STI: treatment of neurosyphilis: practice question

A Dermatology 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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Dermatology · STI: treatment of neurosyphilis

Sample item

Which regimen is appropriate for neurosyphilis?

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

The answer and the reasoning

A. Intravenous aqueous crystalline penicillin G 18 to 24 million units daily for 10 to 14 days

Benzathine penicillin does not achieve treponemicidal levels in the cerebrospinal fluid, so neurosyphilis is treated with high-dose intravenous aqueous penicillin G for 10 to 14 days. Ceftriaxone is an alternative.

Option by option

  • A. Intravenous aqueous crystalline penicillin G 18 to 24 million units daily for 10 to 14 days (correct)

    Correct. High-dose intravenous penicillin reaches CSF.

  • B. Oral azithromycin for 3 days

    Azithromycin for 3 days is inadequate.

  • C. Oral doxycycline for 7 days

    Doxycycline for 7 days is inadequate.

  • D. Single dose benzathine penicillin

    Benzathine penicillin has poor CSF penetration.

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 Dermatology question

What is the answer to this Dermatology question?

The best answer is A, Intravenous aqueous crystalline penicillin G 18 to 24 million units daily for 10 to 14 days. Benzathine penicillin does not achieve treponemicidal levels in the cerebrospinal fluid, so neurosyphilis is treated with high-dose intravenous aqueous penicillin G for 10 to 14 days.

Why is "Oral azithromycin for 3 days" not the answer?

Azithromycin for 3 days is inadequate.

Why is "Oral doxycycline for 7 days" not the answer?

Doxycycline for 7 days is inadequate.

Why is "Single dose benzathine penicillin" not the answer?

Benzathine penicillin has poor CSF penetration.

What concept does this question test?

It tests STI: treatment of neurosyphilis in Dermatology. Ceftriaxone is an alternative.

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 STI: treatment of neurosyphilis?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology 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.