Syphilis

Question 1

name of organism causing syphilis

Answer 1

Treponema pallidum

Question 2

Mode of infection of syphilis

Answer 2

Direct: sexual contact
Congenital: crosses placenta from mother to fetus

Question 3

When does syphilis spread to blood

Answer 3

Before delvelopment of any lesion, it enters lymph vessels then to the blood

Question 4

Constituents of SGT (Sypilitic granulation tissue)

Answer 4

• plasma cells
• Lymphocytes
• few giant cells

Question 5

presence of SGT in blood vessels causes ___

Answer 5

EAO (end arteritis obliterans)

Question 6

stages of syphilis are divided into

Answer 6

• Primary = hard chancre
• Secondary= muco-cutaneous
• Tertiary= gumma

Question 7

primary stage of syphilis occurs within ____ after infection

Answer 7

2 weeks

Question 8

Secondary stage of syphilis occurs within ____ after infection

Answer 8

2 months

Question 9

Tertiary stage of syphilis occurs within ____ after infection

Answer 9

2 years

Question 10

site of primary stage of syphilis

Answer 10

site of entry of bacteria (genital or extragenital –> fingers, lips, tongue

Question 11

Gross morphology of primary stage of syphilis

Answer 11

Ulcer with:
* Flat edges
* Clean floor
* Firm
* painless
* Lymph nodes: enlarged, mobile & painless

Question 12

Microscopic morphology of primary stage of syphilis

Answer 12

• covering epithelium: absent
• sub-epithelial tissue: Syphalitic granulation tissue (SGT)
• Lymph nodes: Reactive hyperplasia

Question 13

Charactaristics of Secondary stage Syphilis

Answer 13

General:
* Fever
* Headache
* weakness
* joint pain
* genralized lymphadenitis

Very infective

Skin Rash:
* Macules (change colur)
* papules
* Pustules (pus)

Condyloma Lata (warts):
* especially in moist areas (axilla & under breast)
* under microscope –> SGT with hyperplastic epithelium

Scaly desquamation of palms and soles:
* Leukoderma (white skin)
* Alopecia (hair loss)

Mucous patches :
* leaving snail trake
* mouth, pharynx, vagina, Anus

Question 14

Tertiary stage syphilis is divided into:

Answer 14

• Localised
• Diffuse

Question 15

morphoogy of gumma

Answer 15

• Central zone: necrosis
• Mid zone: Syphilitic granulation tissue
• Peripheral zone: Fibrosis

Question 16

Fate of Gumma/ 3rd stage syhpilis

Answer 16

forms Gummatous Ulcer:
* Sharp edges (punched out)
* Necrotic floor
* Pre-cancerous in tongue

Question 17

enummerate examples of gumma

Answer 17

• Liver –> Hepar Lobatum
• Heart –> affects septum, causing heart block
• Testis –> Testicular enlargement followed by fibrosis
• Skull –>worm eaten appearance of skull bones
• Palate –> Perforated palate
• Nose –> Saddle Nose
• Tongue –> gummatous ulcer

Question 18

rate of diffuse syphilitic inflammation

Answer 18

very slow

Question 19

most common site of diffuse syphilitic inflammation

Answer 19

• Larynx
• aorta
• testis
• bones
• meninges

Question 20

charactaristic of diffuse syphilitic inflammation

Answer 20

infiltration by Syphilitic granulation tissue with minimal necrosis but thickened fibrosis

Question 21

Early manifestations of Congenital syphilis

Answer 21

same as 2nd & 3rd stage syphilis charactaristics:
Skin Rash:
* Macules (change colur)
* papules
* Pustules (pus)

Condyloma Lata (warts):
* especially in moist areas (axilla & under breast)
* under microscope –> SGT with hyperplastic epithelium

Scaly desquamation of palms and soles:
* Leukoderma (white skin)
* Alopecia (hair loss)

Mucous patches :
* leaving snail trake
* mouth, pharynx, vagina, Anus

Rhagades: scars around angles of mouth & anus

Saddle nose

Syphilitic osteomyelitis

diffuse Syphilitic inflammation

Question 22

Late manifestations of Congenital syphilis

Answer 22

skull, leg, teeth, eye, hearing, paralysis:
* Square shaped skull
* Saber tibia bone
* Hutchinson teeth
* Iritis, keratitis, retinitis & blindness
* 8th CN lesion –> deafness
* CNS lesion –> Paralysis