The Anus Rectum and Prostate Multiple Choice

1. A 28-year-old bus driver presents to the emergency room for pain and drainage from an area at the bottom of her spine. This has never occurred before. On examination of the rectum, a small opening is identified in the midline superficial to the lower sacrum. There is a surrounding halo of erythema. It is tender to palpation and purulent material is expressed. Your most likely diagnosis of this condition is?

(A) Anorectal fistula

(B) Pilonidal cyst

(C) Anal fissure

(D) Thrombosed external hemorrhoid

2. A 24-year-old housewife and mother presents to the clinic for evaluation of rectal bleeding. She has intermittent constipation and frequently has to use a laxative to have a bowel movement. On examination of the anus, you see a reddish, moist, protruding mass located at the 5 o'clock position. What is your most likely diagnosis?

(A) Hemorrhoid

(B) Internal hemorrhoid

(C) External rectal prolapse

(D) Rectal polyp

3. A 35-year-old accountant presents to the clinic for evaluation of sudden onset of pain in his rectum. On examination of the anus, you see a swollen, bluish, ovoid mass at the anal margin, located at the 8 o'clock position. What is your most likely diagnosis?

(A) External hemorrhoid

(B) Internal hemorrhoid

(C) Rectal prolapse

(D) Rectal polyp

4. A 32-year-old farmer presents to the clinic for evaluation of pain with defecation as well as rectal bleeding. His family history is negative for inflammatory diseases of the bowel and for colon cancer. On physical examination, there is a swollen skin tag, and, with gentle separation of the anal margin, a thin line of ulceration is visible. What is your most likely diagnosis?

(A) Pilonidal cyst

(B) Anorectal fistula

(C) External thrombosed hemorrhoid

(D) Anal fissure

5. A 65-year-old gardener presents to the office for difficulty with urination. Increasingly, he has noticed feeling like his bladder has not emptied completely and his urinary stream has a decreased force. He experiences dribbling after he completes urination. These symptoms have been going on for several years, but his level of discomfort has increased over the past few months. On physical examination, you feel a symmetrically enlarged, smooth, and firm prostate gland, which seems to protrude more into the rectal lumen without any discrete lesions. What is your most likely diagnosis?

(A) Normal prostate

(B) Prostatitis

(C) Benign prostatic hyperplasia

(D) Prostate cancer

6. A 36-year-old computer programmer presents to the office with pain with urination, and fever. On palpation of the prostate, his gland is swollen, tender, and warm to the touch. Your most likely diagnosis is?

(A) Normal prostate

(B) Benign prostatic hyperplasia

(C) Prostate cancer

(D) Prostatitis

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