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8th > Chapter 173 - LGV > Flashcards

Chapter 173 - LGV Flashcards

1
Q

LGV is a sexually transmitted infection caused by

A

L serovars of Chlamydia trachomatis

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2
Q

Peak incidence of LGV occurs in sexually active persons ages

A

15-40 years old

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3
Q

Men are __ times more likely than women to manifest clinical infection

A

6

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4
Q

Major predisposing factor for LGV in MSM

A

Fisting

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5
Q

Only __% were asymptomatic

A

6

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6
Q

Infectivity in men ceases after healing of primary mucosal lesion.
True or False

A

True

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7
Q

Other names for LGV (3)

A

Tropical/climactic bubo
Lymphopathia venerea
Nicolas-Favre disease

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8
Q

LGV serovars are more invasive and have high affinity for ___

A

Macrophages

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9
Q

3 clinical stages characterize LGV (3)

A

Primary stage
Secondary stage
Tertiary stage

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10
Q

In males, lesion is usually found in (3)

A

Coronal sulcus
Prepuce
Glans penis

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11
Q

In females, lesion is usually found in (3)

A

Posterior wall of vagina
Vulva
Cervix

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12
Q

Secondary stage of LGV often resolves spontaneously in ___ weeks

A

8-12

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13
Q

Inguinal and or femoral LN involvement and is the major presentation in developing countries

A

Acute genital/inguinal syndrome

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14
Q

Bilateral involvement of LGV occurs in __ of cases

A

1/3

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15
Q

Pathognomonic of LGV

A

Groove sign

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16
Q

Groove sign is usually bilateral.

True or False

A

False, rarely

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17
Q

Inguinal lymphadenitis is rare in females as lymphatic drainage of vagina and cervix drains to ___

A

Deep pelvic/retroperitoneal lymph nodes

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18
Q

Characterized by perirectal nodal involvement, acute hemorrhagic proctitis, and pronounced systemic symptoms

A

Acute anorectal syndrome

19
Q

MC presentation in women and in homosexual men who practice anal sex

A

Acute anorectal syndrome

20
Q

Major source of rectal spread in women is

A

Internal lymphatic drainage in lower 2/3 of vagina

21
Q

Watering can perineum

A

Rectovaginal fistula

22
Q

Perianal outgrowths of lymphatic tissue

A

Lymphorrhoids

23
Q

Rare primary infection of externa genitalia leading to progressive lymphangitis, genital destruction,

A

Esthiomene

24
Q

Sequelae of ruptured deep pelvic nodes (2)

A

Infertility

Frozen pelvis

25
Q

Accuracy of clinical diagnosis is __%

A

20

26
Q

A positive test on LN aspirate is considered diagnostic of LGV.
True or False

A

True

27
Q

Confirmation of LGV requires identification of

A

Genotype L1, L2, L3

28
Q

Specific tests for LGV uses the ff genes to differentiate from non LGV strains

A

pmpH or omp1

29
Q

Specific tests for LGV

A

Real time quadriplex PCR

High resolution melting analysis

30
Q

Most commonly used nonspecific chlamydial tests

A

Complement fixation test

31
Q

In complement fixation test, titers greater than ___ are considered disgnostic

A

1:64

32
Q

In complement fixation test, titers greater than ___ are considered highly suggestive

A

1:256

33
Q

In complement fixation test, titers below ___ exclude the diagnosis

A

1:32

34
Q

Examples of nonspecific chlamydial tests

A 
Complement fixation test
Microimmunofluorescence test
Direct fluorescence microscopy
Serology assays
Frei test
35
Q

Earliest diagnostic modality to identify LGV consist of ID skin test assessing delayed hypersensitivity to chlamydial antigens

A

Frei test

36
Q

Frei test is no longer used due to its low sensitivity and cross reactivity with serovars

A

D to K

37
Q

In contrast to LGV, __ ulcers are more painful and larger, and ___ ulcers have abundant friable granulation tissue without associated lymphadenitis.

A

Chancroid

Donovanosis

38
Q

Proctoscopic exam reveals

A

Multiple discrete and irregular ulcerations and friable granulation tissue confined to distal 10 cm of anorectal canal

39
Q

Treatment for LGV

A

1st: Doxycycline 100 mg PO BID
2nd: azithromycin 1-1.5g PO once weekly for 3 weeks
3rd: Erythromycin 500mg QID for 3 weeks

40
Q

Pregnant and lactating women should be treated with

A

Azithromycin or Erythromycin

41
Q

Doxycycline should be avoided in the ___ trimester of pregnancy

A

2nd to 3rd

42
Q

Persons who had sexual contacts with a patient who had LGV in ___ days before onset of symptoms

A

60

43
Q

To exclude reinfection, retesting by nuclear amplification during ff up after ___ should be offered

A

3 months

8th (28 decks)

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