Sypilis

Question 1

What is the causative organism of syphilis

Answer 1

Tryptonaemia pallidum Graham negative spirochetes

Question 2

How is syphilis contacted

Answer 2

1. Sexual contact
2. blood transfusion
3. needles
4. contact with other fluids of the body
5. Through the birth canal
6. placenta

Question 3

What are the symptoms of primary syphilis

Answer 3

1. Painless genital ulcers (hard chancre)
2. Painless lymphadenopathy

Question 4

If syphilis is contracted through blood transfusion, will chancre be present 

Answer 4

No

Question 5

What is a chancre

Answer 5

Ulcer with raised borders hard base and fluid rich in spirochetes

Question 6

Why are shin Chancre and lymph nodes painless

Answer 6

Due to nerve damage

Question 7

What is the treatment for primary syphilis

Answer 7

1. Benzathine penicillin G 2.4 million units IM in gluteal region given once.
2. Doxycycline 100mg twice daily for 2 weeks if penicillin allergic patient.

Question 8

What are the characteristics of secondary syphilis

Answer 8

1. Spirachetemia 
2. Lymphadenopathy
3. Condylomata lata
4. Snail track ulcer in the mouth
5. Maculopapular rash mainly on soles and palms
6. acute neurological signs
7. hepatitis - jaundice
8. nephrotic syndrome
9. cranial nerve palsy
   

Question 9

What is the treatment for secondary syphilis

Answer 9

Same as given in primary syphilis if thre is no CNS
involvement.

Question 10

What is condylomata lata

Answer 10

Condylomata lata: Watery, plaque-like lesions found in the perianal area and other moist body sites.

Question 11

What are the characteristic findings tertiary syphilis

Answer 11

1. Localized gummatous lesions (gummas)
2. Diffuse inflammation in in arteries and CNS. Aortic aneurisms, neurosyphilis, subacute meningitis, tabes dorsalis, general paralysis. Argyll Robertson pupil

Question 12

What are The signs of early disease in congenital syphilis

Answer 12

1. Stillborn
2. dying in the womb
3. Maculopapular rash
4. hepatosplenomegaly
5. snuffles with spirochetes
6. optic neuritis

Question 13

What are the characteristics symptoms of late disease of congenital syphilis

Answer 13

1. Saddle nose
2. Hutchinson’s in sizers and Mulberry molars
3. hearing loss
4. saber shins

Question 14

What type of hypersensitivity reaction takes place in tertiary syphilis

Answer 14

Hypersensitivity type 4

Question 15

What are the three main antigens On T pallidum

Answer 15

1. Group specific antigens (all treponemas)
2. Species specific antigen (specific to T pallidum)
3. Cardiolipin (spirochetes plus cells in our body)

Question 16

Which type of antigen is present both in spirochetes and the cells in our body

Answer 16

Cardiolipin

Question 17

What are the investigations of syphilis

Answer 17

1. Dark field microscopy
2. VDRL test
3. RPR test
4. FTA-ABS test
5. TP-EIA test

Question 18

Which tests are nonspecific for syphilis and detect anti-cardiolipin

Answer 18

1. VDRL test (venereal disease research laboratory)
2. RPR test (rapid plasma regain)

Question 19

What are specific test for syphilis used to detect antibodies targeting T pallidum

Answer 19

1. FTA-ABS test (Fluorescent triptonemal antibody absorb test)
2. TP-EIA Test (treptonemal antigen base enzyme immunoassay test)

Question 20

If a pregnant patient is allergic to penicillin what you choose to fight off syphilis

Answer 20

1. Penicillin desensitization
2. erythromycin for pregnant women and penicillin for the newborn (Erythromycin crosses placenta poorly)

Question 21

What is Jarisch- Herxheimer reaction 

Answer 21

A reaction caused when using penicillin against spirochetes. Spirochetes die and release lots of antigens which causes over reaction of the immune system such as fever, sweating, muscle, joint pain