[MCQ] Syphilis- Part 2

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Syphilis- Part 2

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Question 1

Which of the following is false about mucous patches in secondary syphilis ?

A	Superficial mucosal erosions
B	Involve oral or genital mucosa
C	Painful
D	Silver-gray erosion surrounded by red periphery

Question 1 Explanation:

Superficial mucosal erosions or mucous patches of secondary syphilis involve oral or genital mucosa, are painless silver-gray erosion surrounded by a red periphery.

Question 2

Which of the following papulosquamous disease shares many clinical features with secondary syphilis ?

A	Psoriasis
B	Lichen planus
C	Pityriasis rosea
D	Dermatophytosis

Question 2 Explanation:

Clinical features of Pityriasis rosea like rash often preceded by herald patch, oval to round plaques with trailing scale, affecting trunk and eruption lines up in skin folds giving a “fir tree” like appearance shares many clinical features with secondary syphilis in which palms & soles are spared.

Question 3

Scattered, poorly circumscribed patches of alopecia seen in secondary stage of syphilis is termed as ?

A	Moth eaten appearance
B	Cheese spread appearance
C	Salt and pepper appearance
D	Wild pluck appearance

Question 3 Explanation:

Scattered, poorly circumscribed patches of alopecia with a “moth-eaten” appearance are a manifestation of secondary stage of syphilis.

Question 4

Which of the following ocular finding is classic of secondary syphilis ?

A	Pupillary abnormalities
B	Optic neuritis
C	Iritis or uveitis
D	Retinitis

Question 4 Explanation:

Ocular findings in secondary syphilis include pupillary abnormalities, optic neuritis and the classic iritis or uveitis. Optic atrophy occurs in tabes.

Question 5

Which of the following is false about hepatic involvement in syphilis ?

A	Usually asymptomatic
B	Unusually high serum alkaline phosphatase
C	No cholestasis
D	None of the above

Question 5 Explanation:

Hepatic involvement is common in syphilis though asymptomatic. Unusually high serum alkaline phosphatase without cholestasis with some hepatocellular damage are common.

Question 6

Diagnosis of latent syphilis is established by ?

A	Positive serologic tests for syphilis
B	Normal CSF examination
C	Absence of clinical manifestations of syphilis
D	All of the above

Question 6 Explanation:

Positive serologic tests for syphilis, with normal CSF examination & absence of clinical manifestations of syphilis indicate a diagnosis of latent syphilis.

Question 7

Meningovascular syphilis manifests at what time after after infection ?

A	1 - 5 years
B	5 - 10 years
C	10 - 15 years
D	15 - 20 years

Question 8

Which of the following comes last in the clinical spectrum of symptomatic neurosyphilis ?

A	Meningeal syphilis
B	Meningovascular syphilis
C	Tabes dorsalis
D	General paresis

Question 8 Explanation:

In symptomatic neurosyphilis, onset of symptoms are <1 year after infection for meningeal syphilis, at 5 - 10 years for meningovascular syphilis, at 20 years for general paresis & at 25 - 30 years for tabes dorsalis

Question 9

Patients presenting with uveitis or iritis frequently have ?

A	Meningeal syphilis
B	Meningovascular syphilis
C	Tabes dorsalis
D	General paresis

Question 9 Explanation:

Patients presenting with uveitis or iritis frequently have meningeal syphilis

Question 10

Meningeal syphilis may present with ?

A	Cranial nerve involvement
B	Seizures
C	Changes in mental status
D	All of the above

Question 10 Explanation:

Meningeal syphilis may may present with headache, nausea, vomiting, neck stiffness, cranial nerve involvement, seizures, and changes in mental status.

Question 11

Meningeal syphilis may be concurrent with or may follow ?

A	Primary syphilis
B	Secondary syphilis
C	Tertiary syphilis
D	Any of the above

Question 11 Explanation:

Meningeal syphilis may be concurrent with or may follow secondary syphilis

Question 12

Most common presentation of meningovascular syphilis is ?

A	Argyll Robertson pupils
B	Illusions, delusions, hallucinations
C	Stroke in MCA territory of a young adult
D	Loss of position sensation

Question 12 Explanation:

Most common presentation of meningovascular syphilis is stroke syndrome involving middle cerebral artery in a relatively young adult.

Question 13

Stroke in meningovascular syphilis is preceded by ?

A	Painful sensory neuropathy
B	Visual disturbances
C	Skin eruption
D	Subacute encephalitic prodrome

Question 13 Explanation:

Gradually progressive vascular syndrome (stroke) in meningovascular syphilis is preceded by a subacute encephalitic prodrome consisting of headache, vertigo, insomnia & psychological abnormalities.

