Ravilya Syphilis, All Books

Front 1

You are caring for a newborn infant of a mother who reports a history of syphilis but had uncertain treatment and no follow-up evaluation for her disease. Which of the following is most useful in determining whether the child has congenital syphilis?

Back 1

Venereal Disease Research Laboratory test (VDRL)

In the newborn, the VDRL may be positive either falsely or because of maternal infection and thus is not useful in screening the newborn. The FTA-ABS is a test specific for syphilis that would be positive in the infant with congenital syphilis and would not be affected by maternal infection unless the disease had been transmitted to the infant; however, there are no currently available recommended commercial tests for FTA-ABS IgM. Thus, in the infant, VDRL titers exceeding those of the mother, along with risk of infection based on the maternal history and findings, determine the need for further testing or treatment. Other findings that support a diagnosis of congenital syphilis include physical or x-ray findings of congenital syphilis, positive CSF VDRL, or elevated CSF cell count or protein. VDRL titers can be followed to determine response to therapy, and with successful therapy should decline. Blood or swab cultures are not helpful in diagnosing syphilis. Dark field microscopy is a useful test for diagnosing syphilis and must be prepared from active lesion

Front 2

what heart problem is ass with syphilis

Back 2

aort regurg

Front 3

tx of syphilis

Back 3

all moms and infants with positive maternal serology without documented adequate tx with Penicillin

Front 4

what is common in tx by penicillin

Back 4

jarish herzheimer reaction

Front 5

if allergic to penicilline how to tx the syphilis

Back 5

give doxycycline

Front 6

what is the best initial test for syphilis
what is thmost accurate test

Back 6

VDRL

FTA-ABC or dark fieldmicroscopy

Front 7

primary syphilis

Back 7

painless, but may be painful after bacterial infection
painless adenopathy

Front 8

how does the chancre heal

Back 8

spontaneusly, even without tx

Front 9

secondary syphilis

Back 9

rash( palms and soles)
alopecia areata
mucous patches
condyloma lata

Front 10

tertiary syphilis

Back 10

neurosyph--- meningo vascular ( stroke from vasculitis)
tabes dorsalis
general paresis- memory and personality change
aortitis ( aort regurge aortic aneurism)
gummas- skin and bone lesion

Front 11

false+ in syphilis

Back 11

infect
old age
inject drug use and AIDS
malaria
endocarditis

Front 12

when titers of VDRL are reliable

Back 12

at greater than 1:8
lower titers are most likely false+
high titers ( greater than 1;32) rarely are false+

Front 13

syphilis - tx

Back 13

primary and second:: single I/M penicillin
oral doxycycline if penicillin alerg

tertiary syphil
IV penicillin
if allerg- desensitize to penicillin

Front 14

when desensitization is answer in tx of syphilis

Back 14

neurosyphilis and pregnant

Front 15

yarisch herxheimer reaction

Back 15

fever and worse symt after tx

give aspirin and antypyretics

Front 16

if dark firld is positive what to do

Back 16

tx, no more testing

Front 17

A 25-year-old man presents
with a single, indurated, painless ulcer
on the penis that appeared two
days ago. His most recent unprotected
sexual contact was 21 days
before. An immediate rapid plasma
reagin (RPR) test is negative.
. The most likely diagnosis is

Back 17

Syphilis

Front 18

what test can be negative in up to 30% of patients at an initial visit for primary syphilis.

2 when The probability of a negative test is increased

Back 18

Nontreponemal tests RPR, VDRL can be negative in up to 30% of patients at an initial visit for primary syphilis. 2 The probability of a negative test is increased if the patient presents early in the course of primary syphilis.

Front 19

what test is more sensitive and
is reactive around the time of appearance of the lesion

Back 19

The FTA-ABS, a treponemal test, is more sensitive and
is reactive around the time of appearance of the lesion

Front 20

first choice to confirm a diagnosis of syphilis when a chancre
is present.

Back 20

The dark-field is the
investigation of first choice to confirm a diagnosis of syphilis when a chancre
is present.

Front 21

Both nontreponemal and treponemal tests will become reactive
within

Back 21

Both nontreponemal and treponemal tests will become reactive
within three weeks after the chancre has occurred

Front 22

The incubation
period for syphilis is

Back 22

The incubation
period for syphilis is between 10 and 90 days, with an average of 21 days.

Front 23

d/d
1 chancroid
2 Herpetic lesions
3 Donovanosis
4 Lymphogranuloma venereum

Back 23

1 The lesion typical of chancroid is a large and painful ulcer with undermined borders. Large inguinal adenopathy, often suppurative, is also
present. The incubation period is usually between 4 and 7 days

2 Herpetic lesions are shallow, painful, and multiple

3 Donovanosis is very rare in
developed countries and is characterized by lesions that slowly enlarge, bleed easily on contact, and often have beefy-red granulomatous tissue

4 Lymphogranuloma venereum is also uncommon. It is primarily a disease of
the lymphatic system. Patients often present with complaints related to
inguinal adenopathy. The initial lesion, which is small, shallow, and painless, often goes unnoticed.

Front 24

Which sexual partners should
be informed of the exposure and
referred for evaluation?

Back 24

For primary syphilis, sexual partners from the
previous three months since the onset of symptoms should be assessed (6
months for secondary syphilis, and 12 months for early latent

Front 25

treatment for
syphilis during pregnancy

Back 25

Penicillin is the only recommended treatment for
syphilis during pregnancy and should be given a least four weeks before
delivery to be effective in treating the fetus.

Regimens are the same as for
nonpregnant women. In this case, it would be prudent to treat as a case of
late latent syphilis (no symptoms consistent with secondary or primary
syphilis, and unable to confirm if early, that is, less than one-year duration).
Women who are allergic should be desensitized under observation and
Epidemiology and Prevention of Communicable Diseases Answers 109
treated with penicillin. A Jarisch-Xerheimer reaction can occur when treating
early syphilis. This may precipitate contractions after the second
trimester, so women should be observed. Erythromycin has an unacceptable
cure rate and is no longer recommended. Doxycycline is contraindicated
during pregnancy. Adequate regimens of ceftriaxone have not been defined.