Professional and Linguistic Assessments Board (PLAB) Practice Exam

What condition is characterized by severe shooting pain in the rectum with no visible abnormalities?

1. Rectal prolapse

2. Proctalgia fugax

3. Chronic anal fissure

4. Hemorrhoids

The correct answer is: Proctalgia fugax

The condition characterized by severe shooting pain in the rectum with no visible abnormalities is proctalgia fugax. This condition is defined by sudden and intense bouts of rectal pain that can last from seconds to minutes, typically occurring without any identifiable underlying cause or anatomical abnormalities. Proctalgia fugax is often described as sharp or cramp-like and can occur unexpectedly. It is believed to be related to muscle spasms in the pelvic floor or rectal area rather than due to structural issues in the rectum or anal canal. Importantly, between episodes, individuals typically have no persistent symptoms or noticeable rectal abnormalities upon examination, which distinguishes it from other conditions like chronic anal fissures or hemorrhoids, both of which are often associated with visible lesions or significant discomfort outside of acute spasmodic episodes. In contrast to other options, rectal prolapse involves the protrusion of the rectum through the anus, leading to physical changes and discomfort that can be identified on examination. A chronic anal fissure presents with pain and observable tears in the anal mucosa, particularly during bowel movements. Hemorrhoids typically result in bleeding and can be visually identified as swollen veins around the anus. These conditions all have recognizable symptoms or visible abnormalities that differentiate them