Uvea: ocular syphilis treatment: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Uvea: ocular syphilis treatment

Sample item

A man with HIV has posterior placoid chorioretinitis and vitritis, and a very high RPR titre. What is the recommended treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Intravenous benzylpenicillin as for neurosyphilis

Ocular syphilis is managed like neurosyphilis because treponemes reach the eye and CSF. A course of intravenous aqueous penicillin G is given. A single benzathine dose does not reach adequate levels in these compartments.

Option by option

  • A. A single intramuscular dose of benzathine penicillin

    A single benzathine dose does not reach adequate levels in the eye and CSF.

  • B. Intravitreal ganciclovir

    Ganciclovir treats cytomegalovirus, and not syphilis.

  • C. Oral prednisolone alone

    Steroid alone does not treat the infection and could worsen it.

  • D. Intravenous benzylpenicillin as for neurosyphilis (correct)

    Correct. Ocular syphilis is treated with intravenous penicillin G, as for neurosyphilis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, Intravenous benzylpenicillin as for neurosyphilis. Ocular syphilis is managed like neurosyphilis because treponemes reach the eye and CSF.

Why is "A single intramuscular dose of benzathine penicillin" not the answer?

A single benzathine dose does not reach adequate levels in the eye and CSF.

Why is "Intravitreal ganciclovir" not the answer?

Ganciclovir treats cytomegalovirus, and not syphilis.

Why is "Oral prednisolone alone" not the answer?

Steroid alone does not treat the infection and could worsen it.

What concept does this question test?

It tests Uvea: ocular syphilis treatment in Ophthalmology. A course of intravenous aqueous penicillin G is given. A single benzathine dose does not reach adequate levels in these compartments.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Uvea: ocular syphilis treatment?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.