Paediatric infections: early congenital syphilis: practice question

A Pediatrics 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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Pediatrics · Paediatric infections: early congenital syphilis

Sample item

A 3-week-old has persistent blood-stained nasal discharge, a copper-coloured maculopapular rash on the palms and soles, and hepatosplenomegaly. The mother's syphilis serology was positive and untreated. Which drug is used?

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

The answer and the reasoning

D. Aqueous crystalline penicillin G for 10 days

Early congenital syphilis presents with snuffles, rash on palms and soles, hepatosplenomegaly and bone changes. Parenteral penicillin G for 10 days is the treatment of choice, and alternatives are not used. Doxycycline is avoided in young children.

Option by option

  • A. Doxycycline for 14 days

    Doxycycline is avoided in infants and is not the recommended therapy.

  • B. Single-dose azithromycin

    A single azithromycin dose does not cure congenital syphilis.

  • C. Oral amoxicillin for 7 days

    Oral amoxicillin does not give reliable treponemicidal CSF levels.

  • D. Aqueous crystalline penicillin G for 10 days (correct)

    Correct. Penicillin G is the drug of choice for congenital syphilis.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Aqueous crystalline penicillin G for 10 days. Early congenital syphilis presents with snuffles, rash on palms and soles, hepatosplenomegaly and bone changes.

Why is "Doxycycline for 14 days" not the answer?

Doxycycline is avoided in infants and is not the recommended therapy.

Why is "Single-dose azithromycin" not the answer?

A single azithromycin dose does not cure congenital syphilis.

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

Oral amoxicillin does not give reliable treponemicidal CSF levels.

What concept does this question test?

It tests Paediatric infections: early congenital syphilis in Pediatrics. Parenteral penicillin G for 10 days is the treatment of choice, and alternatives are not used. Doxycycline is avoided in young children.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Paediatric infections: early congenital syphilis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.