Balanitis;
Vulvovaginitis;
Phimosis;
Indurative swelling;*
Phagedena.
In case of histological examination of syphilids basic changes appear in:
Epidermis;
Blood and lymphatic vessels of the skin;*
Muscles;
Hypodermis;
Dermis.
After contact with syphilitics patient hard chancre appears in:
1 week;
2 weeks;
3-5 weeks;*
6-7 weeks;
8-9 weeks.
What forms of chancre does not belong to the atypical chancres?
Hard chancre on the neck of uterus;*
Indurative swelling;
Chancre panaritium;
Chancre-amygdalitis;
Fissured chancre.*
Decrease of duration of latent period can be observed at the followings concomitant diseases:
Tuberculosis;*
AIDS;*
Pneumonia;
Ulcerous illness of stomach;
Gonorrhoea.
Hard chancre – it is:
Erosion;*
Pustule;
Papula;
Ulcer;*
Crack.
Basic clinical signs of primary period of syphilis are:
General intoxication;
Hard chancre;*
Regional scleradenitis;*
Disturbance of digestion;
Regional lymphangitis.*
Varieties of hard chancre are:
Chancre-imprint;*
Gigantic;*
Dwarfish;*
Diphtheritic;*
Crust.*
The extragenital location of hard chancre is possible at
Any area of skin and mucous membranes;*
Skin of hands;*
Skin of elbow joints;*
Mucous membrane of oral cavity;*
Anus.*
What kind of immunity can develop in the case of disease with syphilis:
Congenital;
Acquired;
Natural;
Unsterile;*
Infectious.*
Basic clinical signs of hard chancre:
Dense erosion;*
Sickliness;
Absence of the subjective feelings;*
Bleeding;
Clear borders.*
The amount of plural hard chancres can arrive at:
3;
6;
2;
Not more than 10;*
More than 10.
A hard chancre must be differentiated with:
Pyodermia;*
Scabies;*
Cancer;*
Vasculitis;
Herpes.*
A fissured hard chancre can be localized at:
Corners of mouth;*
Interdigital folds;*
Anus;*
Cornea of eye;
Skin of hands.
Folman’s erosive chancre is located at:
Glans penis;*
Scalp;
Skin of genitals;
Round an umbilicus;
Any area of skin.
Bubo –it is:
Chancre;
Lymphadenitis;*
Lymphangitis;
Inflammatory papula;
Ulcer.
LESSON 20
Secondary period of syphilis.
The secondary period of syphilis lasts:
10 days;
3-4 weeks;
6-8 weeks;
2-4 years;*
9-12 weeks.
What clinical symptoms are most typical for a secondary early syphilis?
Alopecia;
Leucoderma;
Remnants of the hard chancre;*
Abundance of lesions;*
Tendency to grouping.
The secondary syphilids are characterized the followings signs:
Lesions of the secondary period have unclear edges, irregular outlines;
Lesions of the secondary period are accompanied by feeling of burning and pain;
Lesions of the secondary period persist long term, despite to the conducted therapy;
Lesions quickly disappear under action of treatment;*
Lesions follow acute inflammatory character.
What serological reactions will be positive in the case of secondary early syphilis?
Express-method;*
IFT;*
Wassermann's reaction;*
IFT, TPI;*
All of reactions are negative.
The lesions in the case of secondary early syphilis usually are:
Unabundant;
Abundant;*
Asymmetrical;
Symmetric;*
Grouped.
The secondary period of syphilis from the moment of infection begins on the average in:
1-2 months;
2-3 months;*
4-5 months;
6-7 months;
8-10 months.
Such varieties of syphilitic alopecia:
Microfocal;*
Macrofocal;
Diffuse;*
Mixed;*
Total.
After appearance of hardchancre the period of syphilis comes in average in:
5-6 weeks;
6-7 weeks;*
7-8 weeks;
8-9 weeks;
9-10 weeks.
Papulae of the mucous membranes of the oral cavity in the secondary recurrent syphilis are most frequently involved:
The back of the;
Tonsils;*
Angles of the mouth;
Gums;
Lateral surfaces of the tongue.
Such varieties of syphilitic roseola are:
Urticarial;*
Coalescent;*
Recurrent;*
Lenticular;
Granular.*
What clinical symptoms are most characteristic for secondary recurrent syphilis?
