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Year Three - Reproductive System > Syphillis > Flashcards

Syphillis Flashcards

1
Q

What is syphillis?

A

It is an infection caused by a spirochete bacteria called Treponema pallidum

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2
Q

What are the two mechanisms in which syphillis can be transmitted?

A

Sex

Vertical transmission

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3
Q

How does syphillis tend to present?

A

Asymptomatically

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4
Q

What are the four stages of syphillis?

A

Primary

Secondary

Latent

Tertiary

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5
Q

What are the two clinical features of primary syphillis?

A

Chancre

Local lymphadenopathy

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6
Q

What is a chancre?

A

It is is a painless genital ulcer

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7
Q

How do we treat a chancre?

A

This tends to resolve over three to eight weeks

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8
Q

When does secondary syphillis begin?

A

It starts after the chancre has healed

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9
Q

When do the symptoms of secondary syphillis resolve?

A

They resolve after three to twelve weeks

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10
Q

What are the six clinical features of secondary syphillis?

A

Maculopapular Rash

Condylomata Lata

Alopecia

Oral Lesions

Fever

Lymphadenopathy

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11
Q

In what three locations does the maculopapular rash appear?

A

Trunk

Palms

Soles

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12
Q

What is condylomata lata?

A

They are grey wart-like lesions around the genitals and anus

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13
Q

What is latent syphillis?

A

It occurs after the secondary stage of syphilis and the patient becomes asymptomatic despite still being infected

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14
Q

When does early latent syphillis occur?

A

Within 2 yrs of the initial infection

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15
Q

When does late latent syphillis occur?

A

After 2 yrs of the initial infection

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16
Q

When does tertiary syphillis occur?

A

Years after the initial infection

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17
Q

What are the three clinical features of tertiary syphillis?

A

Gummatous Lesions

Cardiological Features, such as ascending aortic aneurysms

Neurosyphilis

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18
Q

What cardiological feature is associated with tertiary syphillis?

A

Ascending aortic aneurysm

19
Q

What is neurosyphilis?

A

It occurs when the infection reaches the CNS

20
Q

What are the five clinical features of neurosyphilis?

A

Tabes Dorsalis

Argyll Robertson Pupil

Headache

Dementia

Paralysis

21
Q

What is tabes dorsalis?

A

This is demyelination affecting the spinal cord dorsal columns

22
Q

What is Argyll Robertson Pupil?

A

This is a constricted pupil that accommodates when focusing on a near object but does not react to light

23
Q

Are motor deficits associated with neurosyphilis?

A

No

24
Q

What are the three investigations used to diagnose syphillis?

A

Blood Tests

Polymerase Chain Reaction

Dark Field Microscopy

25
Q

How are blood tests generally used to diagnose syphilis?

A

They are used to check for the presence of antibodies that the body produces to fight infection

26
Q

What four blood tests are used to assess for active syphillis infection?

A

Rapid plasma regain (RPR) test

Venereal disease research laboratory (VDRL) test

Enzyme immunoassay test (EIA)

Treponema pallidum particle agglutination assay (TPPA)

27
Q

What is a RPR test?

A

It assesses the quantity of antibodies being produced by the body to an infection with syphilis

28
Q

How do we interpret PRP test results?

A

It is written as the number of times a sample of containing syphilis needs to be diluted before it becomes undetectable

Therefore, 1 in 2 means it needs to be diluted twice

However, 1 in 32 means it needs to be diluted 32 times. This means the disease activity is greater in this sample

29
Q

What are the four causes of a false positive RPR/VDRL result?

A

Some Times Mistakes Happen
SLE

TB

Malaria

HIV

30
Q

What is an EIA test?

A

It detects an acute IgM antibody to syphillis

31
Q

What EIA test result indicates syphillis infection?

A

Positive

32
Q

What is a TPPA test?

A

It is used to detect the presence of treponema pallidum within a blood sample

33
Q

What TPPA test result indicates syphillis?

A

Positive

34
Q

How do we treat syphillis?

A

IM Benzathine Penicillin

35
Q

What is a common side effect after syphilis treatment?

A

Jarisch Herxheimer reaction

36
Q

What is the Jarisch Herxheimer reaction?

A

It is the rapid killing of Treponema pallidum and the release of endotoxins, which occurs 24 hours after starting syphilis treatment

37
Q

What are the four features of a Jarisch Herxheimer reaction?

A

Fever

Rash

Tachycardia

Myalgia

38
Q

How do we manage Jarisch Herxheimer reaction?

A

It requires supportive management, with oral paracetamol, usually resolving within 24 hours

39
Q

How can we determine whether reinfection with syphillis has occurred?

A

The RPR level rises by 4 fold or more

The TPPA result will be positive

The EIA results may be negative

40
Q

How do we treat a reinfection with syphillis?

A

We administer another IM benzathine penicillin G dose

41
Q

What is the first line management option of syphillis during pregnancy?

A

IM Benzathine Penicillin

42
Q

What is the second line management option of syphillis during pregnancy?

A

Orał doxycycline

43
Q

What are the four features of congenital syphillis?

A

Hutchinson’s teeth

Saddle nose

Mulberry molars

Linear scars at the angle of the mouth

Year Three - Reproductive System (52 decks)

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