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Clinical Immunology > Syphilis > Flashcards

Syphilis Flashcards

1
Q

What is the drug of choice for treating syphilis? How did they used to treat it?

A

Penicillin is the gold standard. Old days they used to use heavy metals like arsenic (idiots)

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2
Q

What causes syphilis? specifically the organism.

A

spirochete, T. pallidum

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3
Q

Is syphilis cultivatable with consistency in artifical lab medias?

A

nope, cant grow that sh’t

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4
Q

True or False: Outside of the host, syphilis is extremely susceptible to physical and chemical agents

A

true

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5
Q

T. Pallidum causes?

A

Syphilis, worldwide location

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6
Q

T. pallidum (varient) causes? name a few locations associated with it

A

Causes Bejel, located in mediterranean, balkans and north africa

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7
Q

T. pertenue causes? name a few locations associated with it

A

Causes Yaws, located in the caribbean, latin america, central africa and far east

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8
Q

T carateum causes? location?

A

Pinta in latin America

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9
Q

What are the three reportable diseases by the CDC?

A

Chlamydia, gonorrhea and Syphilis

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10
Q

True or False: Syphilis is higher in men than women

A

true (long live carlos)

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11
Q

Syphilis is considered what type of diease?

A

primary venereal disease and is the most common STD in the U.S

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12
Q

What are the two basic transmission routes of the pathogenic treponemes?

A

transmission via direct contact or infections of the skin/oral regions that contain spirochetes that may be transmitted by personal, not necessarily venereal contact

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13
Q

true or false: syphilis can be aquired by kissing a person with active lesions/bed sharing

A

yes true duh

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14
Q

what is the risk of acquiring syphilis through blood transfusions?

A

In the US transmission is low since we dont do donor-to-donor and syphilis has a short survivial in blood <72 hrs, risk in countries that do d-t-d

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15
Q

Untreated syphilis leads to what chronic disease?

A

subacute chronic disease w/ symptomatic and asymptomatic periods

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16
Q

What are the progressional stages to syphilis? (there are 4)

A

primary, secondary, latent (hidden) and tertiary

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17
Q

How does T. pallidum infect the host?

A

via penetration of intact mucus membranes or enters the body through defects in the epithelium

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18
Q

How long is the incubation period for syphilis?

A

usually about 3wks but can range from 10-19 days

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19
Q

Primary Syphilis: what is the defining characteristic and other characteristics?

A

Chancres in primary inflammation developed at the end of the incubation period, relatively painless and single. Typically around genitalia but can be other places. 50-70% will develop inguinal adenopathy

20
Q

How long does the primary chanchre presist?

A

1-5wks then heals completely within 4-6 weeks without treatment

21
Q

Secondary Syphilis characteristics

A

signs and symptoms usualy devlp 2-8 wks after chancre (as long as 6mos). can overlap with primary and never notice the chancre. Has a generalized illness-begins like a viral infection

22
Q

Secondary syphilis disease progression

A

lymphadenopathy (75%) lesions of skin and MM (80%). lesions contain high spirochete numbers. CNS asymp in 1/3 of pt. Usually resolves within 2-6wk even without treatment

23
Q

Latent syphilis

A

after untreated secondary syphilis, pt enters the non infectious stage (diag. only through serology). during the first 2-4yr after infefction, can relapse into secondary. relapses rare after 4yrs, 1/3 pt spontaneously cured. 1/3 will never have more manifestations or they will develope late syphilis

24
Q

Tertiary (late) syphilis

A

3-10yrs after primary infection, 15% untreated indiv. develope late benign syphilis - destructive granulomas. cardiovascular manifestations and CNS is possible. Spirochetes may infect brain and cause personality changes…etc

25
Q

Meningovascular syphilis usually manifests as what?

A

seizures or strokes

26
Q

Congenital syphilis characteristics

A

major problem in Africa and Far east, can be reduced by treating syph in preggo women. Caused maternal spirochetemia and transplacental transmission. Untreated can cause stillbirtht

27
Q

true or false: congenital syphilis can be prevented if already transmitted with penicillin at least 30 days before delivery

A

true

28
Q

How do you classify congenital syphilis?

A

according to age at diagnosis, early stages seen in 2yrs or younger and late stages in older than 2yrs (hutchinson triad)

29
Q

Neurosyphilis characteristics

A

may be asympt. symptomatic form includes: menigeal syph (1 yr after infection) and meningovascular syph. 5-10yrs after infection or parenchymatous syphilis

30
Q

Characteristics of meningeal syphilis

A

involves brain or spinal cord, headaches and stiff neck

31
Q

meningovascular syphilis characteristic

A

inflammation of the pia mater and arachnoid space w/ focal arteritis

32
Q

parenchymatous syphilis characteristic

A

general paresis, joint degeneration and demyelination of columns

33
Q

what are the two classes of Ag recongnized in treponemes?

A

ag restricted to one or a few species and Ag shared by many different spirochetes

34
Q

what are the specific antitreponemal Ab’s produced in early syphilis?

A

IgM and rapidly followed by IgG

35
Q

True or false: delayed hypersensitivity immune mech are also involved in syphilis

A

ture, ab-ag complexes have been detected in secondary syphilis and can cause glomerunlonephritis

36
Q

Diagnostic evaluations: what are the two types of ab used to measure classical methods?

A

nontreponemal and treponemal/traditional and “reverse” algorithms

37
Q

why are direct observations of spirochetes often unavailabe?

A

uses a darkfield microscope and can miss up to 30% of primary cases, needs a pt with active syphilitic lesions

38
Q

What do nontreponemal methods do?

A

determine the presence of reagin, use rapid plasma reagin (RPR), measures IgM and IgG ab, if present they agglutinate to charcoal particles. More sensitive than VDRL test for syphilis

39
Q

does reactive RPR test confirm T. pallidum infections?

A

no

40
Q

Nontreponemal methods

A

VDRL tests, also focculation (qual/quanitative) serum must be heated to 56 degrees celcius for 30 min. measures IgG and IgM, doesnt confirm T. pallidum

41
Q

what is the preferred test for CSF in suspected teritary syphilis?

A

VDRL with reflex to titer

42
Q

Chemiluminescene immunoassay (CIA/EIA)

A

treponemal method low cost automated equipment becoming more popular

43
Q

Positive ELISA means what with a T.pallidum infection?

A

suggest current or past infection, can also distinguish between IgG ab and neonatal IgM

44
Q

TP-PA Test

A

treponemal, semiquan, not for CSF cant distinguish between IgM and IgG, good to resolve inconclusive FTA result

45
Q

FTA-ABS Test

A

confirms positive non treponemal test, determins titers, may be helpful in late neurosyph when RPR is negative

46
Q

sensitivity procedures in primary, secondary, latent and late stages

A

Primary: serology active 30% after 1wk, 90% after 3wk, reagin titer increase rapidly during first 4wk
Secondary: sero positve
Latent: grad. return of nonreactive manifestation
Late: trep test generally reacitve, nontrep non reactive

47
Q

true or false: CDC suggests the use of TP-PA to rule out false positives?

A

true

Clinical Immunology (14 decks)

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