2S [LAB]: Serologic Tests for Syphilis Flashcards
1
Q
Also known as the great imitator
A
Syphilis
2
Q
Etiologic agent of Yaws
A
T. pallidum subsp. pertenue
3
Q
Etiologic agent of non-venereal syphilis
A
T. pallidum subsp. endemicum
4
Q
Syphilis stage that is marked by the development of a hard, painless, and solitary genital lesion
A
Primary syphilis
5
Q
The lesion that appears in during the primary syphilis stage is called ___
A
Chancre or Hunterian Chancre
6
Q
Syphilis stage that begins 2-12 weeks after the disappearance of the chancer and may cause lymphadenopathy, fever, pharyngitis, malaise, and rashes on the skin and mucous membrane
A
Secondary syphilis
7
Q
In secondary syphilis, the wart-like lesions are called ___
A
Condyloma lata
8
Q
Syphilis stage that is characterized by the disappearance of the signs and symptoms of syphilis, where patients are generally non-infectious
A
Latent syphilis
9
Q
Syphilis stage where patients experience CVD, neurosyphilis, and localized subcutaneous granulomas
A
Tertiary syphilis
10
Q
The localized subcutaneous granulomas in tertiary syphilis are called ___
A
Gummas
11
Q
Screening tests with a high sensitivity for the diagnosis of syphilis
A
Non-treponemal tests
12
Q
Non-treponemal tests involves the detection of ___ using known suspensions of ___
A
Reagin
Cardiolipin
13
Q
An antigen prepared from the alcoholic extract of beef cardiac muscle
A
Cardiolipin
14
Q
Highly specific and sensitive tests that detect treponemal antibodies
A
Treponemal tests
15
Q
Serves as verification procedures for validating results obtained in a non-treponemal test
A
Treponemal tests
16
Q
Main antigen source used in VDRL
A
Cardiolipin
17
Q
Reagent used in VDRL to remove anti-complementary substances of cardiolipin
A
0.21% Lecithin
18
Q
Reagent used to enhance the effective reacting surface of cardiolipin in VDRL
A
0.9% Cholesterol
19
Q
Antigenic stabilizer used in VDRL
A
Benzoic acid
20
Q
Size of needle used in qualitative VDRL
A
18G (60 drops)
21
Q
Size of needle used in quantitative VDRL
A
19G (75 drops)
23G (100 drops)
22
Q
Size of needle used in CSF VDRL
A
21 or 22G (100)
23
Q
Slide used in CSF VDRL
A
Boerner’s slide/ Kline concavity slide
24
Q
Rotation time and RPM required in VDRL
A
4 mins, 180 rpm
25
T/F: In VDRL, the serum is heated to inactivate the complement
True
26
Water bath conditions used to inactivate complement in VDRL
56C for 30 mins
27
Positive result for RPR
Black clumps against a white background
28
Optimal temperature when VDRL is being performed
23-29C/ 73-85F
29
In RPR, this reagent makes the reaction more visible
Charcoal
30
In RPR, this reagent prevents lipid peroxidation
EDTA
31
In RPR, this mercury-based reagent preserves the antigen suspension
Thimerosal
32
In RPR, this reagent acts as a chemical inactivator
Choline chloride
33
Rotation time and RPM used in RPR
8 mins, 100 rpm
34
One of the simplest, most rapid, and specific laboratory procedures done for the detection of antibodies against T. pallidum
SY-TPHA
35
Principle of SY-TPHA
Indirect hemagglutination
36
Reagent used in SY-TPHA
Avian (turkey) RBCs fixed or treated with glutaraldehyde and tannic acid
37
Reagent used on TPI
Live treponemes and Guinea pig complement
38
Principle involved in Treponemal tests
Indirect hemagglutination
39
Principle involved in VDRL
Flocculation
40
Principle involved in RPR
Flocculation
41
Complication most often associated with the tertiary stage of syphilis
Neurosyphilis
42
T/F: A negative result in the direct detection of syphilis eliminates a possibility of the detection
F (false negative due to delay in evaluation may happen)
43
A sensitive and highly specific alternative to dark-field microscopy in direct detection of syphilis
Fluorescent antibody testing
44
Type of test used for syphilis screening
Non-treponemal tests
45
Most widely used nontreponemal test
VDRL
RPR
46
An inactivated serum that has been previously inactivated for more than ___ should be reheated for 10 mins at 56C
4 hours
47
T/F: In treponemal tests, once a patient is reactive, that individual remains so for life
T
48
What is the test ring diameter of the VDRL slide?
