anal pain

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

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 complaining of severe anal pain, especially during and after bowel movements. He also reports seeing bright red blood on the toilet paper. On examination, there is a visible tear in the anal mucosa at the 6 o'clock position. Which of the following is the MOST appropriate initial management strategy?

A. Stool softeners, topical analgesics, and sitz baths

B. Incision and drainage

C. High-fibre diet alone

D. Lateral internal sphincterotomy

E. Rubber band ligation

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A 32-year-old woman presents to her general practitioner complaining of severe anal pain during and after bowel movements, along with bright red blood on the toilet paper. She reports constipation and straining during defecation. Examination reveals a visible longitudinal tear in the anal mucosa at the 6 o'clock position. Which of the following is the MOST appropriate initial management strategy, according to Australian guidelines?

A. Recommend regular sitz baths with antiseptic solution.

B. Prescribe oral antibiotics to treat potential infection.

C. Advise increased fluid and fibre intake, stool softeners, and topical application of a local anaesthetic and a topical nitrate ointment.

D. Refer for surgical lateral internal sphincterotomy.

E. Order a colonoscopy to rule out inflammatory bowel disease.

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anal pain

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