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FD9 > 171 - Endemic (Nonvenereal) Treponematoses > Flashcards

171 - Endemic (Nonvenereal) Treponematoses Flashcards

1
Q

Endemic treponematoses include

A

Pinta
Yaws
Bejel

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2
Q

Important differences between the endemic treponematoses and syphilis

A

Nonvenereal form of transmission
Endemic occurrence
Tendency to affect children
Less likely risk for congenital transmission

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3
Q

Most benign of endemic treponematosis

Clinical manifestations limited to the skin, including vitiligo-like achromic lesions as well as hyperpigmented lesions

A

Pinta

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4
Q

Etiologic agent of pinta

A

Treponema carateum

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5
Q

Considered the first trepanematosis to occur in humans

A

Pinta

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6
Q

It has been said that _____ was man’s best friend: it follows him to the grave

A

Pinta

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7
Q

Stages of pinta

A
  1. Primary stage
    a. Early phase or initial period
    b. Secondary phase or period of cutaneous dissemination
  2. Late stage
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8
Q

Lesions of pinta that are initially red to violaceous and later become slate-blue, brown, gray, or black

A

Pintides

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9
Q

Areas that are often spared by pinta

A

Groin
Genital area
Inner and upper parts of the thighs

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10
Q

Y/N: Therapy can reverse the skin changes of late pinta

A

No - cannot reverse

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11
Q

Y/N: The only known reservoir of pinta is human beings

A

Yes

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12
Q

Assays used to detect Treponema-specific antibodies

When the result is positive, it usually remains positive for life

A

T. pallidum particle agglutination (TPPA)

T. pallidum particle hemagglutination (TPHA)

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13
Q

Y/N: The venereal disease research laboratory (VDRL) and rapid plasma reagin (RPR) tests are specific tests

A

No - nonspecific

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14
Q

More accurate to reflect disease activity, with titers falling rapidly after successful treatment

A

RPR

VDRL

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15
Q

Y/N: Serologic techniques cannot distinguish pinta from syphilis or any of the other nonvenereal treponematoses

A

Yes

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16
Q

Recommended treatment for pinta

A

Single or divided dose of long-acting benzathine penicillin (1.2 MU for adults; 0.6 MU for children)

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17
Q

Treatment with benzathine penicillin renders yaws lesions non-infectious in less than

A

24 hours

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18
Q

Most prevalent of the endemic treponematoses

A

Yaws

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19
Q

Countries with the largest cases of yaws

A

Papua New Guinea
Solomon Islands
Ghana

20
Q

Causative agent of yaws

A

T. pallidum spp pertenue

21
Q

Primary lesion of yaws: papule that evolves into a proliferative, exudative, papillomatous lesion or a crusted, nontender ulcer, most commonly located on the legs

A

Mother yaws, maman pian, or buba madre

22
Q

Secondary lesions of yaws: exudative, proliferative, and papillomatous
Usually generalized, bilateral, and symmetrical

A

Pianomes

23
Q

Secondary lesions of yaws: dry and papulosquamous
Multiple and generalized, and have annular or discoid morphology, with a squamous collaret (tinea yaws), grouped in a corymbose pattern

A

Pianides

24
Q

Most representative lesion of yaws

A

Pianomes or frambesiomas

25
Q

Because the acral lesions of yaws are tender or painful, patients develop a peculiar gait known as

A

Crab yaws

26
Q

Paronychia that originates from hyperkeratotic lesions in the nail folds in yaws

A

Crab yaws

27
Q

Y/N: All secondary yaws resolves, either spontaneously or after treatment

A

Yes

28
Q

Relapsing yaws tend to localize in

A

Perioral, perianal, and axillary areas

29
Q

About _____% of untreated yaws patients progress to the tertiary stage

A

10

30
Q

The complete destruction of the nasal cartilage and the collapse of the nasal pyramid in yaws results in a deformity known as

A

Gangosa

31
Q

The most important noncutaneous findings refer to the involvement of _____ in yaws

A

Osteoarticular structures

32
Q

Fusiform swelling of a finger affecting the two proximal phalanges is a common expression of this dactylitis in yaws

A

Ghoul hand

33
Q

Average number of bones involved in yaws

A

Three

34
Q

Specific hypertrophic bone exostosis of the paranasal area in yaws

A

Gondou

35
Q

Y/N: Late yaws is not associated with cardiovascular or neurologic disease

A

Yes

36
Q

False positives with RPR and VDRL can be seen in patients with

A

Other tropical diseases, such as malaria and leprosy

Rheumatic diseases

37
Q

An importance difference in histopathology with syphilis is that yaws

A

Does not induce vascular changes or endothelial proliferation

38
Q

Treatment of choice for yaws

A

Single-dose, long-acting penicillin

  1. 2 MU for patient older than 10 years
  2. 6 MU for those younger than 10 years
40
Q

Considered as effective as penicillin for yaws

A

One oral dose of azithromycin (30 mg/kg, to a maximal dose of 2g)

41
Q

Alternative drugs for adults with yaws who are allergic to penicillin

A

Oral tetracyclines, doxycycline, and erythromycin

42
Q

Alternative drug of choice for children younger than 12 years of age with yaws

A

Erythromycin

43
Q

Yaws lesions become noninfectious in ______ after therapy

A

24 hours

44
Q

Transmission routes of bejel

A

Direct contact

Fomites by sharing utensils

45
Q

Countries and regions with the largest number of bejel cases

A

African Sahelian countries
Saudi Arabia
(dry, hot climates)

46
Q

Among all the nonvenereal treponematosis, _____ is the one with which the differential diagnosis with venereal syphilis might be tricky

A

Bejel

47
Q

Treatment of choice for bejel

A

1.2 MU of benzathine penicillin in adults

Half the dose in children younger than 10 years

48
Q

Causative agent of bejel

A

T. pallidum spp endemicum

FD9 (108 decks)

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