14 mm
49
What is the test ring diameter of the CSF VDRL slide?
16 mm
50
What is the depth of the concavity of the VDRL slide?
1.75 mm
51
pH requirement for VDRL
6.0 +/- 0.1
52
What is the test ring diameter of the RPR slide?
18 mm
53
Effect of increased pH in VDRL setup
Decreased reactivity
54
Effect of decreased pH in VDRL setup
Increased reactivity
55
Effect of increased temperature in VDRL setup
Increased reactivity
56
Effect of decreased temperature in VDRL setup
Decreased reactivity
57
Slide used in VDRL if the sample is plasma or white blood cells
Brewer's collection slide
58
Viability of Ag suspension in VDRL
24 hours
59
Used slide in VDRL field studies
Brewer's collection slide
60
What coats the Brewer's collection slide?
Anticoagulant (lectin)
61
Strain that is used to coat control cells in TPHA
Reiter (non-pathogenic)
62
Strain that is used to coat test cells in TPHA
Nichol (pathogenic)
63
Diluent used in TPH
PBS with rabbit serum
64
Reference test for syphilis diagnosis
Treponema pallidum Immobilization test (TPI)
65
Reagent used in TPI
Live treponemes
Guinea pig complement
66
T/F: In TPI, the serum is heated
T
67
How much of the treponemes should be immobilized for the TPI to be considered positive?
50%
68
T/F: The TPI is not performed already due to safety reasons
T
69
T/F: TPI may also be used for CSF
T
70
Confirmatory test for syphilis
Fluorescent treponema pallidum antibody
71
Strain used in TPI
Reiter
72
Strain used in Fluorescent treponema pallidum antibody
Nichol
73
Principle of FTA ABS
Indirect fluorescent antibody test
74
Label used in FTA ABS
FITC
75
Identify the reagent used:
HATTS (Hemagglutination Treponemal Test for Syphilis)
i. Colored gelatin particles with Ag
ii. Glutaraldehyde-fixed RBC
iii. Polyurea microcapsule
iv. Rabbit's plasma
ii
76
Identify the reagent used:
TP-PA (Treponema pallidum Particle Agglutination)
i. Colored gelatin particles with Ag
ii. Glutaraldehyde-fixed RBC
iii. Polyurea microcapsule
iv. Rabbit's plasma
i
77
Identify the reagent used:
Microcapsule test for T. pallidum
i. Colored gelatin particles with Ag
ii. Glutaraldehyde-fixed RBC
iii. Polyurea microcapsule
iv. Rabbit's plasma
iii
78
Associate:
Used for inconclusive FTA-ABS result
i. HATTS
ii. TP-PA
iii. Microcapsule test for T. pallidum
iv. Immunochromatography test for syphilis
ii
79
Associate:
Has a reagent that is more stable than RBCs
i. HATTS
ii. TP-PA
iii. Microcapsule test for T. pallidum
iv. Immunochromatography test for syphilis
iii
80
Associate:
Rapid test, like pregnancy test kits
i. HATTS
ii. TP-PA
iii. Microcapsule test for T. pallidum
iv. Immunochromatography test for syphilis
iv
81
Associate:
Similar to RPR
i. Unheated serum reagin test
ii. Gold chloride test
iii. Toluidine red unheated serum test
iv. Wasserman complement fixation test
i
82
Associate:
Test ring of 14 mm
i. Unheated serum reagin test
ii. Gold chloride test
iii. Toluidine red unheated serum test
iv. Wasserman complement fixation test
i
83
Associate:
Used for CSF
i. Unheated serum reagin test
ii. Gold chloride test
iii. Toluidine red unheated serum test
iv. Wasserman complement fixation test
ii
84
Associate:
Positive result is play of color
i. Unheated serum reagin test
ii. Gold chloride test
iii. Toluidine red unheated serum test
iv. Wasserman complement fixation test
ii
85
Associate:
A non-treponemal test; principle: precipitation
i. Unheated serum reagin test
ii. Gold chloride test
iii. Toluidine red unheated serum test
iv. Wasserman complement fixation test
iii
86
Associate:
First serologic test for syphilis
i. Unheated serum reagin test
ii. Gold chloride test
iii. Toluidine red unheated serum test
iv. Wasserman complement fixation test
iv
87
Associate:
Antigen used is from the liver of a still born fetus
i. Unheated serum reagin test
ii. Gold chloride test
iii. Toluidine red unheated serum test
iv. Wasserman complement fixation test
iv
88
False-positive nontreponemal tests for syphilis may occur because of which of the following?
