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Repro Micro > Syphilis > Flashcards

Syphilis Flashcards

1
Q

What is the etiologic agent of syphilis?

A

A spirochete, Treponema pallidum

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2
Q

Can T. pallidum be grown in the lab?

A

No, but it can be propagated in rabbit testes

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3
Q

Does syphilis have distinct sequential phases?

A

Yes, including latent phases

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4
Q

Can T. pallidum cross the placenta?

A

Yes, resulting in congenital syphilis

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5
Q

What is the pathology of syphilis largely due to?

A

Host’s cellular inflammatory response, it resembles and AI response

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6
Q

What is the hallmark feature of primary syphilis?

A

Non-painful ulcer called a chancre, developing at site of entry of treponeme

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7
Q

Secondary syphilis is what kind of infection?

A

Systemic, characterized by fever, swollen LNs, mucous membrane lesions, and sometimes a skin rash that eventually includes soles and palms and/or wart-resembling lesions (condylomata kata)

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8
Q

What is Lab Dx of syphilis done by?

A

Serology, and by microscopic examination of scrapings

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9
Q

What are all forms of syphilis treated with?

A

Penicillins, most commonly Pen G; prevention with abstinence and use of condoms

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10
Q

What type of bacterium is T. Pallidum?

A

Helical/spiral-shaped bacterium

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11
Q

T. pallidum is very thin, what does this mean?

A

Too thin to be seen by standard direct light transmission microscopy (gram stain useless)

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12
Q

What method is T. pallidum seen by?

A

Indirect light microscopy method called darkfield microscopy

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13
Q

What is dark field useful for?

A

Useful Dx method early in disease process, before antibodies develo

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14
Q

What do spirochetes resemble?

A

gram negative bacteria

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15
Q

What membranes to spirochetes have?

A

An inner membrane, a periplasm with peptidoglycan and an outer sheath/membrane

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16
Q

What is different about the outer sheath in spirochetes?

A

It’s proteins are mainly lipoproteins and lipids (not LPS) that probably contribute to the pathogenic inflammatory process

17
Q

What is the immune response to spirochetes?

A

Rigorous humoral and cellular response that does not eliminate the infection; Host’s cellular immune response probably controls the infection but also responsible for pathology (tert sylph)

18
Q

Does T. pallidum have a latent phase?

A

Yes, unknown mechanism and if untreated infection and continue for life/can progress to tertiary stage

19
Q

What is the incubation time and symptom resolution time of primary syphilis?

A

2-3 week incubation w/ resolution in 3-6 weeks

20
Q

What is the manifestation and resolution time of 2ndary syphilis?

A

1-2 months after infection; resolve in a month or so w/o tx

21
Q

What is early latent syphilis?

A

The 1-2 yr period after resolution of 2ndary syphilis

22
Q

What is late latent syphilis?

A

Begins 1-2 years post infection, may last lifetime, may progress to tertiary or resolve spontaneously

23
Q

What can be affected in tertiary syphilis?

A

Almost any organ system can be affected

24
Q

Will symptoms be present at birth with congenital syphilis?

A

Sometimes, stigmata may develop 2 yrs or more after birth

25
Q

What are the signs/sx of primary syphilis?

A

Painless ulcer (chancre) at sight of entry, nontender inguinal LAD

26
Q

What are the signs/sx of secondary syphilis?

A

Disseminated infection, hyperpigmented maculopapular rash over entire body that with time extends to palms and soles; mucous membrane patches in mouth and genitals a.k.a. snail track lesionsl condylomata lata; and the patient is sick (fever, headache, diffuse LAD); may also have mild meningitis

27
Q

What 4 diseases have a rash on palms and soles?

A

Secondary syphilis, RMSF, hand foot mouth dz, and rarely meningococcemia

28
Q

What are the signs/sx of early latent Syphilis?

A

No symptoms, positive serology, may relapse to secondary (can spread in utero)

29
Q

What are the signs/sx of late latent syphilis?

A

No symptoms, positive serology, no relapse to secondary (not infectious even to fetus)

30
Q

What are the signs/sx of tertiary syphilis?

A

Progressive, inflammatory disease that may take years to develop; Tertiary S in endarteritis, few spirochetes can be detected in lesions, Gummas, CV and CNS S can take years to develop (Any organ system can be involved here… LOTS of symptoms)

31
Q

What are the signs/sx of Congenital S?

A

May or may not be symptoms at birth, can cause spontaneous abortion; disseminated infection transmitted transplacentally after first trimester via blood, no chancre

32
Q

In late congenital syphilis what develops?

A

Stigmata over years, generally starting around age 2

33
Q

Syphilis is an STD, but how else can it be transmitted?

A

Biting or through a crack in skin by touching a chancre or snail track lesion or handling contaminated catheter (doesn’t remain viable outside the body very long)

34
Q

How is lab diagnosis of syphilis done?

A

Serology and occasionally microscopic examination of scrapings from chancre

35
Q

What types of serology are done for syphilis?

A

Non-treponemal serologic tests and treponemal tests

36
Q

What are the non-treponemal serologic tests for syphilis?

A

Non-specific tests; the Ag is NOT T. pallidum but rather is beef heart mitochondria cardiolipin. KNOW THESE TWO NAMES: Rapid Plasma Reagin (RGR) test and Venereal disease research laboratory (VDRL); they are cheap and sensitive, there are false positives; Titers drop after patient is cured (good test for antibiotic efficacy)

37
Q

What are the Treponemal tests?

A

Antigen is pathogenic T. Pallidum. KNOW THIS ONE: Fluorescent Treponemal Antigen-Absorbed (FTA-ABS); Titers tend to remain for months to years after patient is cured

38
Q

What is in the Ddx for syphilis?

A

Any ulcer forming STD; herpes, LGV, haemophilis ducreyi, warts, etc.

39
Q

How is syphilis prevented/treated?

A

Large, single IM dose of PenG

Repro Micro (6 decks)

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