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ClinMed1 Exam 4 > Syphilis > Flashcards

Syphilis Flashcards

1
Q

How is T palidum tested (3)

A

serologically
biopsy of lesion
LP

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2
Q

What technique is used in serological syphilis testing

A

microscopic detection by darkfield exam or immunofluorescence

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3
Q

2 types of serologic testing for T palidum

A

non-treponemal (VDRL & RPR) and treponemal

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4
Q

How long after infection before Venereal Disease Research Lab (VDRL) comes up positive for T palidum

A

4-6 weeks

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5
Q

false positives for VDRL (5)

A 
old age, 
CTD, 
HCV, 
HIV, 
mono
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6
Q

what is the danger of the Rapid Plasma Reagent test for Treponema palidum

A

may sero-convert back to negative despite presence of tertiary syphilis

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7
Q

What is the danger of non-treponemal tests

A

extremely high titres can be false negatives - go to treponemal test!

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8
Q

what test should be used to measure efficacy of Syphilis TX

A

non-treponemal Ab test(VDRL, RPR)

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9
Q

what type of test is Fluorescent Treponemal Antibody (FTA)

A

treponemal Ab test

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10
Q

most sensitive test for syphilis

A

FTA

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11
Q

what do you do if syphilis highly suspected but VDRL comes back negative

A

confirm with FTA (treponemal Ab test)

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12
Q

where are the painless ulcers of primary syphilis found (5)

A 
genitalia, 
perianal, 
rectum, 
pharynx, 
tongue
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13
Q

how long after exposure before primary syphilis rears its ugly head? How much longer before serologic tests come up positive?

A

2-6 weeks chancre, then 1-2 weeks later serologic tests confirm

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14
Q

secondary sign of primary and secondary syphlis

A

non-tender regional lymph adenopathy

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15
Q

what will appear in labs of folks presenting with primary syphilis lesions right away

A

dark field treponemes (95%)

and CSF pleocytosis (increased CSF WBC)

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16
Q

4 differential diagnoses for syphilitic chancre

A

chancroid,
lymphogranuloma venereum,
genital herpes
neoplasm

17
Q

3 choices of drugs to use in treating primary AND secondary syphilis

A

benzathine PCN G
doxycycline
ceftriaxone

18
Q

how does primary syphilis lesion differ from that of secondary

A

primary has painless ulcer @ infection site

secondary has mucous membranous, weeping papules

19
Q

why is secondary syphilis called “the great imposter”

A

generalized maculopapular rash

20
Q

how long after chancres do secondary syphilis signs appear

A

Weeks to 6 months after primary lesions

21
Q

describe maclopapular rash of syphilis (2)

A

annular like ringworm

MC on palms and soles

22
Q

what are condyloma lata

A

fused WEEPING papules on moist areas of skin and mucous membranes

23
Q

signs of late latent syphilis

A

late latent syphilis does not present with physical signs! (neurosyphilis may also present with no signs)

24
Q

how do we know someone has latent syphilis

A

declared hx of syphilis (possible decades ago)

+ serological test

25
Q

DOC for late latent syphilis

A

benzathine PCN G once weekly 3 weeks

26
Q

2 alternative treatments for late latent syphilis

A

tetracycline or doxycyline 28 days

27
Q

where are tumors of tertiary syphilis located (4)

A

skin
bone
liver
respiratory

28
Q

4 aortic disorders of tertiary syphilis

A

aortitis
aneurysms
aortic regurgitation
narrowing of coronary ostia

29
Q

nodular lesions of tertiary syphilis that ulcerate with “rat-eaten order”

A

gummas

30
Q

oral exam findings of tertiary syphilis (2)

A

leukoplakia

gummas

31
Q

5 musculoskeletal sequelae of tertiary syphilis

A 
destructive lesions
periostitis
arthritis
myalgias
myostitis
32
Q

eye exam finding of tertiary syphilis

A

keratoconjunctivitis

33
Q

how does tabia dorsalis present in physical exam (5)

A

this sign of neurosyphilis presents with
loss of vibration, proprioception, and balance.
Argyll Robertson pupils
hypotonia
hyporeflexia
wide-based gait

34
Q

define tabia dorsalis

A

degeneration of parenchyma of posterior columns and posterior sensory ganglia, nerve roots

35
Q

term for large vessel involvement in the brain of neurosyphilitic patients

A

meningovascular syphilis (prone to CVAs)

36
Q

what is Argyll Robertson (prostitutes) pupil

A

finding of tabes dorsalis where pupils constrict to accomodation, but not light

37
Q

DOC for neurosyphilis

A

aqueous crystalline PCN G infusion qid 10-14 days

38
Q

alternative drug to treat neurosyphilis

A

procaine PCN

ClinMed1 Exam 4 (5 decks)

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