chancre (primary stage)

Question 1

lesions

Answer 1

appears 18-30 days after infection.

small red ppule or crusted superficial erosion. in a few days to weeks, becomes round or oval or indurated , slightly elevated papule. w an eroded but not ulcerated surface that exudes serous fluid.

palpation: cartilage like consistency

lesion usually no invariably painless.

regional ln on 1 or both sides are usually enlarged firm and non tender and do not suppurate.

adenopathy begins 1-2 weeks after chancre appears.

Question 2

chancrre that leaves konscars when it heals

Answer 2

hunterian chancre

Question 3

a chancre in the prepuce being too hard to bend will flip over all at once when the prepuce is dran back a phenomenon called

Answer 3

“dory flop” ( resembling a brod beamed skiff or dory being turned upside down)

Question 4

if untreated chancre tends to heal spont in

Answer 4

1-4 months

Question 5

extragenital chancre areas

Answer 5

bigger than genitall.

lips 
tongue
uvula
tonsillar pillar 
adsoc w hx of oral sex

Question 6

presenting complaints on anal chancre

Answer 6

anal sore
fissure
irritation
bleeding on defacation

anal chancre must be ruled out in any anal fissure not at the 6 or 12 oclock position

Question 7

phagedenic chancre results from comb of

Answer 7

syphilitic chancre

contaminating bacteria

Question 8

a relapse of a chancre w insufficient tx acc by emlarged ln

Answer 8

chancre redux

Question 9

is a gumma occuring at the site of previous chancre . it is distinguished from relapsing chancre by the absence of lymphadenopathy and a negative dark field exam.

Answer 9

Pseudochancre redux

Question 10

H of syphilitic chancre

Answer 10

ulcer covered by neutrophils and fibrin.
subajacent, dense infiltrate kf lymphocytes and plasma cells.
blood vessels are prominent w plump endothelial cells.
spirochetes are numerous in untreated chancre.

spirochetes are best found in overlying epitheliun kr adjacent or overlying blood vessels.

Question 11

causes yaws

Answer 11

Treponema pertenue

t carateum- pinta.

both indiringuishable from tbpallidum

Question 12

alt to dadk field microscopy

Answer 12

DFAT-TP for t pallidum identification in lesions.

can be used to examine oral lesions unlike dark field microscopy.

Question 13

serologic tests for syphilis are positive in

Answer 13

75% non treponemal test

90% treponemal test.

of pxs w primary syphilis.

Question 14

diff syphilitic chancre from chancroid

Answer 14

chancre- inc of 3 weeks.usually painless erosion.not an ulcer. no surrounding inflamm zone. round or oval.
edge not undermined and surface is smooth. at level of the skin. it has dark vvery ree lacquered appearance. no overlying membrane. cartilage hard on palpation. lymphadenopathy bilateral, non tender and non suppurative.

Question 15

chancroid

Answer 15

short incu- 4-7 days.
ulcer acutely inflammed. extremely painful. surroundinh inflammatory zone.
uncer edge undermined and extends to dermis. xovered by anmembrane and feels soft. lymphadenopathy is unilateral and tender and may suppurate. lesions usually multiple and extend into each other.

cultures flr chancroid on special media confirm dx.

Question 16

primary lesions for grabuloma inguinale

Answer 16

begins as an indurated nodule that erodes to prod hypertrophic vegetative granulation tissue. soft and beefy red and bleeds easily.

Question 17

Lgv

Answer 17

small painless transient papule or superficial non indurated ulcer. most often occurs on coronal sulcus prepuce or glans in men or on fourchette vagina or cervix in women.
primary lesion is noted by about 30% of infected heterosexual m3’n.
primary lesions are ff by 7-30 days by adenopathy of the regiona lymphnodes.

confirmed by serologic tests.

Question 18

herpes simplex

Answer 18

grouped vesicles off accompanid or preceded by burning pain.

after rupture of vesicles irregular scalloped tender soft erosions form.