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  #1  
Old 10-20-2012
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Arrow Billy Step 1 Questions # 40

A 20-year-old man who has multiple sexual partners and does not use barrier precautions comes to the physician
complaining of a nontender ulcer on the penis that has been present for 1 week. On physical examination, the 0.6-cm
lesion has a firm, erythematous base and sharply demarcated borders. The lesion is scraped, and darkfield examination is
positive for spirochetes consistent with Treponema pallidum. Which of the following is most likely to be seen microscopically in the biopsy specimen?


□ (A) Granulomatous inflammation with suppuration
□ (B) Granulomatous inflammation with caseation
□ (C) Acute inflammation with abscess formation
□ (D) Perivascular inflammation with plasma cells
□ (E) Gummatous inflammation
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  #2  
Old 10-20-2012
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have no idea of this....thanks for the question

if have to choose anything..would go with A) granulomatous inflammation with suppuration

thanks
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Old 10-20-2012
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I will go with C
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  #4  
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Default The correct answer is D

Syphilis cause endarteritis obliterans and periarteritis with plasma cells infiltration
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  #5  
Old 10-20-2012
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Quote:
Originally Posted by venky2600 View Post
have no idea of this....thanks for the question

if have to choose anything..would go with A) granulomatous inflammation with suppuration

thanks

ya D seems the right one.....
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  #6  
Old 10-20-2012
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Default Answer is D

According to Rapid review Goljan says, Vasculitis caused by T.pallidum reveals histologically perivascular infiltration of plasma cells known as endarteritis obliterans. So i would go with option D
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  #7  
Old 10-20-2012
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Default DD??...primary syphilis

C & D but D my best guess since no abscess in condyloma lata?

those discussing endarteritis obliterans,is that not seen only in tertiary syphylis??...
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  #8  
Old 10-20-2012
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Correct Answer D is correct

Syphilitic chancres occur in the primary stage of syphilis and are characterized by lymphoplasmacytic infiltrates and
by an obliterative endarteritis. Similar lesions also may appear with secondary syphilitic mucocutaneous lesions.
Suppurative granulomas are typical of cat-scratch disease. Caseating granulomatous inflammation is more characteristic
of tuberculosis or fungal infections. Acute inflammation with abscess formation is characteristic of bacterial infections such
as gonorrhea. Gummatous inflammation can be seen in adults with tertiary syphilis or in congenital syphilis.
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  #9  
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Quote:
Originally Posted by billy View Post
Syphilitic chancres occur in the primary stage of syphilis and are characterized by lymphoplasmacytic infiltrates and
by an obliterative endarteritis. Similar lesions also may appear with secondary syphilitic mucocutaneous lesions.
Suppurative granulomas are typical of cat-scratch disease. Caseating granulomatous inflammation is more characteristic
of tuberculosis or fungal infections. Acute inflammation with abscess formation is characteristic of bacterial infections such
as gonorrhea. Gummatous inflammation can be seen in adults with tertiary syphilis or in congenital syphilis.
really thanks for the question....i never knew it before...i googled it and changed my answer......
only thought obliterative endarteritis occurs in tertiary syphilis until now..
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  #10  
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Yeah I Didnt know that too
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Old 10-21-2012
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Perivascular inflammation with plasma cells
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