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NBME 15 Answers

nbme15/Block 0/Question#0 (reveal difficulty score)
A previously healthy 26-year-old woman comes ...
External hemorrhoid ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—hungrybox(1277)
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A: Anal carcinoma | Would not be so acute

B: Anal fissure

C: External hemorrhoid | Correct!

D: Human papillomavirus infection

E: Skin tag


picture from the problem

picture showing most answers

*couldn't find a good image for anal carcinoma, if someone wants to share one that would be great

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drdoom  wowee thatโ€™s a lot of butthole .. +12
hungrybox  hawt +2
underd0g  Why isn't this HPV given the sexual history? +1
prosopagnosia  Anal fissure and Anal carcinoma - would present with rectal bleeding which our patient denies. HPV could lead to anal carcinoma and the image isn't similar to the morphology of condylomata acuminata. External hemorrhoid is the only one that presents with rectal pain (due to somatic innervation from the pudendal nerve) and no bleeding. +1
chaosawaits  The answer is not HPV because papillomas are typically not that vascular. It's much more likely to be external hemorrhoid, despite the lack of bleeding. Although hemorrhoids can bleed, not all do. +



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