Anorectal: atypical fissure: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Anorectal: atypical fissure

Sample item

A patient has a painless, broad anal fissure situated laterally with undermined edges. Which underlying conditions should be considered?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Crohn disease, tuberculosis, HIV or malignancy

Typical fissures lie in the posterior midline and are painful. Fissures that are lateral, multiple, painless or indolent are atypical and suggest Crohn disease, tuberculosis, syphilis, HIV, leukaemia or carcinoma. Biopsy and evaluation are needed and sphincterotomy is avoided.

Option by option

  • A. Crohn disease, tuberculosis, HIV or malignancy (correct)

    Correct. Atypical fissures indicate systemic or neoplastic disease.

  • B. Diabetes insipidus

    Diabetes insipidus is unrelated.

  • C. Simple constipation only

    Constipation produces typical midline fissures.

  • D. Pregnancy only

    Pregnancy is not a cause of atypical fissures.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Crohn disease, tuberculosis, HIV or malignancy. Typical fissures lie in the posterior midline and are painful.

Why is "Diabetes insipidus" not the answer?

Diabetes insipidus is unrelated.

Why is "Simple constipation only" not the answer?

Constipation produces typical midline fissures.

Why is "Pregnancy only" not the answer?

Pregnancy is not a cause of atypical fissures.

What concept does this question test?

It tests Anorectal: atypical fissure in General Surgery. Fissures that are lateral, multiple, painless or indolent are atypical and suggest Crohn disease, tuberculosis, syphilis, HIV, leukaemia or carcinoma. Biopsy and evaluation are needed and sphincterotomy is avoided.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anorectal: atypical fissure?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.