Syphilis Flashcards

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1
Q

Syphilis is caused by

A

Treponema pallidum
STD

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2
Q

Treponema pallidum spirals

A

10-20

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3
Q

Clinical classification

A

Early syphilis
Late syphilis
Congenital syphilis

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4
Q

Early syphilis stages

A

Primary syphilis
Secondary syphilis
Latent syphilis

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5
Q

Inflammation at inoculation site and regional lymph node inflammation occurs at with stage of early syphilis

A

Primary syphilis

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6
Q

Bacteremia
Exanthem
Systemic signs
Antibodies are seen in which stage of early syphilis

A

Secondary syphilis

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7
Q

Symptom free with positive serological is seen in which stage of early syphilis

A

Latent syphilis

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8
Q

Granulomatous inflammation with cellular immune response is seen in

A

Late syphilis

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9
Q

Syphilis occurring more than 2 years after primary infection is

A

Late syphilis

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10
Q

Organs involved in late syphilis are

A

Skin
Bones
CVS
CNS

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11
Q

Congenital syphilis is also known as

A

Syphilis connata

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12
Q

Congenital syphilis is transmitted via

A

Placenta

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13
Q

Late syphilis is seropositive or seronegative

A

Seronegative

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14
Q

What happens at sight of entry in primary syphilis

A

Dark red nodule develops
Then becomes eroded and ulcerated

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15
Q

Chancre

A

Firm circumscribed ulcer

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16
Q

Chancre locations

A

Prepuce
Glans
Perianal region
Vagina cervix
Labia majora labia minora
Rectum
Lips
Tongue
Palette
Finger

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17
Q

Chancre is followed by __________ in primary syphilis

A

Regional lymphadenopathy

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18
Q

Diagnosis

A

Dark field microscopy
FTA (Fluorescent Treponemal antibody) technique

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19
Q

The rashes in secondary syphilis are called

A

Syphilids

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20
Q

Are rashes pruritic in secondary syphilis

A

No
And no scaling

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21
Q

Syphilis rash clinical features

A

Pink macules (red brown) on
Side of chest then to
Trunk
Palms
Soles

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22
Q

Is rash in secondary syphilis blanchable?

A

Yes

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23
Q

Are there mucosal changes in secondary syphilis

A

Yes

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24
Q

Mucosal changes in secondary syphilis

A

Plaques on oral mucosa that can be eroded
Tonsils
tongue

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25
Q

Systemic changes in secondary syphilis

A

Generalized lymphadenopathy
Acute hepatitis
Acute Glomerulonephritis
Splenomegaly
Meningitis
Meningoencephalitis

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26
Q

Syphilitic handshake

A

Antecubital lymphadenopathy palpation

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27
Q

Are there musculoskeletal abnormalities in secondary syphilis

A

Yes

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28
Q

Musculoskeletal abnormalities in secondary syphilis

A

Periostitis
Polyarthritis
Tenosynovitis

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29
Q

Diagnosis of secondary syphilis

A

Serology 100% positive

30
Q

Prognosis in secondary syphilis

A

Good
All lesions resolve

31
Q

Latent syphilis

A

After secondary syphilis resolution. No clinical manifestation but serology is positive

32
Q

Tertiary syphilis manifestations

A

Cutaneous
Musculoskeletal
Cardiovascular
CNS

33
Q

Tertiary syphilis
Cutaneous manifestation

A

Tuberous syphilid
Gumma

34
Q

Grouped red brown papules that clear centrally and expand peripherally are called___________and seen in which syphilis?

A

Tuberoserpiginous syphilis and seen in tertiary syphilis

35
Q

Gumma

A

Subcutaneous nodules
Solitary

36
Q

Are gumma painful?

A

No they are painless

37
Q

Why does gumma discharge?

