II: Syphilis Flashcards
Non Treponemal Test
Principle: Quantitative and Qualitative Flocculation Test
VDRL
Venereal Disease Research Laboratory Test
VDRL Specimen
50 ul of Serum/CSF
Specimen in VDRL must be heated for ____ under ____
30 mins
56 deg Cel
VDRL
Antigen consist of
0.03% Cardiolipin
0.9% Cholesterol
0.21% Lecithin
Antigen delivery needle required for VDRL
Hamilton Syringe
VDRL Antigen Delivery Needle:
Qualitative
18 g
60 drops Ag suspension/mL
VDRL Antigen Delivery Needle:
Quantitative
19 g
75 drops Ag suspension / mL
23 g
100 drops saline / mL
VDRL Antigen Delivery Needle:
CSF
21 or 22 g
100 drops / mL
VDRL Rotator:
Serum
4 mins
180 rpm
VDRL Rotator:
CSF
8 mins
180 rpm
VDRL Reading of Reports under:
LPO (100x)
VDRL Reporting:
Nonreactive
No clumping / Slight roughness
VDRL Reporting:
Weakly Reactive
small clumps
VDRL Reporting:
Reactive
Medium-large clumps
VDRL:
Weakly reactive or reactive result must be subject to
Quantitative result (dilution from 1:2 to 1:32)
VDRL:
A positive test on a spinal fluid is a diagnostic of
Neurosyphilis
Non Treponemal Test that is a modified VDRL with CHARCOAL PARTICLES
Rapid Plasma Reagin (RPR) Test
RPR Test Specimen
50 uL serum (NO HEATING REQUIREMENT)
RPR Antigen consist of:
Same with VDRL Reagent with addition of
EDTA
Charcoal
Thimerosal
Choline chloride
RPR:
Purpose of Charcoal
Enhance macroscopic visualization of reaction
RPR:
Purpose of thimerosal
Preservative
RPR:
Purpose of Choline Chloride
Inactive complement
RPR:
Rotator Requiremen
8 mins
100 rpm
RPR:
Antigen Delivery Needle
20 g
60 drops Ag suspension / mL
RPR:
Non Reactive
no clumping / slight roughness
RPR:
Reactive
Clumping
Treponemal Test of Reference
- If individual is reactive; it persist to life
Treponemal Pallidum Immobilization Test (TPI)
Treponemal Test:
TPI
Treponemal Antibody in the presence of complement will inhibit the normal movement of active treponemes acquired from
Testicular Chancre of Rabbit
TREPONEMAL TEST:
Patient serum in Fluorescent Treponemal Antibody Absorption Test must be
Heat Inactivated
TREPONEMAL TEST:
In Fluorescent Treponemal Antibody Absorption Test it is added to avoid cross-reactivity with other treponemes other than T. pallidum
Nonpathogenic Treponemes strains (REITER STRAIN)
TREPONEMAL TEST:
Fluorescent Treponemal Antibody Absorption Test
Strain that is added on the slide
Nichols strain
REPONEMAL TEST:
Fluorescent Treponemal Antibody Absorption Test
Result must be observed using
Fluorescence Microscope
REPONEMAL TEST:
Fluorescent Treponemal Antibody Absorption Test
Reaction is equivalent to the
Intensity of Green Fluorescence
REPONEMAL TEST:
Fluorescent Treponemal Antibody Absorption Test
Reactive
2+ green fluorescence
TREPONEMAL TEST:
Fluorescent Treponemal Antibody Absorption Test
Negative
No Fluorescence
TREPONEMAL TEST:
Fluorescent Treponemal Antibody Absorption Test
1+
Repeat test with 2nd specimen after 1 to 2 weeks
TREPONEMAL TEST:
Agglutination Test (4)
- Hemagglutination Treponemal Test for Syphilis (HATTS)
- Treponema Pallidum Hemagglutination Assay (TPHA)
- MicroHemagglutination Assay for Antibodies of T. pallidum (MHA-TPA)
- T. pallidum Particle Agglutination (TPPA)
TREPONEMAL TEST:
Agglutination Test
Uses gluteraldehyde-stabilized TURKEY RBC
HATTS
TREPONEMAL TEST:
Agglutination Test
Uses Tanned Sheep’s RBC coated with antigen of Nichol’s strain
TPHA
TREPONEMAL TEST:
Agglutination Test
Same with TPHA but uses Microtiter Plates
w/
Formalinized Sheep’s RBC
coated w/ nichol’s strain
MHA-TPA
TREPONEMAL TEST:
Agglutination Test
Uses Gelatin Particles
TPPA
Other Treponema-Associated Diseases in Humans
T. pertenue
YAWS
“pertenYOWS”
Other Treponema-Associated Diseases in Humans
T. carateum
Pinta
“pinta-cara”
Other Treponema-Associated Diseases in Human
T. pallidum endemicum
Bejel
Endemic Syphilis
Other Treponema-Associated Diseases in Humans
T. cuniculi (Wasserman NR)
Rabbit’s Syphilis
VDRL uses slides with
Ceramic rings
VDRL
Purpose of Cardiolipin
Main reacting component
VDRL
Purpose of Cholesterol
Enhances reacting surface of cardiolipin
VDRL
Purpose of Lecithin
removes anti-complement activity of cardiolipin
NONTREPONEMAL TEST (6)
- VDRL
- RPR
- Plasmacrit
- Toluidine Red Unheated Serum Test (TRUST)
- Unheated Serum Reagin (USR)
- Reagin SCREEN test (RST)
TREPONEMAL TEST (7)
- T. pallidum Immobilization Test (TPI)
- Fluorescent Treponemal Antibody Test
- Fluorescent Treponemal Antibody Absorption Test
- T.pallidum Hemagglutination
- T. pallidum complement fixation
- Reiter’s protein complement fixation
- Direct Fluorescent Antibody Test
Used for diagnosing Congenital Syphilis & Neurosyphilis
VDRL
What substance is detected by VDRL and RPR test
Anticardiolipin Antibody
Establish diagnosis for Late Latent Syphilis
Treponemal Test