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 P for P Stage P 3/4 P - P resection, P down P to P internal P anal P sphincter
Rectal PProlapse P - P CORRECT P ANSWER P -- P starts P 6-7 P cm P proximal P from P anal P verge
- pudendal Pneuropathy, P laxity Pof Panal P sphincters
- female Pgender, Pstraining, Pchronic Pdiarrhea, Pprevious Ppregnancy, Predundant Psigmoid
- tx P - P high-fiber P diet
- surgery P - P rectopexy
- rectopexy P + P LAR P if P constipation
- Altemeier P if P older/frail
Altemeier P Procedure
(perineal Prectosigmoidectomy) P - PCORRECT P ANSWER P-- Plithotomy P position
- prolapse P rectum
- circular P incision P through P mucosa P 2 P cm P proximal P to P dentate P line
- dissect P peritoneum P away P from P rectum
- ligate Pmesorectum/mesosigmoid
- suture P peritoneum P to P anterior P bowel P as P proximal P as P possible
+/- Pre-approximate Ppuborectalis
- incise P anterior P redundant P bowel P 1 P cm P distal P to P anal P verge
- anchor P sutures
- resect Predundant Pbowel
- colo-anal P anastomosis
Condyloma P Acuminata P - P CORRECT P ANSWER P -- P p/w P cauliflower P mass
- due P to P HPV
- tx P - P laser P surgery
Anal P Fissure P - P CORRECT P ANSWER P -=split P in P anoderm P from P straining/constipation
- 90% P in P posterior P midline