Nokea
An 18-year-old patient has enlarged inguinal lymph nodes, they are painless, thickened on palpation. In the area of genital mucous membrane there is a small-sized ulcer with thickened edges and "laquer"bottom of greyish colour. What is the most probable diagnosis?
Correct Answer: A
Rationale: The correct answer is A: Syphilis. The presentation of painless inguinal lymph nodes, along with a small-sized ulcer with thickened edges and a "laquer" bottom of greyish color on the genital mucous membrane, is classic for primary syphilis. The painless nature of the lymph nodes and the specific characteristics of the ulcer are key features of syphilitic infection. Primary syphilis is caused by the bacterium Treponema pallidum and typically presents with a single, painless ulcer known as a chancre. It is important to consider syphilis in the differential diagnosis of genital ulcers.
Summary of other choices:
B: Tuberculosis - Unlikely, as tuberculosis typically presents with pulmonary symptoms and does not cause genital ulcers.
C: Lepra - Unlikely, as leprosy does not typically present with painless inguinal lymph nodes and the specific ulcer characteristics described.
D: Trophic ulcer - Unlikely