A 35-year-old homosexual man is referred to the local genitourinary clinic following the development of a solitary painless penile ulcer associated with painful inguinal lymphadenopathy. He has recently developed rectal pain and tenesmus.
What is the most likely diagnosis?
Correct Answer E:
Lymphogranuloma venereum usually involves three stages:
STI: ulcers:
1- Genital herpes: is most often caused by the herpes simplex virus (HSV) type 2 (cold sores are usually due to HSV type 1). Primary attacks are often severe and associated with fever whilst subsequent attacks are generally less severe and localized to one site.
2- Syphilis: is a sexually transmitted infection caused by the spirochaete Treponema pallidum. Infections characterized by primary, secondary and tertiary stages. A painless ulcer (chancre) is seen in the primary stage. The incubation period= 9-90 days.
3- Chancroid: is a tropical disease caused by Haemophilus ducreyi. It causes painful genital ulcers associated with inguinal lymph node enlargement.
4- Lymphogranuloma venereum is caused by Chlamydia trachomatis. Typically infection comprises of three stages:
5- Other causes of genital ulcers:
*previously called Calymmatobacterium granulomatis
Note Genital ulcers:
Which one of the following organisms causes erysipelas?
Correct Answer D: Streptococci are gram-positive cocci. They may be divided into alpha and beta haemolytic types.
1- Alpha haemolytic streptococci (partial haemolysis):
The most important alpha haemolytic Streptococcus is Streptococcus pneumoniae(pneumococcus). Pneumococcus is a common cause of pneumonia, meningitis and otitis media. Another clinical examples Streptococcus viridans.
2- Beta haemolytic streptococci (complete haemolysis):
These can be subdivided into groups A-H. Only groups A, B & D are important in humans.
Group A:
Group B:
Group D:
A 39-year-old man is admitted to hospital with decompensated liver disease of unknown etiology. As part of a liver screen the following results are obtained:
Anti-HBs = Hepatitis B Surface Antibody; Anti-HBc = Hepatitis B Core Antibody; HBs antigen = Hepatitis B Surface Antigen
What is this man's hepatitis B status?
Correct Answer B:
Hepatitis B serology:
Interpreting hepatitis B serology is a dying art form which still occurs at regular intervals in medical exams. It is important to remember a few key facts:
Example results:
A 38-year-old man presents to the genitourinary clinic with multiple, painless genital ulcers. A diagnosis of granuloma inguinale is made.
What is the causative organism?
Correct Answer A:
2- Syphilis: is a sexually transmitted infection caused by the spirochaete Treponema pallidum. Infection is characterized by primary, secondary and tertiary stages. A painless ulcer (chancre) is seen in the primary stage. The incubation period= 9-90 days.
4- Lymphogranuloma venereum: is caused by Chlamydia trachomatis. Typically infection comprises of three stages:
A 19-year-old man presents with an annular rash, pyrexia and polyarthralgia to an the Emergency Department. He has just returned from the New Forest and remembers being bitten by a tick. Given the likely diagnosis, what is the most appropriate antibiotic therapy?
Correct Answer D: As he only has features of early disease, doxycycline is sufficient.
Lyme disease: Lyme disease is caused by the spirochaete Borrelia burgdorferi and is spread by ticks.
Features:
Investigation:
Management:
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