AAAAA
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HELP
Which one of the following is the most common cause of asymptomatic vaginal ulcaeration or erosion?
1. tampons
2. TEN toxic epidermal necrolysis
3. herpes genitalis
4. vaginal carcinoma
5. bacterial vaginosis
Thanks
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| AAAAA
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1 or 5 ??
Help !
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| Rasul
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Asymptomatic-I guess 5. Cannot explain detailed...
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| AAAAA
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May be 1
Any help ?????
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| AAAAA
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Foreign objects are the number one cause of vaginal ulceration and erosion (I am not talking about cervix but vagina)
So tampons would be the No. 1 answer for asymptomatic ulceation and erosion.
Tampon are basically a foreign object but a MUST for woman and the most common cause of asymptomatic ulceration and erosion in the vainal wall
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| determine
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1
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| AAAAA
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Determine,
Do you have all the SAFE questions download ?
Can you PM me ????
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| determine
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I already sent the ones that I have, check your e mail pls.
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| yasmeen
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I THINK 1 IS RIGHT HERPES IS VERY PAINFUL.
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| Valiant
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This q gave such a HA....I'll go with 1 as well
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| msyamp
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why cant it be bacterial vaginosis??
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| yasmeen
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BACTERIAL VAGINOSIS DOSON,T CAUSE ULCERATION.INFACT EVEN ITCING IS NOT THERE ONLY COMPLAIN IS ASYMPTOMATIC VAGINAL DISCHARGE
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| yasmeen
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BACTERIAL VAGINOSIS DOESN,T CAUSE ULCERATION.INFACT EVEN ITCING IS NOT THERE ONLY COMPLAIN IS ASYMPTOMATIC VAGINAL DISCHARGE
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| wyvern
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 - fishy odour
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| ruhighazi
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Usual causes of genital ulcers are HSV, Treponema(primary syphilis) & Hameophilus ducreyi(Chancroid).
Atypical or clinically trivial ulcers may be more common manifestations of genital herpes than classic vesiculopustular lesions.
So I think the answer is HSV
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| drk1980
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd...
above is reason for debate wth respect to choice 1......also do all women across various cultures use tampons??
Yasmeen, its true tht bact vaginosis commonly presents wth vag discharge alone...but one wud think vag discharge is a symptom(not aymptomatic i mean!!)
i think HSV seems likely above all...will go wth RUHIGHAZI on this one.
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| yasmeen
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drk u r choosing hsv but giving evidence in the favour of tempons as most common cause of asymptomatic vaginal ulcer.neverthless hsv ulcerations r very painful atleast what pts suffering i ve examined myself and thats what textbooks say
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| ruhighazi
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yasmeen, my reference was Harrison chapter 115
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| drk1980
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Yasmeen, the following quote kinda stood out frm the article "Clinically apparent vaginal ulceration due to tampon usage is rare" ...and IMO, the Q above is not referring to micro-ulcers, right?
and besides, isnt it more likely that women of all cultures hv intercourse(at risk for STDs), rather than use tampons?
open to discussion.
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| yasmeen
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 BUT HSV ULCER WITHOUT PAIN IS ALSO VERY RARE .ULCERATION DUE TO TEMPON USE ISN,T VERY UNCOMMON AND IT DOES CAUSE PAINLESS VAGINAL ULCER .AND I THINK KEY WORD HERE IS PAINLESS.PAIN IS THE MOST IMP SYMPTOM TO DIFFERENTIATE HSV FROM OTHER GENITAL ULCERS.
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| achilles
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i'll go with yasmeen on this one. if its herpes ulcer, its usually painful.
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| AAAAA
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drk1980,
There is a cardinal sin here !!!
"Do all women across culture use tampoons"
The question is irrevelant here !
You are taking USMLE and USMLE does not care about other coutnries' culture.
Welcome to USMLE,
Do you know United States is the
only country in the world that
refuse to use international unit !
United States still uses gallon,
miles, inches, feet, lbs and not
litres, meters, cm, mmol. etc.
What is the cholesterol level 6.4?
OMG, In America it is 100 LDL
But throughout the world , it is
5.4 ! Welcome to USMLE !!
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| AAAAA
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You have to know all the different fungal infection in different geographic area in US and also bioterrorism in US !!!!
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| drk1980
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i was referring actually to the melting pot of various cultures tht make up America. but ur right, tht really opened my eyes AAAAA!...literally
anyhow, if the correct ans is already wth u, ths dsnt need furthr discussion.
however, if we r tryin to get there via logical reasoning, then plz bear wth me.
i tried to look up the incidence of tampon use-related ulcers but unfortunately thr doesnt seem to be much data on tht(or tht i cudnt find it).
As for the most common cause of genital ulcer disease, HSV2 has been a major cause of concern giving rise to the need for awareness. I read abt this on the sites of Medscape, WHO and US Dept of Health and Human Services. Incase anyones interested..(Note: they r long and boring)
http://www.medscape.com/viewarticle/458822_print
http://www.scielosp.org/scielo.php?pid=S0042-9686...
http://hab.hrsa.gov/publications/womencare05/WG05...
Abt the asymptomatic aspect....thts got me in a double mind as well...but this is wht i read in the WHO report, wch is talking abt the concern of HSV2 ulcers being a portal of entry for HIV.
"HSV-2 causes ulcers and micro-ulcerations, which are often asymptomatic and thus unrecognized;..."
So i guess, wht iam trying to reach at here is, a proper statistical reason for the right answer to this Q...
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| AAAAA
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This question came from a pool of Canadian Medial examination.
Canadian examination has much more Canadian healthcare system questions than USMLE.
Actually USMLE is very fair and I have not encountered any major Medicaid, Medicare and Department of Health, CDC administrative questions at all.
USMLE actually provides a lot of clues in a question but you are taking the exam to prepare you to practice in US.
MCC asks a lot of common sense questions so tampon is the correct answer !
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