Alopecia;*
Leucoderma;*
Remnants of the hard chancre;
Abundance of lesions;
Tendency to grouping.*
It is necessary to differentiate the syphilitic papulae of mucus of mouth from:
Follicular tonsillitis;*
Diphtheria of the throat;*
Lichen ruber planus;*
Nevus;
Aphthous stomatitis.*
All from the following are characteristically for the secondary syphilis, except for:
Affect of palms and soles;
Presence of the acute inflammatory phenomena;*
Absence of the acute inflammatory phenomena;
Polyadenitis;
Remnants of the hard chancre.
Most syphilides are resolved without treatmen in:
1-2 month;
2-3 month;*
3-4 month;
4-5 month;
5-6 months.
It is necessary to differentiate the syphilitic papulae from:
Lichen ruber planus;*
Psoriasis;*
Scrofuloderma;
Scabies;*
Herpes simplex.
What from the following are the varieties of papular syphilids?
“Crown of Venus”;*
“Necklace of Venus”;
Lenticular syphilide;*
Moist syphilide;*
Nummular syphilide.*
The lesions in the case of secondary recurrent syphilis usually are:
Unabundant;*
Abundant;
Symmetric;
Have colouring of acute inflammation;
Asymmetrical.*
It is characteristically for a erythematous, syphilitic tonsillitis:
Discrete boundary of erythema in the pharynx;*
Undiscrete boundary of erythema in the pharynx;
Oedematic tissues of amygdalae;
Severe pain;
High temperature.
What from the following are the varieties of pustular syphilid?
Acne syphilitica;*
Varicella syphilitica;*
Impetigo syphilitica;*
Furuncle syphilitica;
Rupia syphilitica.*
The secondary syphilids have all of signs except for:
High quality;
Presence of signs of acute inflammation;*
Polymorphism;
They quickly disappear under action of treatment;
Absence of the subjective feelings.
Such sings belong to clinical manifestation of secondary early syphilis:
Bullae;
Roseola;*
Hard chancre or its remnants;*
Papulae;*
Condylomata lata.
What clinical signs are characteristically for syphilitic roseola?
Pink;*
Itchy;
Does not peel;*
Does not confluence;*
Painless.*
What signs of the secondary period of syphilis are the most contagious?
Papulae of palms and soles;
Erosive papulae;*
Roseola;
Papulae of the mucous membranes;*
Condylomata lata.*
A 38 years old patient does not have any complaints. He revealed as a donor with positive Wassermann's reaction. Physical examination: there are depigmented round maculae of the identical sizes on the skin of the back and neck. On the mucous membranes of tongue there are 2 whitish papulae and the size of 5-7 mm, sharply demarcated from surrounding mucous. During a meal there are slightly unpleasant subjective sensations. Pharynx is hyperemic. There are no pathological elements on genitals. A size of lymphatic nodes of the neck is of the pea, they are painless and dense. What is your conjectural diagnosis?
Lichen ruber planus;
Pemphigus vulgaris;
Erythema exudativum multiforme;
Recurrent secondary syphilis;*
Toxicodermia.
A 25 years old patient complains of albication of lateral surfaces of tongue and mucous membranes of lips near the both angles of the mouth. It appeared without any apparent reason 10 days ago together with occurring of hoarse voice. Objectively: there are plural papular rashes on the skin of face and neck. Submaxillary and neck lymphatic nodes are enlarged, dense and painless. On the mucous membranes of lateral surfaces of the tongue and on the mucous membranes of lips, near the angles of the mouth, are revealed plaques of greyish-white color rise over the surface of mucous membranes and resemble macerated mucous membranes. They are painless during scraping and erosions of colour of red meat are appeared. Make the diagnose:
Candidiasis cheilitis of the mouth angles;
Recurrent secondary syphilis;*
Leukoplakia;
Psoriasis;
Lichen ruber planus.
What organs except skin and mucous membranes can be affected in the secondary period of syphilis?
Bones;
Central nervous system;
Sense-organs;
Hemopoietic organs;
All listed is correctly.*
The basic appearance of the secondary period of syphilis is:
Hard chancre;
Affection of the urogenital system;
Generalized rash at the skin and mucous membranes;*
Regional lymphadenitis;
Regional lymphangitis.
