Neuropsychiatry Flashcards
1
Q
What does the common presentations Neurosyphilis?
A
Memory impairment Personality changes Neuro signs and symptoms Aggression Delirium Hallucinations Mania Delusions Dysphoria
2
Q
When do you perform a lumbar puncture for neurosyphilis?
A
- Positive blood serology & psychiatric/neurological symptoms
- Never been treated
3
Q
What are the CSF finding in neurosyphilis?
A
- Positive serological testing
- Raised protein
- Raised WCC
- Raised IgG-index
- Decreased CSF-glucose
4
Q
When should follow-up LPs be performed?
A
- 6 months
- 12 months
- 24 months
5
Q
When does CSF protein and VDRL return to normal in neurosyphilis?
A
After 2 years
6
Q
What are the advantages of Non-treponemol test?
A
(VDRL and RPR)
- cheap
- screening test
- gives titre
- monitor treatment
- dectect reinfection
7
Q
What are the disadvantages of Non-treponemol test?
A
(VDRL and RPR)
- non specific
- less sensitive for primary and latent syphilis
- false positives and negatives
8
Q
What are the advantages of Treponemol test?
A
(TPHA and FTA ABs)
- remains positive regardless of treatment
- specific to T.pallidum
- low risk for false positives and negatives
9
Q
What are the disadvantages of Treponemol test?
A
(TPHA and FTA ABs)
- expensive
- no titre
- remains positive
- not sensitive to reinfection
10
Q
What is the management of neurosyphilis?
A
Pen G - 5 million units IV 6 hourly x14 days
OR
Procain Penicillin - 2.4 million units IM once daily PLUS Probenicid 500mg 6 hourly x14 days
