Which STD can present with the characteristic symptom of a 'chancre' at the site of infection?

MP NHM CHO-2024 (Shift-2)

Obstetrics and Midwifery Nursing

Easy

Appeared in: MP NHM CHO-2024 (Shift-2)

Explanation

Syphilis is a bacterial infection caused by the spirochete Treponema pallidum.
The primary stage of syphilis is classically defined by the appearance of a chancre at the site of inoculation.
A chancre is typically a single, firm, round, and painless ulcer with indurated (hardened) borders.
This lesion appears approximately 3 weeks after infection and will heal spontaneously, but the disease progresses to secondary syphilis if untreated.

Option A: Gonorrhea, caused by Neisseria gonorrhoeae, typically presents with purulent discharge (from the urethra or cervix) and dysuria (painful urination), not a chancre.
Option C: Chlamydia, caused by Chlamydia trachomatis, is often asymptomatic. When symptoms do occur, they typically include mucopurulent discharge and painful urination. It does not cause a chancre.
Option D: HIV is a viral infection that compromises the immune system. Acute HIV infection may present with non-specific, flu-like symptoms such as fever, rash, and sore throat. A chancre is not a characteristic sign of HIV.

Visual 1: Image: A close-up photograph of a classic syphilitic chancre, showing its distinct round shape, clean base, and raised, firm border. This helps learners visually anchor the term 'chancre'.
Visual 2: Chart: A comparative table illustrating the key differences (pain, number, base, border) between genital ulcers caused by syphilis (chancre), herpes simplex virus, and chancroid (soft chancre).

Clinical Relevance

Nursing practice connection: Knowing Identification of the characteristic lesion of primary syphilis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Early recognition of a chancre is critical for nursing assessment. Prompt diagnosis allows for timely treatment with penicillin, which can cure the infection and prevent its progression to the more dangerous secondary and tertiary stages.
Patient education is a key nursing role. Since the chancre is painless and heals on its own, patients may not seek treatment. Nurses must explain the importance of completing treatment and notifying partners to prevent further spread.
A thorough sexual health history and physical assessment are essential. A chancre can appear on any area exposed to contact, including the genitals, mouth, or anus.

How to Approach the Question

First, identify the key clinical term in the question stem, which is 'chancre'.
This is a factual recall question. Your task is to connect this specific clinical sign to the correct disease.
Systematically review the classic presentations of the sexually transmitted diseases listed in the options.
Recall that Gonorrhea and Chlamydia primarily cause discharge, while HIV causes systemic viral symptoms.
Associate the term 'chancre'—a specific type of painless, indurated ulcer—with its classic cause, which is primary syphilis.
Select Syphilis as the correct answer based on this direct association.

Concept Tested & Keywords

Concept Tested: Identification of the characteristic lesion of primary syphilis.
Stem keywords: STD, chancre, symptom, site of infection
Lead-in keywords: Which
Negative lead-in flag: false

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