Genital Lesions

Question 1

Genital lesions

Answer 1

swollen lymph nodes = buboes, may break and suppurate
warts = proliferation of skin papillae
Molluscum = dome shaped growths with central indentations

Question 2

Haemophilis ducreyi

Answer 2

Painful, soft genital ulcer; 50% tender lymph N and often supp

Culture difficult - elisa and PCR

Chancroid, increased susceptibility to other STDs

Gram - rod

VFs: Fimbrae, no capsule, hemoglobin binding protein, cytotoxic

Question 3

Klebsiella Granulomatis

Answer 3

Carribean and New Guinea
Bright and red (velvet-beefy color) painless genital ulcers, tender lymph nodes, no supp

Gram neg rod, capsule, facultative intracellular

Lesion= granuloma venerum/ Donovon bodies (bipolar staining IC rods)

Question 4

Chlamydia Trachomatis (L1-L3)

Answer 4

Painless genital ulcers with groove sign, genital elephanititis in late stage

Obligate IC bact (need ATP) with EB and RB

Infects non ciliated columnar and cuboidal epi cells of mucosal membranes

Asia, africa, SA

Diag: Inclusion bodies, non gram stainable

Question 5

Herpes Simplex Virus

Answer 5

Enveloped dsDNA, inhabit sacral dorsal root ganglia
Tx: acyclovir
Diag= old Tzank smear - looks for syncytia = mulinuc giant cells with intranuc Inc Bodies

Question 6

Molluscum Contagiosum Virus

Answer 6

Cutaneous genital water warts with indentations
Linear dsDNA enveloped. Reps in cytoplasm with eosinophilic Inc bodies = henderson-paterson bodies
Benign tumor or papulary eruption, genids rep in stratum basale to dermis

Question 7

HPV

Answer 7

soft genital warts
non enveloped dsDNA virs
Diag - pap for koilocytes
E6 = muts p53, E7= muts p105RB
VCCN: Guardosil (HPV 6, 11, 16, 18) Ceverix (16 and 18)