neurosyphilis

Question 1

can occur at anybstage of syphilis even primary stage.

Answer 1

CNS infection.

upto 100 % of pxs w sy may decelop cns infectiom. only 80% is spontaneously cleared by the immune system. thsi ex why most persons w cns inv have no symptoms.

Question 2

used to confirm the dx of cns infection by t pallidum

Answer 2

CSF pleocytosis

positive CSF-VDRL

Question 3

in pxs w negative CSF VDRL but pleocytosis this test can be performed

Answer 3

FTA test.

can comb w flow cytometry to look for B cells will allow confirmation lr exclusion of neurosyphilis in most pxs w csf pleocytosis.

Question 4

the likelihood of having cns infection is 10 fold higher in persons w

Answer 4

RPR OF 1:32 or greater.

Question 5

test recommended in all pxs w sy w any neurologic auditory or ophthalmic signs or symptoms poss resulting from sy. independent of HIV status

Answer 5

CSF evaluation.

Question 6

2 factors pedicting the likelihood of cns infection are

Answer 6

rpr of 1:32 or more.

CD4 count of 350 cells/uL. or less.

Question 7

predicts clearing of cns infection

Answer 7

fall in serum rpr.

so a reapeat lumbar puncture after tx is not required in HIV negative or HIV positice pxs adeq treated for neurosy

Question 8

early neurosy

Answer 8

mainly meningeal oxcurs in 2 years of infection. 1.4-6% of untreated persons w sy.

Question 9

meningovascular neurosy

Answer 9

5-12 yes after infection. affectig 3% of untreated sy.

eyes may show argyll robertson pupils or anisocoria.

Question 10

late (parenchymatous) neurosy

Answer 10

more than 10 years after infection.

2 classic clinical patterns: tabes dorsalis aand general paresis.

Question 11

late cardiovascular sy

Answer 11

in 10% of untreated pxs.

aortitis is the basic lesion. a