Term
| Spirochetes have a gram negative __________, but are not gram stainable. |
|
Definition
|
|
Term
| What gives spirochetes their spiral appearance? |
|
Definition
|
|
Term
| What type of stain is most commonly used for spirochetes? |
|
Definition
|
|
Term
| What other alternative staining techniques can be used for spirochetes besides silver stain? |
|
Definition
| dark field or fluorescent microscopy |
|
|
Term
| virulence factors for treponema |
|
Definition
-no known toxins
-induces inflammatory reaction with/without tissue destruction |
|
|
Term
|
Definition
|
|
Term
| transmission of treponema |
|
Definition
sexual contact
placenta
contact with infected ulcers |
|
|
Term
| Treponema pallidum is not routinely __________. |
|
Definition
|
|
Term
| What is the diagnosis of Treponema pallidum usually based on? |
|
Definition
material from lesions
clinical presentation
serology |
|
|
Term
| painless ulceration formed during the primary stage of primary syphilis |
|
Definition
|
|
Term
| What type of serology is done to test for syphilis? |
|
Definition
non-treponemal antibodies
treponemal antibodies |
|
|
Term
| incubation period for Treponema pallidum |
|
Definition
|
|
Term
| Where does the chancre form in primary syphilis? |
|
Definition
|
|
Term
| What are the classifications of syphilis? |
|
Definition
primary
secondary
tertiary
congenital |
|
|
Term
| Which serology test is used as a screening test for syphilis? |
|
Definition
| non-treponemal (reaginic) test |
|
|
Term
| The non-treponemal test has ________ sensitivity and __________ specificity. |
|
Definition
high sensitivity
low specificity |
|
|
Term
| What antigens are tested for in the non-treponemal test? |
|
Definition
|
|
Term
| What are the names of the non-treponemal (reaginic) tests? |
|
Definition
VDRL (Venereal Disease Research Laboratory)
RPR (Rapid Plasma Reagin) |
|
|
Term
| Which tests are ordered first when testing for syphilis? |
|
Definition
| non-treponemal (VDRL, RPR) |
|
|
Term
| What conditions may cause the non-treponemal tests to be falsely positive? |
|
Definition
pregnancy
elderly
viral infection |
|
|
Term
| What tests do you use to confirm syphilis? |
|
Definition
| treponemal antibody tests (FTAB-ABS, MHA-TP) |
|
|
Term
| What is used to confirm positive non-treponemal screening tests? |
|
Definition
| treponemal antibody tests |
|
|
Term
| The treponemal antibody titer _________ with disease, and remains positive for years, even with treatment. |
|
Definition
|
|
Term
| What are the treponemal antibody tests? |
|
Definition
FTAB-ABS (Fluorescent Treponemal Antibody-Absorption)
MHA-TP (Microhemagglutination-Treponema pallidum) |
|
|
Term
What do the following results mean?
+ VDRL or RPR
+ FTA-ABS or MHA-TP |
|
Definition
| active syphilis infection |
|
|
Term
What do the following results mean?
+ VDRL or RPR
- FTA-ABS or MHA-TP |
|
Definition
|
|
Term
What do the following results mean?
- VDRL or RPR
+ FTA-ABS or MHA-TP |
|
Definition
|
|
Term
What do the following results mean?
