American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is a complication of tertiary syphilis?

1. Respiratory failure

2. Cardiovascular disease

3. Liver failure

4. Neuropathy

The correct answer is: Cardiovascular disease

Tertiary syphilis is the late stage of syphilis infection that typically occurs years after the initial infection if left untreated. One of the significant complications associated with tertiary syphilis is cardiovascular disease, particularly aortitis which can lead to aneurysm formation and other cardiovascular issues. This condition arises primarily due to the inflammation of the cardiovascular system caused by the Treponema pallidum bacteria. The cardiovascular complications may encompass aortitis, endocarditis, and other related conditions that can compromise the cardiovascular health of an individual. As tertiary syphilis progresses, these complications can manifest in various symptoms, including chest pain, heart failure, and potentially life-threatening events if not identified and treated. In contrast, other options such as respiratory failure, liver failure, and neuropathy, while they may occur in other diseases or stages of syphilis, are not considered direct complications of tertiary syphilis. This distinction is crucial because it highlights the specific risk factors and health outcomes associated with untreated syphilis, emphasizing the need for timely diagnosis and management to prevent these severe complications.