American Board of Internal Medicine (ABIM) Certification Practice Exam

Neurosyphilis can present in which of the following forms?

1. Skin

2. Endocrine

3. Meningovascular

4. Musculoskeletal

The correct answer is: Meningovascular

Neurosyphilis is a serious complication of syphilis that primarily affects the central nervous system. One of its notable forms is meningovascular neurosyphilis, which occurs when the infection leads to inflammation of the meninges and blood vessels in the brain. This condition can result in various neurological symptoms, including headaches, seizures, and even strokes due to vascular occlusion. Meningovascular neurosyphilis is characterized by the infiltration of lymphocytes within the meninges and the small blood vessels of the brain. This inflammatory process can disrupt normal blood flow, leading to ischemia and subsequent neurological deficits. The clinical presentation may vary depending on the areas of the central nervous system that are affected. Other forms of presentation from the other options do not relate to the typical manifestations of neurosyphilis. Skin manifestations are typically seen in primary syphilis (chancre) or secondary syphilis (rash), while endocrine symptoms are not commonly associated with neurosyphilis. Though musculoskeletal pain can occur in various conditions, it is not a recognized direct manifestation of neurosyphilis itself. Therefore, meningovascular is the distinct and relevant form of neurosyphilis in this context.