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Bacte LEC > Spirochetes > Flashcards

Spirochetes Flashcards

1
Q

are specialized flagella located between the outer membrane and the cell wall of spirochetes, in the periplasmic space.

A

Axial filaments

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2
Q

• Structure: Composed of multiple protein filaments that wrap around the cell body in a helical fashion.

A

Axial filaments

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3
Q

• Function:
• Responsible for the corkscrew-like motility of spirochetes.
• Enable the organism to move efficiently through viscous environments like mucus or tissue.

A

Axial filaments

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4
Q

are structural attachments where the axial filaments are anchored to the cell.

A

Insertion disks

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5
Q

Protein complexes that secure the ends of the axial filaments to the poles of the cell.

A

Insertion disks

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6
Q

• Serve as the anchoring point for axial filaments, ensuring stability during movement.
• Play an indirect role in motility by facilitating the tension and relaxation of the axial filaments

A

Insertion disks

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7
Q

Treponema

A

6-10
1

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8
Q

Borrelia

A

30-40
2

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9
Q

Leptospira

A

2
3-5

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10
Q

• Immunofluorescent stain, dark-field illumination, or iron staining are used
• Seen in tissues with silver impregnation method

A

Treponema species

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11
Q

• lipid-rich outer membrane, with cytoplasmic filaments
• Do not stain with Gram’s method

A

Treponema species

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12
Q

• Slender spirals (0.1-0.5 um in width & 5-15 um in length), tightly coiled

• Rotate steadily around their endoflagella (complex, with sheath and core) even after attaching to cells by their tapered ends,

A

Treponema species

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13
Q

Treponema pallidum Antigenic Structures
• Outer sheath (________)
•________ surrounds the periplasmic space and the peptidoglycan- cytoplasmic membrane complex

•_______ (axial filaments)
• _______ enzyme??

•_____ protein antigens, i.e. cardiolipin

• Develop______ (antibody-like substance)

A

glycosaminoglycan coating

Outer membrane

Endoflagella

Hyaluronidase

> 100

reagin

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14
Q

Treponema species
• Has never been cultured on______
• Experimentally: infected skin, testes, & eye of rabbits;

• Grown in_____, short periods of time

• O2 need???; best in _____oxygen

• May remain motile in____ days @_____

• Remain viable for at least_____ hours in whole blood or plasma stored at____;

A

artificial media

tissue culture

Microaerophile; 1-4%

3-6 days at 25°C

24hrs; 4°C

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15
Q

TREPONEMA (3)

(part of the normal flora) seen in oral infections.

A

T. denticola
T. socranskii
T. pectinovorum

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16
Q

is associated with ulceromembranous gingivitis or pharyngitis, aka

A

T. vincentii (or Vincent’s spirillum)

Vincent’s angina.

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17
Q

Treponema pallidum = SYPHILIS
A. ACQUIRED SYPHILIS
• Sexual contact______ incubation
• Infectious lesions on (2)
• Intrarectal, perianal, or oral (____cases)

Multiply locally, spread to nearby lymph nodes, then reach the blood stream
• 4 stages

A

3-6 week

On skin or mucous membranes of genitalia

10-20%

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18
Q

Stage???

: presence of dry, non-tender lesion (hard chancre/Hunterian chancre @ site of inoculation)

A
  • 1º stage
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19
Q

: dry lesions (Condylomata lata or condyloma)
found on other parts of the body

A

• 2nd stage

20
Q

: no signs & symptoms (serological test)

A

Latent stage

21
Q
  • No symptoms but found specific antitreponemal antibodies
    • Untreated infection remains latent
A

LATENT STAGE

22
Q

GUMMAS (skin, internal organs, CNS, bones, eyes, heart)
CNS = neurosyphilis → paralysis
Eyes → blindness
Heart → aortic damage or aneurisms

A

TERTIARY STAGE

23
Q

Congenital syphilis

• treponemes cross the____, infecting the fetus

• usually latent stage of syphilis,_____ to _____ week of gestation

A

placenta

10th to 15th

24
Q

• fetal death, miscarriages, stillborn at term

• live but with congenital syphilis in childhood:

• symptoms????

