Syphilis

Question 1

What is syphilis?

Answer 1

Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum.

Question 2

How is syphilis transmitted?

Answer 2

Syphilis is transmitted through direct contact with syphilitic sores during vaginal, anal, or oral sex, or from mother to child during pregnancy.

Question 3

What are the stages of syphilis?

Answer 3

The stages include primary, secondary, latent, and tertiary syphilis.

Question 4

What is the characteristic feature of primary syphilis?

Answer 4

Primary syphilis presents with a painless ulcer called a chancre at the site of infection.

Question 5

What are the symptoms of secondary syphilis?

Answer 5

Symptoms include a maculopapular rash (often on the palms and soles), mucous patches, condylomata lata, fever, and lymphadenopathy.

Question 6

What is latent syphilis?

Answer 6

Latent syphilis is a stage with no clinical symptoms but positive serological tests for Treponema pallidum.

Question 7

What are the complications of tertiary syphilis?

Answer 7

Complications include cardiovascular syphilis (e.g., aortitis), neurosyphilis (e.g., tabes dorsalis), and gummatous syphilis (destructive granulomatous lesions).

Question 8

What is congenital syphilis?

Answer 8

Congenital syphilis occurs when Treponema pallidum is transmitted from mother to child during pregnancy, leading to serious complications.

Question 9

What are the symptoms of congenital syphilis?

Answer 9

Symptoms include bone deformities, hepatosplenomegaly, jaundice, rash, and neurological impairment.

Question 10

How is syphilis diagnosed?

Answer 10

Diagnosis involves serological testing, including non-treponemal tests (e.g., RPR, VDRL) and treponemal tests (e.g., TPPA, FTA-ABS).

Question 11

What is the role of dark-field microscopy in syphilis diagnosis?

Answer 11

Dark-field microscopy can detect Treponema pallidum directly from chancre exudates in primary syphilis.

Question 12

What is the treatment for syphilis?

Answer 12

The treatment of choice is intramuscular benzathine penicillin G.

Question 13

What is the alternative treatment for syphilis in penicillin-allergic patients?

Answer 13

Alternatives include doxycycline or azithromycin, but penicillin desensitisation is preferred for pregnant patients.

Question 14

What is the Jarisch-Herxheimer reaction?

Answer 14

It is an acute febrile reaction following antibiotic treatment of syphilis, due to the release of bacterial endotoxins.

Question 15

How is congenital syphilis prevented?

Answer 15

Prevention involves antenatal screening and treatment of syphilis during pregnancy.

Question 16

What is the incubation period of syphilis?

Answer 16

The incubation period ranges from 10 to 90 days, with an average of 21 days.

Question 17

What are condylomata lata?

Answer 17

Condylomata lata are highly infectious, wart-like lesions found in secondary syphilis, often in moist areas such as the genital or perianal region.

Question 18

What are the differential diagnoses for a genital ulcer?

Answer 18

Differentials include herpes simplex virus, chancroid, lymphogranuloma venereum, and Behçet’s disease.

Question 19

How can syphilis affect the nervous system?

Answer 19

Neurosyphilis can occur at any stage, presenting with symptoms like meningitis, cranial nerve palsies, tabes dorsalis, or general paresis.

Question 20

What is cardiovascular syphilis?

Answer 20

Cardiovascular syphilis occurs in tertiary syphilis and includes complications such as aortitis, aortic aneurysm, and aortic regurgitation.

Question 21

What are gummas in syphilis?

Answer 21

Gummas are destructive granulomatous lesions found in tertiary syphilis, typically affecting the skin, bones, or liver.

Question 22

How is syphilis monitored after treatment?

Answer 22

Monitoring includes repeated non-treponemal serological tests (e.g., RPR or VDRL) to assess treatment response.

Question 23

Why is partner notification important in syphilis?

Answer 23

Partner notification helps identify and treat sexual contacts, preventing further transmission and reinfection.

Question 24

Can syphilis co-exist with other STIs?

Answer 24

Yes, co-infections with other STIs, such as HIV, are common and may complicate diagnosis and management.

Question 25

How is syphilis prevented?

Answer 25

Prevention strategies include practising safe sex, routine STI screening, and treating sexual partners of infected individuals.