Syphilis in pregnancy

Question 1

How is syphilis transmitted?

Answer 1

Via mucus membranes and epithelial abrasions

Question 2

What percent of people will contract syphilis if they are sexually active with an infected partner?

Answer 2

50%

Question 3

What is the clinical manifestation of primary syphilis?

Answer 3

Nontender chancre/ulcer

Question 4

How long after exposure does the primary chancre form?

Answer 4

3 weeks

Question 5

What is the most common location of the primary chancre?

Answer 5

Genital, 90%

Question 6

How long does it take for primary syphilis to resolve if untreated?

Answer 6

3-6 weeks

Question 7

What other PE are seen with primary syphilis?

Answer 7

Painless nontender regional lymphadenopathy

Question 8

What are the manifestations of secondary syphilis?

Answer 8

Maculopapular rash, constitutional symptoms, generalized nontender lymphadenopathy

Question 9

How long does it take for secondary syphilis to resolve

Answer 9

2 - 6 weeks

Question 10

How long can latent syphilis last?

Answer 10

1-25 yrs

Question 11

What is the definition of early latent syphilis?

Answer 11

< 1 year since resolution of symptoms

Question 12

What is the definition of late latent syphilis?

Answer 12

> 1 year since resolution of symptoms

Question 13

True or false: in late latent syphilis, there is no possibility of horizontal (partner to partner) spread

Answer 13

True

Question 14

True or false: in late latent syphilis there is no possibility of vertical spread

Answer 14

False

Question 15

What is the appropriate screening test for syphillis and is it specific?

Answer 15

RPR, not specific

Question 16

Does RPR become negative following adequate treatment?

Answer 16

Yes

Question 17

What is the confirmatory test for syphilis?

Answer 17

Tpab, FTA-ABS

Question 18

Do TPAB and FTABS stay positive even following adequate treatment?

Answer 18

Yes

Question 19

How do you treat primary, secondary or early latent syphilis?

Answer 19

Bezathine PCN G 2.4 million Units X 1 dose

Question 20

How do you treat late latent syphilis?

Answer 20

Bezathine PCN G 2.4 million Units X 3 weeks

Question 21

How do you treat tertiary syphilis without neuro involvement?

Answer 21

Bezathine PCN G 2.4 million Units X 3 weeks

Question 22

How do you treat tertiary syphilis with neuro involvement?

Answer 22

Crystaline Pen G 18 - 24 million U x 10 - 14 days

Question 23

Tertiary syphilis is also known as

Answer 23

Gummatous syphilis

Question 24

What are common organs affected by tertiary syphilis?

Answer 24

Liver, skeleton

Question 25

What is the most severe form of tertiary syhilis?

Answer 25

neurosyphilis

Question 26

How does syphilis affect end arterioles?

Answer 26

obliterative endarteritis

Question 27

How does syphilis affect the aorta?

Answer 27

aneurysm

Question 28

What is the rate of vertical transmission for primary syphilis?

Answer 28

50%

Question 29

What i the rate of vertical transmission for secondary syphilis?

Answer 29

67%

Question 30

What is the rate of transmission for tertiary syphilis?

Answer 30

83%

Question 31

What are common placental findings in fetuses affected by neonatal syphilis?

Answer 31

Non immune fetal hydrops, polyhydramnios, placentamegoly, hepatomegaly, IUFD

Question 32

How do you treat a patient with syphilis who is pregnant and has a PCN allergy?

Answer 32

PCN Desensitization

Question 33

How do you treat a patient with syphilis who is NOT pregnant and has a PCN allergy?

Answer 33

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