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Micro > 01b: Syphilis > Flashcards

01b: Syphilis Flashcards

1
Q

T. pallidum stains as gram (pos/neg).

A

Neither (though may stain as weak gram-neg)

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2
Q

List the modes of transmission of T. pallidum.

A
  1. Sex contact
  2. Transplacental
  3. Blood contact
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3
Q

Primary syphilis emerges within (X) days of acquisition and the classic finding is (Y).

A 
X = 10-90
Y = chancre (painless, indurated, usually solitary lesion at site of inoculation)
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4
Q

T/F: Syphilis is almost always sexually transmitted.

A

True

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5
Q

Spirochetes have unique ability to penetrate (X).

A

X = blood vessels

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6
Q

T/F: There has been a recent rapid decline in syphilis cases.

A

False - increase

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7
Q

Key clinical picture of primary syphilis.

A
  1. Painless ulcer/chancre at inoculation site (heaped borders, clean base)
  2. Painless bilateral lymphadenopathy
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8
Q

T/F: Primary syphilis symptoms resolve within few weeks, even without treatment.

A

True - but spirochetes disseminate

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9
Q

Key clinical picture of secondary syphilis.

A
  1. Low-grade fever, malaise, sore throat, lymphadenopathy
  2. RASH (including palms/soles)
  3. Condyloma lata (wart-like lesions in moist areas)
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10
Q

T/F: Secondary syphilis symptoms resolve within few weeks, even without treatment.

A

True

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11
Q

Rash in (primary/secondary/tertiary) syphilis is (macular/pustular/plaque/scaling) and often confused with:

A

Secondary;
Can be any of those;

Drug eruption

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12
Q

Symptoms of early neurosyphilis occurs in about (X) time after infection. It presents as (Y) disease.

A 
X = within 1 year
Y = meningitis (headache, photophobia, CN abnormalities)
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13
Q

Symptoms of late neurosyphilis usually occurs in about (X) time after infection. They fall into which two categories?

A

X = 10 years

  1. Meningovascular
  2. Parenchymatous
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14
Q

T/F: Both secondary and tertiary stages of syphilis represent reactivation of latent syphilis.

A

False - tertiary stage

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15
Q

Typical clinical manifestations of meningovascular symptoms of late neurosyphilis.

A

STROKES and seizures

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16
Q

Typical clinical manifestations of parenchymatous symptoms of late neurosyphilis.

A
  1. Tabes Dorsalis (shooting pains, ataxia)
  2. General paresis (dementia, psychosis, slurry speech)
  3. Argyll Robertson pupil
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17
Q

Argyll Robertson pupil is symptom of (X). Describe it.

A

X = late neurosyphilis

Bilateral small pupils that constrict to accommodation, but not light

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18
Q

List the three general presentations of tertiary syphilis.

A
  1. Late neurosyphilis
  2. CV syphilis
  3. Late benign syphilis
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19
Q

Symptoms of CV syphilis, which occurs more often in (M/F).

A

M (3x)

AAA, aortic insufficiency, coronary artery stenosis, myocarditis

20
Q

“Gummas” are seen in which infectious disease? Briefly describe these.

A

Late stage of syphilis;

Granulomatous process (involving skin, cartilage, bone)

21
Q

T/F: Syphilis in pregnancy increases risk for many adverse effects on child.

A

True - miscarriage/stillbirth, premature delivery, low weight, hydrops fetalis, congenital infection

22
Q

Incidence of congenital syphilis is clearly related to:

A

Socioeconomic factors and availability/use of pre-natal care

23
Q

T/F: Most syphilitic infants lack manifestations at birth.

A

True - typically takes 3 weeks to 3 months

24
Q

Classic findings of congenital syphilis.

A
  1. Rhinitis
  2. Skin eruptions
  3. Hepatomegaly, anemia, lymphadenopathy
25
Q

Failure to treat congenital syphilis can lead to which malformations?

A
  1. Dental abnormalities
  2. Eye damage
  3. Saddle-nose deformity
  4. Neurosyphilis
26
Q

T/F: T. pallidum is large enough to be seen in light microscope.

A

False - too thin

27
Q

(X) microscopy used to see T. pallidum. Best to isolate from (primary/secondary/tertiary) lesion.

A

X = dark-field or phase-contrast

Primary or secondary

28
Q

In most cases, how is syphilis diagnosed?

A
  1. Hx and physical exams

2. Serological tests

29
Q

Non-treponemal tests are used to diagnose (X). What do they detect?

A

X = syphilis

Ab against host antigens (cardiolipin), released from cells damaged during spirochete dissemination

30
Q

(Non-treponemal/Treponemal) tests used as screening test for (X). What are some risks for false positive?

A

Non-treponemal
X = syphilis

Advanced age, pregnancy, autoimmune diseases, viral infections

31
Q

Prozone effect can produce false (pos/neg) on (Non-treponemal/Treponemal) test. Describe this phenomenon.

A

False neg;
Non-treponemal

Too many Ab interferes with proper formation of antigen-antibody lattice

32
Q

Which value of (non-treponemal/treponemal) test is used to indicate of cure from (X) infection?

A

Non-treponemal;
X = syphilis
4-fold decline after treatment (independent of end titer)

33
Q

Treponemal tests are used to diagnose (X). What do they detect?

A

X = syphilis

IgG (and maybe IgM) against treponemal agents

34
Q

T/F: A positive treponemal test usually means it’ll be positive for life.

A

True

35
Q

It takes (X) days/weeks/months after infection for VDRL/RPR, aka (treponemal/non-treponemal) tests to come back positive if (Y) infection present.

A

X = 4-6 weeks
Non-treponemal
Y = syphilis

36
Q

T/F: In late syphilis, most untreated patients have negative non-treponemal tests.

A

False - 25%

37
Q

The gold standard for neurosyphilis diagnosis is:

A

None

38
Q

T/F: All treatment regimens for syphilis involve penicillin.

A

True

39
Q

When should pregnant women be screened for syphilis?

A

First prenatal visit

And if high risk, twice more in 3rd trimester (one at time of delivery)

40
Q

The Jarisch-Herxheimer reaction occurs after (X) treatment in some patients. What are the symptoms?

A

X = syphilis (with penicillin)

Similar to allergic reaction, but endotoxin-related (fever, chills, headaches, joint pain

41
Q

T/F: All patients with syphilis should be evaluated for other sexually transmitted
infections.

A

True

42
Q

What’s the etiologic agent in Chancroid? It’s a gram (pos/neg) (aerobe/anaerobe).

A

Haemophilus ducreyi;
Gram-negative;
Facultative anaerobe

43
Q

“School of fish” pattern in gram staining should make you think of which infective organism? What’s responsible for this pattern?

A

Haemophilus ducreyi (Chancroids);

agglutination properties that lead to clumping of organisms

44
Q

Describe the classic hallmark of Chancroid.

A

PAINFUL, ragged, NON-INDURATED, sharply demarcated ulcer which often has a necrotic, friable (crumbly) base

45
Q

Diagnosis of chancroid is almost always via (X).

A

X = history and physical exam

46
Q

Top two preferable treatments for Chancroid are:

A
  1. Azithromycin

2. Ceftriaxone

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