Sexual Health

Question 1

Syphilis HIV co-infection

Answer 1

40%

Question 2

How many women screen positive for syphilis require treatment in pregnancy?

Answer 2

40%

Question 3

Risk factors for syphilis in pregnancy

Answer 3

Low socioeconomic status
Multip
History STIs
Illicit drug use before 18yo
>3 sexual partners in 12 months

Question 4

How many patients exposed to syphilis will contract infection

Answer 4

1/3

Question 5

What is Early latent syphilis

Answer 5

Infection within the past 1 year

Question 6

What is late latent syphilis

Answer 6

Infection more than 1 year ago

Question 7

How long do chancres take to heal?

Answer 7

3-8 weeks

Question 8

Risk of secondary syphilis without treatment

Answer 8

25%

Question 9

How long does it take for secondary syphilis to resolve?

Answer 9

1-3 months

Question 10

What is secondary syphilis?

Answer 10

Syphilis 4-10 weeks after primary infection
Mucocutaneous rash
Malaise and loss of appetite
Infectious condylomata

Question 11

Risk of tertiary syphilis if left untreated

Answer 11

30%

Question 12

When can spirochete bacteria cross the placenta?

Answer 12

From 14 weeks

Question 13

Consequence of fetal syphilis

Answer 13

Fetal loss 40%
1/3 congenital syphilis
FGR
PTB
NND
Hepatomegaly
Thrombocytopenia
Anaemia
Ascites

Question 14

Transmission risk of primary, early latent and late latent syphilis

Answer 14

100%
40%
10%

Question 15

USS features of syphilis infection

Answer 15

Ascites
Hydrops
Hepatosplenomegaly
Placentomegaly
Intrahepatic calcification

Question 16

Incubation period of syphilis

Answer 16

6-12 weeks

Question 17

Causes of false positive tests for syphilis

Answer 17

Endocarditis
SLE
Yaws

Question 18

Optimal treatment time of syphilis before delivery?

Answer 18

30 days minimum

Question 19

Treatment of early syphilis 1st and 2nd trimester

Answer 19

Stat 2.4 MU IM benzathine penicillin G
OR
500mg ceftriaxone IM for 10/7

Question 20

Treatment of early syphilis in 3rd trimester

Answer 20

Benzathine penacillin 2.4MU IM weekly for 2 doses

OR

Ceftriaxone 500mg IM OD for 10/7

Question 21

What is Jarish-Herxheimer reaction?

Answer 21

Fever + rigours + skin rash following syphilis treatment
Can cause uterine contractions

Question 22

Risk of jarisch-herxheimer reaction in pregnancy?

Answer 22

50% in primary syphilis
90% secondary syphilis
25% latent syphilis

Question 23

When does Jarisch-Herxheimer reaction occur?

Answer 23

Within 24 hours of syphilis treatment

Question 24

Asymptomatic Congenital syphilis

Answer 24

2/3 at birth

Question 25

When do symptoms of congenital syphilis occur?

Answer 25

3-8 weeks of life

Question 26

Signs of early congenital syphilis?

Answer 26

Skin rashes
Stigmata of meningitis
Jaundice
Hepatosplenomegaly
Anaemia
Periositis
Syphilitic rhinitis - bloody snuffles

Question 27

Early congenital syphilis

Answer 27

First 2 years of life

Question 28

Late congenital syphilis

Answer 28

After first 2 years of life

Question 29

Signs of late congenital syphilis

Answer 29

Hutchinson’s teeth
8th nerve deafness
Interstitial keratitis
Saddle nose
Sabre shins
Asymptomatic neurosyphilis

Question 30

Treatment of late latent, cardiovascular and gummatous syphilis in pregnancy

Answer 30

Benzathine penicillin G 2.4 million units IM weekly days 1,8 and 15
For cardiac - 40-60mg prednisolone OD for 3/7 24 hours prior to abx

Question 31

Treatment of neurosyphilis in pregnancy

Answer 31

Procaine penicillin G 2.4 million units IM OD + pro-benecid 500mg PO QDS for 14/7
Benpen 1.8-2.4g IV 4 hourly for 14/7