2: Syphilis & Pediculosis Flashcards
What MOST complicates treatment of syphilis at the primary and secondary stages?
Lesions eventually go away so patients don’t present.
Neurosyphilis is diagnosable by the presence of?
The Argyll Robertson pupil–One or both pupils fails to constrict in response to light, but DOES constrict to focus on a near object.
_____ is the most effective antibiotic against syphilis.
Penicillin is the most effective antibiotic against syphilis.
Which factors complicate the diagnosis and treatment of genital syphilis?
a. Can’t culture, Can’t Gram stain
B. Antibiotic resistance, patient noncompliance
C. No useful serologic tests, difficult to diagnose on exam
D. All of the above
a. Can’t culture, Can’t Gram stain
Which modern invention has been LEAST useful in reducing human morbidity from spirochetes?
Latex condom
Insect repellent
Water chlorination
acyclovir
acyclovir
Pediculosis is caused by three types of lice. Head: _____, itchy behind ears. Body: _____, itchy at night. Pubic: _____, itchy groin. Diagnose in office by _____, magnifying glass, microscope. Head & pubic nits are on _____, body nits are on _____. Head & body lice are _____, pubic lice are _____ (crabs). Treat with _____ rounds of insecticide AND nit combing AND hot _____. Check close contacts, inform all contacts. Pubic: perform full STD panel!
Pediculosis is caused by three types of lice. Head: schoolkids, itchy behind ears. Body: homeless, itchy at night. Pubic: promiscuous, itchy groin. Diagnose in office by eye, magnifying glass, microscope. Head & pubic nits are on hair, body nits are on clothes. Head & body lice are elongated, pubic lice are wide (crabs). Treat with TWO rounds of insecticide AND nit combing AND hot laundering. Check close contacts, inform all contacts. Pubic: perform full STD panel!
Treponema:
Too _____ to see by standard microscopy, use _____ (no Gram stain!)
_____ be cultured
Invade lymphatics and bloodstream right away (no build-up)
Virulence based on immune _____ – _____ inflammation
Treponema:
Too small to see by standard microscopy, use darkfield (no Gram stain!)
Can’t be cultured
Invade lymphatics and bloodstream right away (no build-up)
Virulence based on immune evasion – low inflammation
_____ transmitted sexually or congenitally, yaws & pinta by _____ contact. Humans raise mostly-_____ antibodies, in quantity (reagin)
T. pallidum (Syphilis) transmitted sexually or congenitally, yaws & pinta by direct contact. Humans raise mostly-useless antibodies, in quantity (reagin)
Syphilis has four-stage disease: primary _____, secondary ( _____-wide rashes, _____ lata, and patchy _____), _____ period, _____ gummas, neurosyphilis, cardiac involvement
Syphilis has four-stage disease: primary chancre, secondary (body-wide rashes, condylomata lata, and patchy alopecia), latent period, tertiary gummas, neurosyphilis, cardiac involvement
_____ may be meningitis, tabes dorsalis, general paresis, check for Argyll-Robertson pupil
Neurosyphilis may be meningitis, tabes dorsalis, general paresis, check for Argyll-Robertson pupil
Congential syphilis kills _____% fetus/newborn, survivors are infected, _____ deformities, interstitial keratitis, progress rapidly to symptoms of secondary&tertiary syphilis if _____
Congential syphilis kills 50% fetus/newborn, survivors are infected, bone deformities, interstitial keratitis, progress rapidly to symptoms of secondary&tertiary syphilis if untreated
Diagnosis of syphilis depends on assembling accurate timecourse of the many varied symptoms: patient may have _____ early ones that appeared to resolve spontaneously
Diagnosis of syphilis depends on assembling accurate timecourse of the many varied symptoms: patient may have ignored early ones that appeared to resolve spontaneously
Labs: Syphilis serology for reagin (_____, _____) is best test for disease-in-progress and for efficacy of treatment; confirm exposure with tests for treponeme-specific _____; histo of lesions shows infiltrate rich in plasma cells
Labs: Syphilis serology for reagin (VDRL, RPR) is best test for disease-in-progress and for efficacy of treatment; confirm exposure with tests for treponeme-specific antibodies; histo of lesions shows infiltrate rich in plasma cells
Treat Syphilis w/ _____
Treat Syphilis w/ Penicillin G
