EMQs in Clinical Medicine.pdf - Peshawar Medical College

Anorectal conditions 153
65 Anorectal conditions
A
B
C
D
E
F
fissure in ano
perianal warts
proctalgia fugax
second-degree haemorrhoids
fistula in ano
pilinoidal sinus
G
H
I
J
K
L
anal carcinoma
rectal prolapse
pruritus ani
ischiorectal abscess
third-degree haemorrhoids
syphilitic gumma
For each clinical scenario below, give the most likely cause for the clinical findings.
Each option may be used only once.
1 A 28-year-old man with Crohn’s disease complains of watery discharge from a
puckered area 2 cm from the anal canal.
2 A 32-year-old woman who has recently given birth complains of excruciating
pain on defecation, which persists for hours afterwards. Examination reveals a
defect posterior to the anal canal.
3 A 30-year-old builder complains of a pain and discharge from an area in the
midline of the natal cleft about 4 cm above the anus. This problem has been
remitting and recurring for 2 years.
4 A 27-year-old pregnant woman presents with constipation and bright-red blood
coating her stools. On examination in the lithotomy position, two bluish tender
spongy masses are found protruding from the anus. These do not reduce
spontaneously and require digital reduction.
5 A 19-year-old woman presents with multiple papilliferous lesions around
the anus.
Answers: see page 179.