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8th > Chapter 174- Granuloma inguinale > Flashcards

Chapter 174- Granuloma inguinale Flashcards

1
Q

Rare, chronic progressive ulcerative disease that mainly affects genital and perigenital skin

A

Granuloma inguinale/Donovanosis

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2
Q

Causative agent of GI

A

Klebsiella granulomatis

Calymmatobacterium granulomatis

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3
Q

Confirmatory dx of GI

A

Demonstration of intracellular Donovan bodies on histology

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4
Q

GI is most commonly seen in individuals with ___ socioeconomic status and secually active adults between ages ___

A

Lower; 20-40 years old

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5
Q

All GI cases are sexually transmitted.

True or False

A

False, GI can occur in sexually inactive adults

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6
Q

Transvaginal transmission of GI during delivery can occur.

True or False

A

True, but rarely

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7
Q

Incubation period for GI

Treatment period for Gi

A

2-3 weeks

3 weeks

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8
Q

4 clinical types of GI

A

Ulcerogranulomatous (MC)
Hypertrophic
Necrotic
Sclerotic

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9
Q

Matching type

A.Ulcerogranulomatous
B.Hypertrophic
C.Necrotic
D.Sclerotic

  1. Non bleeding ulcers that form fibrous band like scars
  2. Resembles condyloma acuminata
  3. Highly vascular, beefy red, nontender but bleed to touch
  4. Foul-smelling, deep with copious gray exudate
  5. Kissing lesions
  6. Extensive destruction to surrounding tissues
A 
D
B
A
C
A
C
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10
Q

The genital region is affected ___% and inguinal area in ___% and extragenital area in ___%

A

90%; 10%

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11
Q

Most common sites involved in men (3)

A

Coronal sulcus
Prepuce
Glans penis

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12
Q

Most common sites involved in females (3)

A

Labia minora
Fourchette
Perineum

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13
Q

GI involvement of regional lymph nodes presenting as abscess or subcutaneous granuloma that ulcerates

A

Pseudobubo

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14
Q

Sites of extragenital involvement (9)

A

Nose, cheeks, lips, gums, palate, pharynx, larynx, neck, chest

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15
Q

GI presentation in exposed infants (4)

A

Meningitis
Otitis media
Mastoiditis
Lymphadenitis

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16
Q

K. Granulomatis is Gram (___) facultative, nonmotile, pleomorphic bacteria that resides in cytoplasm of mononuclear cells.

A

Negative

17
Q

K. Granulomatis ___ form is encapsulated, ___ form demonstrates a closed safety pin appearance.

A

Mature; immature

18
Q

Stains to demonstrate Donovan bodies (4)

A

Gram
Wright
Giemsa
Silver

19
Q

Used to stain tissue smears for rapid diagnosis

A

Rapid Giemsa method (Rapid-Diff)

20
Q

Site of biopsy for GI

A

Advancing edge of the ulcer

21
Q

Cultures and serology play a major role in diagnosis of GI.

True or False

A

False, neither

22
Q

Culture for GI

A

Human peripheral mononuclear blood cells (HEp-2)

23
Q

Distinguishing features of GI (3)

A

Lack of pain
Beefy red appearance
Presence of kissing lesions

24
Q

GI has high rate for spontaneous healing.

True or False

A

False, no tendency

25
Q

Genital complication of GI (4)

A

Genital swelling (pseudoelephantiasis)
Phimosis
Paraphimosis
Genital destruction

26
Q

Major risk if untreated GI

A

Increases risk of HIV transmission

27
Q

Development of carcinoma (SCC) is a serious but rare complication ___%

A

0.25%

28
Q

Addition of this antibiotic should be considered for Tx resistant cases of GI

A

Gentamicin 1mg/kg q 8 hrs

29
Q

Children with GI or born to mothers with GI should be treated with

A

Azithromycin 20mkday for 3 days

30
Q

Relapse may occur __ mos after effective therapy hence requiring long ff up

A

6-18 mos

31
Q

Complications of long standing cases (2)

A

Fistula

Abscess formation

32
Q

All sexual contacts in the previous __ months should be screened and examined

A

6 months

33
Q

Treatment of asymptomatic sexual partners of GI is necessary.
True or False

A

False, not necessary

34
Q

CDC recommendation for GI (2015)

A

Azithromycin 1g PO once weekly

Or 500 mg daily for 3 weeks

35
Q

WHO recommendation for GI (2003)

A

Azithromycin 1g PO once
Then 500 mg daily for 3 weeks
OR
Doxycycline 100 mg BID for 3 weeks

36
Q

Alternative WHO regimen for GI (4)

A 
Doxycycline 100 mg BID for 3 weeks
Or
Erythromycin 500 mg PO QID
Or 
TMP-SMX (160mg/800mg) PO BID
Or
Ciprofloxacin 750 mg BID
37
Q

Alternative Tx regimen for WHO (2003) (3)

A 
Erythromycin 500 mg PO QID
Or 
TMP-SMX (160mg/800mg) PO BID for 14 days
Or
Tetracycline 500 mg QID

8th (28 decks)

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