A

Interstitial keratitis
Hutchinson’s teeth
Saddlenose
Periostitis
damage to mental development or other neurological symptoms

25
Q

Cranial nerve

Hurchinsons

A

8

Vestibulochochlear

26
Q

Non venereal treponemas

A

Pertrnur
Endemicum
Carateum

27
Q

______: Caused by Treponema pallidum pertenue

_____: Caused by Treponema carateum

_____: Also known as____, caused by Treponema pallidum endemicum

A

Yaws

Pinta

Endemic syphilis; bejel

28
Q

The genus Treponema includes four pathogenic species for humans:
1. Treponema pallidum subsp. pallidum: Causative agent of_____.
2. Treponema pallidum subsp. pertenue: Causative agent of_____.
3. Treponema pallidum subsp. endemicum: Causative agent of endemic syphilis (_____).
4. Treponema carateum: Causative agent of_____

A

syphilis

yaws

bejel

pinta

29
Q

T. pallidum

Primary Stage
• Onset:_____ days after infection.
• Lesion Characteristics:
• Single chancre at the site of inoculation, resulting from the inflammatory response.
• Appearance: Erythematous, firm, non-tender lesion with a clean surface and raised border.
• Lesion contains numerous treponemes and is highly infectious.
• Common Locations:
• Men:_____.
• Women:_____(may go unnoticed due to non-tender nature).
• Both sexes:_____ (often undetected).
• No systemic signs or symptoms during this stage.

A

10 to 90

Penis

Cervix or vaginal wall

Anal canal

30
Q

T pallidum

Secondary Stage
• Onset:______ after primary lesion development.
• Clinical Features:
• Fever, sore throat, generalized lymphadenopathy, headache.
• Lesions on mucous membranes and a generalized rash:
• Types: Macular, papular, follicular, papulosquamous, or pustular.

A

2 to 12 weeks

31
Q

T pallidum

• Unusual feature: Rash can involve______.
• Secondary lesions are highly infectious.
• Duration: Can last several weeks, may_____, or be mild and unnoticed.

A

palms and soles

relapse

32
Q

Tertiary Stage
• ________:
• Begins after secondary lesions heal.
• Early latent syphilis: Within 1 year of infection.
• Late latent syphilis: After 1 year.

•	Outcomes of untreated latent syphilis:
•	Biological cure in one-third of patients (loss of serologic reactivity).
•	Lifetime latency in one-third (with reactive sera).
•	Progression to tertiary syphilis in one-third.
A

Latent Period

33
Q

T pallidum

Clinical Manifestations (decades later):
•	\_\_\_\_\_\_\_\_: Skin, bones, liver (benign tertiary syphilis).
•	\_\_\_\_\_\_\_\_\_: Degenerative CNS changes.
•	\_\_\_\_\_\_\_\_\_: Aortitis, aneurysms, and aortic valve insufficiency.

Patients with tertiary syphilis are not_____.
• Rare in developed countries due to effective antimicrobial treatment

A

Granulomatous lesions (gummas)

Neurosyphilis

Cardiovascular syphilis

infectious

34
Q

T pallidum

Dark-Field Microscopy:
•	Requires expertise and special equipment.
•	Visualization of motile treponemes is diagnostic for\_\_\_\_\_
A

primary syphilis

35
Q

Nontreponemal Tests

A

Vdrl
Rpr

36
Q

Nontreponemal Tests:
• Detect ______targeting lipids released from damaged cells.

•	Use \_\_\_\_\_\_complex as the antigen (from bovine hearts).

•	Advantages:
•	Excellent for screening.
•	Low-cost and easy to perform.
•	Rising/falling titers correlate with clinical status.

•	Limitations:
•	Lower specificity; false positives may occur.
A

reaginic antibodies

cardiolipin-lecithin-cholesterol

37
Q

Widely Used Nontreponemal Tests:

• Requires a microscope to observe flocculation of cardiolipin-antibody complexes in serum or CSF.
——————
• Uses charcoal particles for macroscopic visualization.
• More commonly used than VDRL.
• Positive results require titration and confirmation with a treponemal test

A

Venereal Disease Research Laboratory (VDRL):

Rapid Plasma Reagin (RPR):

