Deck 20: Anus, Rectum, and Prostate

Question 1

Very light tan or gray stools may indicate:

A) upper gastrointestinal bleeding.
B) obstructive jaundice.
C) lower gastrointestinal bleeding.
D) polyposis.

Answer 1

obstructive jaundice.

Question 2

The prostatic sulcus:

A) divides the right and left lateral lobes.
B) is the site of the seminal vesicle emergence.
C) refers to the anterior aspect of the prostate.
D) secretes clear viscous mucus.

Answer 2

divides the right and left lateral lobes.

Question 3

Which of the following is a risk factor for colorectal cancer?

A) High-fiber diet
B) Diet low in animal fats and proteins
C) Irish descent
D) History of colonic polyps

Answer 3

History of colonic polyps

Question 4

The caliber of the urinary stream is routine information in the history of:

A) adolescents.
B) infants.
C) older adults.
D) sexually active young men.

Question 5

The cervix may be palpated through the:

A) anterior rectal wall.
B) internal umbilical wall.
C) lateral urethral meatus.
D) posterior uterine surface.

Question 6

Nodules found in the peritoneum through the anterior rectal wall:

A) are found with bidigital palpation.
B) are called shelf lesions.
C) are chronic fibrosis.
D) are found by having the patient bear down.

Question 7

Baby Sue is born with an imperforate anus. However, her outward anal appearance is normal. Which sign would indicate to the health care provider that she has a closed anal passageway?

A) Development of a scaphoid abdomen
B) Vomiting after her first feeding
C) Bleeding from the rectum
D) Failure to pass meconium stool

Question 8

Perianal abscesses, fissures, or pilonidal cysts will cause the patient to experience:

A) bulging and wrinkling.
B) constipation and pallor.
C) diarrhea and redness.
D) tenderness and inflammation.

Question 9

The proximal end of the rectum is continuous with the:

A) sigmoid colon.
B) duodenum.
C) ileum.
D) rectal sphincter.

Question 10

The mother of a 1-week-old, breast-fed baby tells you that she is concerned because her baby has a small bowel movement each time he feeds. You should let the mother know that:

A) this is normal.
B) she should feed the baby less.
C) this usually indicates an abnormality.
D) she needs to switch the baby to formula.

Question 11

The rectal past medical history of all patients should include inquiry about:

A) bowel habits.
B) dietary habits.
C) hemorrhoid surgery.
D) laxative use.

Question 12

The adult internal rectal sphincter is controlled by the:

A) autonomic nervous system.
B) central nervous system.
C) lumbar spinal reflexes.
D) sacral spinal reflexes.

Question 13

Equipment for examination of the anus, rectum, and prostate routinely includes gloves and:

A) a hand mirror and gauze.
B) a lubricant and penlight.
C) slides and normal saline.
D) swabs and culture medium.

Question 14

The posterior surface of the prostate can be located by palpation of the:

A) anal canal and perineum.
B) anterior wall of the rectum.
C) lateral wall of the anus.
D) lower abdomen and perineum.

Question 15

Factors associated with increased risk of prostate cancer include:

A) African descent.
B) cigarette smoking.
C) a low-fat diet.
D) alcoholism.

Question 16

Palpation of the anal ring is done by:

A) bidigital palpation with the thumbs.
B) inserting the smallest finger into the anus.
C) pressing a gauze pad over the anus.
D) rotation of the forefinger inside the anus.

Question 17

Your patient's chief complaint is repeated, pencil-like stools. Further examination should include:

A) a stool culture.
B) parasite testing.
C) a digital rectal examination (DRE).
D) a prostate examination.

Question 18

The urge to defecate is caused by:

A) constriction of the internal sphincter.
B) the rectum filling with feces.
C) cognitive processes.
D) fluid volume in the stomach.

Question 19

In males, which surface of the prostate gland is accessible by digital examination?

A) Median lobe
B) Posterior
C) Superior
D) Anterior

Question 20

The effects of aging on the gastrointestinal system lead to more frequent experiences of:

A) constipation.
B) prolonged satiety.
C) diarrhea.
D) prostate glandular atrophy.

Question 21

A healthy prostate protrudes into the rectal wall a distance of _____ cm.

Question 22

Palpation of a normal prostate in an older adult is likely to feel:

A) cool.
B) grainy.
C) polypoid.
D) rubbery.

Question 23

An infant with constipation and a consistently empty rectum may need evaluation for:

A) sexual abuse.
B) Hirschsprung disease.
C) rectal abscess.
D) intestinal parasites.

Question 24

An expected anal or rectal finding late in pregnancy is the presence of:

A) cysts.
B) hemorrhoids.
C) hypertrophy.
D) polyps.

Question 25

A 70-year-old man has a prostate-specific antigen (PSA) value of 6 ng/mL and a negative digital rectal examination (DRE). These results indicate:

A) prostatic hypertrophy.
B) prostate cancer.
C) internal hemorrhoids.
D) a normal finding.

Question 26

Mr. Sweeney is a 58-year-old man who has presented for a routine annual prostate examination. On examination, you note a normal prostate gland. Which of the following characteristics should describe the normal prostate?

A) Rubbery consistency
B) About 4 cm in diameter
C) Fluctuant softness
D) Gland protruding 1 cm into the rectum
E) Firm, smooth, and slightly movable

Question 27

A lower spinal cord lesion may be indicated by which finding?

A) Lack of an anal wink
B) Rectal prolapse
C) Anal fistula
D) Small flaps of anal skin

Question 28

Prostate-specific antigen (PSA) screening is controversial because:

A) there are many false-negative results.
B) PSA is produced by many other tissues.
C) it is less sensitive than digital rectal examination.
D) no data have proved that it decreases mortality.

Question 29

Which finding in an infant may indicate lower spinal deformities?

A) Perirectal redness
B) Shrunken buttocks
C) Rectal prolapse
D) Dimpling in the pilonidal area

Question 30

Mr. Gregorio is a 38-year-old patient who presents with complaints of anal pruritus. As part of your examination you complete a cellulose tape test. The cellulose tape test is used for the detection of:

A) enterobiasis.
B) carcinoma.
C) amebiasis.
D) steatorrhea.

Question 31

A common cause of dark green or black stools during pregnancy is:

A) consumption of iron preparations.
B) consumption of vitamins.
C) slow intestinal bleeding.
D) slow bleeding of hemorrhoids.

Question 32

Tarry black stools should make you suspect:

A) internal hemorrhoids.
B) rectal fistula.
C) upper intestinal bleeding.
D) prostatic cancer.

Question 33

Thrombosed hemorrhoids are:

A) flabby skin sacs.
B) red, inflamed, and painful.
C) fluctuant soft papules.
D) blue, shiny, painful masses.

Question 34

Pinworms and Candida may both cause:

A) constipation.
B) hemorrhoids.
C) perirectal irritation.
D) perirectal protrusion.

Question 35

Mr. Dunn is a 62-year-old man who has presented for a routine annual examination. On examination of the prostate you note a hard, irregular, painless nodule and obliteration of the median sulcus. These are signs of:

A) benign prostatic hypertrophy.
B) cancer of the prostate.
C) long-standing prostatitis.
D) swelling as a result of aging.

Question 36

When performing a rectal examination in a man, the patient is placed in the ______________ position.