A newborn is diagnosed with congenital syphilis. Classic signs of congenital syphilis are?

DHS Staff Nurse - 2018 (Shift-2nd)

Child Health Nursing (Pediatrics)

Easy

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

Congenital syphilis is a systemic infection caused by the spirochete Treponema pallidum, transmitted from mother to fetus.
Early manifestations (birth to 2 years) are analogous to the secondary stage of acquired syphilis and involve multiple organ systems.
The classic triad of early signs includes rhinitis ('snuffles'), a maculopapular rash often on the palms and soles, and hepatosplenomegaly.
Rhinitis is a persistent, often bloody, nasal discharge that is highly infectious.
The rash is typically copper-colored and can lead to desquamation (peeling) of the skin on the hands and feet.
Hepatosplenomegaly, or the enlargement of the liver and spleen, is a common sign of systemic inflammation and infection.

Option A: This option is incorrect because a 'white strawberry tongue' is a classic sign of Kawasaki disease or scarlet fever, not congenital syphilis.
Option C: This option is incorrect because 'red edematous cheeks,' also known as a 'slapped cheek' appearance, is the hallmark sign of Fifth disease (Erythema infectiosum), caused by parvovirus B19.
Option D: This option describes dysmorphic features characteristic of a genetic condition, not an infection. Epicanthal folds, low-set ears, and a protruding tongue are classic features of Down syndrome (Trisomy 21).

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of congenital syphilis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Maternal screening for syphilis is a critical public health measure. All pregnant women should be tested at their first prenatal visit to prevent congenital syphilis.
Timely treatment of an infected mother with penicillin, ideally before the 16th week of pregnancy, can prevent fetal transmission and damage.
Untreated congenital syphilis can lead to severe long-term complications, including deafness, blindness, bone deformities, and neurodevelopmental problems.

How to Approach the Question

First, identify the core concept of the question, which is the 'classic signs' of 'congenital syphilis' in a 'newborn'. This points to early-stage manifestations.
Second, analyze each option by breaking it down into its individual signs.
Third, recall or look for the hallmark signs of early congenital syphilis. The key triad is rhinitis ('snuffles'), a specific type of rash (maculopapular, on palms/soles), and hepatosplenomegaly.
Fourth, evaluate the distractor options. Identify the specific sign in each option that does not fit with congenital syphilis (e.g., strawberry tongue, slapped cheeks, features of Down syndrome) and associate it with the correct disease.
Finally, select the option that contains the complete and accurate cluster of signs for early congenital syphilis.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1872-1874

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 384-386

E6 Medicine Harrison 22e Part 1 p. 1474-1476