Syphillis

Question 1

Time at which person cannot spread syphilis sexually (assuming immunocompetent

Answer 1

4 years

Question 2

Conditions in which T. pallidum remain viable

Answer 2

37 degrees, carbon dioxide enriched environment

Question 3

Incubation period of syphilis

Answer 3

3 weeks (varies from 3 to 90 days

Question 4

Primary stage of syphilis

Answer 4

painless chancre at site of inoculation. Painless papule

Question 5

Secondary stage of syphilis

Answer 5

parenchymal, constitutional and mucocutaneous manifestations. Skin rash, lymphadenopathy, mouth and throat, genital lesions, constitutional symptoms, CNS (40%). Palmar lesions.

Question 6

Latent syphilis

Answer 6

treponemal antibody test positive but no symptoms.

Question 7

Late syphilis (tertiary disease)

Answer 7

vasa vasorum of aorta or small arteries of the CNS, gumma (skin, liver, bones, spleen)

Question 8

Percentage of patients that will clear syphilis

Answer 8

two thirds

Question 9

When to check CSF in a patient syphilitic patient

Answer 9

neurologic, otologic, ophthalmologic signs. Late or latent syphillis, treatment failure (lack of fourfold decrease at 24-60 months or fourfold increase at any time (RPR). VDRL/RPR titer> 32.

Question 10

Neonatal syphilis likelihood

Answer 10

VDRL/RPR higher than 1:16 and primary, secondary and early latent syphilis in mother during pregnancy or more than 30 days since treatment.

Question 11

Direct examination for spirochetes

Answer 11

DFA, PCR assay or darkfield examination

Question 12

VDRL test antigen

Answer 12

Cardiolipin, cholesterol lecithin antigen

Question 13

RPR

Answer 13

lipodal antigens resulting from host interaction with treponema pallidum

Question 14

When does a VDRL/RPR become negative

Answer 14

1 year after primary syphilis and 2 hears after secondary syphilis. 5 years after late syphilis

Question 15

Treponemal tests

Answer 15

measuring antibodies against T Pallidum antigens
verify a non treponemal tests
-treponemal tests once positive will remain positive for life

Question 16

Treatment for early syphilis (primary, secondary, early latent)

Answer 16

B Pen 2.4 million im single dose

Question 17

Early latent syphilis

Answer 17

B pen 2.4 million im single doses

Question 18

Late Latent (>4 years from disease or unknown)

Answer 18

B Pen 2.4 million once a week for 3 weeks

Question 19

Neurosyphilis

Answer 19

3-4 million iv q4 for 10-14 days. or ceftriaxone

Question 20

Pregnancy, neonates and children

Answer 20

only penicillin

Question 21

Interval for repeat testing of non treponemal testing

Answer 21

Early or congenital (3, 6, and 12 months)
Secondary syphilis or > 1 year’s duration - 24 months
Late syphilis - 5 years

Question 22

When to retreat

Answer 22

signs or symptoms or sustained level or increase in non treponemal test after 6 months
positive VDRL/RPR persisting beyond 12 months in syphillis and 5 years in late syphilis.