9.1 - genus treponema-syhphilis

Question 1

syphilis caused by

Answer 1

Treponema pallidum

Question 2

genus treponema morphology

Answer 2

spirochetes - spiral shape

Question 3

genus treponema proporties

Answer 3

○ Obligate intracellular pathogen - require a host cell

§ Cannot be grown in vitro on artificial media

Question 4

genus treponema gram stain

Answer 4

cannot be seen on gram stain

Question 5

2 subspecies of treponema palladium

Answer 5

pallidum - cause of phyphilis

endemicum

Question 6

3 species of genus treponema

Answer 6

treponema palldum
treponema cerateum
treponema pertenue

Question 7

syphilis causes

Answer 7

Causes genital ulceration and enhances the cause of HIV

Question 8

syphilis most common in

Answer 8

• Highest in indigenous communities and homosexual males

Question 9

syphilis acquired by

Answer 9

• Acquired by direct contact or mucous membrane contact wth an individual in the primary or secondary stage

Question 10

primary syphilis stage

Answer 10

§ 3-10 weeks 
			§ Chancre at side of inoculation 
				□ Ulcer
				□ Painless
				□ Raised firm edges 
			§ Ulcer contains replicating spirochetes and is infectious

Question 11

ulcer in syphilis contains

Answer 11

§ Ulcer contains replicating spirochetes and is infectious

Question 12

chancre in syphilis

Answer 12

□ Ulcer
□ Painless
□ Raised firm edges

Question 13

chancre located at

Answer 13

site of inoculation

Question 14

primary stage lasts for

Answer 14

3-10 weeks

Question 15

secondary stage syphilis lasts for

Answer 15

3-6 weeks

Question 16

secondary stage syphilis begins with

Answer 16

§ Typically begins with skin rash
□ Rough reddish spots on palms or soles
□ Other forms of rash

Question 17

symptoms of secondary stage syphilis

Answer 17

condyloma lata, mucous patches

Question 18

condyloma lata

Answer 18

□ Large broad-based grey of white warty lesions
□ Moist areas much as mouth, groin, armpits
□ Highly infectious

Question 19

mucous patches in syphilis

Answer 19

□ Ulcerated areas of mucosal breakdown
□ Tongue, palate, tonsils, inside lips and cheeks, vulva, vagina
□ Highly infectious

Question 20

systemic features of second stage syohilis

Answer 20

□ Fever
				□ Pharyngitis
				□ Muscle aches, joint aches
				□ Fatigue 
				□ Lymphadenopathy 
				□ Headache, aseptic meningitis with 7th and 8th cranial nerve palsies 
				□ Weight loess
				□ Patchy hair loss

Question 21

latent stages of syphilis

Answer 21

§ Early < 1 year post infection

§ Late > 1 year post infection, may last decades

Question 22

early latent stage

Answer 22

Early < 1 year post infection

Question 23

late latent stage

Answer 23

§ Late > 1 year post infection, may last decades

Question 24

tertiary stage syphilis

Answer 24

Years to decades (25% of untreated cases)

Question 25

three forms of tertiary syphilis

Answer 25

1. central nervous system syphilis
2. cardiovascular syphilis
3. gummatous syphilis

Question 26

central nervous system syphilis

Answer 26

• Neurosyphilis
  - Cerebral damage results in a condition of progressive dementia, termed ‘general paresis of the insane’ or GPI
  - Damage to the dorsal columns of the spinal cored results in tabes dorsalis

Question 27

GPI - general paresis of the insane

Answer 27

progressive dementia

Question 28

tabes doraslis

Answer 28

◊ Sensory ataxia, lancinating pains and pupillary abnormalities
dorsal columns of the spinal cord results in loss of sensation of the lower limbs
◊ Characteristic gait
◊ Loss of sensation causes damage to the knee and joints

Question 29

ciliospinal reflex in syphilis

Answer 29

• Loss of ciliospinal reflex results in pupils that are small and irregular, don’t constrict to light but constrict to accommodation (near vision)
  ◊ Calles Argyll-Robertson pupils

Question 30

neurosyphilis occurring during first and second stages of syphilis

Answer 30

may be
◊ Asymptomatic
◊ aseptic meningitis which resolves
◊ meningovascular syphilis

Question 31

maningovascular syphilis

Answer 31

} A combination of chronic meningitis and arteries of the small vessels of the leptomeninges, brain and spinal cord, leading to infarctions (strokes)

Question 32

cardiovascular syphilis caused by

Answer 32

• Caused by a small vessel vasculitis involving most commonly the blood vessels supplying the ascending aorta

Question 33

cardiovascular syphilis leads to

Answer 33

• The aortic walls become weakened and dilated which may result in deformity of the aortic valve
  - The resulting aortic regurgitation can lead to heart failure

Question 34

gummatous syphilis

Answer 34

least common form in the antibiotic era

- Granulomatous lesions of the skin, bones or viscera

Question 35

gum matous syphilis - skin

Answer 35

◊ Ulcerated or heaped up lesions causing significant deformity

Question 36

gum matous syphilis - viscera

Answer 36

◊ Mass lesions which may impair function of the organ affected

Question 37

gum matous syphilis - bone

Answer 37

◊ Tibia, sternum, nasal septum, cranium

} Necrosis, destruction, deformity

Question 38

congenital syphilis

Answer 38

○ May be passed to foetus transplacentally (less commonly during birth) if the mother has untreated syphilis

Question 39

transplacental infection rate

Answer 39

○ Transplacental infection rate increases as pregnancy advances

Question 40

severity of foetal illness

Answer 40

○ Severity of foetal disease diminishes as pregnancy advances

Question 41

maternal infection status influencing foetal infection risk

Answer 41

§ Mother in 1st or 2nd stage 
				□ 60-90% risk
			§ Mother in early latent stage 
				□ 40% risk 
			§ Mother in late latent stage 
				□ <10% risk of transmission

Question 42

sequelae for infected foetus

Answer 42

§ 40% are still born (if mother has 1st or 2nd degree syphilis)

Question 43

in infected live births

Answer 43

□ Perinatal death 
				□ Premature delivery 
				□ Low birth weight 
				□ Congenital abnormalities 
				□ Long term sequelae

Question 44

preventing congenital infection

Answer 44

§ Detection of syphilis in pregnancy, and adequate treatment, is essential in order to prevent congenital infection

Question 45

sequelae in surviving children

Answer 45

□ Deafness 
				□ Corneal inflammation
				□ Saddle nose 
				□ Abnormal teeth - Hutchinson's teeth
				□ Bone abnormalities - sabre shins

Question 46

sabre shins

Answer 46

bone abnormalities