PAEA Surgery End Of Rotation (EOR) Practice Exam

How is a Grade II hemorrhoid characterized?

1. Prolapse upon defecation but spontaneously reduces

2. No prolapse, bulge in anal canal lumen

3. Prolapse and cannot be manually reduced

4. Prolapse upon defecation - manually reducible

The correct answer is: Prolapse upon defecation but spontaneously reduces

A Grade II hemorrhoid is characterized by its ability to prolapse during defecation but spontaneously reduces afterward. This means that when a person strains to have a bowel movement, the hemorrhoid may protrude outside the anal canal, but it will retract back inside without the need for manual intervention once the straining stops. Understanding the different grades of hemorrhoids is crucial. Grade I hemorrhoids do not prolapse but instead present as a bulge in the anal canal. Grade III hemorrhoids, on the other hand, do prolapse during defecation and require manual reduction, while Grade IV hemorrhoids are those that are prolapsed and cannot be reduced at all. The ability of a Grade II hemorrhoid to spontaneously reduce sets it apart from the other grades. This characteristic is often associated with moderate discomfort during bowel movements but generally does not lead to significant complications. This knowledge can be vital in both diagnosing and managing patients presenting with symptoms related to hemorrhoids. Recognizing the specific characteristics of each grade aids in developing appropriate treatment plans.