que.. help!!

[usmle.2016]

painless ulcerative penile lesion and inguinal lympadenopathy?
1.chlamydia
2.syphillis
3.klebsiella
4.candidia

[Keto]

Originally Posted by usmle.2016

painless ulcerative penile lesion and inguinal lympadenopathy?
1.chlamydia
2.syphillis
3.klebsiella
4.candidia

syphilis?

[ucheeee]

Chlamydia L type

[Keto]

Originally Posted by ucheeee

Chlamydia L type

usually small ulcerative lesions and painful inguinal lymphnodes

[san.usmle]

Both chlamydia & treponema (syphilis) cause "painless" penile lesions. But "inguinal lymphadenopathy" specifically occurs in chlamydia. So according to my knowledge, ans should be chlamydia.

[virendra ravat]

It could be klabseilla inguinale. Chlamydia cause painful lymphadenopathy

[Lillybethcervant]

as per your question if you open your First Aid Book I have 2014 version page 176...
Then easily you can find the answer..
Answer is secondary Syphilis... Painless chancre, fever, lymphadenopathy, skin rash, condylomata kata.

The reason is not Clamydia is because Lymphogranuloma Venerum the characteristics are a small and shallow ulcers, they heal rapidly, do not have lymphadenopathy, they have I infra cytoplasmic chlamydial inclusion bodies in epithelial cells and leukocytes.

😛 i hope it helps... Please post more questions it helps to test knowledge...

[san.usmle]

On the same page of FA, lymphogranuloma venereum (caused by chlamydia) is described as "painless" penile ulcerative lesion with "painful" inguinal lymphadenopathy.

In the question here the "painless" is referred to the lesion itself, not to the lymphadenopathy. The qs doesn't differenciate between painless/painful lymphadenopathy.

Anyway, I agree that syphilis has a good chance of being the right ans (because it too, has painless penile lesions with lymphadenopathy), but why I think chlamydia still is the right ans because inguinal lymphadenopathy is more specific for chlamydia in the form of lymphoggranuloma venereum. Infact, inguinal lymphadenopathy is the most common "presenting" symptom of chlamydia because the penile lesions are painless they may go unnoticed.
Also, not to forget that Chlamydia is the most common STD in the United states at present. In USMLE questions whenever there is too much confusion between the options, the right answer is usually the "most common" thing.

Usmle2016, please post the correct answer to the qs if you have. I would be happy to have my doubts cleared incase my answer is wrong.