Chancroid

Chancroid

Q. 1

Chancroid is caused by?

 A

H. Ducrei 

 B

N. Gonnorrea

 C

T. Pallidum 

 D

H. Influenza

Q. 1

Chancroid is caused by?

 A

H. Ducrei 

 B

N. Gonnorrea

 C

T. Pallidum 

 D

H. Influenza

Ans. A

Explanation:

Ans:A.)H. Ducrei 

CHANCROID (SOFT SORE)

This venereal infection is caused by the Gram-negative bacillus Haemophilus ducreyi. One to 5 days post-infection, a soft sloughy ulcer appears on the penis or vulva. The treatment of choice is erythromycin (500 mg 6-hourly for 14 days).


Q. 2 “Chancroid” is caused by:
 A H. ducreyi
 B H. influenzae
 C H. aprophilus
 D All the above
Q. 2 “Chancroid” is caused by:
 A H. ducreyi
 B H. influenzae
 C H. aprophilus
 D All the above
Ans. A

Explanation:

H. ducreyi


Q. 3

Tender Bubos seen are used in the diagnosis of:

 A Gonorrhoea
 B Herpes
 C Chancroid
 D Granuloma venereum
Q. 3

Tender Bubos seen are used in the diagnosis of:

 A Gonorrhoea
 B Herpes
 C Chancroid
 D Granuloma venereum
Ans. C

Explanation:

Chancroid


Q. 4

Which of the following is the causative organism for Chancroid?

 A

Haemophilus ducreyi

 B

Haemophilus influenza

 C

Treponema pallidum

 D

Neisseria Gonorrhea

Q. 4

Which of the following is the causative organism for Chancroid?

 A

Haemophilus ducreyi

 B

Haemophilus influenza

 C

Treponema pallidum

 D

Neisseria Gonorrhea

Ans. A

Explanation:

Haemophilus ducreyi, a gram-negative, facultative anaerobic coccobacillus is the causative agent of Chancroid.

Painful, soft ulcers with ragged undermined margins develop 1–2 weeks after inoculation (usually seen in prepuce and frenulum in men and vulva, cervix, and perianal area in women). 

Must Know:

  • Chancroid facilitates the transmission of HIV.
  • Azithromycin and Ceftriaxone are recommended as single-dose treatment.
  • It is a sexually transmitted disease, but nonsexual transmission has been reported recently.

Ref: Lautenschlager S. (2012). Chapter 202. Chancroid. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick’s Dermatology in General Medicine, 8e.


Q. 5

Ito’s test is used in the diagnosis of the following infection:

 A

Gonorrhoea

 B

Herpes

 C

Chancroid

 D

Granuloma venereum

Q. 5

Ito’s test is used in the diagnosis of the following infection:

 A

Gonorrhoea

 B

Herpes

 C

Chancroid

 D

Granuloma venereum

Ans. C

Explanation:

The Ito Reenstierna test was developed for detecting Haemophilus ducreyi using a commercial antigen by intradermal testing and proved positive in 90% of cases.
 
Gram staining shows ‘school of fish’ or ‘railroad track’ appearance which is characteristic.

Nucleic acid amplification tests are now the optimal method of diagnosing H. ducreyi.
 
Ref: Oxford Textbook of Medicine: Infection edited by David Warrell, Timothy M. Cox, John Firth, Estée Török, 2012, 375-376.

Q. 6

Incubation period of chancroid is:

 A

< 7 days

 B

10-14 days

 C

2-3 weeks

 D

3-4 weeks

Q. 6

Incubation period of chancroid is:

 A

< 7 days

 B

10-14 days

 C

2-3 weeks

 D

3-4 weeks

Ans. A

Explanation:

Chancroid: caused by Hemophilus  ducreyi

  • Incubation period is 4 to 7 days
  • Azithromycin  is drug of choice
 
Ref: Park 21st edition, page 305.

Q. 7

Chancroid may be caused by:

 A

T. pallidium

 B

G. donovani

 C

Chlamydia Trachomatis

 D

Herpes Hominis Virus

Q. 7

Chancroid may be caused by:

 A

T. pallidium

 B

G. donovani

 C

Chlamydia Trachomatis

 D

Herpes Hominis Virus

Ans. D

Explanation:

D i.e. Herpes virus – hominis


Q. 8

Reliable test for chancroid detection-

 A

Skin test

 B

Biopsy

 C

Grams stained smear

 D

Clinical examination

Q. 8

Reliable test for chancroid detection-

 A

Skin test

 B

Biopsy

 C

Grams stained smear

 D

Clinical examination

Ans. C

Explanation:

C i.e. Grams stained smear


Q. 9

DOC in chancroid is

 A

Tetracycline

 B

Doxycycline

 C

Erythromycin

 D

Streptomycin

Q. 9

DOC in chancroid is

 A

Tetracycline

 B

Doxycycline

 C

Erythromycin

 D

Streptomycin

Ans. C

Explanation:

C i.e. Erythromycin

Distinguishing Features of Genital Ulcers

Features

Syphilis (1°chancre)

Chancroid

(soft chancre)

Lymphogranuloma

Venereum

Donovanosis Granuloma

venerum/inguinale)

Herpes genitalis

Causative agent

Treponema

Haemophilus

Chlamydia

Calymmatobacterium

Herpes simplex

 

pallidiumQ

ducreyiQ

trachomatisQ

granulomatisQ

virus type HQ

 

 

 

(LI,L2,L3)

 

(rarely type I)

Incubation period

9 – 90 daysQ

1 – 7 days rarely > 10

days

3 days – 6 weeks

1-4 weeks (upto 6 months)

2-7 days

No. of attacks

Only one (1)

1 or 2

Only one (1)

Only one (1)

Reccurent

No. of lesions

Usually 1

Usually multipleQ

may coalesce

Usually 1

Variable

MultipleQ, may

coalesce

Early 1° lesion

Papule

Pustule

Papule, pustule

Papule

VesicleQ

Diameter

5-15 mm

Variable

2-10 mm

Variable

1-2 mm

Depth

Superficial or deep

Excavated

Superficial or deep

Elevated

Superficial

Edges

Sharply demarcated,

elevated, round or

oval

Undermined,

ragged, sloughedQ

irregular

Elevated, round or

oval

Elevated, irregular

serpiginous

Erythematous

Base

Smooth, non-

purulent, non-

vascula,Q

(relatively)

Purulent, bleeds

easily

Variable,

nonvascular

Red & velvety (beefy red),

bleeds easily with

exuberant granulation

tissueQ

Serous,

erythematous,

nonvascular.