Secondary syphilids are characterized by:
Benign course;*
Absence of feverish syndrome;*
Absence of the acute inflammatory phenomena;*
Absence of the subjective feelings;*
Resistance to local treatment.
It is necessary to differentiate condylomata lata in the secondary period of syphilis with:
Haemorrhoids;*
Condylomata acuminatum;*
Pemphigus vegetans;*
Psoriasis;
Scabies.
What diseases is it necessary to differentiate secondary early syphilis with?
Toxicoderma;*
Allergic dermatitis;*
Jibert’s pityriasis;*
Pyodermia;
Pemphigus.
What diseases is it necessary to differentiate second recurrent syphilis with?
Pyodermia;*
Atopic dermatitis;
Psoriasis;*
Lichen ruber planus;*
Molluscum contagiosum.
Which elements of rash can appear in the secondary period of syphilis?
Papulae*
Lichenification;
Spots;*
Tubercles;
Pustules.*
Syphilitic alopecia must be differentiated with:
Alopecia areata;*
Microsporosis;*
Trichophytoses;*
Psoriasis;
Seborrhoea.
Syphilitic leucoderma must be differentiated with:
Pityriasis versicolor;*
Vitiligo;*
Scabies;
Herpes;
Candidiasis.
Pinkus's sign it is:
Syphilitic alopecia;
Unequal (ladder-shaped) length of cilia;*
Hoarseness of voice;
Affection of tongue;
Disturbance of sight.
LESSON 21
Tertiary period of syphilis. Congenital syphilis.
Tertiary period of syphilis lasts:
9-12 weeks;
5-9 months;
1-2 years;
7 years;
25 years.*
Tertiary tubercular syphilids have to be differentiated from the followings dermatosis:
Lupus vulgaris;*
Lupus erythematosus;
Lepra;*
Eczema;
Psoriasis.
The following forms of tubercular syphilids are distinguished:
Grouped;*
Linearis;
Dwarf;*
Stellate;
Serpiginous.*
Syphilitic gummata on the skin are differentiated from:
Scrofuloderma;*
Trophic ulcers;*
Chronic ulcerous pyoderma;*
Psoriasis;
Cancer ulcer.*
Involution of syphilitic gummata can occur such ways:
Resolution without trace;
Cicatrical atrophy;*
Fibrous tissue;*
Ulceration;*
Erosion.
Scars in tertiary period of syphilis look like:
Indrawn;*
Flat;
Atrophic;
Stellate;*
Superficial.
Tertiary period of syphilis is characterized:
Limited focus of affection;*
Tendency to disintegration;*
Formation of scars in place of involution of tertiary syphilids;*
Bright colouring of syphilids;
Frequent finding of T. pallidum in syphilids.
What are the pathognomonic signs of late congenital syphilis?
Tubercles of skin of trunk;
Labyrinthine deafness;*
Gummata of skin of trunk;
Hutchinson's teeth;*
Tobacco-pouch molars.
What are the pathognomonic signs of early congenital syphilis?
Periostitis;
Grade III osteochondritis;*
Osteomyelitis;
Arthritis;
Osteoperiostitis.
What are the pathognomonic signs of early congenital syphilis?
Papular rash of skin of trunk;
Syphilitic pemphigus;*
Syphilitic alopecia;
Syphilitic erythema;
Gummata of skin of shins.
X-ray examination of the child’s skeleton at the age of more then 1 year of his life with the purpose of inspection on early congenital syphilis should be:
It is advisable to make;
It is does not advisable to make;*
To discretion of doctor;
To discretion of parents;
Depending on the results of serum reactions.
Osteochondritis at early congenital syphilis occur:
In 2-3 months of life;
In 4-5 month of life;
In 5-6 months of intrauterine life;*
In 6-7 month of life;
After the year of life.
What are the pathognomonic signs of early congenital syphilis?
Macular lesions on the skins of trunk;
Papular lesions on the skins of trunk;
Syphilitic rhinitis;*
Syphilitic alopecia;
Remnants of the hard chancre.
What are the pathognomonic signs of early congenital syphilis?
Conjunctivitis;
Chorioretinitis;*
Iritis;
Keratitis;
Blepharitis.
What are the pathognomonic signs of late congenital syphilis?
