Anus, Rectum, Prostate

Question 1

Concerning Symptoms

Answer 1

Changes in bowel habits
Blood in stool
Pain with defecations, rectal bleeding or tenderness
Anal warts or fissure
Weak stream of urine
Burning with urination

Question 2

What position should the patient be to examine the anus?

Answer 2

Left, lateral decubitus

Question 3

Prostate Cancer Risk Factors

Answer 3

• Older than 50
• African American
• First degree relative: 2-3 times more likely
• Diet high in saturated fat from dairy or animal source (controversial)

Question 4

PSA

Answer 4

Prostate Sensitive Antigen

- Want to monitor for trend, refer for increase upward trend and symptoms

Question 5

Prostatitis

Answer 5

• Acute bacterial infection: Gram negative; E. coli
• Fever, urinary tract symptoms
• Low back pain
• Gland is tender, swollen, boggy and warm

Question 6

Prostate size and shape?

Answer 6

4cm diameter

Bi-lobed structure- heart shaped

Question 7

Benign Prostatic Hyperplasia

Answer 7

• Non-malignant enlargement of the prostate
• Usually over 50 yr
• Enlarged prostrate applies compression of the urethra
• May feel enlarged, smooth and firm, obliteration of median sulcus and protrusion into the rectal cavity
• Causes: Urgency, frequency, nocturia, decreased stream, incomplete emptying, straining

Question 8

Prostate Cancer

Answer 8

Hardening of the gland
Hard nodule alters contour of the gland
Irregular borders

Question 9

External Hemorrhoids

Answer 9

• dilated veins that originate below the pectinate line and are covered with skin.
• rarely produce symptoms unless thrombosis occurs.
• Acute local pain that increases with defecation and sitting.
• A tender, swollen, bluish, ovoid mass is visible at the anal margin

Question 10

Internal Hemorrhoids

Answer 10

• enlargements of the normal vascular cushions above the pectinate line
• Not usually palpable.
• May bleed during defecation
• May prolapse through the anal canal and appear as reddish, moist, protruding masses

Question 11

Pilonidal Cyst

Answer 11

• Common, congenital, abnormality located in the midline superficial to the coccyx or the lower sacrum.
• Look for the opening of a sinus tract.
• May exhibit a small tuft of hair and be surrounded by a halo of erythema.
• Abscess formation and secondary sinus tracts may occur