A

Because they often ulcerate leading to discharge

38
Q

Gumma sites

A

Palate (perforation)
Nose (saddle nose)
Scalp
Face
Liver
Bones
Testes

39
Q

Musculoskeletal disease in tertiary syphilis

A

Periostitis
Osteolysis
Gummata
Juxtaraticular nodes

40
Q

Juxtaarticular nodes

A

Gummata that do not liquefy

41
Q

Osteolysis complication

A

Ivory bone: bone marrow sclerosis
No bone marrow and blood vessels in bone marrow cavity

42
Q

How does treponema pallidum affect the aorta

A

It affects vasa vasorum leading to
Aneurysm and
Aortic insufficiency

43
Q

In late syphilis CNS symptoms are caused by

A

Chronic vessel inflammation

44
Q

Quaternary syphilis includes

A

General paresis
Tabes dorsalis

45
Q

General paresis

A

Paralysis
Damage to grey matter of anterior lobe
Psychiatric diseases

46
Q

Tabes dorsalis

A

Damage to
Dorsal root and
Posterior columns of spinal cord

47
Q

Tabes dorsalis stages

A

Anesthetic stage
Ataxic stage
Pseudoparetic stage

48
Q

Anesthetic stage

A

Hypesthesia
Leads to neurotropic ulcer
Lacinating abdominal pain
Extremity pain

49
Q

Paralysis of ocular nerve is seen in

A

Quaternary syphilis
Tabes dorsalis
Anesthetic stage

50
Q

Hypesthesia

A

Loss of sensitivity

51
Q

Ataxic stage

A

Romberg sign positive
Uncoordinated movements with typical locomotion (slap walk)

52
Q

Romberg sign

A

Unable to stand steady with eyes closed

53
Q

Pseudoparetic stage

A

Signs and symptoms of paresis

54
Q

Congenital syphilis subtypes

A

Early congenital syphilis (before 2 yrs)
Late congenital syphilis (after 2 yrs)

55
Q

Mother with early syphilis (less than 2 yrs)

A

Dangerous for fetus

56
Q

Mother with late syphilis (greater than 2 yrs)

A

Child little risk

57
Q

During pregnancy 1st half

A

Death of child

58
Q

During pregnancy 2nd half

A

Child can develop late congenital syphilis and mother secondary syphilis

59
Q

Early congenital syphilis signs

A

Low birth weight
Hepatosplenomegaly
Blisters and erosions on palms and soles
Osteomyelitis

60
Q

Early congenital syphilis
Development in first month in untreated infants

A

Chronic runny nose, often bloody
Periorificial rhagades
Pemphigus syphiliticus
Periostitis
Osteochondritis
CNS disease
Glomerulonephritis

61
Q

Late congenital syphilis

A

Similar to late syphilis
CVS involvement is uncommon

62
Q

Interstitial keratitis is seen in

A

Late congenital syphilis

63
Q

Interstitial keratitis

A

Affect iris (iritis)
Corneal neovascularization and clouding

64
Q

Interstitial keratitis treatment

A

Topical corticosteroids
No antibiotics as it can cause flare up
Corneal transplantation

65
Q

Sensory deafness and neurosyphilis are seen in which congenital syphilis

A

Late congenital syphilis

66
Q

Gummata and tuberous lesions are seen in

A

Late congenital syphilis and
Tertiary syphilis

67
Q

Clinical lesions secondary to congenital syphilis

A

Saddle nose
Frontal bossing
Maxillary hypoplasia
Higoumenaki sign
Saber shins
Clutton joints
Gothic palate (high arched palate)
Periorificial rhagades
Dental changes:
Hutchison incisors
Mulberry molars

68
Q

Hutchinson triad includes

A

Hutchison incisors
Sensory deafness
Interstitial keratitis

69
Q

Higoumenaki sign

A

Thickening of medial end of clavicle

70
Q

Clutton joints

A

Effusion into large joints

71
Q

Syphilis treatment

A

Penicilin
Doxycycline
Erythromycin