Syphillis

Question 1

What is the causative organism in syphilis?

Answer 1

Treponema pallidum

Question 2

What are the features of primary syphilis?

Answer 2

Chancre (painless ulcer at the site of TP entry)

Lymphadenopathy

Question 3

What are the features of secondary syphilis?

Answer 3

Symmetrical non-itchy maculopapular rash particularly on the palms of the hands and soles of the feet
Condylomas

Question 4

What are the features of tertiary syphilis?

Answer 4

Neurosyphilis
Cardiosyphilis
Gumma

Question 5

What are the investigations for syphilis?

Answer 5

Visualise TP under dark field microscopy
Enzyme immunoassay looking for IgM and IgG as a screening test (VDRL)
Further tests include TPHA or TPPA

Question 6

What is the treatment of choice for syphilis?

Answer 6

Penicillin

Question 7

What is meant by the Jarisch-Herxheimer reaction?

Answer 7

Within the first 24 hours following treatment
Release of pro-inflammatory cytokines following death of spirochetes
Fever, malaise and exacerbation of symptoms
In pregnancy, can trigger preterm labour

Question 8

State one false-positive result for the VDRL test

Answer 8

Pregnancy, TB, SLE

Question 9

State one false-positive result for the TPHA test

Answer 9

Yaws