Frontal bossing of the skull;
Barrel-shaped teeth;*
Hutchinson's teeth;*
Gaps between the incisors;
Gashe’s diastema.
Early congenital syphilis is diagnosed in children at the age of:
1 year;
1 to 4 years;*
2 to 5 years;
3 to 6 years;
6 to 7 years.
Late congenital syphilis is manifested usually at the age of:
3 to 4 years;
4 to 17 years;*
17 to 20 years;
20 to 30 years;
30 to 40 years.
What are the pathognomonic signs of late congenital syphilis?
Gummata of hard palate;
Tubercles of skin of trunk;
Roseola of skin of trunk;
Interstitial keratitis;*
Syphilitic pemphigus.
What are the pathognomonic signs of early congenital syphilis?
Diffuse papular infiltration;*
Papular elements;
Macular elements;
Diffuse alopecia;
Specific paronychia.
In what age is most often manifested osteochondritis in patients with early congenital syphilis?
In the first 3 months of life;*
In the first 4-5 months of life;
In the first 6-7 months of life;
In the first 8-9 months of life;
In the first 10-12 months of life.
Which signs do not belong to “Hutchinson's triad”?
Syphilitic pemphigus;*
Barrel-shaped teeth;
Specific labyrinthitis;
Sabre shins;*
Interstitial keratitis.
All of the following signs on skin and mucous membrane can be in patients with early congenital syphilis except for:
Diffuse papular infiltration of skin;
Papular rashes;
Specific rhinitis;
Follicular hyperkeratosis;*
Syphilitic pemphigus.
Which manifestation on skin can be observed in patients with early congenital syphilis?
Hives;
Gummata;
Tubercles;
Diffuse infiltration;*
Angioneurotic oedema.
What pathognomonic changes of bones can be in patients with early congenital syphilis?
Grade II or III syphilitic osteochondritis;*
Deforming arthritises;
Osteoporosis;
Osteosclerosis;
Osteochondrosis.
X-ray examination of the child’s long tubular bones at the age no later than the first three months of life with the purpose of inspection on early congenital syphilis should be:
It is advisable to make;*
It is does not advisable to make;
To discretion of doctor;
To discretion of parents.
The tertiary period of syphilis is diagnosed by the followings methods of examination:
Clinical blood test;
Clinical analysis of urine;
Serologic reactions;*
IFT, TPI;*
Fluorography;*
Fibrogastroscopy.
The general signs of tertiary period of syphilis are (point erroneous answers):
Basic elements: tubercle or gumma;
The amount of rash is small;
Elements of rash are painless;
A rash has tendency to resolution;*
Plenty of treponemas locate on the surface of elements;*
Rash is not very contagious.
What complaints are characteristic for tertiary period of syphilis?
Presence of rash;*
Itch;
Burning;
Fall of hairs;
Hoarseness of voice;
Sickly bubo.
What tertiary syphilids is characterized general signs by?
Dense consistency;*
Copper-coloured color;*
Itching rash;
Sickly elements;
Painless rash;*
Soft consistency.
What possible consequences of gummatous syphilids can be (point erroneous answers)?
Resolution without leaving a trace;*
Atrophic scars;
Disintegration, ulcer, scar;
Fibrosis (sclerose);
Petrifaction;
Malignant degeneration.*
With what diseases it is necessary to differentiate tertiary syphilids?
Tuberculosis of skin;*
Epithelioma;*
Carcinoma;*
Pyococcal ecthyma;*
Acne vulgaris;
Leishmaniasis.*
What morphological elements of rash are characteristic for tertiary period of syphilis?
Tubercles;*
Spots;
Papulae;
Chancre;
Gumma;*
Vesicles.
Point the variety of tubercular (І) and gummatous (II) syphilids from the following:
Grouped;
Gummatous infiltration;
Syphilid, that coalesce into a single patch;
Single;
Periarticular nodules;
Serpiginous syphilid;
Fourniet’s erythema;
Verrucous;
Dwarfish.
I – 1), 3), 6), 9).
II – 2), 4), 5).
What characteristic have scars in the tertiary period of syphilis?
Retracted;*
Stellate;*
Mosaic;*
Superficial;
Thickened;
Relapses can be on scars;
Smooth.