Induration

FirmQ

SoftQ (mostly)

Occasionly firm

Firm

None

Pain

UncommonQ

Usually very tender

Variable

Uncommon

Frequenctly

tenderQ

Lymphadenopathy

Firm, non tender,

shotty, bilateralQ

Tender, may

suppurate, loculated,

usually unilateral

(Bubo)

Tender, may

suppurate, loculated,

usually unilateral

(Bubo)

No lymphadenopathy

pseudobuboesQ

(subcutaneous nodules in

inguinal region, may

ulcerate)

Firm, tender,

often bilateral

Diagnosis

Dark field

Clinical features

Demonstration of

– On tissue smear &

Multinucleate

 

microscopyQ

Serologicaltests

– Gram staining

(gram -ve cocco-

baccili with rail

road appearance)

LGV as elementary

& inclusion bodies

Frie’s testQ

Hyper gamma-

globulinemia

– Complement

fixation +ve

histopathological

microscopy using Giemsa,

Wrights or Silver stain

or Leishman Stain

1. Gram negative C.

granulomatis may be

seen within

characteristic large

mono nuclear cell as

d giant cell on

Tzank smear

– Culture is

confirmatory

 

 

 

 

Donovan bodies

 

 

 

 

 

2. Donovan bodies are

seen in vacuolated

cytoplasm of large

mono nuclear cells as

bipolar inclusionsQ

 

 

 

 

 

(safety pin or telephone

handle appearance)

measuring 1 to 2 um x

 

 

 

 

 

0.5 to 0.7 um.

 

Drug

Benzathine/procaine

– Azithro/

– Doxy / tetra

DoxycyclineW tetracycline

AcyclovirQ

 

Penicillin in all

erythromycin

cyclineQ

Azithromycin /

 

 

except neurosyph-

ilis & congenital

syphilis in which

crystalline penicillin

Ciftriaxone

.

– Ciprofloxacin

– Erythromycin

erythromycin (in

pregnancy)

 

 

(aqueous benzyl

penicillin) is used

 

 

 

 

 

– In penicillin

sensitive patient,

Tetracycline or

erythromycin is

used

 

 

 

 


Q. 10

A man having multiple, painful, indurated, undermined, sloughed edged glans which occurred 5 days after exposures; most likely diagnosis is

 A

Chancroid

 B

Primary chancre

 C

Herpes genitalisLGV

 D

All

Q. 10

A man having multiple, painful, indurated, undermined, sloughed edged glans which occurred 5 days after exposures; most likely diagnosis is

 A

Chancroid

 B

Primary chancre

 C

Herpes genitalisLGV

 D

All

Ans. A

Explanation:

A i.e. Chancroid


Q. 11

Painful lymphadenopathy is seen in:

 A

Donovanosis

 B

Syphilis

 C

Chancroid

 D

All

Q. 11

Painful lymphadenopathy is seen in:

 A

Donovanosis

 B

Syphilis

 C

Chancroid

 D

All

Ans. C

Explanation:

C i.e. Chancroid


Q. 12

Syndromic Management of genital ulcer syndrome in India includes

 A

Chancroid and Primary chancre

 B

Chancroid and herpes simplex

 C

Chancroid, Primary Chancre and herpes simplex 

 D

Herpes simplex and primary chancre

Q. 12

Syndromic Management of genital ulcer syndrome in India includes

 A

Chancroid and Primary chancre

 B

Chancroid and herpes simplex

 C

Chancroid, Primary Chancre and herpes simplex 

 D

Herpes simplex and primary chancre

Ans. C

Explanation:

C i.e. Chancroid, Primary Chancre and herpes simplex

STDs presenting with genital ulcers include herpes genitalis (by HSV typell), primary syphilis (primary chncre), chancroid and donovanosisQ. And syndromic management of genital ulcers include if vesicle or multiple painful ulcers.


Q. 13

Chancroid is caused by:

September 2005

 A

Herpes simplex virus

 B

HPV

 C

T. pallidum

 D

H.ducreyi

Q. 13

Chancroid is caused by:

September 2005

 A

Herpes simplex virus

 B

HPV

 C

T. pallidum

 D

H.ducreyi

Ans. D

Explanation:

Ans. D: H.Ducreyi

Chancroid is a sexually transmitted infection caused by the bacteria Haemophilus ducreyi.

Most people with chancroid will develop one or more red, inflamed lumps in the genital area 3-7 days after being infected during sexual intercourse.

These become larger and pus-filled until they rupture, leaving a painful ulcer.

If left untreated, 50% of cases develop infected lymph glands, which become large, hard painful lumps (buboes), on either one or both sides of the groin.

The site of most infections in men is the foreskin but other parts of the penis may be affected.

In women, ulcers may be located on the labia, thigh, perineum and cervix.

Women generally have less specific symptoms such as painful urination or pain on passing bowel motions (defaecation), vaginal discharge, painful sexual intercourse (dyspareunia) and rectal bleeding.



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