9-8 Spirochetes-Treponemes Flashcards
A: Why are Spirochetes able to Flex and rotate in a spiral?
B: Describe this structure in [Treponema Pallidum]
A: Axial Fibrils wind around the cell wall of Spirochetes
B: Axial Fibril – “internal flagellum”, THREE in T. pallidum. Contained in periplasm
A: 3 Growth Characteristics of [Treponema Pallidum]
B: Can NOT be spread sexually after __ years from acquisition
- Only cultured in [Rabbit epithelial cells]
- Very sensitive to Drying and Heat
- Microaerophilic (survives 3-5% Oxygen)
B: Can NOT be spread sexually after 4 years from acquisition
Pathogenesis of [Treponema Pallidum]
A: Transmission (2)
B: How does it disseminate once it invades
C1: When do Sx/signs first appear?
C2: What are the sx mostly caused by?
D. Primary and secondary stages are ________. Each are followed by periods of ________
E: Explain how immunity works for both early and late stage Syphilis
Pathogenesis
A. Passes through [intact mucus membrane] or abraded skin
B. Multiplies locally in subepithelial tissue and disseminates to lymph nodes and other organs
C. Symptoms and signs = 10-90 days after initial infection
C2: Pathologic lesion is from an [obliterative endarteritis] and hypersensitivity response later in dz
D. Primary and secondary stages are self-limiting (HEAL SPONTANEOUSLY). Each are followed by periods of latency
E. Immunity to reinfection after treatment of EARLY syphilis is not sufficient to prevent reinfection. PT ACQUIRES GREATER IMMUNITY AFTER BEING INFECTED WITH LATER STAGE
Describe the Syphilis Chancre (3)
Syphilis Chancre
1. Appears 10-90 days after initial infection
- Ulcer has smooth, heaped margins and crusted dry base
- Accompanied with [Firm local adenopathy]
LATENT SYPHILIS Definition
B: What fraction of infected individuals develop this?
Latent syphilis - Defined as the presence of a positive treponemal serologic test in the absence of clinical manifestations
B: 2/3 develop LATENT “quiet” syphilis
A: 1/3 of untreated develop ____ syphilis: neurosyphilis, _____ syphilis or[____ benign ___ syphilis]
B: Describe NEUROSYPHILIS
1. Asymptomatic
- Meningovascular
- Paresis
- [Tabes Dorsalis]
A: 1/3 of untreated develop late syphilis: neurosyphilis, cardiovascular syphilis, [late benign “gummatous” syphilis]
Neurosyphilis
- Asymptomatic - evidence of infection in CSF without symptoms or signs
- Meningovascular - chronic meningitis which can affect major arteries to brain
- Paresis - cortical degeneration of the brain with mental changes
- Tabes dorsalis - Demyelination of posterior columns and dorsal roots —> loss of pain, temperature and position sense in limbs with or without ataxia
Describe the process of [Nontreponemal reaginic tests for Syphilis”]
B: What is Cardiolipin?
Describe these Types:
C. VDRL
D. RPR - Rapid Plasma Reagin
E: These Tests are _______ and used to follow treated
patients. Pt Should revert to _______ after successful treatment of primary (1 year) and secondary (2 years) syphilis.
NonTreponemal reaginic tests for Syphilis”= reaginic antibodies are [IgG and IgM] directed against cardiolipin, BUT NOT [Treponema Pallidum]
B: Cardiolipin = a lecithin-cholesterol mixture present on mitochondrial membrane. Is extracted from beef heart.
C. VDRL [Venereal Diseases Research Laboratories] is the Only NonTreponemal test done on CSF
D. RPR - Rapid Plasma Reagin = Most commonly performed on serum
E: These Tests are QUANTITATED (diluted) and used to follow treated patients. Pt Should revert to negative after successful treatment of primary (1 year) and secondary (2 years) syphilis.
Specific treponemal tests – Measure specific ______ against _________
B: Describe the [FTA-Abs] Test (2)
Specific treponemal tests – Measure specific antibody against T. pallidum
i. FTA-Abs - Fluorescent Treponemal Antibody - Absorption Test.
Serum is absorbed with extracts of cultivated non-T. pallidum treponeme
Antigen is killed Reiter strain of T. pallidum on a slide
Specific treponemal tests – Measure specific ______ against _________
B: Describe the [MHA-TP-TPPA] (MTT) Test (2)
Specific treponemal tests – Measure specific antibody against T. pallidum
ii. [MHA-TP-TPPA] (Microhemagglutination Treponemal pallidum)
1. Treponemal antigens adsorbed onto erythrocytes or
latex particles.
2. Agglutinated by serum containing antibody against T.
pallidum.
Specific treponemal tests – Measure specific ______ against _________
B: Describe the [EIA] Test (2)
C: What is CIA
Specific treponemal tests – Measure specific antibody against T. pallidum
B. EIA –automated, inexpensive tests done in large laboratories, used to SCREEN.
-Positive EIA should be confirmed with [Quantitative Nontreponemal test].
C. CIA (chemiluminescence immunoassay) automated like EIA
A: What are the 4 things that can give FALSE POSITIVE [Treponema Pallidum] Result?
B: Which Test do they skew?
- Febrile Illness -Skews NONTreponemal
- Pregnancy - Skews NONTreponemal
- Autoimmune Dzs - Skews SPECIFIC Treponemal
- Chronic Infections - Skews SPECIFIC Treponemal
“Treponema PallidumFalsePositivesAren’tC**onclusive! “
A: What Abx do you use to treat [Treponema Pallidum]
B: Why this specific Abx?
C: What’s the alternative? What are the 2 contraindications to this?
A: [Benzathine LA Penicillin G]
B: Long acting injectable formulation for long generation time of [Treponema Pallidum]
C: [DOXY-Tetracycline] is alternative BUT NOT FOR NEUROSYPHILIS OR PREGNANT WOMAN
A: What bacteria causes Bejel?
B: How is it transmitted?
A: [Treponema Pallidum ss. Endemicum]
B: CONTAMINATED UTENSILS
A: What bacteria causes YAWS?
B: How is it transmitted?
A: [Treponema Pertenue]
B: DIRECT LESION CONTACT
A: What bacteria causes Pinta?
B: How is it transmitted?
A: [Treponema Carateum]
B: DIRECT LESION CONTACT
