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Old 10-20-2012
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USMLEWorld Uworld Micro Question

1Q) a 45 yr old sailor presents with penile lesions to a physician..he says that he first noticed a papule on his penis. soon thereafter draining ulcers are formed and his inguinal region being hurt.he also complains of mild fever and red eyes. cell scrapings from genital lesions show inclusion bodies.which of the following is the most likely cause of the pt.'s condition..?

a) hemophilus ducreyi
b) calymmatobacterium inguinale
c) herpes simplex virus(HSV)
d) treponema pallidum
e) chlamydia trachomatis

friends.., this is Uworld question...i went through it likewise 4 times but never answered correctly...i want to know if any buzz words or concept behind this question..
i'm not posting the answer coz i want to see the approach of you ppl to the answer which might help me....
thanks..

BONUS----1 logical question

2Q) which of the following nerve cannot be associated with schwannoma with s-100 postive..?

a) olfactory nerve
b) chorda tympani nerve
c) occulomotor nerve
d) hypoglossal nerve
e) optic nerve
f) lingual nerve
g) vestibulocochlear nerve
h) greater occipital nerve
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Old 10-20-2012
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Default E squared

1..EE...lymphogranuloma venerum
2...EE...optic N is myelinated by oligodendrocyte
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Old 10-20-2012
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i looked up for the details and got this !

If it is H.Ducreyi or Herpes ... the first presentation is PAIN ,PAIN AND PAIN( it woudn't be like "he noticed a papule and went to the doctor".......(herpes usually as well presents with mutiple tiny ulcers or vesicles kind of a thingy)...so put them aside ...

treponema.. painless ,it's cause of the ulcer is due to obliteration of the blood vessel (more like an ischemic nectrotic ulcer).. in these cases ,the inguinal lymph nodes do not undergo reactive hyperplasia ...no inclusion bodies in here...

that leaves with K.glanulomatis (C.inguinale..)..painless yes,inclusion bodies present but remember that MOSTLY lymphadenopathy or reactive hyperplasia is not seen ...(if you see lymph node involvement ,,then better dont go for it )G inguinale is a disease of the is a disease of the skin and mucous membranes...

for some reason, C.Trachomatis/LGV has a predisposition to lymphatics (LGV has the word "lymph" in it and wiki talks all about lymph and the organism travelling thru lymphatics ).. so when you seen lymph nodal involvement , then go for LGV

Last edited by alice; 10-20-2012 at 09:12 AM.
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Old 10-20-2012
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Default here is my answer

1. Option E is right answer where as rest are painful like herpes and ducryi, syphilis is painless. there is eye involvement which can be due to chlamydiae.

2. Option is optic nerve as it is not a part of PNS which gets affected in schwannoma, it is an extension of diencephalon.
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Correct Answer

all are correct........

1st one-----is chlamydia trachomatis(i always get screwed between chlamydia and HSV----i was unable to differentiate)

2nd one is------ya optic nerve(coz lined by oligodendrocytes--it's not a true peripheral nerve...that's the reason multiple sclerosis also affects it)
remaining options are all peripheral nerves(cranial /spinal nerves___which can be affected by schwann cells)....and also remember only vestibular schwannoma is associated with neurofibromatosis 2


thanks for all ur explanations....they cleared me..
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