II: Syphilis Flashcards by Franchezka Ignacio

Non Treponemal Test

Principle: Quantitative and Qualitative Flocculation Test

VDRL
Venereal Disease Research Laboratory Test

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VDRL Specimen

50 ul of Serum/CSF

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Specimen in VDRL must be heated for ____ under ____

30 mins
56 deg Cel

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VDRL

Antigen consist of

0.03% Cardiolipin
0.9% Cholesterol
0.21% Lecithin

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Antigen delivery needle required for VDRL

Hamilton Syringe

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VDRL Antigen Delivery Needle:

Qualitative

18 g
60 drops Ag suspension/mL

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VDRL Antigen Delivery Needle:

Quantitative

19 g
75 drops Ag suspension / mL

23 g
100 drops saline / mL

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VDRL Antigen Delivery Needle:

CSF

21 or 22 g
100 drops / mL

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VDRL Rotator:

Serum

4 mins
180 rpm

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VDRL Rotator:

CSF

8 mins
180 rpm

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VDRL Reading of Reports under:

LPO (100x)

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VDRL Reporting:

Nonreactive

No clumping / Slight roughness

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VDRL Reporting:

Weakly Reactive

small clumps

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VDRL Reporting:

Reactive

Medium-large clumps

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VDRL:

Weakly reactive or reactive result must be subject to

Quantitative result (dilution from 1:2 to 1:32)

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VDRL:

A positive test on a spinal fluid is a diagnostic of

Neurosyphilis

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Non Treponemal Test that is a modified VDRL with CHARCOAL PARTICLES

Rapid Plasma Reagin (RPR) Test

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RPR Test Specimen

50 uL serum (NO HEATING REQUIREMENT)

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RPR Antigen consist of:

Same with VDRL Reagent with addition of

EDTA
Charcoal
Thimerosal
Choline chloride

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RPR:

Purpose of Charcoal

Enhance macroscopic visualization of reaction

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RPR:

Purpose of thimerosal

Preservative

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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)

1. Hemagglutination Treponemal Test for Syphilis (HATTS) 2. Treponema Pallidum Hemagglutination Assay (TPHA) 3. MicroHemagglutination Assay for Antibodies of T. pallidum (MHA-TPA) 4. 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)

1. VDRL 2. RPR 3. Plasmacrit 4. Toluidine Red Unheated Serum Test (TRUST) 5. Unheated Serum Reagin (USR) 6. Reagin SCREEN test (RST)

TREPONEMAL TEST (7)

1. T. pallidum Immobilization Test (TPI) 2. Fluorescent Treponemal Antibody Test 3. Fluorescent Treponemal Antibody Absorption Test 4. T.pallidum Hemagglutination 5. T. pallidum complement fixation 6. Reiter's protein complement fixation 7. 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