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
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
