Syphilis Flashcards
Causative agent of syphilis
Treponema pallidum subsp. pallidum
syphilis is transmitted by?
direct contact
sexual and perinatal (across the placenta)
early asymptomatic phase lasts?
10 days to 10 weeks
after T. pallidum enters the body, what’s next?
it reaches the bloodstream and is disseminated to all organs
identify the stage
chancre appears
primary syphilis
painless initial lesion, nonbleeding ulcer
“punched out” appearance with a red and smooth based and visible scant serous secretions
chancre
appears after the initial infection
chancre appears — after the initial infection
days/weeks
2 - 3 weeks after initial infection
primary syphilis
what’s next after the chancre appears?
lymph nodes enlarge
identify the stage
antibodies are produced
primary
antibodies are produced — after the infection
days/weeks
1-4 weeks
darkfield analysis of lesion demonstrates?
spirochetes
enumerate the symptoms that starts to appear during the secondary stage
7 symptoms
- skin rash
- low-grade fever
- malaise
- pharyngitis
- weight loss
- arthralgia
- lymphadenopathy
symptoms during secondary syphilis last?
4-6 weeks
identify.
spirochetes are present throughout the body during this stage
secondary syphilis
identify the stage
ulcer develop on mucous membranes
secondary
identify the stage
serologic tests are positive
secondary
identify the stage
condyloma lata
secondary
formed by coalescence of large, pale, flat-topped papules. occur in warm, moist areas
condyloma lata
condyloma lata occur in warm, moist areas such as — and are highly infectious
perianal
identify
stage of syphilis with no signs or symptoms
latency
identify the stage
nontreponemal and treponemal serologic tests are positive
latency
identify the stage
one in four individuals relapses into secondary syphilis
early latency
identify the stage
the patient is resistant to reinfection and to relapses
late latency
symptoms of tertiary occur — after initial infetion
2 - 40 years
this refers to the syphilis lesions due to hypersensitivity reaction to treponemal antigens and are found throughout the body
gummas
identify the stage
gummas
tertiary
this diseases/symptoms can occur during tertiary stage
enumerate!
- syphilitic aortitis
- aortic valve insufficiency
- thoracic aneurysm
neurosyphilis can cause?
blindness and senility
most common complication of late syphilis
gummas
it may be single or multiple.
indolent, slowly progressive, and indurated granulomata, with central healing and atrophic scar surrounded by hyperpigmented borders.
true or false
gummas are destructive and hard to treat
FALSE
gummas responds rapidly to treatment
true or false
T. pallidum can cross the placenta during any stage of the disease
TRUE
congenital syphilis
congenital syphilis
infection of the fetus causes —
enumerate
- late abortion
- stillbirth
- neonatal death/disease
- latent infection
true or false
the outcome does not depend on the stage of the mother’s disease - primary or secondary syphilis causing the worst outcome - and the age of the fetus at infection
FALSE
it DOES depend
Congenital syphilis is avoided if the mother received the treatment during —
first 4 months of pregnancy
congenital syphilis presents in the neonate as?
enumerate the 7
- maculopapular desquamatous rash (mouth, palm, soles)
- hemolytic anemia
- jaundice
- hepatosplenomegaly
- abnormal cartilage and bone involvement
- mental retardation
definitive diagnosis is made by detection of T. pallidum in —
enumerate the 4
- CSF
- umbilical cors
- skin
- mucous membrane lesions
depending on the stage of the disease
T. pallidum is detected using?
darkfield microscopy or silver stain
used to detect T. pallidum in lesions
fluorescence labeled antibody
Direct Fluorescent antibody-Z pallidum (DFA-TP) test
identify what test
detect reagin and are only used for screening because antibody will cross react with similar antigens present in SLE, autoimmune disease, pregnancy, and some chronic infections such as hepatitis
nontreponemal antigen tests
nontreponemal test
SLE, autoimmune disease, pregnancy, and some chronic infections such as hepatitis
these conditions can result in?
false positives
enumerate the nontreponemal antigen tests
- Venereal Disease Research Laboratory (VDRL)
- unheated serum reagin (USR)
- rapid plasma reagin (RPR) assays
all reactive results must be confirmed using a test called?
treponemal antigen tests
uses T. pallidum cells as antigen source and these assays are highly specific
identify what test
treponemal antigen test
identify the treponemal antigen tests
- fluorescent treponemal antibody absorption (FTA-ABS)
- T. pallidum particulate agglutination (TP-PA)
- microhemmaglutination T. pallidum tests
this test measures the antibody (reagin) a patient has formed against cardiolipin, cholesterol, and lecithin
VDRL test
Venereal Disease Research Laboratory
VDRL tests are read microscopy for?
flocculation
nonreactive NR, weak reactive WR, reactive R
this test is positive 1-3 weeks after the chancre appears
VDRL test
limited to use on CSF
the only serologic test approved for testing CSF
a modified VDRL test in which choline-chloride EDTA is added to the VDRL antigen. the addition of this compound allows serum that has not been heat inactivated to be tested
USR test
unheated serum reagin
macroscopic flocculation
the assay uses VDRL antigen with charcoal particles. the antigen is not attached to the charcoal as in latex agglutination assays. the charcoal is trapped in the flocculation reaction, which allows the reaction to be seen macroscopically
RPR test
rapid plasma reagin
RPR test
dilutions are made to semi quantify the?
amount of antibody present
this test can be quali or semiquantitative
identidy what test
treponemal antigen is combined with liposomes. if antibodies are present, a mat of agglutination forms in wells of a microtiter plate
TP-PA test
T. pallidum particulate agglutination
principle of FTA-ABS test
indirect antibody test
FTA-ABS test
— of T. pallidum subsp. pallidum is affixed into wells of microscope slides
Nichol’s strain
patient serum is heated inactivated
FTA-ABS
nontreponemal antibody is absorbed from patient serum with a sorbent of — of nonpathogenic treponeme
Reiter’s strain
FTA-ABS
fluorescent reactions are graded —
1 - 4+
FITC-labeled antihuman antibody is added
