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anal fissure

Practice targeted AMC-style multiple-choice questions on anal fissure.

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A 35-year-old man presents with 3 weeks of anal pain after defecation, blood on wiping, and constipation (firm stool every 2-3 days). What is the likely diagnosis?

A. Perianal abscess
B. Anal skin tags.
C. Anal fissure
D. Fistula-in-ano
E. Haemorrhoids
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A 32-year-old male presents to his general practitioner with persistent anal pain and bleeding on defecation for the past 8 months. He reports a cycle of pain, relief after bowel movements, followed by throbbing pain lasting several hours. Examination reveals a visible anal fissure at the 6 o'clock position, along with a skin tag. Which of the following is the MOST appropriate next step in management, according to Australian guidelines?

A. Topical glyceryl trinitrate (GTN) ointment and stool softeners
B. Fibre supplementation and sitz baths
C. Botulinum toxin injection into the internal anal sphincter
D. Excision of the fissure and skin tag with advancement flap
E. Lateral internal sphincterotomy
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