i. Infectious mononucleosis
ii. Systemic lupus
iii. Pregnancy
iv. All of the above
iv
89
In the FTA-ABS test, what is the purpose of absorption with Reiter treponemes?
i. Removes reactivity with lupus antibody
ii. Prevents cross-reactivity with antibody to other T. pallidum subspecies
iii. Prevents cross-reactivity with antibody to nonpathogenic treponemes
iv. All of the above
iii
90
Which test is recommended for testing CSF for neurosyphilis?
VDRL
91
Advantages of direct fluorescent antibody testing to T. pallidum include all of the following except:
i. Reading is less subjective than with dark-field testing
ii. Monoclonal antibody makes the reaction very specific
iii. Slides can be prepared for later reading
iv. Careful specimen collection is less important than in dark-field testin
iv
92
Which of the following is true of nontreponemal antibodies?
i. They can be detected in all patients with primary syphilis
ii. These antibodies are directed against cardiolipin
iii. Nontreponemal tests remain positive after successful treatment
iv. The antibodies are only found in patients with syphilis
ii
93
Which syphilis test detects specific treponemal antibodies?
i. RPR
ii. VDRL
iii. FTA-ABS
iv. Agglutination
iii
94
Which of the following is true of treponemal tests for syphilis?
i. They are usually negative in the primary stage
ii. Titers decrease with successful treatment
iii. In large-volume testing, they are often used as screening tests
iv. They are subject to a greater number of false positives than nontreponemal tests
iii
95
An RPR test done on a 19-year-old woman as part of a prenatal workup was negative but exhibited a rough appearance. What should the technologist do next?
i. Report the result out as negative
ii. Do a VDRL test
iii. Send the sample for confirmatory testing
iv. Make serial dilutions and do a titer
iv
96
Treponemal EIA tests for syphilis are characterized by all of the following except:
i. They are adaptable to automation
ii. They are useful in monitoring antibody titers in syphilis patients undergoing therapy
iii. Subjectivity in reading is eliminated
iv. They can be used to distinguish between IgG and IgM antibodies
ii
97
A 24-year-old man who had just recovered from IM had evidence of a genital lesion. His RPR test was positive. What should the technologist do next?
i. Report out as false positive
ii. Do a confirmatory treponemal test
iii. Do a VDRL
iv. Have the patient return in 2 weeks for a repeat test
ii
98
The reverse screening algorithm for syphilis testing:
i. Is the CDC preferred algorithm
ii. Is more labor intensive than the "traditional" method
iii. Has a high number of false positives that must be resolved by doing a TP-PA test
iv. Is more prone to transcription errors in reporting
iii
99
The dispense-stir used for RPR test can deliver how much reagent/serum?
50 uL
100
What is the expected result in W2 of TPHA?
Negative (presence of cell button)
