syphilis

Question 1

what is the causative organism behind syphilis ?

Answer 1

treponema pallidum

Question 2

how is syphilis transmitted ?

Answer 2

can be vertically transmitted or sexually

Question 3

what group of people are at a higher risk of getting syphilis ?

Answer 3

homosexual men

Question 4

what other STD is commonly associated with syphilis ?

Answer 4

HIV

Question 5

what are the stages of infection of syphilis ?

Answer 5

primary syphilis
secondary syphilis
latent or dormant phase
tertiary syphilis ( which is rare nowadays due to availability of penicillin )

Question 6

what are the features of primary syphilis ?

Answer 6

single shallow painless ulcers on mucous membranes , this is also accompanied by regional lymphadenopathy

Question 7

what are the features of secondary syphilis ?

Answer 7

generalized rash
generalized lymphadenopathy
most patients experience signs of vasculitis

Question 8

where are rashes commonly found in secondary syphilis ?

Answer 8

palm and soles

Question 9

How is congenital syphilis acquired ?

Answer 9

through vertical transmission , common cause of miscarriages

Question 10

what are the features of latent syphilis ?

Answer 10

no symptoms or signs after syphilis infection

Question 11

how long does the latent phase usually last ?

Answer 11

2-3 years

Question 12

what are the features of tertiary syphilis ?

Answer 12

bacteria has reached the blood and affects the heart and brain

Question 13

what are the symptoms pf tertiary syphilis ?

Answer 13

neurosyphilis ( dementia/stroke/spinal cord)
cardiovascular syphilis ( heart failure/angina/aortic aneurysm)
Gummata (necrotic skin/bone lumps)

Question 14

how can we generally make a diagnosis of syphilis ?

Answer 14

clinical assesment
tests : direct test
serology

Question 15

what are the direct tests that are used for the detection of syphilis ?

Answer 15

PCR

dark ground microscopy

Question 16

what is dark ground microscopy ?

Answer 16

a sample from the ulcer ground/base is taken and examined under dark ground microscopy

Question 17

what are the tests used in serology to detect syphilis ?

Answer 17

treponemal test

non-treponemal tests ( RPR )

Question 18

how accurate is using PCR for the detection of syphilis ?

Answer 18

the most sensitive and specific , a positive result indicates early syphilis

Question 19

what are the treponemal tests ?

Answer 19

EIA/TPPA

Question 20

what are the features of the TPPA test ?

Answer 20

stays positive lifelong even after treatment of syphilis

and will only be positive for syphilis

Question 21

what are the features of non-treponemal tests ?

Answer 21

they can be positive for several conditions not just necessarily syphilis

Question 22

which test is used for the screening of syphilis ?

Answer 22

EIA

Question 23

which test is used for the confirmation of syphilis after using EIA ?

Answer 23

TPPA

Question 24

which test is used for follow up purposes after treatment of syphilis ?

Answer 24

RPR

Question 25

how can we detect that the patient has been re infected with syphilis ?

Answer 25

if there is a 4 fold increase in RPR

Question 26

what special investigations can be performed if a patient presents with neurological manifestations and is suspected to have syphilis ?

Answer 26

lumbar puncture and perform serology on the sample

Question 27

after a diagnosis of syphilis is made what is the best next step in management ?

Answer 27

advice on further investigations STI/HIV screening partner notification

Question 28

what is the treatment for primary syphilis ?

Answer 28

long acting penicillin single dose ( benzathine)

Question 29

what is the treatment for secondary latent and tertiary syphilis ?

Answer 29

long acting penicillin in 3 doses , one dose a week

Question 30

if the patient is found to be allergic penicillin what other medication can be used for treatment ?

Answer 30

doxycycline (vibramycin)