Syphilis (Treponema pallidum)

Question 1

Venereal syphilis

Answer 1

T. pallidum ss pallidum

Question 2

Yaws

Answer 2

T. pallidum ss pertenue

Question 3

Bejel

Answer 3

T. pallidum ss endemicum (aka endemic syphilis)

Question 4

Pinta

Answer 4

T. pallidum ss carateum

Question 5

Syphilis: Chancre and regional lymphadenitis

Answer 5

Primary syphilis

Question 6

Syphilis: Painless papule appears at site of entry ___ after inoculation

Answer 6

2-6 weeks

Question 7

Clean, painless, highly contagious ulcer with raised borders

Answer 7

Chancre

Question 8

T/F Chancre is highly contagious

Answer 8

T

Question 9

Symptoms related to spirochetemia

Answer 9

Secondary syphilis

Question 10

Secondary syphilis symptoms are noted when

Answer 10

2-10 weeks after chancre heals

Question 11

Syphilis: Generalized non-pruritic maculopapular rash, notable involving the palms and soles

Answer 11

Secondary syphilis

Question 12

Condyloma lata

Answer 12

Secondary syphilis

Question 13

Gray-white to erythematous wartlike plaques in moist areas around the anus and vagina

Answer 13

Secondary syphilis (condyloma lata)

Question 14

Meningitis occurs in ___% of patients with syphilis characterized by CSF pleocytosis and elevated protein

Answer 14

30

Question 15

Syphilis: Relapses can occur with secondary manifestations when

Answer 15

Early latent period

Question 16

Asymptomatic late syphilis

Answer 16

Late latent period

Question 17

Symptomatic late syphilis

Answer 17

Tertiary syphilis

Question 18

Gummas

Answer 18

Tertiary syphilis

Question 19

Syphilis: Neurologic, cardiovascular, and gummatous lesions

Answer 19

Tertiary syphilis

Question 20

Nonsuppurative granulomas of the skin and musculoskeletal system resulting from host’s hypersensitivity reaction

Answer 20

Tertiary syphilis

Question 21

Untreated syphilis during pregnancy has a vertical transmission rate approaching ___

Answer 21

100%

Question 22

Early signs of congenital syphilis are analogous to the ___ stage of acquired syphilis

Answer 22

Secondary

Question 23

Characteristic anemia in congenital syphilis

Answer 23

Coombs’ negative hemolytic anemia

Question 24

Osteochondritis and periostitis of long bones (rarely the skull) and a mucocutaneous erythematous maculopapular or vesiculobullous lesions followed by desquamation of the hands and feet in a neonate

Answer 24

Congenital syphilis

Question 25

Persistent rhinitis or snuffles in a neonate

Answer 25

Congenital syphilis

Question 26

Metaphyseal demineralization of the medial aspect of the proximal tibia

Answer 26

Wimbergerr’s lines (congenital syphilis)

Question 27

Painful osteochondritis seen in congenital syphilis resulting in irritability and refusal to move involved extremity

Answer 27

Pseudoparalysis of Parrot

Question 28

Late manifestations of congenital syphilis seen in children >2 years of age result primarily from

Answer 28

Chronic granulomatous inflammation of bone, teeth, and CNS

Question 29

Syphilis: Bony prominence of the forehead due to persistent or recurrent periostitis

Answer 29

Olympian brow

Question 30

Syphilis: Unilateral or bilateral thickening or the sternoclavicular third of the clavicle

Answer 30

Higoumenakis sign

Question 31

Syphilis: Anterior bowing of the midportion of the tibia

Answer 31

Saber shins

Question 32

Syphilis: Convexity along the medial border of the scapula

Answer 32

Scaphoid scapula

Question 33

Syphilis: Peg-shaped upper central incisors

Answer 33

Hutchinson teeth

Question 34

Syphilis: Abnormal 1st lower molars characterized by small biting surface and excessive number of cusps

Answer 34

Mulberry molars

Question 35

Syphilis: Depression of the nasal root with destruction of bone and cartilage from syphilitic rhinitis

Answer 35

Saddle nose

Question 36

Syphilis: Linear scars that extend in a spoke-like pattern from previous mucocutaneous fissures of the mouth, anus, and genitalia

Answer 36

Rhagades

Question 37

Syphilis: Latent meningovascular infection, rare, and typically occursduring adolescence with behavioral changes, focal seizures, or loss of intellectual function

Answer 37

Juvenile paresis

Question 38

Syphilis: Rare spinal cord involvement and cardiovascular involvement with aortitis

Answer 38

Juvenile tabes

Question 39

Syphilis: Hutchinson triad

Answer 39

Hutchinson teeth, interstitial keratitis, 8th nerve deafness

Question 40

Syphilis: Unilateral or bilateral PAINLESS joint swelling (usually involving the knees) due to synovitis with sterile synovial fluid

Answer 40

Clutton joint

Question 41

Diagnosis of primary syphilis is confirmed with

Answer 41

Dark field microscopy or direct fluorescent antibody testing

Question 42

Specimen that can be used for diagnosis of primary syphilis

Answer 42

Skin lesions, placenta, umbilical cord

Question 43

Principal means for diagnosis of syphilis

Answer 43

Serologic testing

Question 44

Sensitive nontreponemal tests for syphilis

Answer 44

RPR and VDRL

Question 45

VDRL and RPR detect

Answer 45

Antibodies against phospholipid antigens on treponeme surface that cross-react with mammalian cardiolipin-lecithin-cholesterol antigen

Question 46

DOC for syphilis

Answer 46

Penicillin

Question 47

Acute systemic febrile reaction due to massive release of endotoxin-like antigen during bacterial lysis in patients with syphilis treated with Penicillin

Answer 47

Jarisch-Herxheimer reaction

Question 48

Jarisch-Herxheimer reaction occurs in ___% of patients treated with Pen

Answer 48

15-20%

Question 49

T/F Jarisch-Herxheimer reaction is an indication to discontinuing penicillin therapy

Answer 49

F

Question 50

Persons exposed >90 days before diagnosis in a sex partner of a person with syphilis should be treated if

Answer 50

Seropositive OR serologic test not available