Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Uveitis > Syphilitic Uveitis > Flashcards

Syphilitic Uveitis Flashcards

1
Q

(Syphilitic uveitis) When talking about the manifestations of syphilis, this distiction must be considered first:

A
  • Acquired

- Congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

(Congenital Syphilis) What is the most common ocular manifestation of congenital syphilis?

A

Intersticial keratitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

(Congenital Syphilis) In general terms, what is intersticial keratitis (IK)?

A

An inflammatory condition of the corneal stroma in the absence of primary involvement of either the corneal epithelium or endothelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

(Congenital Syphilis - IK) What does it mean to say the corneal stroma in inflamed?

A

It means inflammatory cells are present in the interlamellar stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

(Congenital Syphilis - IK) So, there’s pus in the stroma?

A

NO - IK is a nonsupurative condition. IK represents a Tipe IV hypersensitivity reaction to antigens within the cornean stroma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

(Congenital Syphilis - IK) At what age does the IK of congenital syphilis typically present?

A

Around 9 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

(Congenital Syphilis - IK) How does it present?

A

Pain, photophobia and injection, +/- a salmon patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

(Congenital Syphilis - IK) With the respect to IK, to what does the term salmon patch refer?

A

As the disease progresses, deep stromal vessels appear and make their way toward the central cornea. if/when the stromal vascularization is aprticularly dense and the blood flow is exuberant, the resulting color of the cornea has been likened to that of salmon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

(Congenital Syphilis - IK) How is it treated?

A

WIth frequent topical steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

(Congenital Syphilis - IK) What is the natural course of syphilitic IK if it goes untreated?

A

It tends to burn itself out in a matter of weeks to months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

(Congenital Syphilis - IK) Irrespective of whether it was treated, what stigmata of resolved IK that may be seen at the slit lamp?

A
    • Formerly perfused, now-empty stromal blood vessels (aka ghost vessels)
    • Corneal scarring, which may produce visually significant haze and/or astigmatism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

(Congenital Syphilis - IK) What is the most common cause of IK (Hint: It’s not syphilis)?

A

Herpetic dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

(Congenital Syphilis - IK) Other than herpesviruses and T. pallidum, three other infections causes of IK are worth mentioning (in thar they would make good OKAP questions). What are they?

A
    • Mycobacterium tuberculosis (ie, TB)
    • Mycobacterium leprae (leprosy/Hansen’s dz)
  • Borrelia burgdorferi (Lyme dz)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

(Congenital Syphilis - IK) There is a noninfectious cause worth mentionning (for the same reason) – what is it?

A

Cogan Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

(Congenital Syphilis - IK) There is a noninfectious cause worth mentionning (for the same reason) – what is it? Cogan Syndrome.

How does Cogan Syndrome present?

A

With IK and CN8-related symptoms: deafness, tinnitus and vertigo.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

(Congenital Syphilis) What is the most common manifestation of congenital Syphilis in the posterior pole?

A

TWO manifestations are common:

    • a salt-and-pepper retinopathy
    • a retinitis pigmentosa (RP)-like presentation: OHN pallor, arteriolar narrowing, RPE clumping
17
Q

(Congenital Syphilis) What is the other classic cause of congenital salt-and-pepper retinopathy?

A

Rubella

18
Q

(Congenital Syphilis) What are the classic nonocular findings associated with congenital syphilis?

A
    • Circumoral scars (formal term: Rhagades)
    • Hutchinson teeth (“Peg-shaped”)
    • Saddle nose
    • Saber shins
    • Mental retardation
    • CN8 deafness
19
Q

(Congenital Syphilis)

Hutchinson teeth: Name two other congenital eye syndromes that are associated with abnormal dentition:

A
    • Axenfeld-Rieger
    • Incontinentia pigmenti

In three words, what sort of condition is Axenfeld-Rieger?
An anterior-segment dysgenesis.

If limited to one word, what sort of condition is Axenfeld-Rieger?
A neurocristopathy.

In one word, what sort of condition is incontinentia pigmenti?
A phakomatosis.

20
Q

(Congenital Syphilis)

Saber shins: Why sabr shins; ie, to what does this term refer?

A

It refers to the fact that the tibia of congenital-syphilis pts tendt to be shaped like a saber, a type of sword.

