Treponema Pallidum: Diagnosis and Treatment
Treponema pallidum isolation from CSF is maximum in which stage of syphilis?
| A |
Primary syphilis |
|
| B |
Secondary syphilis |
|
| C |
Tertiary syphilis |
|
| D |
Tabes dorsalis |
Treponema pallidum isolation from CSF is maximum in which stage of syphilis?
| A |
Primary syphilis |
|
| B |
Secondary syphilis |
|
| C |
Tertiary syphilis |
|
| D |
Tabes dorsalis |
B. i.e. Secondary syphilis
True about syphilis is A/E:
| A |
True about syphilis is A/E: |
|
| B |
Infection leads to life long immunity |
|
| C |
IgM SE IgA |
|
| D |
b and c |
True about syphilis is A/E:
| A |
True about syphilis is A/E: |
|
| B |
Infection leads to life long immunity |
|
| C |
IgM SE IgA |
|
| D |
b and c |
B/C. i.e. Infection leads to life long immunity; IgNI & IgA
A patient has syphilis since 2 year. CSF examination was done & treatment started. Which of the following test is most useful in monitoring treatment
| A |
TPI |
|
| B |
VDRL |
|
| C |
FTA |
|
| D |
Dark ground microscopy |
A patient has syphilis since 2 year. CSF examination was done & treatment started. Which of the following test is most useful in monitoring treatment
| A |
TPI |
|
| B |
VDRL |
|
| C |
FTA |
|
| D |
Dark ground microscopy |
B i.e. VDRL
Drug of choice for syphilis in a pregnant women
| A |
Azithromycin |
|
| B |
Penicillin |
|
| C |
Tetracycline |
|
| D |
Ceftriaxone |
Drug of choice for syphilis in a pregnant women
| A |
Azithromycin |
|
| B |
Penicillin |
|
| C |
Tetracycline |
|
| D |
Ceftriaxone |
B i.e. Penicillin
Penicillin is the only recommended agent for treatment of syphilis in pregnancyQ. If the patient has a documented penicillin allergy, desensitization and penicillin therapy should be given.
All is true about syphilis except
| A |
Seropositive infant not treated at birth if mother received penicillin in 3rd trimester |
|
| B |
For neurosyphilis FTA-ABS is sensitive; VDRL diagnostic but CSF pleocylosis is best treatment response guide. |
|
| C |
HIV patients are less likely to become VDRL nonreactive after treatment |
|
| D |
EIA+, RPR+, indicate past or current infection |
All is true about syphilis except
| A |
Seropositive infant not treated at birth if mother received penicillin in 3rd trimester |
|
| B |
For neurosyphilis FTA-ABS is sensitive; VDRL diagnostic but CSF pleocylosis is best treatment response guide. |
|
| C |
HIV patients are less likely to become VDRL nonreactive after treatment |
|
| D |
EIA+, RPR+, indicate past or current infection |
A i.e. Seropositive infant not treated at birth if mother received penicillin in 3rd trimester
Biological False l’ositive/ BFP serological test for syphilis may be encountered in:
September 2004
| A |
Viral hepatitis |
|
| B |
SLE |
|
| C |
Leprosy |
|
| D |
All of the above |
Biological False l’ositive/ BFP serological test for syphilis may be encountered in:
September 2004
| A |
Viral hepatitis |
|
| B |
SLE |
|
| C |
Leprosy |
|
| D |
All of the above |
Ans. D i.e. All of the above
Dosage and drug of choice for primary syphilis:
September 2012
| A |
Amoxicillin (500 mg for 5 days) |
|
| B |
Benzathine penicillin (2.4 mega units deep IM) |
|
| C |
Erythromycin (2 gm daily for 2 weeks) |
|
| D |
Doxycycline (100 mg daily for 2 weeks) |
Dosage and drug of choice for primary syphilis:
September 2012
| A |
Amoxicillin (500 mg for 5 days) |
|
| B |
Benzathine penicillin (2.4 mega units deep IM) |
|
| C |
Erythromycin (2 gm daily for 2 weeks) |
|
| D |
Doxycycline (100 mg daily for 2 weeks) |
Ans. B i.e. Benzathine penicillin (2.4 mega units deep IM)
Treatment of syphilis
- Primary or secondary syphilis – Benzathine penicillin G 2.4 million units intramuscularly (IM) in a single dose
- Early latent syphilis – Benzathine penicillin G 2.4 million units IM in a single dose
- Late latent syphilis or latent syphilis of unknown duration – Benzathine penicillin G 7.2 million units total, administered as 3 doses of 2.4 million units IM each at 1-week intervals
- Pregnancy – Treatment appropriate to the stage of syphilis is recommended.
- In patients with a history of penicillin allergy, skin testing is recommended.
Which of the following is best used in the diagnosis of congenital syphilis:
March 2011
| A |
Dark ground microscopy |
|
| B |
VDRL |
|
| C |
IgM FTA-ABs |
|
| D |
TPI |
Which of the following is best used in the diagnosis of congenital syphilis:
March 2011
| A |
Dark ground microscopy |
|
| B |
VDRL |
|
| C |
IgM FTA-ABs |
|
| D |
TPI |
Ans. C: IgM FTA-ABs
A positive VDRL test has to be confirmed by fluorescent treponemal antibody absorption test (FTA-ABS) and treponema pallidum micro hemagglutination (MHA-TP) test which are specific
Late Congenital syphilis:
- Hutchinsons triad:
– Hutchinson teeth
– 8th cranial nerve deafness
– Interstitial keratitis
- Periosteitis (Higaumenakis sign)
- IgM FTA-Abs is best to diagnose syphilis
Diagnostic test for syphilis:
March 2013
| A |
VDRL |
|
| B |
RPR |
|
| C |
FTA-ABS |
|
| D |
IgG ELISA |
Diagnostic test for syphilis:
March 2013
| A |
VDRL |
|
| B |
RPR |
|
| C |
FTA-ABS |
|
| D |
IgG ELISA |
Ans. C i.e. FTA-ABS
Which of the following is not a test for syphilis:
September 2011
| A |
VDRL |
|
| B |
Frei test |
|
| C |
TPHA |
|
| D |
FTA-Abs |
Which of the following is not a test for syphilis:
September 2011
| A |
VDRL |
|
| B |
Frei test |
|
| C |
TPHA |
|
| D |
FTA-Abs |
Ans. B: Frei test
Frei test is an obsolete intradermal test done for lymphogranuloma venerum
The test shown in the picture below is most sensitive for diagnosis during which stage of syphilis?
| A |
Primary. |
|
| B |
Secondary. |
|
| C |
Tertiary. |
|
| D |
Congenital. |
The test shown in the picture below is most sensitive for diagnosis during which stage of syphilis?
| A |
Primary. |
|
| B |
Secondary. |
|
| C |
Tertiary. |
|
| D |
Congenital. |
Ans:B.)Secondary.
The test shown in the picture above is VDRL.
VDRLprinciple:
- When the heat inactivated (to destroy complement) serum of patient is reacted with freshly prepared non-treponemal antigen, flocculation reaction (antigen and antibody complex are suspended) occurs. The flocculation can be observed by using microscope.
- Reactive VDRL test serum can be quantitated to obtain the titre of “reagin antibodies” by using serial double dilution method.
