05-23-2009, 09:46 AM
A 24-year-old male presents to your clinic with a 5-
day history of rectal bleeding. For several years, he has
had constipating stools but has developed rectal
bleeding in the last few days. In addition, he has
severe, intermittent, crampy abdominal pain (presumably
from constipation). He reports a mild fever. On
examination, temperature is 37.9° C, pulse 95, respirations
12, and blood pressure 108/78. His abdomen
is nontender. He has no guarding or rebound tenderness.
Anoscopy reveals gross blood and 2 internal
hemorrhoids.
Regarding hemorrhoids in general, which of the
following is true?
A) Patients with hemorrhoids most commonly complain
of perianal burning, itching, swelling, and
pain.
B) A grade III hemorrhoid can be reduced manually.
C) If a patient under the age of 50 with rectal bleeding
is found to have hemorrhoids on examination,
further studies are not indicated.
D) Because they are above the dentate line, strangulated
internal hemorrhoids are not painful
day history of rectal bleeding. For several years, he has
had constipating stools but has developed rectal
bleeding in the last few days. In addition, he has
severe, intermittent, crampy abdominal pain (presumably
from constipation). He reports a mild fever. On
examination, temperature is 37.9° C, pulse 95, respirations
12, and blood pressure 108/78. His abdomen
is nontender. He has no guarding or rebound tenderness.
Anoscopy reveals gross blood and 2 internal
hemorrhoids.
Regarding hemorrhoids in general, which of the
following is true?
A) Patients with hemorrhoids most commonly complain
of perianal burning, itching, swelling, and
pain.
B) A grade III hemorrhoid can be reduced manually.
C) If a patient under the age of 50 with rectal bleeding
is found to have hemorrhoids on examination,
further studies are not indicated.
D) Because they are above the dentate line, strangulated
internal hemorrhoids are not painful