Syphilis Flashcards

1
Q

What is the causative agent of syphilis?

A

Treponema pallidum.

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2
Q

How is syphilis transmitted?

A

Sexual, congenital, and bloodborne.

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3
Q

What is the primary disease progression of syphilis?

A

Painless ulcer ~ 3 weeks after infection.

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4
Q

What is the secondary disease progression of syphilis?

A

~1-2 months after primary progression, a systematic dissemination will occur: rash; lymphadenopathy; possible neurological symptoms.

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5
Q

What is the latent disease progression of syphilis?

A

No clinical symptoms; remains dormant. Mother can pass off to unborn fetus (congenital syphilis).

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6
Q

What is the tertiary disease progression of syphilis?

A

Appears 10-30 years later if left untreated. Granulomas on bones, skin and tissues. Cardiovascular complications. Neurosyphilis.

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7
Q

What happens to babies born to mothers with untreated syphilis?

A

Stillborn or die from infection.

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8
Q

What are the two methods for syphilis laboratory diagnosis?

A

Direct and serological detection.

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9
Q

What testing method is used for direct detection in syphilis?

A

Fluorescent antibody testing (tissue fix on slide).

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10
Q

What must be present in order for direct detection of syphilis to be accurately measured?

A

Skin lesions.

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11
Q

What testing method is used for serological detection in syphilis?

A

Nontreponemal testing: screening

Treponemal testing: confirmatory

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12
Q

Screening for syphilis has a high sensitivity, and low specificity, which may produce what kind of results?

A

False-positives.

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13
Q

Describe what nontreponemal testing detects.

A

Presence of reagin that forms against cardiolipin that is released from damaged cells.

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14
Q

Describe VDRL testing for syphilis.

A

Flocculation - precipitation reaction that occurs over a narrow range of particle concentration.

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15
Q

What is the microscopic results for the following VDRL results: nonreactive, weakly reactive, and reactive?

A

Nonreactive - no clumping
Weakly reactive - small clumps present
Reactive - medium to large clumps present

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16
Q

Describe the RPR test for syphilis testing.

A

RPR (rapid plasma reagin) uses agglutination reaction that uses cardiolipin bound to charcoal.

17
Q

Describe Treponemal testing.

A

Fluorescent treponeme antibody absorption test; indirect fluorescent antibody.

18
Q

Describe the Treponemal testing process.

A

Nonpathologic T. Pallidum strain is fixed a slide, patient antibodies are added, incubated, and washed.

AHG with fluorescent tag is added, incubated, than washed again.

19
Q

What type of agglutination is T. pallidum particle agglutination for confirmatory testing?

A

Passive.

20
Q

What should a patient be tested for syphilis?

A

Pregnant women; sexually active MSM; HIV and sexually active patient.

21
Q

What type of serological testing can be used for presumptive diagnosis?

A

A nontreponemal test and confirmatory treponemal test.