38
Q

NONSPECIFIC, NONTREPONEMAL TESTS

Screening purposes; efficacy of therapy

Lipid-antigen particles dispersed in serum and flocculate with reagin

Antigens:_______

• Detect_______
(nontreponemal antibodies)

A

cardiolipin, cholesterol, & purified lecithin

reagin or Wasserman antibodies

39
Q

4 non treponemal tests

A

Rapid plasma reagin (RPR) card tests - uses cardiolipin (not for CSF)

Venereal Disease Research Laboratory (VDRL)

Unheated serum reagin (USR) test

Toluidine red unheated serum test (TRUST)

40
Q

SPECIFIC, TREPONEMAL TESTS | Confirm positive nontreponemal results

(5)

A

• T pallidum-particle agglutination (TP-PA) - Gelatin particles sensitized with TP

• T pallidum hemagglutination (TPHA)

• Microhemagglutination T pallidum (MHA-TP) Sheep erythrocytes

• Enzyme immunoassay (EIA) for T pallidum

• Fluorescent treponemal antibody absorbed(FTA-ABS)

41
Q

Treatment:
__________
__________(primary/secondary syphilis)
If allergic,_______(3)

A

Benzylpenicillin

Procaine penicillin

erythromycin, tetracycline, or chloramphenicol

42
Q

What kills the spirochetes?

A

• Drying/desiccation
• Detergents
• Elevation of the temperature to 42°C
• Trivalent arsenical, mercury, bismuth

43
Q

Common Treponemal Tests:

____________
• Uses gelatin particles coated with treponemal antigens.
• Agglutination indicates antitreponemal antibodies.

___________
• Automated, widely available, and comparable to TP-PA.

__________
• Uses fluorescent-labeled antibodies to detect treponemal-specific antibodies on a prepared slide.
• Less commonly used due to subjectivity and higher cost.

___________
• Automated treponemal test followed by nontreponemal test.
• Higher false-positive rates, so CDC recommends traditional approach.

A

Treponema pallidum-particulate agglutination (TP-PA)

Enzyme Immunoassays (EIAs)

Fluorescent Treponemal Antibody Absorption (FTA-ABS)

Reverse Sequence Screening:

44
Q

Yaws
• Causative Agent:_______
• Geographic Distribution:
• Tropical regions of Africa, South America, India, Indonesia, and the Pacific Islands.

•	Not present in the\_\_\_\_\_.

•	Transmission:\_\_\_\_\_\_\_

•	Clinical Course:
•	Early lesions: Elevated, granulomatous nodules.
•	Resembles syphilis but with distinct lesion presentation in primary and secondary stages.
A

Treponema pallidum subsp. pertenue.

United States

Direct contact with infected skin lesions.

45
Q

Endemic Syphilis (Bejel)
• Causative Agent:_________
• Geographic Distribution:
• Middle East and arid, hot regions worldwide.

•	Transmission: \_\_\_\_\_\_

•	Clinical Course:
•	Primary and secondary stages present as\_\_\_\_\_ that often go unnoticed.
•	Progression to\_\_\_\_\_\_ of the skin, bones, and nasopharynx can occur.
•	Dark-field microscopy is not useful due to the presence of normal oral spirochetal biota.

•	Contributing Factors: Poor hygiene and crowded living conditions.
A

Treponema pallidum subsp. endemicum.

Direct contact or sharing contaminated eating utensils.

papules

gummas

46
Q

Pinta
• Causative Agent:_______
• Geographic Distribution:
• Tropical regions of Central and South America.

•	Transmission:\_\_\_\_\_\_

•	Clinical Course:
•	Begins with scaling, painless papules.
•	Followed by an erythematous rash that becomes hypopigmented over time.
A

Treponema carateum.

Person-to-person contact; rarely sexual.

47
Q

Venereal Syphilis
1. Transmission:
• _______treponemal diseases are spread through nonsexual contact.

  1. Geography:
    • Occur in tropical and arid regions with poor hygiene and overcrowding.
  2. ______Stage:
    • Rare in nonvenereal treponematoses, while venereal syphilis commonly progresses to tertiary manifestations if untreated.
  3. Congenital Infections:
    • Nonvenereal treponemal diseases do not cause congenital infections, unlike syphilis.
A

Nonvenereal

Tertiary

Bacte LEC (51 decks)

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