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Internal hemorrhoids โ painless rectal bleeding
Mnemonic: Internal bleeding? No pain, just red rain.
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77. Which of the following is a characteristic feature of internal hemorrhoids?
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Ruptured AAA โ severe pain, hypotension, pulsatile midline mass
Mnemonic: AAArupts = Pain, Pressure drops, Pulsing belly.
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76. A 70-year-old male presents with sudden severe abdominal pain and hypotension. On examination, a pulsatile mass is palpable in the midline of the abdomen. The most likely diagnosis is:
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Diverticulitis โ LLQ pain, fever, pericolic fat stranding
Mnemonic: Diverti-LLQ: Left lower quadrant inflamed party.
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75. A 40-year-old female presents with left lower quadrant pain, fever, and leukocytosis. CT scan shows colonic wall thickening with pericolic fat stranding. The most likely diagnosis is:
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Hallmark of perforated peptic ulcer = sudden severe pain with board-like rigidity
Mnemonic: Ulcer burst โ Rigid gut like a board.
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Sudden severe abdominal pain in afib patient โ mesenteric ischemia
Mnemonic: Afib clot, gut rot = mesenteric crisis.
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73. A 60-year-old female with a history of atrial fibrillation presents with sudden severe abdominal pain, vomiting, and bloody diarrhea. On examination, she has abdominal distension and absent bowel sounds. The most likely diagnosis is:
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Bloody nipple discharge โ intraductal papilloma
Mnemonic: Papilloma pops blood, not fibrous or ovaries.
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72. A 50-year-old woman presents with bloody nipple discharge. The most likely diagnosis is:
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Small bowel obstruction โ colicky pain + air-fluid levels
Mnemonic:
Small bowel stuck = Air-water circus.
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71. A patient presents with colicky abdominal pain, distension, vomiting, and constipation. Abdominal X-ray shows multiple air-fluid levels. The most likely diagnosis is:
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Free air under diaphragm โ perforated peptic ulcer
Mnemonic: Ulcer pops = Air hops under diaphragm.
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70. A patient with acute abdomen shows free air under the diaphragm on erect chest X-ray. The most likely diagnosis is:
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Late signs of acute appendicitis = Rovsing, Psoas, Obturator
Mnemonic: RPO = Really Painful Ouch.
