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14 Cards in this Set

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What are the 2 major clinical stages of syphilis?
• early (infectious) syphilis: includes primary and secondary lesions
• late syphilis
What are characteristics of primary syphilis?
• develops a chancre (a papule that ulcerates)
• painless, border-raised, firm
• persists 3-6 weeks
When does secondary syphilis develop?
develops 6-8 weeks after chancre
Describe the skin lesions in secondary syphilis
• mucous membrane lesion (ex. patches, ulcers)
• red-brown hyperpigmented macules on the palms and soles
• can form condylomata lata (large, pale, flat-topped papules): florent manifestation
• can develop lesions on palms and soles
What are other manifestations of secondary syphilis?q
• alopecia (moth-eaten appearance)
• gastritis
• hepatitis
• lymphadenopathy
• nephritis or nephrosis
• meningitis
• osteitis
• pityriasis rosea
• uveitis
What are manifestations of late syphilis?
• gummatous lesoins
• cardiovascular syphilis (with development of aortitis with medial necrosis)
• CNS syphilis (ex. meningovascular, tabes dorsalis, general paresis)
What is a Jarish-Herxheimer reaction?
• a systemic response to penicillin-induced lysis of spirochetes
• seen in patients with neurosyphilis
What are the indirect antibody tests used to measures titers for syphilis?
• VDRL
• RPR
What titers would be considered "false-positive"?
1:1, 1:2, 1:4

* titers can be < 1:4 in the late (tertiary) stage
What are diseases that can cause false-positive results in an indirect antibody test?
• autoimmune disease
• mononucleosis
• infective endocarditis
• hepatitis C
• HIV
What is the treatment for primary or secondary syphilis?
Benzathine penicillin 2.4 MU IM
What is the treatment for late latent or late syphilis?
Benzathine penicillin, 2.4 MU IM per week for 3 weeks
What is the treatment for neurosyphilis, cardiovascular, or gummatous involvement?
Aqeuous penicillin G, 20 MU IV per day for 10 days
One of the manifestations of tertiary syphilis is general paresis. What are manifestations of general paresis?
• personality changes
• hyperactive reflexes
• Argyll Robertson pupil
• decreased memory
• slurred speech
• optic atrophy