Anal conditions: Clinical (To be retired)
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Anal conditions: Clinical (To be retired)
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
Hypertension: Clinical (To be retired)
Hypercholesterolemia: Clinical (To be retired)
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Dermatology and plastic surgery
Hypersensitivity skin reactions: Clinical (To be retired)
Eczematous rashes: Clinical (To be retired)
Papulosquamous skin disorders: Clinical (To be retired)
Alopecia: Clinical (To be retired)
Hypopigmentation skin disorders: Clinical (To be retired)
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Endocrinology and ENT (Otolaryngology)
Diabetes mellitus: Clinical (To be retired)
Hyperthyroidism: Clinical (To be retired)
Hypothyroidism and thyroiditis: Clinical (To be retired)
Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
Hypothyroidism medications
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Gastroenterology and general surgery
Gastroesophageal reflux disease (GERD): Clinical (To be retired)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Diarrhea: Clinical (To be retired)
Malabsorption: Clinical (To be retired)
Colorectal cancer: Clinical (To be retired)
Diverticular disease: Clinical (To be retired)
Anal conditions: Clinical (To be retired)
Cirrhosis: Clinical (To be retired)
Breast cancer: Clinical (To be retired)
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Hematology and oncology
Anemia: Clinical (To be retired)
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Infectious diseases
Pneumonia: Clinical (To be retired)
Urinary tract infections: Clinical (To be retired)
Skin and soft tissue infections: Clinical (To be retired)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anti-mite and louse medications
Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Non-biologic disease modifying anti-rheumatic drugs (DMARDs)
Osteoporosis medications
Assessments
Anal conditions: Clinical (To be retired)
USMLE® Step 2 questions
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Questions
USMLE® Step 2 style questions USMLE
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Transcript
Content Reviewers
Rishi Desai, MD, MPHContributors
Antonella Melani, MDThe 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.
Summary
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.
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