21
Q

(Congenital Syphilis) In the context of congenital syphilis, what three findings constitute Hutchinson’s triad?

A
    • Interstitial keratitis
    • Deafness
    • Hutchinson teeth
22
Q

(Congenital Syphilis) Recall that Cogan’s syndrome is amrked by IK and CN8 dysfunction. If a patient with both of these, how you can determine whether they have Cogan’s syndrome vs congental syphilis?

A

1) The IK of congenital syphilis presents at 9, whereas Cogan’s presents in young adulthood.
2) The congenital syphilis pt with have the other stigmata of their condition, which are not present in Cogan’s syndrome.

23
Q

(Acquired Syphilis: Overview) Syphilis infection passes through four stages – what are they?

A
    • Primary syphilis
    • Secondary syphilis
    • Latency period
    • Tertiary syphilis
24
Q

(Acquired Syphilis: Overview) How much time typically passes between inoculation and the onset of primary syphilis?

A

~3 weeks post inoculation.

25
Q

(Acquired Syphilis: Overview)

Primary Syphilis is characterized by…

A

the appearance of a chancre at the site of inoculation.

What is a chancre? An ulcerated lesion.

It is painful, or painless? Painless.

Does it linger, or resolve spontaneously?
Resolves spontaneously

How long does it takes to resolve? Up to 3 months or so.

26
Q

(Acquired Syphilis: Overview) How much time typically passes between resolution of the chancre and the onset of secondary syphilis?

A

~6 to 8 weeks after chancre resolution

27
Q

(Acquired Syphilis: Overview)

Secondary Syphilis is characterized by…

A

Lymphadenopathy, and maculopapular rash

Two areas of the body are particularly prone to development of the rash – what are they?
The palms and soles.

28
Q

(Acquired Syphilis: Overview)

What portion of UNtreated secondary syphilis cases go on to develop tertiary syphilis?

A

About 1/3.

29
Q

(Acquired Syphilis: Overview)

How long does the latency period typically last?

A

Latency period of one year to many decades.

30
Q

(Acquired Syphilis: Overview)

Tertiary syphilis is characterized by one of three patterns:

A
    • Benign tertiary syphilis: Gummas
    • Cardiovascular syphilis: aortic syphilitis
    • Neurosyphilis: tabes dorsalis, including Argyll-Robertson pupils
31
Q

(Acquired Syphilis: Overview)
Tertiary syphilis is characterized by one of three patterns:
– Benign tertiary syphilis: Gummas

What are gummas?

Where are they located?

A

Benign inflammatory tumors–granulomas, essentially

They can be found anywhere but have a predilection for the liver and the skin

32
Q

(Acquired Syphilis: Overview)

Tertiary syphilis is characterized by one of three patterns:

    • Benign tertiary syphilis: Gummas
    • Cardiovascular syphilis: Aortic syphilitis

What is the feared, life-threatening sequelae of syphilitic aortitis?

A

Formation of an aortic aneurysm.

33
Q

(Acquired Syphilis: Overview)

Tertiary syphilis is characterized by one of three patterns:

    • Benign tertiary syphilis: Gummas
    • Cardiovascular syphilis: aortic syphilitis
    • Neurosyphilis: tabes dorsalis, including Argyll-Robertson pupils

What is tabes dorsalis?

What is the phenomenon known as Argyll Robertson pupils?

A

A degenerative neurologic condition characterized by a variety of sensory and motor abnormalities.

A-R pupils do not miose in response to light, but do so briskly in response to the near reflex.

34
Q

(Acquired Syphilis: Overview)

Argyll-Robertson pupils: Two descriptors typically apply to the appearance of A-R pupils – what are they?

A
    • They are small

- - Theay are irregular

35
Q

(Acquired Syphilis: Overview)

– Neurosyphilis: Tabes Dorsalis, including Argyll-Robertson pupils

What are some of the “non A-R pupils” findings of tabes dorsalis?

A
    • Loss of reflexes, which leads eventually to joint damage (ie. Charcot joints
    • Pain, parasthesias
    • A foot-slapping gait
36
Q

(Acquired Syphilis: Overview)

At which stage can/does uveitis occur?

A

Any stage. That said, uveitis in a pt with serologic evidence of untreated syphilis should be considered neurosyphilis until proven otherwise.

Uveitis (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions