Syphalis

Question 1

Gen

Answer 1

3 stages, congenital, spread hematogenously or via lymph

Question 2

1st stage

Answer 2

Chancre = single, firm, non tender raised lesion

Question 3

2nd stage

Answer 3

Palmer rash (mucopapula/scaly), lymphoadenopathy, chondyloma latum (broad raised plaques). 
2-10 wks after initial

Question 4

3rd stage

Answer 4

neurosyphalis: PARESIS (CSF test), aortitis, Gummas (type 4 HSR)

Question 5

PARESIS

Answer 5

P = personality (emotional liability and Paranoia)
A = Affect (carelessness in appearance)
R = Reflexes (hyperactivity)
E = Eye (Argyll Robertson Pupils)
S = Sensory (illusions, delusions, megolomania)
I = Intellect (decreased memory, judgement, insight)
S = Speech (slurred)

Question 6

Diag

Answer 6

Use darkfield microscopy or silver stain - no culture

Question 7

Bacteria

Answer 7

Treponema Pallidum: Gram neg spirochete

Thick rigid spirals, endoflagella, axial filaments

Question 8

Treatment

Answer 8

Penicillin - risk Jarish - herxheimer rxn (TSS to lipid A)

Question 9

Tests

Answer 9

1. Non treponemal test - VDRL or RPR for screening. pos during first and second stage (except HIV). Directed against cardiolipin Ag
2. Treponeal Test: FTA - Abs, used to confirm above. Detects specific Abs via indirect IF. Not useful to follow tx as always pos