Syphilis in pregnancy Flashcards
How is syphilis transmitted?
Via mucus membranes and epithelial abrasions
What percent of people will contract syphilis if they are sexually active with an infected partner?
50%
What is the clinical manifestation of primary syphilis?
Nontender chancre/ulcer
How long after exposure does the primary chancre form?
3 weeks
What is the most common location of the primary chancre?
Genital, 90%
How long does it take for primary syphilis to resolve if untreated?
3-6 weeks
What other PE are seen with primary syphilis?
Painless nontender regional lymphadenopathy
What are the manifestations of secondary syphilis?
Maculopapular rash, constitutional symptoms, generalized nontender lymphadenopathy
How long does it take for secondary syphilis to resolve
2 - 6 weeks
How long can latent syphilis last?
1-25 yrs
What is the definition of early latent syphilis?
< 1 year since resolution of symptoms
What is the definition of late latent syphilis?
> 1 year since resolution of symptoms
True or false: in late latent syphilis, there is no possibility of horizontal (partner to partner) spread
True
True or false: in late latent syphilis there is no possibility of vertical spread
False
What is the appropriate screening test for syphillis and is it specific?
RPR, not specific
Does RPR become negative following adequate treatment?
Yes
What is the confirmatory test for syphilis?
Tpab, FTA-ABS
Do TPAB and FTABS stay positive even following adequate treatment?
Yes
How do you treat primary, secondary or early latent syphilis?
Bezathine PCN G 2.4 million Units X 1 dose
How do you treat late latent syphilis?
Bezathine PCN G 2.4 million Units X 3 weeks
How do you treat tertiary syphilis without neuro involvement?
Bezathine PCN G 2.4 million Units X 3 weeks
How do you treat tertiary syphilis with neuro involvement?
Crystaline Pen G 18 - 24 million U x 10 - 14 days
Tertiary syphilis is also known as
Gummatous syphilis
What are common organs affected by tertiary syphilis?
Liver, skeleton
What is the most severe form of tertiary syhilis?
neurosyphilis
How does syphilis affect end arterioles?
obliterative endarteritis
How does syphilis affect the aorta?
aneurysm
What is the rate of vertical transmission for primary syphilis?
50%
What i the rate of vertical transmission for secondary syphilis?
67%
What is the rate of transmission for tertiary syphilis?
83%
What are common placental findings in fetuses affected by neonatal syphilis?
Non immune fetal hydrops, polyhydramnios, placentamegoly, hepatomegaly, IUFD
How do you treat a patient with syphilis who is pregnant and has a PCN allergy?
PCN Desensitization
How do you treat a patient with syphilis who is NOT pregnant and has a PCN allergy?
Doxycyline 100 mg BID x 2 weeks, Tetracycline 500 mg PO QID for 2 weeks, Ceftriaxone 1 g IM for 8-10 days, Azithromycin 2 g x 1 dose
