Page 1 of 1: syphils-- med

shraddha · Credits: 19590 My Scrapbook

A politician went to Japan as part of a delegation trying to sell the Great Basin National Park to the Japanese so that a Japanese mulching company can convert the 3000-year-old bristlecone pines. About six weeks after some intense entertaining of the delegation by the Japanese, the politician develops a low-grade fever and a red-brown macular rash on the palms of his hand and the soles of his feet. He comes to your clinic for evaluation of the rash. He has only vague memory of a tea ceremony involving attractive young Japanese women. Which of the following actions is entirely without a rational basis in this medical situation and/or would not reflect good wisdom on your part:
A. You put on gloves to exam the rash further, and wear the gloves to examine the patient's mouth.
B. You order a serologic test for which the antigen is a non-organism-specific cardiolipin. If the previous test is positive, you may want to confirm it with an organism-specific test like the T. pallidum FTA-ABS test.
C. You tell the patient not to have unprotected sex with anyone until the results of the serologic test in B are available.
D. You tell the patient that this rash is most likely the initial manifestation of an infection that is likely to progress quickly, so immediate IV antibiotics are necessary

manpreet108 · Credits: 30682 My Scrapbook

A politician went to Japan as part of a delegation trying to sell the Great Basin National Park to the Japanese so that a Japanese mulching company can convert the 3000-year-old bristlecone pines. About six weeks after some intense entertaining of the delegation by the Japanese, the politician develops a low-grade fever and a red-brown macular rash on the palms of his hand and the soles of his feet. He comes to your clinic for evaluation of the rash. He has only vague memory of a tea ceremony involving

attractive young Japanese women.

i wd suspect --secondary stage of syphilis with the highlighted leads in mind.

Which of the following actions is entirely without a rational basis in this medical situation and/or would not reflect good wisdom on your part:

A. You put on gloves to exam the rash further, and wear the gloves to examine the patient's mouth.

thats quite logical...condyloma lata seen in second stage is infact the most infectious lesion.

B. You order a serologic test for which the antigen is a non-organism-specific cardiolipin. If the previous test is positive, you may want to confirm it with an organism-specific test like the T. pallidum FTA-ABS test.

since the test is not very sensitive we have to confirm it with more specific ones--like TPHA,FTA-ABS,

C. You tell the patient not to have unprotected SEX with anyone until the results of the serologic test in B are available.

thats justified ..

D. You tell the patient that this rash is most likely the initial manifestation of an infection that is likely to progress quickly, so immediate IV antibiotics are necessary .

untreated secondary syphilis resolves in 3-12 wks leaving the pt in asymptomatic latent phase.
so t/t policy is to give im--benzathine penicillin wkly for 3 wks.

so i wd go for 4.

shraddha · Credits: 19590 My Scrapbook

thanks

manpreet108 · Credits: 30682 My Scrapbook

a small addition here/correction rather--

t/t plan for sec syphilis /or early latent syphilis --is im benzathine peniccilin--2.4MIU--sinle dose..

what i mentioned in my prev post was that for late latent syphilis /or syphilis of unknown duration...

pls note the correction...

vineetgsvm · Credits: 122773 My Scrapbook

nice synopsis and explanation indeed
thanx manpreet n shraddha for the vigennette

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