Genital Ulcers

Question 1

well demarcated indurated borders and clean base (chancre)

PAINLESS

single

mild and minimally tender

Answer 1

SYPHILIS (PRIMARY)

Treponema pallidum

dark field microscopy

Question 2

unindurated borders and purulent base
PAINFUL
MULTIPLE
PAINFUL NODES > 59%
INGUINAL BUBO

Answer 2

CHANCROID

detection of Haemophilus ducreyi by culture

Question 3

vesicles rupture to form shallow ulcers
PAINFUL
MULTIPLE
constitutional symptoms and nodes

Answer 3

HERPES SIMPLEX TYPE 2

detection of HSV by culture or PCR from ulcer scraping or aspiration of vesicle fluid

Question 4

Treatment of Syphilis

Answer 4

CONGENITAL - Aqueous crystalline Pen G

PRIMARY, SECONDARY, EARLY LATENT - Pen G Benzathine

LATE LATENT SYPHILIS - Pen G Benzathine

NEUROSYPHILIS - Aqueous Crystalline Pen G

Question 5

Treatment for Chancroid

Answer 5

most are resistant to penicillin and ampicillin d.t. plasmid mediated B lactamase production

AZITHROMYCIN
CEFTRIAXONE

ERYTHROMYCIN
CIPROFLOXACIN

Question 6

Treatment of HSV

Answer 6

Acyclocir
Vanacyclovir
Famciclovir