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Kaplan Qbank USMLE



Author10 Posts
  #1

M. 25 years when he goes to toilet, he complains of painful defecation in the anal region, at the exam you will find bluish mass at the anal margin.. what is the Diagnosis ? <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

-Hemorrhoids internal sclerosed

-Hemorrhoids external strangulated

-Hemorrhoids external thrombosed

-Pilonidal cyst
-Poliposis

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  #2

hemorrhoids external thrombosed..

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  #3

Hemorrhoids external strangulated


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  #4

Hemorrhoids external thrombosed

Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids.

Prolapsed hemorrhoids are internal hemorrhoids that are so distended that they are pushed outside of the anus.

If the anal sphincter muscle goes into spasm and traps a prolapsed hemorrhoid outside of the anal opening, the supply of blood is cut off, and the hemorrhoid becomes a strangulated hemorrhoid.


  #5

Sounds right...thanks for all the help!




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IM resident

  #6

Pt only complains of pain when he defecates. Since thrombosed hemorrhoids cause persistent pain, that usually persists even as pt arrives to hospital, isn't there a chance the hemorrhoids in this case are only strangulated?

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  #7

can someone explain why its not strangulated?

  #8

a stranglated hemarrhoid has to have systemc symptoms too, i guess....as it will be inflamed and stuff.

correct me if wrong

  #9

i think pain would persist in case of strangulated hemorrhoids, while defecation will cause or increase pain in thrombosed ones.

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  #10

I guess there is no Hemorrhoids external strangulated.

internal one could be stranglulated, exernal be strangulated? rare at least. Just guess.








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