Venerology — MCQs

Venerology Indian Medical PG Practice Questions and MCQs

Question 281: Higoumenaki sign is suggestive of:

A. Psoriasis
B. Congenital syphilis (Correct Answer)
C. Cholecystitis
D. Tetany

Explanation: Higoumenaki sign is suggestive of: ***Congenital syphilis*** - The **Higoumenakis sign** is a unilateral or bilateral thickening of the medial third of the **clavicle**, resulting from periostitis and osteitis. - This sign is a classic, though rarely observed, manifestation of **late congenital syphilis**. *Psoriasis* - Psoriasis is a chronic autoimmune skin condition characterized by **red, scaly patches** (plaques), not bone changes like clavicular thickening. - While psoriasis can have musculoskeletal involvement (**psoriatic arthritis**), it does not present with the Higoumenakis sign. *Cholecystitis* - **Cholecystitis** is inflammation of the gallbladder, typically causing acute right upper quadrant abdominal pain, fever, and leukocytosis. - It is an abdominal condition and has no association with clavicular changes or systemic infectious diseases like syphilis. *Tetany* - Tetany is a state of **neuromuscular hyperexcitability** characterized by carpopedal spasm, muscle cramps, and tremors, often due to **hypocalcemia**. - This condition affects muscle and nerve function and does not involve bony changes such as clavicular thickening.

Question 282: Jarish-Herxheimer reaction is seen in early cases of what?

A. Syphilis (Correct Answer)
B. Gonorrhea
C. Lymphogranuloma venereum
D. Granuloma inguinale

Explanation: ***Syphilis*** - The **Jarisch-Herxheimer reaction** is an acute, self-limiting febrile reaction that occurs within a few hours of treatment initiation for spirochetal infections, most notably **syphilis** [1]. - It results from the release of **endotoxins** from dying spirochetes, leading to systemic inflammatory symptoms such as fever, chills, myalgia, headache, and exacerbation of existing skin lesions [1]. *Gonorrhea* - **Gonorrhea** is caused by the bacterium *Neisseria gonorrhoeae*, which is not a spirochete and does not typically trigger a Jarisch-Herxheimer reaction upon treatment. - Treatment for gonorrhea, usually with antibiotics like ceftriaxone, does not result in the rapid release of toxins associated with this specific immunologic response. *Lymphogranuloma venereum* - **Lymphogranuloma venereum (LGV)** is caused by specific serovars of *Chlamydia trachomatis* and is characterized by genital ulcers and prominent lymphadenopathy. - As it is not a spirochetal infection, treatment with antibiotics like doxycycline does not induce a Jarisch-Herxheimer reaction. *Granuloma inguinale* - **Granuloma inguinale**, also known as donovanosis, is caused by *Klebsiella granulomatis*. - This bacterial infection, characterized by progressive ulcerative lesions, is not a spirochetal disease, and thus, treatment does not lead to a Jarisch-Herxheimer reaction.

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Syphilis

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Gonorrhea

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Chlamydial Infections

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Chancroid and Other Genital Ulcers

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Genital Herpes

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Human Papillomavirus Infections

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HIV and STIs

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Pelvic Inflammatory Disease

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STI Screening and Prevention

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Partner Notification and Treatment

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Sexually Transmitted Enteric Infections

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Special Populations Management

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Venerology — MCQs

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