Syphillis Flashcards

1
Q

What is syphilis?

A

A sexually transmitted infection (STI) caused by the spirochete bacterium Treponema pallidum.

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2
Q

What are the key stages of syphilis?

A

Primary syphilis: Characterized by a painless chancre.

Secondary syphilis: Systemic symptoms and rash.

Latent syphilis: Asymptomatic period.

Tertiary syphilis: Severe systemic complications (e.g., gummas, cardiovascular, neurosyphilis).

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3
Q

Who is most at risk for syphilis?

A

Sexually active individuals, particularly those with multiple partners.

Men who have sex with men (MSM).

People with HIV.

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4
Q

What bacterium causes syphilis?

A

Treponema pallidum, a thin, spiral-shaped spirochete.

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5
Q

How is syphilis transmitted?

A

Sexual transmission: Through direct contact with a chancre or mucocutaneous lesions.

Vertical transmission: From mother to fetus (congenital syphilis).

Rarely through blood transfusion or direct inoculation.

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6
Q

How does Treponema pallidum spread in the body?

A

Through hematogenous and lymphatic dissemination, leading to systemic involvement.

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7
Q

Why does syphilis progress through stages?

A

The immune response controls some bacterial spread but allows persistence in latent reservoirs, causing relapse or progression.

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8
Q

What are the hallmark features of primary syphilis?

A

Chancre: Painless, indurated ulcer at the site of inoculation (e.g., genitals, mouth, rectum).

Regional lymphadenopathy.

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9
Q

When does a chancre appear after exposure?

A

About 3 weeks post-exposure.

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10
Q

What are the hallmark features of secondary syphilis?

A

Symmetric, non-itchy maculopapular rash (often on palms and soles).

Condylomata lata: Moist, wart-like lesions in mucocutaneous areas.

Systemic symptoms: Fever, malaise, sore throat, lymphadenopathy.

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11
Q

When does secondary syphilis occur?

A

6–8 weeks after the primary stage.

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12
Q

What is latent syphilis?

A

Asymptomatic phase after untreated secondary syphilis, divided into:

Early latent: Within 1 year of infection, still infectious.

Late latent: Beyond 1 year, non-infectious except for vertical transmission.

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13
Q

What are the key manifestations of tertiary syphilis?

A

Gummas: Granulomatous lesions in skin, bone, or liver.

Cardiovascular syphilis: Aortitis, aortic aneurysms.

Neurosyphilis: Tabes dorsalis, general paresis, cranial nerve abnormalities.

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14
Q

What are the types of neurosyphilis?

A

Early neurosyphilis: Aseptic meningitis, cranial nerve palsies.

Late neurosyphilis: Tabes dorsalis (sensory ataxia), general paresis (dementia, psychiatric symptoms).

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15
Q

What are the clinical features of congenital syphilis?

A

Early signs: Snuffles (nasal discharge), rash, hepatosplenomegaly.

Late signs: Hutchinson teeth, saddle nose, frontal bossing, saber shins.

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16
Q

What tests are used to diagnose syphilis?

A

Non-treponemal tests: RPR (Rapid Plasma Reagin), VDRL (Venereal Disease Research Laboratory).

Treponemal tests: FTA-ABS (Fluorescent Treponemal Antibody Absorption), TP-PA (Treponema Pallidum Particle Agglutination).

17
Q

What is the purpose of non-treponemal tests?

A

To screen for syphilis and monitor treatment response (titers decrease after treatment).

18
Q

What is the purpose of treponemal tests?

A

To confirm the diagnosis of syphilis; remains positive for life.

19
Q

How is neurosyphilis diagnosed?

A

Lumbar puncture with CSF analysis showing:

  • Elevated WBCs and protein.
  • Positive VDRL in CSF.
20
Q

What is the first-line treatment for syphilis?

A

Benzathine penicillin G:
- Single dose for primary, secondary, or early latent syphilis.
- Weekly doses for 3 weeks for late latent or tertiary syphilis.

21
Q

What is the treatment for neurosyphilis?

A

IV penicillin G for 10–14 days.

22
Q

What alternative treatments are available for penicillin-allergic patients?

A

Doxycycline (14–28 days for early or latent syphilis).

Ceftriaxone for neurosyphilis (if penicillin desensitization is not feasible).

23
Q

What is the Jarisch-Herxheimer reaction?

A

An acute febrile reaction with headache and myalgia within 24 hours of treatment, due to rapid lysis of treponemes.

24
Q

How is the response to treatment monitored?

A

Repeat non-treponemal titers (e.g., RPR) at 3, 6, and 12 months.

A four-fold decrease in titer (e.g., 1:32 to 1:8) indicates successful treatment.