CC Sept 2015 Secondary syphilis

echoecho's version from 2015-11-03 03:17


Question Answer
Patients who are infected with Treponema pallidum and whoa re not initially diagnosed and treated may progress to what?secondary syphilis
When does the above occur?6-8 weeks after the primary infection occurs
Compare early primary syphilis to scondary syphilis as serological testsearly primary syphilis has negative testing while secondary syphilis testing is positive
List the s/s of secondary syphilis?1) cutaneous leions (81%) 2) oral lesions (36%) 3) genital lesions (20%) 4) CNS involvement (10%) 5) alopecia (7%)
List the cutaneous s/s (caused by direct invasion of the skin by the spirochete) as to their variability?1) macular or papular rash generally diffuse and symmetrical involving the trunk and extremities 2) palms and soles are often involved, which differentiates it from many other exanthems
List the differential diagnosis of secondary syphilis?1) erythema multiforme 2) granuloma annulare 3) lichen planus 4) SLE 5) psoriasis 6) sarcoidosis 7) vasculitis
Why has syphilis been called the "great masquerader"?because of the extensive differential diagnosis
*** Alopecia associated with secondary syphilis is characterized by what?moth eaten appearance (present in minority of patients)
Compare the lesions seen in secondary syphilis to HPV lesions?Secondary syphilis lesions are condyloma lata (flat,raised lesions occurring on the genitals or in the peri-anal region) 2) HPV lesions are papillary lesions called condyloma cuminata
List the systemic symptoms likely a result of a wide spread inflammatory response?1) weight loss 2) fatigue 3) fever 4) nausea 5) headache 6) sore throat 7) arthritis 8) hepatitis 9) uveitis 10) meningismus 11) synovitis 12) glomerulonephritis 13) nephrotic syndrome
The CDC recommends what treatment for secondary syphilis? for those with PCN-allergies, what should be done?1) one-time IM dose of 2.4 million units of benzathine penicillin G
List the nonpenicillin regimens?tetracycline, macrolides, ceftriaxone (not been studied extensively and data is limited)
Hand, foot and mouth disease is seen usually in what age group? Describe the lesions?1) children 2) vesicular and tender and usually resolve within a few days
Erythema multiforme lesions are located where and look like what?on the palms and soles (target-like)
Psoriasis can involve what part of the body? Decribe the lesions?entire body including the palms and soles. Lesions are more plaque-like and scaling
Scabies has a rash where? Are the lesions itchy? Distribution?1) hands, feet and body 2) intensely itchy 3) interdigit regions, belt line, skin folds INSTEAD OF A DIFFUSE distribution
*** SUMMARY= Serologic tests are ______ (negative vs. positive)?positive
*** SUMMARY = List the manifestations of secondary syphilis?cutaneous, oral, genital or CNS involvement
*** SUMMARY = What is treatment?one time IM dose of 2.4 million units of benathine penicillin