USMLE Forum Archives - USMLE Step 2 CK - HIV p-t
HIV p-t
ysemak - 11-04-09 08:20
A 55-y/o/, HIV-positive man has a fungating mass growing out of the anus. He can feel it when he wipes himself after having a bowel movement, but it is not painful. For the past 6 months, he has noticed blood on the toilet paper, and from time to time there has also been blood coating the outside of the stools. He has lost weight, and he looks emaciated and ill. On physical examination, the mass is easily visible. It measures 3.5 cm in diameter, is fixed to surrounding tissues, and appears to grow out of the anal canal. He also has rock-hard, enlarged lymph nodes on both groins, some of them as large as 2 cm in diameter. Which of the following is the most likely diagnosis?
ysemak - 11-04-09 08:20
A 55-y/o/, HIV-positive man has a fungating mass growing out of the anus. He can feel it when he wipes himself after having a bowel movement, but it is not painful. For the past 6 months, he has noticed blood on the toilet paper, and from time to time there has also been blood coating the outside of the stools. He has lost weight, and he looks emaciated and ill. On physical examination, the mass is easily visible. It measures 3.5 cm in diameter, is fixed to surrounding tissues, and appears to grow out of the anal canal. He also has rock-hard, enlarged lymph nodes on both groins, some of them as large as 2 cm in diameter. Which of the following is the most likely diagnosis?
The correct answer and explanation will be available after you answer.
Page 1
#5
Re: HIV p-t conym5 - 11-17-09 09:21 My answer is: b.
fungating mass growing out of the anus with HIV-positive history..main differentials are Condyloma acuminata of the anus , but there is a possibility of External hemorrhoids also,
but it is rock-hard, enlarged lymph nodes on both groins,most likely looks like condyloma..
#37
Re: HIV p-t ammulufy - 03-18-10 08:05 My answer is: e.
The ptnt is also reporting rock-hard n enlarged lymph nodes in both groins indicative of possible metastasis n since it is the anal canal whch is involved e is d answer....c is not d answer bcos external haemarrhoids are associated wid excruciating pain which is lackin in patient's history....condyloma acuminata does not lead to lymphadenopathy...hence e is d answer.
#39
Re: HIV p-t hem7sak - 03-26-10 00:10 My answer is: e.
squamous cell ca metastasizes to the groin nodes while adeno ca does not
#48
Re: HIV p-t mtniharika - 04-30-10 08:36 My answer is: a.
a slow growth,blood on stool and toilet paper and rock hard inguinal lymph nodes points to the possibility of advanced adenocarcinoma rectum...
#49
Re: HIV p-t babbu5508 - 05-21-10 14:11 My answer is: e.
mass is easily visible. It measures 3.5 cm in diameter, is fixed to surrounding tissues, and appears to grow out of the anal canal. He also has rock-hard, enlarged lymph nodes on both groins.. Squamous cell carcinoma of the anus
Page 1
