PHRM 514 STD's Fall 2012 (1)

Secondary syphilis palmar lesions secondary stage

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Secondary Syphilis –  Palmar Lesions Secondary stage syphilis sores (lesions) on the palms of the hands. Referred to as "palmar lesions."  Centers for  Disease Control and Prevention. http://www.cdc.gov/std/syphilis/images/rash-palmar.htm.  Updated August  2, 2012.   Accessed October 17, 2012.
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Secondary Syphilis - Rash Secondary syphilis rash on the back.  Centers for Disease Control and Prevention.  http://www.cdc.gov/std/syphilis/images/rash-gbr.htm.  Updated August  2, 2012.  Accessed October 17, 2012.
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Latent Syphilis n Positive serologic test + no evidence of disease n Asymptomatic n Early latency § Acquired within the preceding year § 25% risk of spontaneous relapse n Late latency § 25-30% progress to tertiary syphilis or neurosyphilis n Latent syphilis of unknown duration Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028. Mehring, PM.  Sexually transmitted diseases.  In:  Porth, CM, editor.  Pathophysiology Concepts of Altered Health  States.   7th Ed.  Philadelphia:  Porth Lippincott Williams and Wilkins; 2005:1101-1110. Centers for Disease Control and Prevention.  Sexually Transmitted Diseases Treatment Guidelines.  MMWR  2010;59(RR-12):1-116.
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Neurosyphilis and Tertiary Syphilis n Delayed response of untreated or inadequately treated  syphilis 10-30 years after initial infection n ~30% of untreated patients progress n Neurosyphilis § Cerebrospinal fluid abnormalities consistent with CNS infection § Meningitis, general paresis, dementia, tabes dorsalis, deafness,  blindness, ataxia, sensory loss n Tertiary syphilis § Gumma § Rubbery, necrotic, destructive lesions § Can infiltrate any organ or tissue § Most common in skin, bone, soft tissue, and liver § Cardiovascular § Aortitis or aortic insufficiency Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028. Mehring, PM.  Sexually transmitted diseases.  In:  Porth, CM, editor.  Pathophysiology Concepts of Altered Health  States.   7th Ed.  Philadelphia:  Porth Lippincott Williams and Wilkins; 2005:1101-1110.
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Congenital Syphilis n T. pallidum  can cross the placenta anytime  during pregnancy n May result in: § Death § Prematurity § Congenital syphilis n Symptoms may be seen in: § 1st months of life § Later in childhood or adolescence Knodel, LC.  Sexually transmitted diseases.  In:  DiPiro JT, Talbert RL, Yee GC, et al., editors.  Pharmacotherapy a  pathophysiologic approach.  8th ed.  New York:  McGraw Hill Medical; 2011:2011-2028.
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