Syphilis

Question 0

Multiple chancre may form if?

Answer 0

HIV positive

Question 1

Chancre usually forms where/when?

Answer 1

At site of entrance within one week to three months of inoculation

Question 2

Chancroid versus syphilis Versus herpes simplex?

Answer 2

Painful, exudative, with ragged borders and a necrotic base

not erythematous, painless, with rolled borders and clean base

Painful, group vesicles on erythematous base that eventually ulcerate

Question 4

Late stage syphilis?

Answer 4

Proliferative, obliterative endarteritis

1. Granulomas with coagulated center called gummas
2. In aorta, vasa vasorum involved, leading to necrosis and aneurysmal dilation
3. Neuro: Neurosyphilis, tabes dorsalis, Argyll Robertson pupil

Question 5

Tabes dorsalis?

Answer 5

Demyelination of the posterior column with wide based gait and loss of proprioception

Question 6

Test for syphilis?

Answer 6

1. Fluorescent treponemal antibody absorption (FTA-ABS) or microhemagglutination assay
2. Dark field microscopy
3. VDRL

Question 7

Treatment of Syphilis?

Answer 7

1. Infection for <1 year: single intramuscular injection of penicillin
2. For patients with latent syphilis/cardiac symptoms: three weekly injections penicillin G
3. Neurosyphilis or HIV-infected: IV penicillin for 10 to 14 days

Question 8

Ways to measure treatment effectiveness?

Answer 8

RPR: Fourfold drop in titers within three months and negative titer after one year

FTA – ABS : positive for life

Question 9

Common complication after treatment?

Answer 9

Reactive arthritis

Question 10

If Allergic to penicillin?

Answer 10

Desensitize and then give penicillin

Question 11

All HIV-infected patients with syphilis should undergo?

Answer 11

LP

Question 14

Second stage of syphilis?

Answer 14

1. Pruritic, maculopapular diffuse rash that involves the palms and soles
2. Condyloma lata
3. Patchy hair loss
4. Mucous patches