LGV

Question 1

LGV is a sexually transmitted inf causes by?

Answer 1

Chlamydia trachomatis

Question 2

LGV is also called as?

Answer 2

Nicholas -favre dis, tropical bubo/climatic bubo/lymphopathia venerea

Question 3

Diagnosis of LGV is by?

Answer 3

serology or genotyping

Question 4

LGV clinically manifests as ?

Answer 4

inguinal and anorectal syndromes

Question 5

LGV spreads by which route?

Answer 5

hematogenous

Question 6

In LGV peak incidence occurs in which age group?

Answer 6

15-40

Question 7

LGV is contract by?

Answer 7

direct contact w infectious secretions - unprotected intercourse

Question 8

Asymptomatic rectal inf&/ penile or oral inf is the source through?

Answer 8

sex toy sharing and fisting

Question 9

which variant suggests more aggressive clinical course causing severe proctitis

Answer 9

L2c

Question 10

In primary stage erythematous papules / small herpetiform ulcers appear how many days after inoculation?

Answer 10

3-30 days

Question 11

Primary stage in LGV is of how many days?

Answer 11

3-30

Question 12

In males at the primary stage of LGV lesions appear more on ?

Answer 12

coronal sulcus, prepuce or glans penis

Question 13

In females the LGV lesions appear on ?

Answer 13

post wall of the vagina,vulva, or occasionally the cervix

Question 14

In secondary stage the primary lesions appears where?

Answer 14

lymph node involvement and hematogenous dissemination

Question 15

what are the signs and sxs in secondary stage of LGV?

Answer 15

fever, myalgia, dec apetite and vomiting, photosensitivity after bubo formation, meningoencephalitis, hepatosplenomegaly, arthralgia and iritis

Question 16

lymphadenitis episodes in secondary stage resolves within how many days?

Answer 16

8-12 wks

Question 17

In secondary stage depending on the mode of transmission which 2 syndromes are involved?

Answer 17

acute genital syndrome/ inguinal syndrome

Question 18

In secondary stage nodal involvement on either side of the inguinal ligament which sign is pathognomonic?

Answer 18

groove sign

Question 19

in secondary stage why there’s low abdominal/back pain in women that exacerbates upon lying supine and pelvic adhesions may ensue?

Answer 19

bc inguinal lymphadenitis the lymph drainage of the vagina and cervix is to the deep pelvic/retroperitoneal LN

Question 20

in secondary stage which is the most common presentation in woman and homosexual men who practice anal sex?

Answer 20

acute anorectal syndrome (perirectal nodal involvement, acute hemorrhagic proctitis and systemic symptoms)

Question 21

Tertiary stage of HSV is seen most often w ?

Answer 21

women w untreated anorectal syndrome

Question 22

which finding is common in tertiary stage?

Answer 22

rectal strictures

Question 23

what are other findings in tertiary stage of LGV ?

Answer 23

abscess, perineal sinuses, rectovaginal fistulae (watering can perineum) and lymphohemarroids, esthiomene (eating away) , ruptured deep LN causes infertility and frozen pelvis, urethral strictures , genital elephantiasis, saxophone penis

Question 24

positive test on ___is considered diagnostic of LGV

Answer 24

lymph node aspirate

Question 25

which is the earliest diagnostic test in LGV?

Answer 25

Frei test

Question 26

which is the preferred test for LGV?

Answer 26

PCR-based assays

Question 27

On histopathologic examination of HSV primary lesions reveal?

Answer 27

nonspecific ulceration, granulation tissue, endothelial swelling

Question 28

Biopsy of the affected LN reveals?

Answer 28

granulomatous inflammation

Question 29

What are the DDx of LGV?

Answer 29

Chancroid, granuloma inguinale

Question 30

Ulcers in chancroid are?

Answer 30

larger and painful

Question 31

in granuloma inguinale ulcers are?

Answer 31

abundant friable granulation tissue w/o associated lymphadenitis

Question 32

what are the complication of LGV?

Answer 32

HIV,hep C , reactive arthritis in HLA-B27

Question 33

what is first line treatment for LGV ?

Answer 33

oral doxycycline 100mg BID for 3 weeks

Question 34

LGV infected pregnant and lactating women should be treated w?

Answer 34

azithromycin or erythromycin

Question 35

doxycycline should be avoided in which week of pregnancy bc it inc risk of discoloration of teeth and bones

Answer 35

2nd & 3rd