- VDRL or RPR
- FTA-ABS or MHA-TP |
|
Definition
negative for syphilis
too early for immune response
immunocompromised |
|
|
Term
| major symptoms of primary syphilis |
|
Definition
-non-tender, indurated chancre (ulcer) with fairly smooth margins at the site of inoculation
-regional lymphadenopathy |
|
|
Term
| Primary syphilis is highly _________. |
|
Definition
|
|
Term
| The chancre associated with primary syphilis heals spontaneously within __________. |
|
Definition
4-6 weeks
(without a scar) |
|
|
Term
| major symptoms of secondary syphilis |
|
Definition
-rash (including palms and soles)
-condyloma lata
-alopecia |
|
|
Term
| What constitutes early latent syphilis? |
|
Definition
An asymptomatic patient with positive RPR and TPHA and one of the following:
-negative serology within the past 2 years (new onset positive serology)
-fourfold increase in RPR titer on subsequent testing
-fourfold decline in RPR within 12 months after treatment |
|
|
Term
| major symptoms of tertiary syphilis |
|
Definition
neurologic and cardiovascular signs
-aoritis
-gummas
-tabes dorsalis, subacute meningitis, and/or general paresis |
|
|
Term
| When is tertiary (late) symptomatic syphilis suggested? |
|
Definition
| When a positive treponemal test (RPR may be negative) occurs in association with the typical neurologic or cardiovascular signs. |
|
|
Term
| What suggests asymptomatic neurosyphilis? |
|
Definition
| positive serology and a positive CSF-VDRL |
|
|
Term
| When testing CSF-VDRL, the disease is active if there are ___________ mononuclear cells/mm3 in the CSF. |
|
Definition
|
|
Term
| How long after primary syphilis does secondary syphilis occur if untreated? |
|
Definition
1-3 months
(usually about 6 weeks) |
|
|
Term
| Secondary syphilis resolves over _____ weeks, but serology remains positive. |
|
Definition
|
|
Term
| After secondary syphilis resolves, the patient may be ____________ or may... |
|
Definition
| asymptomatic or interrupted by relapses of secondary syphilis |
|
|
Term
| If secondary syphilis resolves and the patient has no relapses for over 4 years, they are _________ to the general public. |
|
Definition
|
|
Term
| Even if the patient has been relapse-free for over 4 years after secondary syphilis, who can they still infect? |
|
Definition
|
|
Term
| Even if the patient has been relapse-free for over 4 years after secondary syphilis, the infection can still... |
|
Definition
| progress to tertiary syphilis |
|
|
Term
| How long after the initial primary infection does tertiary syphilis present? |
|
Definition
|
|
Term
| Treponema pallidum crosses the placenta after _______ gestation if the woman has been infected less than ___ years. |
|
Definition
|
|
Term
| What major complications result from congenital syphilis? |
|
Definition
still birth
abortion
neonatal death |
|
|
Term
| clinical manifestations of early congenital syphilis |
|
Definition
-multiple fetal abnormalities
-secondary syphilis (nasal membrane snuffles, maculopapular rash, mucous patch) |
|
|
Term
| clinical manifestations of late congenital syphilis |
|
Definition
-asymptomatic until age 2-5
-neurosyphilis like tertiary syphilis
-saddle nose, Hutchinson teeth, saber shin |
|
|
Term
| mass of dead and swollen fiber-like tissue representing a localization of T. pallidum bacteria, which can form in the liver, brain, testis, heart, skin, and bone |
|
Definition
gumma
(associated with tertiary syphilis) |
|
|
Term
| Why is syphilis known as the "great imitator?" |
|
Definition
manifestations often resemble other disease processes
gummas can be very similar in appearance to other granulomatous inflammatory conditions such as tuberculosis, leprosy, and some fungal infections |
|
|
Term
| What bacteria is responsible for causing an erythematous rash with expanding borders and a clearing center? |
|
Definition
|
|
Term
| How is Borrelia burgdorferi detected? |
|
Definition
| culture or PCR (at the leading edge of the rash) |
|
|
Term
| What can cause stage one (early infection) Lyme disease? |
|
Definition
any Borrelia bacteria
(B. bissettii, B. lonestari, B. burgdorferi) |
|
|
Term
| transmission of Borrelia burgdorferi |
|
Definition
|
|
Term
|
Definition
fever, chills, fatigue
headache
flu-like symptoms
typical rash |
|
|
Term
| What bacteria causes the characteristic "bulls-eye" rash? |
|
Definition
|
|
Term
| What is the bulls-eye rash called? |
|
Definition
|
|
Term
| What species of tick causes B. burgdorferi infection? |
|
Definition
|
|
Term
| reservoir for B. burgdorferi |
|
Definition
white foot mice
whitetail deer |
|
|
Term
| How do you make a B. burgdorferi diagnosis? |
|
Definition
-serology
-PCR
-special stains
-culture (modified media) |
|
|
Term
| How long must the tick be attached for the organism to reach the salivary gland and infect the host? |
|
Definition
|
|
Term
| late symptoms of Lyme disease |
|
Definition
polyarthritis
neurologic impairment
fatigue (chronic) |
|
|
Term
| What, besides syphilis, does treponema cause? |
|
Definition
|
|
Term
| What do relapsing-fever borreliae cause? |
|
Definition
| recurrent febrile bacteremia |
|
|
