WBR0856
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| Author | [[PageAuthor::Mohamed Moubarak, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 3 |
| Main Category | MainCategory::Primary Care Office |
| Sub Category | SubCategory::Infectious Disease |
| Prompt | [[Prompt::A 26 year- old male comes to your office complaining of multiple vesicles on his penis. He noticed these vesicles 2 days ago when he had body aches, and fever controlled by Tylenol. The patient has a single partner who never had the same symptoms before. On examination, patient has normal vital signs, and enlarged adenopathy in the inguinal area. What is the next step in managing this patient?]] |
| Answer A | AnswerA::Topical clindamycin |
| Answer A Explanation | [[AnswerAExp::Incorrect
It can be used only after ulceration of the vesicles to prevent bacterial super infection]] |
| Answer B | AnswerB::Famciclovir |
| Answer B Explanation | [[AnswerBExp::Correct
Acyclovir, valacyclovir, or famciclovir for 7-10 days used to reduce symptoms and decrease the risk of transmission to a partner]] |
| Answer C | AnswerC::Tzank prep |
| Answer C Explanation | [[AnswerCExp::Incorrect
It is used as the best initial diagnostic test only when the roofs come off the vesicles and the lesion become an ulcer]] |
| Answer D | AnswerD::Viral culture |
| Answer D Explanation | [[AnswerDExp::Incorrect
Although viral culture is the most accurate test for herpes, it is not necessary when there is a clear vesicle, and we should proceed to the treatment]] |
| Answer E | AnswerE::Ganciclovir |
| Answer E Explanation | [[AnswerEExp::Incorrect
Ganciclovir is the best antiviral therapy for cytomegalovirus (CMV) infection]] |
| Right Answer | RightAnswer::B |
| Explanation | [[Explanation::Genital herpes is a common STD, and most people with genital herpes infection do not know they have it. Patient can get genital herpes even if the partner shows no signs of the infection. When there are clear vesicular lesions, there is no need to do a specific diagnostic test for herpes. The best treatment in genital herpes is acyclovir, valacyclovir, or famciclovir for 7-10 days. There is no cure for herpes, but treatment is available to reduce symptoms and decrease the risk of transmission to a partner. Educational Objective: |
| Approved | Approved::No |
| Keyword | [[WBRKeyword::Herpes simplex]] |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |