QUESTION 7-1. A 31-year-old HIV-positive veterinary assistant presents with an erythematous smooth nodule on the shin with focal ulceration. There is regional lymphadenopathy. You forget to include the pertinent clinical history on the specimen requisition form and a diagnosis of “pyogenic granuloma” is rendered. Which of the following statements regarding this lesion is INCORRECT?
Part (A) reproduced, with permission, from Wolff K, Johnson RA, Saavedra AP. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology. 7th ed. New York, NY: McGraw-Hill Education; 2013.
A) The causative microorganisms are best highlighted with a Warthin-Starry stain, revealing granular clusters of bacilli within endothelial cells, macrophages, and within the dermis.
B) This condition is associated with exposure to cats and cat fleas.
C) Low-power microscopic examination will reveal a well-circumscribed pedunculated proliferation of small vessels with an overlying epidermal collarette.
D) These lesions typically respond to a course of antibiotics.
E) The endothelial cells will stain positive for HHV8 via immunohistochemistry.
QUESTION 7-2. In the clinic during your summer externship to South Africa, you encounter a 21-year-old male with a painful ulcerated erythematous ulcer on the coronal sulcus of the penis with suppuration. The ulcer edge is ragged, undermined, and its base is formed by granulation tissue covered by a necrotic, yellowish-gray exudate. Gram stain of a scraping reveals short gram-negative bacilli that form parallel chains resembling a “school of fish.” His last sexual encounter was 7 days ago. There is associated regional lymphadenopathy with an overlying draining sinus tract producing copious amount of suppurative material. Which of the following statements regarding this condition is CORRECT?
Reproduced, with permission, from Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, eds. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York, NY: McGraw-Hill Education; 2012.
A) The causative microorganism is Haemophilus ducreyi.
B) The ulcer is histopathologically characterized by two distinct layers: necrosis and granulation tissue.
C) Tissue cultures consistently fail to grow the causative microorganisms.
D) Smears from the ulcer examined under dark field microscopy consistently reveal organisms.
E) Clumped collections of the microorganisms form structures referred to as Donovan bodies.
QUESTION 7-3. Three weeks after having unprotected intercourse, a 22-year-old Jamaican male presents with serpiginous painless ulcers with central red friable centers on the penis, ...