemorrhoids - CORRECT ANSWER -- bleeding

- prolapse



Stage 1 - protrudes below dentate with strain

Stage 2 - prolapses and reduces spontaneously

Stage 3 - prolapse, reduces manually

Stage 4 - unable to reduce



- tx for Stage 1/2 - banding

, - tx for Stage 3/4 - resection, down to internal anal sphincter



Rectal Prolapse - CORRECT ANSWER -- starts 6-7 cm proximal from anal verge

- pudendal neuropathy, laxity of anal sphincters

- female gender, straining, chronic diarrhea, previous pregnancy, redundant sigmoid

- tx - high-fiber diet

- surgery - rectopexy

- rectopexy + LAR if constipation

- Altemeier if older/frail



Altemeier Procedure

(perineal rectosigmoidectomy) - CORRECT ANSWER -- lithotomy position

- prolapse rectum

- circular incision through mucosa 2 cm proximal to dentate line

- dissect peritoneum away from rectum

- ligate mesorectum/mesosigmoid

- suture peritoneum to anterior bowel as proximal as possible

+/- re-approximate puborectalis

- incise anterior redundant bowel 1 cm distal to anal verge

- anchor sutures

- resect redundant bowel

- colo-anal anastomosis



Condyloma Acuminata - CORRECT ANSWER -- p/w cauliflower mass

- due to HPV

- tx - laser surgery



Anal Fissure - CORRECT ANSWER -=split in anoderm from straining/constipation

- 90% in posterior midline