Question 14

Which of the following is not a manifestation of general paresis ?

A	Argyll Robertson pupils
B	Areflexia
C	Decrease in recent memory
D	Illusions, delusions, hallucinations

Question 14 Explanation:

Manifestations of general paresis reflect widespread late parenchymal damage that include personality, affect, reflexes (hyperactive), eye ( Argyll Robertson pupils), sensorium (illusions, delusions, hallucinations), intellect (a decrease in recent memory and in the capacity for orientation, calculations, judgment, and insight), and speech.

Question 15

Which of the following structures is involved in tabes dorsalis ?

A	Posterior columns
B	Dorsal roots
C	Dorsal root ganglia
D	All of the above

Question 15 Explanation:

Tabes dorsalis is a late manifestation of syphilis with presentation due to demyelination of posterior columns, dorsal roots & dorsal root ganglia

Question 16

Which of the following is a manifestation of Tabes dorsalis ?

A	Ataxic wide-based gait
B	Argyll Robertson pupil
C	Areflexia
D	All of the above

Question 16 Explanation:

Tabes dorsalis is a late manifestation of syphilis that presents as Argyll Robertson pupil, ataxic wide-based gait & footslap, paresthesia, bladder disturbances, impotence, areflexia & loss of position, deep pain & temperature sensations, Charcot’s joints & perforating ulceration of feet

Question 17

Visceral crisis in tabes refers to ?

A	Acute abdominal pain
B	Acute vomiting
C	Acute abdominal pain with vomiting
D	Any of the above

Question 17 Explanation:

Acute abdominal pain with vomiting in tabes is termed as visceral crisis. Occurs in 15 - 30% of patients.

Question 18

Cardinal sign of tabes is ?

A	Loss of reflexes in legs
B	Impaired position & vibratory sense
C	Romberg’s sign
D	All of the above

Question 18 Explanation:

Cardinal signs of tabes are loss of reflexes in legs, impaired position & vibratory sense, Romberg’s sign and, bilateral Argyll Robertson pupils (fail to constrict to light but accommodate).

Question 19

Which of the following is false about syphilitic aneurysms ?

A	Saccular aneurysm
B	Involves ascending aorta
C	Frequently lead to dissection
D	Due to endarteritis obliterans of vasa vasorum

Question 19 Explanation:

Syphilitic aneurysms are usually saccular, involve ascending aorta and do not lead to dissection. These cardiovascular manifestations are due to endarteritis obliterans of vasa vasorum, which supply blood to large vessels. Syphilitic periaortitis & mesoaortitis damage elastic fibers with weakening of aortic wall. ~90% of syphilitic aneurysms are located in ascending aorta or aortic arch.

Question 20

Which of the following about cardiovascular syphilis is false ?

A	Endarteritis obliterans of vasa vasorum
B	Symptoms usually appear 10 to 40 years after infection
C	Linear calcification of descending aorta on chest x-ray
D	Syphilitic aneurysms are saccular & do not lead to dissection

Question 20 Explanation:

Radiological sign of cardiovascular syphilis is appearance of linear calcification of ascending aorta

Question 21

Which is the commonest valvular lesion in syphilis ?

A	Aortic stenosis
B	Aortic regurgitation
C	Mitral regurgitation
D	Tricuspid regurgitation

Question 21 Explanation:

Cardiovascular manifestations that come up 10 - 40 years after infection are uncomplicated aortitis, aortic regurgitation, saccular aneurysm of ascending aorta and coronary ostial stenosis

Question 22

Till what time, adequate treatment of syphilis mother could prevent congenital syphilis ?

A	Before 16th week of pregnancy
B	Before 24th week of pregnancy
C	Before 28th week of pregnancy
D	Before 32nd week of pregnancy

Question 22 Explanation:

Adequate treatment of the mother before 16th week of pregnancy prevents fetal damage & treatment of mother before third trimester adequately treats the infected fetus.

Question 23

Which is the earliest sign of congenital syphilis ?

A	Rhinitis
B	Superficial desquamation
C	Petechiae
D	Papulosquamous lesions

Question 23 Explanation:

Earliest sign of congenital syphilis (2 - 6 weeks after birth) is usually rhinitis, or “snuffles” which is soon followed by other mucocutaneous lesions which include bullae (syphilitic pemphigus), vesicles, superficial desquamation, petechiae, and papulosquamous lesions, mucous patches & condylomata lata.