LESSON 22
Laboratory diagnostics of venereal diseases. Treatment of syphilis.
Syphilis is caused by:
Blue-pus bacillus;
Streptococcus;
Staphylococcus;
Escherichia coli;
Treponema pallidum.*
The basic signs of syphilis are:
Chancroid;
Hard chancre;*
Polyadenitis;*
Regional scleradenitis;*
Negative serum reactions;
Positive serum reactions;*
Syphilids.*
The most reliable method of diagnostics of tertiary syphilis is:
Examination of material taken from the bottom of ulcer;
Examination of neurolymph;
Blood examination (Wassermann's reaction);
T. pallidum immobilization test;*
Precipitin reactions.
The most specific serological reaction for syphilis is:
The fluorescence test;
T. pallidum immobilization test;*
Wassermann's reaction with the treponemal antigen;
Wassermann's reaction with the cardiolipin antigen;
Microreaction.
Who must be inspected (serological test of blood) in case of suspicion of congenial syphilis?
Father;
Mother;*
Child;*
Brothers and sisters of child;
Mother’s relatives;
Father’s relatives.
Select multiplicity and terms of examination of pregnant for syphilis (Wassermann's reaction):
Examination is carried out not less than twice, during the first and second periods of pregnancy;*
In each 2 monthes;
Single examination before childbirth;*
Single examination in the II trimester of pregnancy.
A 22 years old woman complains of appearance of ulcer on a large vulvar lips. The subjective feelings are absent. In anamnesis – there was a sexual contact with a little known man month ago. What examinations must be done first of all for determination of diagnosis?
Examination for T. pallidum;*
Examination for gonococci;
Examination for trichomonads;
Examination for fungi;
Examination for Chlamydia.
The serological reactions of pregnant in the first and second half of pregnancy is conducted in:
Skin and venereal dispensary;
Maternity ward;
Gynaecological department;
Maternity welfare centre;*
Out-patients' clinic.
After contact with a syphilitic patient Wassermann's reaction becomes positive in:
1 week;
2 weeks;
4-5 weeks;
6-8 weeks;*
9-10 weeks.
After appearance the hard chancre Wassermann's reaction becomes positive in:
1 week;
2 weeks;
3-4 weeks;*
5-6 weeks;
8-9 weeks.
What serological reactions for syphilis can be positive in the case of the primary seronegative period of syphilis?
IFT;*
Wassermann's reaction;
IFT, TPI;
TPI;
Classical, serological reactions.
What method of diagnosing is used in everyday practice for the reveal of T. pallidum?
Cultivation on nutrient mediums;
Staining by the Romanovsky-Giemsa;
Staining by methylene blue;
Examination of native preparations in dark field illumination of the microscope;*
Silvering by the Morozov.
After an infection with syphilis, usually, the Wassermann's reaction becomes positive in:
3-4 weeks;
6-8 weeks;*
9-12 weeks;
3-4 months;
2-4 years.
What physiological secretion and excreta can be contagious in syphilis?
Saliva;*
Sweat;
Urine;
Milk;*
Sperm.*
What serological reactions for syphilis can be positive in the case of the primary seropositive period of syphilis?
Express-method;*
IFT;*
Wassermann's reaction;*
TPI;
Classical, serological reactions.*
What serological reactions can be positive in the case of secondary recurrent syphilis?
Express-method;*
IFT;*
Wassermann's reaction;*
TPI;*
IFT, TPI.*
The positive results of the followings tests are needed for diagnosis of primary seropositive period of syphilis with typical clinical picture:
IFT;
TPI;
Microreaction;
Wassermann's reaction.*
What serological reactions will be positive in the case of secondary early syphilis?
Express-method;*
IFT;*
Wassermann's reaction;*
IFT, TPI;*
All of reactions are negative.
The diagnosis of syphilis always is based on signs:
Clinical manifestation;
Information of anamnesis;
Laboratory examinations;
All above-listed.*
The laboratory methods of diagnostics of syphilis are distinguished:
Detection of causative agent of disease in lesions;
Serological reactions for syphilis;
Microprecipitation test;
Immunofluorescence test;
T. pallidum immobilization test;
All above-listed.*
The T. pallidum immobilization test is used with a purpose for:
Making the diagnosis of primary syphilis;
Making the diagnosis of early syphilis;
Making the diagnosis of latent syphilis;*
Appraising the efficacy of antisyphilitic therapy;
Taking off the record completely cured patient.
