Syphilis

Question 1

Pathogen cause of syphilis

Answer 1

Treponema Pallidum

Question 2

Risk populations for syphilis

Answer 2

Homosexual men, HIV positive people, sexual contact with person in endemic area

Question 3

Presentation of primary syphilis

Answer 3

Painless ulcer, lymphadenopathy

Question 4

Presentation of secondary syphilis

Answer 4

Mucosal lesions, rash, arthralgia, lymphadenopathy, meningitis, cranial nerve palsies, iritis, uveitis

Question 5

Presentation of latent syphilis

Answer 5

Asymptomatic, detectable by abnormal serological test results

Question 6

Presentation of tertiary syphilis

Answer 6

CVS - aortic aneurysm, regurgitation, CAD, gummatous syphilis
Neurosyphilis - tabes dorsalis, meningovascular, general paresis

Question 7

Stages of syphilis

Answer 7

Early = within 2 years - primary, secondary, early latent
Late = after 2 years - late latent / tertiary

Question 8

When does primary syphilis occur after exposure

Answer 8

Anything from 9-90 days

Question 9

Diagnosis of syphilis

Answer 9

Dark field microscopy
Antigen based assays (EIAs)
Nontreponemal (non-specific) - VDRL/RPR
Treponemal (specific) - TPPA/TPHA

Question 10

What does a negative VDRL mean

Answer 10

Very early infection
Treated old infection
Not infectious
Used for monitoring treatment and disease activity

Question 11

Management of syphilis

Answer 11

IM penicillin
Early = benzathine penicillin 2.4 mu - 1 dose
Late = benzathine penicillin 2.4 mu - 3 doses
IF allergy then give doxycycline

Question 12

What happens if syphilis is left untreated

Answer 12

1.3 develop late complications

Question 13

Does serology ever turn negative

Answer 13

No - syphilis antibody and TPPA remain positive for life