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WorksheetsDr. Heemer Endo Exam 4
Total questions: 25
Worksheet time: 50mins
What areas does anorectal disorders involve?
perianal area
anal canal
lower rectum
bowels
What anorectal disorders can be self-treated?
Hemorrhoid's
Abscess
anal fistula
anal fissure
Which anorectal disorders require medical treatment?
anal fistula
anal fissure
anal neoplasm
polyps
abscess
What are the characteristics of non-thrombosed hemorrhoids?
pink in color
bleeding
itching
fever
What are the characteristics of thrombosed hemorrhoids?
purple/blue color
with pain
with feve
pink in color
bleeding
What are the mild symptoms of hemorrhoids that can be self-treatable?
itching
discomfort
burning
inflammation
swelling
What are the serious symptoms of hemorrhoids that require medical attention?
pain
bleeding
seepage
change in bowel patterns
prolapse
What are the exclusions for self-treatment of hemorrhoids?
Age < 12 years
Age > 12 years
Crohn’s disease
Family history of colon cancer
polyps
What is the non-drug treatment for hemorrhoids?
Avoid heavy lifting
Avoid foods that may irritate or aggravate symptoms
Increase dietary fiber
exercise
What are FDA approved OTC agents for symptoms of hemorrhoids?
Local anesthetics
vasoconstrictors
protectants
corticosteroids
keratolytics
What is the mechanism of action of local anesthetics?
reversibly block the transmission of nerve impulses
Structure related to natural catecholamines
Prevents irritation of anorectal area and water loss from the stratum corneum by forming a physical barrier
Promotes coagulation of the skin cells which protects the underlying tissue while decreasing cell volume
A patient comes to the pharmacy for a counseling. The patient has hemorrhoids with pain, irritation, itching, burning and discomfort. Which of the following OTC externally medications would be the most recommended for use?
local anesthetics
(benzocainde, lidocaine, pramoxine, tetracaine)
vasoconstrictors
(ephedrine, epinephrine, phenylephrine)
Protectants
(cocoa butter, glycerin, zin oxide, calamine)
Keratolytics
(alcloxa, resorcinol)
What are some adverse effects of local anesthetics?
May cause an allergic reaction
May cause contact dermatitis
Systemic effects
Fever
Use externally to temporarily relieve discomfort, itching, swelling and shrinkage of hemorrhoid tissue.
Which of the following is correct?
Vasoconstrictors
(ephedrine sulfate, epinephrine hcl, phenylephrine hcl)
Local anesthetics
(lidocaine, pramoxine hcl, tetracaine)
Protectants
(cocoa butter, glycerin, cod liver oil)
Astringents
(calamine, zinc oxide, witch hazel)
What is the mechanism of action of Vasoconstrictors?
α-adrenergic stimulation causes constriction of arterioles producing modest and transient reduction in swelling
reversibly block the transmission of nerve impulses
Prevents irritation of anorectal area and water loss from the stratum corneum by forming a physical barrier
Promotes coagulation of the skin cells which protects the underlying tissue while decreasing cell volume
Temporary relief of discomfort, itching, irritation and burning associated with internal and external hemorrhoids
Protectants
(cocoa butter, kaolin, mineral oil)
Astringents
(Calamine, zinc oxide, witch hazel)
Keratolytics
(Alcloxa, resorcinol)
Corticosteroids
(hydrocortisone)
What is the only Protectants for external use?
Glycerin
white petrolatum
aluminum hydroxide gel
zinc oxide
What is the mechanism of action of Protectants?
Prevents irritation of anorectal area and water loss from the stratum corneum by forming a physical barrier
Promotes coagulation of the skin cells which protects the underlying tissue while decreasing cell volume
Provides a cooling, warm or tingling sensation when applied which distracts from the symptoms
Acts as vasoconstrictor and antipruritic when applied topically
What is the mechanism of action of Astringents?
Promotes coagulation of the skin cells which protects the underlying tissue while decreasing cell volume
Exact mechanism unknown for reducing itching and discomfort
Provides a cooling, warm or tingling sensation when applied which distracts from the symptoms
Acts as vasoconstrictor and antipruritic when applied topically
Astringents for the temporary relief of itching, irritation and burning symptoms of hemorrhoids.
Which of the following are astringent?
Calamine
Zinc oxide
witch hazel
hydrocortisone
Witch hazel is external use and calamine and zinc oxide is internal and external use.
True
False
Temporary relief for external anorectal discomfort and itching.
Keratolytics
(alcloxa, resorcinol)
Astringents
(calamine, zinc oxide, witch hazel)
Corticosteroids
(hydrocortisone)
Protectants
(cocoa butter, mineral oil, cod liver oil)
What is the mechanism of action of Keratolytucs?
Causes desquamation and debridement of epidermal surface, fosters cell turnover, may help expose underlying tissue for other medications
Provides a cooling, warm or tingling sensation when applied which distracts from the symptoms
Acts as vasoconstrictor and antipruritic when applied topically
Promotes coagulation of the skin cells which protects the underlying tissue while decreasing cell volume
Temporary relief of itching, discomfort, pain and burning associated with perianal.
Provides a cooling, warm or tingling sensation when applied which distracts from the symptoms.
Analgesics/Anesthetics/Antipruritics
(menthol, camphor, juniper tar)
Keratolytics
(alcloxa, resorcinol)
Astringents
(calamine, zinc oxide, witch hazel)
Protectants
(cocoa butter, lanolin, mineral oil)
Indication: Temporary relief of minor external anal itching caused by minor irritation or rash
MOA: Acts as vasoconstrictor and antipruritic when applied topically.
Corticosteroids
Astringents
Protectants
Keratolytics
