October 04, 2010

PLAB Question 3

A 31 year old male develops a sudden onset of small boils on his genitals rapidly becoming painful open sores. He is noted, on examination, to have large swollen, tender lymph nodes in the groin.

A likely diagnosis is:

a) Gonorrhea
b) Chlamydia
c) scabies
d) Hemophilus Ducreyi
e) a DNA Virus of the hepadnaviridae family
f) human papilloma virus
g) Trichomonas
h) Syphilis
i) Human Immuno-deficiency Virus
j) Herpes

The correct answer is D

Chancroid is caused by a bacterium known as Hemophilus Ducreyi. Chancroid may be transmitted through oral, vaginal, or anal intercourse.

Untreated chancroid can infect and swell the glands located in the groin. Men are more commonly infected than women. Chancroid is especially dangerous because the sores it causes increase the chances of getting HIV.

First, a small boil or ulcer - 'bubo' - appears, usually on the genitals. But it does not heal like a common pimple. Later, the bubo becomes an open sore. There may be pus and pain. Women may have no sores, but they may have painful urination or bowel movements, painful intercourse, rectal bleeding, or vaginal discharge. Chancroid buboes can be confused with herpes, syphilis, and other conditions.

Microscopic examination of the discharge from the bubo is necessary.

Both partners can be treated successfully with oral antibiotics. The infection begins with the appearance of painful open sores on the genitals, sometimes accompanied by swollen, tender lymph nodes in the groin. These symptoms occur within a week after exposure. Symptoms in women are often less noticeable and may be limited to painful urination or defecation, painful intercourse, rectal bleeding, or vaginal discharge.

Chancroid lesions may be difficult to distinguish from ulcers caused by genital herpes or syphilis. A physician must therefore diagnose the infection by excluding other diseases with similar symptoms.

People with chancroid can be treated effectively with one of several antibiotics. Chancroid is one of the genital ulcer diseases that may be associated with an increased risk of transmission of the human immunodeficiency virus (HIV), the cause of AIDS.

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