Question 1

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

Accepted Answer

A healthy prostate should not protrude more than 1 cm into the rectum.

Question 2

Palpation of a normal prostate in an older adult is likely to feel:
A) cool.
B) grainy.
C) polypoid.
D) rubbery.

Accepted Answer

Older men are more likely to experience prostate hypertrophy, which when palpated feels smooth, rubbery, and symmetric.

Question 3

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.

Accepted Answer

A consistently empty rectum in the presence of constipation is a clue to the diagnosis of Hirschsprung disease. Other presentations include the failure to pass meconium in the first 24 hours. along with a gradual onset of abdominal distention and vomiting.

Question 4

An expected anal or rectal finding late in pregnancy is the presence of:
A) cysts.
B) hemorrhoids.
C) hypertrophy.
D) polyps.

Accepted Answer

Hemorrhoids are an expected variation late in pregnancy.

Question 5

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.

Accepted Answer

The normal range for the PSA value is less than 4 ng/mL and between 4 and 10 ng/mL is borderline, with older men having normal higher levels. Considering the patient's age, a negative DRE and borderline PSA value probably represent a normal finding.

Question 6

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

Accepted Answer

The gland should feel like a pencil eraser, firm, smooth, and slightly movable and should be nontender. It has a diameter of 4 cm, with a 1-cm protrusion into the rectum.

Question 7

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

Accepted Answer

Lightly touching the anal opening of an infant should produce a contraction referred to as an anal wink. A negative wink may indicate a lower spinal cord lesion.

Question 8

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.

Accepted Answer

There are no data confirming that PSA screening decreases mortality from prostate cancer.

Question 9

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

Accepted Answer

Sinuses, tufts of hair, and dimpling in the pilonidal area may indicate lower spinal deformities such as a pilonidal cyst.

Question 10

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.

Accepted Answer

Enterobiasis (pinworm infestation) is detected by the cellulose tape test. Pinworms are collected by applying tape to the perianal folds and then pressing the tape on a glass slide.

Question 11

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.

Accepted Answer

The daily use of iron replacement therapy, as expected during pregnancy, results in dark green or black stools.

Question 12

Tarry black stools should make you suspect:
A) internal hemorrhoids.
B) rectal fistula.
C) upper intestinal bleeding.
D) prostatic cancer.

Accepted Answer

Upper intestinal tract bleeding results in tarry black stools.

Question 13

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

Accepted Answer

Thrombosed hemorrhoids appear as blue shiny masses at the anus; they contain clotted blood and are edematous and painful.

Question 14

Pinworms and Candida may both cause:
A) constipation.
B) hemorrhoids.
C) perirectal irritation.
D) perirectal protrusion.

Accepted Answer

Pinworms and Candida both cause perirectal irritation and itching.

Question 15

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.

Accepted Answer

Obliteration of the median sulcus is consistent with organ enlargement; however, the associated findings of a hard, irregular, and painless nodule indicate a cancerous growth.

Question 16

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

Accepted Answer

The male patient is usually positioned left lateral or standing, with the upper body flexed at the waist over the examination table and with the toes pointed together for increased exposure of the area.

Quiz 20: Anus, Rectum, and Prostate

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

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

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

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

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:

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 lower spinal cord lesion may be indicated by which finding?

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

Which finding in an infant may indicate lower spinal deformities?

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

Tarry black stools should make you suspect:

Thrombosed hemorrhoids are:

Pinworms and Candida may both cause:

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:

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