Anal conditions: Clinical

To be retired ⓘ

00:00 / 00:00



Anal conditions: Clinical

USMLE® Step 2 questions

0 / 11 complete


USMLE® Step 2 style questions USMLE

of complete

A 70-year-old man comes to the office because he has had increasing frequency of urination. He says that he has to get out of bed about five times per night to go to the bathroom. Further examination is performed and he is diagnosed with benign prostatic hyperplasia. Which of the following is the most appropriate management for this patient? 


Content Reviewers

The anus is the final 3 to 4 centimeters of the gastrointestinal tract, and it extends from the rectum to the anal margin.

The top and bottom of the anal canal are surrounded by the internal and the external anal sphincters, which are two muscular rings that control defecation.

The internal sphincter is under involuntary control, while the external sphincter is under voluntary control.

Within the anal canal, there are mucosal membrane infoldings that form the anal columns.

And at the base of these columns, there is the dentate or pectinate line, which divides the upper two thirds and lower third of the anal canal.

Above the dentate line, there’s the mucosa is lined by simple columnar epithelium, and below the dentate line, there’s the anoderm, which has no hair and sebaceous and sweat glands, and is lined by squamous epithelium.

Now, hemorrhoids are normal vascular structures in the anal canal that act as cushions for the stool as it passes through.

Hemorrhoidal disease is when hemorrhoids get swollen or inflamed; but the term "hemorrhoid" is often used to refer to the disease.

Hemorrhoids are often caused by chronically or recurrently increased abdominal pressure, from a variety of causes.

For example, straining during bowel movements, chronic diarrhea or constipation, obesity, pregnancy, and old age.

Complications of hemorrhoids can include anemia due to chronic blood loss; strangulation if the blood supply to an internal hemorrhoid is cut off, leading to ischemia; and thrombosed hemorrhoids, which is when blood pools inside a hemorrhoid and forms clots.


Conditions that can be found during anal clinical practice include, but are not limited to: hemorrhoids, anal fissures, abscesses, fistulas, and tumors.

Hemorrhoids are swollen veins in and around the anus. They may cause pain, itching, and bleeding. Anal fissures are tears in the skin around the opening of the anus. They may cause pain and bleeding. Abscesses are collections of pus caused by infection. Fistulas are tunnels that form between two organs or between an organ and the skin. Tumors are solid masses of tissue that form due to abnormal cell growth. They may be cancerous or noncancerous.


Copyright © 2023 Elsevier, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Cookies are used by this site.

USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.