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Worksheetshaemorrhoidal disease
Total questions: 10
Worksheet time: 5mins
A 52-year-old man presents with painless bright red rectal bleeding during defecation. Which vascular structure is most directly responsible for this bleeding?
inferior rectal artery
middle rectal artery
superior rectal artery
middle rectal vein
Why are internal haemorrhoids typically painless despite active bleeding?
Low arterial pressure supply
Rich autonomic innervation
Absence of somatic sensory innervation above the dentate line
Reduced mucosal thickness
Which structure plays the MOST critical role in anchoring anal cushions and preventing prolapse?
internal anal sphincter
external anal sphincter
Park's ligament
Levator ani muscle
Which statement BEST explains why portal hypertension causes venous engorgement but is not the primary cause of haemorrhoids?
Portal hypertension increases inferior rectal arterial flow
Haemorrhoids result from sliding cushion pathology, not venous pressure alone
Systemic veins compensate for portal flow
Rectal venous valves prevent congestion
According to accepted pathophysiology, Which of this consider causes of haemorrhoid?
Abnormal downward displacement of anal cushions
abnormal integrity of connective tissue
metaplasia of venous valves
Stasis of arteial flow
Squatting defecation posture contributes to haemorrhoidal disease primarily because it:
Prevents straightening of the anorectal angle
Increases anal sphincter tone
Reduces rectal compliance
Enhances arterial inflow to cushions
Which of these condition MOST Appropriate to do open excisional haemorrhoidectomy (EH)
Grade II internal haemorrhoid with bleeding
Grade IV haemorrhoid with irreducible prolapse
Grade II internal haemorrhoid with spontaneous reduction
Asymtopmatic Thrombosed external haemorrhoid >72 hours
Which of these reasons is true about chronic diarrhoea is now considered a stronger risk factor for haemorrhoidal disease than constipation.
Causes repeated arterial hyperperfusion
Leads to direct erosion of haemorrhoidal mucosa
Weakens connective tissue anchoring the anal cushions
Increases anal sphincter resting pressure
Which pathological process MOST directly leads to permanent (Grade IV) haemorrhoidal prolapse?
Venous thrombosis within sinusoids
Persistent internal anal sphincter hypertonia
Structural failure of Treitz’s muscle and submucosal support
increased VEGF-mediated neovascularisation
Which complication is uniquely associated with stapled haemorrhoidopexy ?
Delayed wound healing
Rectovaginal fistula
Postoperative pain
Secondary bleeding