What reaction is used for express-diagnostics of syphilis?
RW;
Microprecipitation test;*
IFT;
TPI.
Criteria of cure of syphilis is considered:
Quality of the conducted treatment;
Data of clinical inspection (skin, mucous membranes, internal organs, nervous system, organs of sense);
Data of laboratory examinations (CSR, IFT, TPI);
All above-listed.*
Wassermann's reaction is based on:
Hematolysis;*
Yellow-green fluorescence of T. pallidum;
Recognition of false positive non-specific results of standard serum reactions.
The basic specific antisyphilitic medicines are considered all from following, except for:
Penicillin;
Bicillin;
Retarpen;
Extencilline;
Tetracycline.*
Nonspecific medicines for treatment of syphilis are considered:
Immune preparations (Thymogen, Thymalin, Laferon, Methyluracil);*
The group of stimulating preparations (Pyrorenal, Aloe, FIBS, Plasmol, extract of placenta and others like that);*
Vitamin therapy;*
The group of reserve.
What can be taken excretions for laboratory examination from?
Lesions;*
Aspirate of a regional lymph node;*
Serum;*
Neurolymph;*
Scales from papular shyphilids.
Criteria of cure of syphilis are:
Patients who have completed antisyphilitic treatment are kept under dispensary care;*
The patient visits the physician once in three months during the first two years;*
The patient visits the physician once in six months during the third year for medical examination and serological tests and then they are taken off the record;*
During 3 years;*
During 5 years.
Basic medicines for treatment of patients with syphilis are:
Preparations of penicillin;*
Preparations of tetracycline;
Preparations of erythromycin;
Macrolids.
What is characteristic for latent early syphilis with sharply positive Wassermann's reaction:
Low titre of reaginic antibodies;
High titre of reaginic antibodies;*
The titre of reaginic antibodies does not have any value.
Such complications can be during the treatment of syphilis with penicillin except for:
Anaphylactic shock;
Toxicodermia;
Hives;
Candidiasis;
Alopecia.*
The second recurrent syphilis is suspected in a patient. CSR are weakly positive. It is necessary to apply the followings reactions:
Kolmer's test;
The fluorescence test;
T. pallidum immobilization test;*
Microreaction;
Wassermann's reaction with the cardiolipin antigen.
Patients with a gonorrhoea with the unrevealed source of infection, but having a permanent address and work:
Preventive antisyphilitic treatment is conducted;
Preventive antisyphilitic treatment is not conducted;
Clinical and serological control is carried out during 3 months;*
Clinical and serological control is carried out during 6 months;
Right 2) and 3).
LESSON 23
Gonorrhoeal and non-gonorrhoeal urethritis in males. Treatment and prevention.
Choose the causative agen of diseases which are transmitted by sexual contact:
Syphilis; a) Chlamydia trachomatis;
Gonorrhoea; b) Trichomonas vaginalis;
Chlamydias; c) Gonococcus;
HIV infection; d) Treponema pallidum;
Trichomoniasis; е) Human immunodeficiency virus.
*(1d, 2с, 3а, 4е, 5b).
Social factors which promote to dissemination of venereal diseases:
Unemployment;*
Prostitution;*
Drug addiction;*
Alcoholism;*
Doing sports;
Tourism;
Business trip.
What complaints has a patient with acute anterior gonorrhoeal urethritis?
An abundance discharge from an urethra;*
A scanty discharge from an urethra;
There is no discharge from an urethraare;
Cutting pain at the beginning of urination;*
Cutting pain at the end of urination;
The external urethral opening in case of acute anterior urethritis is:
Swollen and hyperemic;*
Cyanotic;*
Everted.*
Results of the two-glass test in acute anterior urethritis:
The first portion of urine is cloudy, second - transparent;*
The first and second portions of urine are cloudy;
Two portions of urine with flakes;
The first portion of urine with flakes, second, is transparent;
What laboratory examinations are conducted in a gonorrhoea:
Virological;
Bacterioscopic;*
Serological;
Bacteriological;*
Immunofluorescence method.
What medicines inexpedient to prescribe for pregnant patients with a gonorrhoea:
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