OnlineMedEd: Infectious Disease - "Genital Ulcers"

Question 1

Compare the four types of genital ulcers by the etiology, the number of ulcers, presence or absence of pain, and presence or absence of lymphadenopathy.

Answer 1

Syphilis:

• Etiology: Treponema pallidum
• Number of ulcers: singular
• Pain: absent
• Lymphadenopathy: present, non-tender

Lymphogranuloma venereum:

• Etiology: Chlamydia trochomatis
• Number of ulcers: singular
• Pain: absent
• Lymphadenopathy: present, tender or draining

Chancroid:

• Etiology: Hemophilus ducreyi
• Number of ulcers: singular
• Pain: painful
• Lymphadenopathy: present, tender

Herpes:

• Etiology: herpes simplex virus
• Number of ulcers: multiple, shallow
• Pain: present
• Lymphadenopathy:

Question 2

Secondary syphilis is similar to _______________.

Answer 2

HSV with erythema multiforme: fever, targetoid rash on hands and feet

Question 3

How do you diagnose primary, secondary, and tertiary syphilis?

Answer 3

• Primary: darkfield microscopy
• Secondary: serum RPR followed up by FTA
• Tertiary: LP for RPR and FTA

Question 4

How is syphilis treated?

Answer 4

• Primary, secondary, and early latent: penicillin G x 1 IM
• Late latent: penicillin G IM Qwk x 3
• Tertiary: IV penicillin G Q4H x 10-14 days

Question 5

Which is a more benign test, 1:2 or 1:1056 RPR?

Answer 5

1:2

Question 6

What is the treatment for H. ducreyi?

Answer 6

Azithromycin or ciprofloxacin

Question 7

Diagnose HSV with ____________.

Answer 7

PCR