Bates- Chapter 15 The Anus, Rectum, & Prostate Graded A

Bates- Chapter 15 The Anus, Rectum, & Prostate Graded A 1. A 36-year-old married bank teller presents with pain with defecation and occasional blood on the toilet paper after a recent episode of food poisoning. What is the most likely diagnosis? A) Hemorrhoids B) Anal fissure C) Diverticulitis D) Inflammatory bowel disease Correct answer: B) Anal fissure 2. A 42-year-old house painter complains of pain with defecation and profuse bleeding after taking prescription narcotics for a shoulder injury. What is the most likely diagnosis? A) External hemorrhoid B) Internal hemorrhoid C) Fissure D) Rectal cancer Correct answer: A) External hemorrhoid 3. A 75-year-old retired construction worker presents with bright red blood in the toilet for several months, no pain with defecation, and occasional constipation. What is the most likely diagnosis? A) Diverticulosis B) Hemorrhoids C) Anal cancer D) Inflammatory bowel disease Correct answer: C) Anal cancer 4. A 60-year-old coach complains of difficulty starting to urinate, weak stream, and frequent urination. What is the most likely diagnosis? A) Benign prostatic hyperplasia (BPH) B) Prostatitis C) Bladder cancer D) Prostate cancer Correct answer: A) Benign prostatic hyperplasia (BPH) 5. A 24-year-old graduate student complains of burning during urination, increased urinary frequency, and a low-grade fever. He has had a recent history of unprotected sex. What is the most likely diagnosis? A) Urinary tract infection (UTI) B) Prostatitis C) Chlamydia infection D) Gonorrhea infection Correct answer: B) Prostatitis A 45-year-old African-American minister comes to your clinic for a general physical examination. He has not been feeling very well for about 3 months, including night sweats and a chronic low-grade fever of 100 to 101 degrees. He denies any upper respiratory symptoms, chest pain, nausea, constipation, diarrhea, blood in his stool, or urinary tract symptoms. He has had some lower back pain. He has a past history of difficult-to-control high blood pressure and high cholesterol. He has had no surgeries in the past. His mother has diabetes and high blood pressure. He knows very little about his father because his parents divorced when he was young. He knows his father died in his 50s, but he is unsure of the exact cause. The patient denies smoking, drinking, or drug use. He is married and has three children. On examination he appears his stated age and is generally fit. His temperature is 99.9 degrees and his blood press ️C) Prostate cancer A 26-year-old woman comes to your clinic, complaining of leakage of stool despite generally normal, pain-free bowel movements. She denies any blood in her stool or on the toilet paper. She has had no recent episodes of diarrhea. Her past medical history includes a spontaneous vaginal delivery 3 months ago. She had a fourth-degree tear of the perineal area (from the vagina through the rectum) that was surgically repaired after delivery. A few days later the patient developed an abscess in the anal area that had to be incised and drained. She denies using any tobacco, alcohol, or illegal drugs. Her mother and father are both in good health. She denies any weight gain, weight loss, fever, or night sweats. She is still breast-feeding without any problems. On examination you visualize a small opening anterior to the anus with some surrounding erythema. There is not a mass or other inflammation on inspection. Digital recta ️D) Anorectal fistula A 22-year-old nurse comes to your clinic, complaining of severe constipation and pain during defecation. She has also seen blood on the toilet paper. She states that she eats a healthy diet and does some light exercising. She is currently at the beginning of her third trimester of an unremarkable pregnancy. Her past medical history is unremarkable. Her mother has high cholesterol but her father is in good health. She does not smoke, drink alcohol, or use illegal drugs. She is married and expecting her first child. On examination she appears healthy and is afebrile, with a blood pressure of 110/60. Her abdominal examination reveals a gravid uterus but is otherwise unremarkable. On visualization of the anus there is a slight red, moist-appearing protrusion from the anus. As you have her bear down, the protrusion grows larger. On digital rectal examination you can feel an enlarged tender area on the posterior side. Ther ️C) Internal hemorrhoids A 55-year-old retired property manager comes to your clinic, concerned that she may have a tumor in her rectum. When asked why, she states that after straining at a bowel movement she felt a mass around her rectum. She denies any blood in her stool, black stools, or pain with defecation. She admits to having had chronic constipation for 30 years. She often uses laxatives to be able to have a bowel movement. She denies any recent weight gain, weight loss, fever, or night sweats. Her past medical history consists of hypothyroidism, and she has had two spontaneous vaginal deliveries. Her mother died recently of colon cancer and her father has high blood pressure but is otherwise healthy. She denies any smoking and only occasionally drinks alcohol. On examination she seems nervous. Her blood pressure is 140/90 and her pulse is 100. Her cardiac, lung, and abdominal examinations are normal. On visualization of her anus, no ️A) Prolapse of the rectum A 50-year-old truck driver comes to your clinic for a work physical. He has had no upper respiratory, cardiac, pulmonary, gastrointestinal, urinary, or musculoskeletal system complaints. His past medical history is significant for mild arthritis and prior knee surgery in college. He is