Perianal abscess and fistula Quiz: Ace Your Exams
Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!
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A 73-year-old woman presents to the office with anal pain from sitting and defecation for the past 2 weeks. She also notes malodorous anal discharge. She has a history of 2 anal abscesses treated with incision and drainage in the past 6 months. Her medical history is notable for hypertension, degenerative arthritis, and type 2 diabetes mellitus. Her medications include lisinopril, metformin, and naproxen daily. Temperature is 37.2 °C (99 °F), pulse is 85/min, blood pressure is 145/75 mmHg, and respirations are 16/min. Cardiopulmonary and abdominal examinations are normal. Anal examination reveals an excoriated, erythematous perianal region associated with an external opening and drainage. Anoscopy reveals an opening in the anal wall surrounded by erythema and purulent fluid. Pelvic MRI reveals a perianal fistula involving 45% of the external anal sphincter and extending to the ischiorectal fossa. Empiric antibiotics are initiated. Which of the following is the best next step in management?
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