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See all quizzes of Syphilis- Part 2 here:

1 Which of the following is false about mucous patches in secondary
syphilis ?
A. Superficial mucosal erosions
B. Involve oral or genital mucosa
C. Painful
D. Silver-gray erosion surrounded by red periphery

2 Which of the following papulosquamous disease shares many
clinical features with secondary syphilis ?
A. Psoriasis
B. Lichen planus
C. Pityriasis rosea
D. Dermatophytosis

3 Scattered, poorly circumscribed patches of alopecia seen in
secondary stage of syphilis is termed as ?
A. Moth eaten appearance
B. Cheese spread appearance
C. Salt and pepper appearance
D. Wild pluck appearance

3 Which of the following ocular finding is classic of secondary
syphilis ?
A. Pupillary abnormalities
B. Optic neuritis
C. Iritis or uveitis
D. Retinitis

4 Which of the following is false about hepatic involvement in
syphilis ?
A. Usually asymptomatic
B. Unusually high serum alkaline phosphatase
C. No cholestasis
D. None of the above

5 Diagnosis of latent syphilis is established by ?
A. Positive serologic tests for syphilis
B. Normal CSF examination
C. Absence of clinical manifestations of syphilis
D. All of the above

6 Meningovascular syphilis manifests at what time after after infection ?
A. 1 – 5 years
B. 5 – 10 years
C. 10 – 15 years
D. 15 – 20 years
7 Which of the following comes last in the clinical spectrum of
symptomatic neurosyphilis ?
A. Meningeal syphilis
B. Meningovascular syphilis
C. Tabes dorsalis
D. General paresis

8 Patients presenting with uveitis or iritis frequently have ?
A. Meningeal syphilis
B. Meningovascular syphilis
C. Tabes dorsalis
D. General paresis

9 Meningeal syphilis may present with ?
A. Cranial nerve involvement
B. Seizures
C. Changes in mental status
D. All of the above

10 Meningeal syphilis may be concurrent with or may follow ?
A. Primary syphilis
B. Secondary syphilis
C. Tertiary syphilis
C. Any of the above

11 Most common presentation of meningovascular syphilis is ?
A. Argyll Robertson pupils
B. Illusions, delusions, hallucinations
C. Stroke in MCA territory of a young adult
D. Loss of position sensation

12 Stroke in meningovascular syphilis is preceded by ?
A. Painful sensory neuropathy
B. Visual disturbances
C. Skin eruption
D. Subacute encephalitic prodrome

13 Which of the following is not a manifestation of general
paresis ?
A. Argyll Robertson pupils
B. Areflexia
C. Decrease in recent memory
D. Illusions, delusions, hallucinations

14 Which of the following structures is involved in tabes dorsalis ?
A. Posterior columns
B. Dorsal roots
C. Dorsal root ganglia
D. All of the above

15 Which of the following is a manifestation of Tabes dorsalis ?
A. Ataxic wide-based gait
B. Argyll Robertson pupil
C. Areflexia
D. All of the above

16 Visceral crisis in tabes refers to ?
A. Acute abdominal pain
B. Acute vomiting
C. Acute abdominal pain with vomiting
D. Any of the above

17 Cardinal sign of tabes is ?
A. Loss of reflexes in legs
B. Impaired position & vibratory sense
C. Romberg’s sign
D. All of the above

18 Which of the following is false about syphilitic aneurysms ?
A. Saccular aneurysm
B. Involves ascending aorta
C. Frequently lead to dissection
D. Due to endarteritis obliterans of vasa vasorum

19 Which of the following about cardiovascular syphilis is false ?
A. Endarteritis obliterans of vasa vasorum
B. Symptoms usually appear 10 to 40 years after infection
C. Linear calcification of descending aorta on chest x-ray
D. Syphilitic aneurysms are saccular & do not lead to dissection

20 Which is the commonest valvular lesion in syphilis ?
A. Aortic stenosis
B. Aortic regurgitation
C. Mitral regurgitation
D. Tricuspid regurgitation

21 Till what time, adequate treatment of syphilis mother could prevent
congenital syphilis ?
A. Before 16th week of pregnancy
B. Before 24th week of pregnancy
C. Before 28th week of pregnancy
D. Before 32nd week of pregnancy

22 Which is the earliest sign of congenital syphilis ?
A. Rhinitis
B. Superficial desquamation
C. Petechiae
D. Papulosquamous lesions

Syphilis

[MCQ] Syphilis- Part 2

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Syphilis- Part 2

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