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DEN 7102 Micro & Immuno Concepts > Exam 3 Spirochetes > Flashcards

Exam 3 Spirochetes Flashcards

1
Q

Spirochetes are structurually ___ like, but are not visualized by ____

A

Gram-negative like; Gram stain

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2
Q

Spirochetes should be visualized using:

A
  • dark field microscopy
  • silver stain
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3
Q

Spirochetes are shaped like a:

A

Corkscrew

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4
Q

Spirochete movement

A

Rotation locomotion via endoflagellum that wraps around the cell

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5
Q

Treponema is aerobic or anaerobic?

A

Anaerobic

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6
Q

Disease caused by Treponema

A

Syphilis

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7
Q

Oral treponemes are implicated in:

A
  • periodontal disease
  • acute necrotizing ulcerative gingivitis (ANUG)
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8
Q

ANUG stands for

A

Acute necrotizing ulcerative gingivitis

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9
Q

___ is vector borne

A

Borrelia

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10
Q

Leptospira is aerobic or anaerobic?

A

Aerobic

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11
Q

Relapsing fever and Lyme disease are caused by what species?

A

Borrelia

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12
Q

Third most common bacterial STD

A

Syphilis

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13
Q

What group of people have the highest rates of syphilis cases?

A
  • American Indian or Alaska native
  • Black/African American
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14
Q

___ account for the most cases of syphilis

A

Men

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15
Q

Vast majority of syphilis cases occur among:

A

Men who have sex with men (MSM)

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16
Q

Syphilis often occurs in patients with ____; important facilitator of ____

A

other STDs; HIV

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17
Q

Treponema pallidum looks like:

A

long, thin, spiral

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18
Q

True or false: Treponema pallidum can be cultured on medium

A

False - limited growth in tissue culture, rapidly dies on drying

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19
Q

Treponema pallidum has limited ____ capacity; it is an _____

A

metabolic (missing TCA cycle); obligate internal parasite

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20
Q

Treponema pallidum lack what two virulence factors?

A
  • no catalase
  • no superoxide dismutase
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21
Q

Treponema pallidum virulence factors

A
  • immune avoidance (few surface antigens)
  • surface adhesins to bind fibronectin
  • hyaluronidase facilitates infiltration
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22
Q

Syphilis - modes of transmission

A
  • Sexual contact
  • Transplacental
  • Close contact with active lesion (also perinatal)
  • Blood transfusion
  • Accidental direct inoculation
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23
Q

Patient with syphilis is most infectious during:

A

Early disease stages

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24
Q

Syphilis patient is considered not infectious after ____ years due to ____

A

4; low bacterial load

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25
Q

What are the clinical stages of syphilis?

A
  1. Primary
  2. Secondary
  3. Latent
  4. Tertiary
  5. Congenital
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26
Q

What happens during primary syphilis?

A
  • primary lesion formed is a chancre
  • infiltrated with lymphocytes and plasma cells
  • heals after 14 days
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27
Q

The chancre formed during primary syphilis is:

A
  • painless
  • highly infectious
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28
Q

How long are you seropositive for syphilis once contracted?

A

For life

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29
Q

Primary syphilis incubation period

A

3-4 weeks

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30
Q

Where can primary syphilis chancres occur?

A
  • lip
  • tongue
  • on hand (infected cut)
  • genitals
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31
Q

A high increase of plasma cells in tissues, exudates, or blood is indicative of:

A

Some kind of infection (could be syphilis)

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32
Q

When does secondary syphilis occur?

A

2-10 weeks after primary syphilis

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33
Q

Secondary syphilis occurs in ____ of those with untreated primary syphilis

A

25%

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34
Q

What happens during secondary syphilis?

A
  • Wide dissemination of T. pallidum (highly infectious)
  • causes skin rashes, mucous patches, condylomata lata
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35
Q

Condylomata lata

A

Wart-like growths

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36
Q

Syphilis skin rashes are:

A
  • widespread (palms, soles)
  • macular/papular
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37
Q

Secondary syphilis mucous patches can occur on:

A
  • tonsil
  • soft palate
  • palms and soles
  • scalp (alopecia)
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38
Q

Latent syphilis is characterized as being:

A

Seropositive with no symptoms

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39
Q

Latent syphilis occurs in ____ of patients with untreated secondary syphilis

A

15%

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40
Q

How long can latent syphilis last?

A

Several years to decades

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41
Q

____ is more infectious than late latent stage, including transmission to fetus

A

Early latent

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42
Q

Those with HIV experience ____ if they have syphilis

A

Shortened latency

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43
Q

Tertiary syphilis is not common anymore due to _____

A

Antibiotics

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44
Q

In the beginning of a syphilis infection, bacterial load is ____. Towards the end of the infection (tertiary syphilis), bacterial load is ___

A

high; low

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45
Q

Tertiary syphilis occurs ____ after the primary infection

A

Several months to 30 years

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46
Q

In _____ syphilis, 50% develop gumma

A

Tertiary

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47
Q

Is gumma contagious?

A

No

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48
Q

Gumma is highly ____ but often painless

A

Destructive

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49
Q

What does a gumma look like?

A
  • white-grey
  • rubbery
  • single or multiple
  • tiny to tumor like sizes
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50
Q

Tertiary syphilis is associated with ____ involvement. Organisms ____

A

Multisystem; spread to other body parts

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51
Q

Where can a gumma occur?

A
  • skin
  • oral cavity
  • bone
  • joints
  • cardiovascular system
  • nervous system

can occur in most organs

52
Q

A ____ is a soft tumor-like inflammation

A

Gumma

53
Q

A gumma in the oral cavity can lead to:

A

Perforated palate (can bore holes in the tissue)

54
Q

Gumma in the joints can lead to:

A

Charcot’s joints (neuropathic)

55
Q

Gumma in the cardiovascular system can lead to:

A

Aortic aneurism (abnormal bulge that occurs in the wall of the aorta)

caused by syphilitic aortitis

56
Q

_____ can lead to collapse of midfoot arch

A

Charcot’s foot (joint) - tertiary syphilis

57
Q

Aortic aneurism (definition)

A

Abnormal bulge that occurs in the wall of the aorta

58
Q

When does neurosyphilis occur?

A

At any stage of syphilis

59
Q

True or false: neurosyphilis is symptomatic

A

False - can be asymptomatic

60
Q

Early neurosyphilis occurs:

A

A few months to a few years after infection

61
Q

Acute syphilitic meningitis and ocular involvement occur during what stage of neurosyphilis?

A

Early neurosyphilis

62
Q

Late neurosyphilis occurs during what stage of syphilis?

A

Tertiary syphilis

63
Q

Late neurosyphilis can lead to:

A
  • general paresis
  • tabes dorsalis
64
Q

General paresis

A

Brain cortex degeneration

65
Q

Tabes dorsalis

A
  • damage to dorsal root ganglia
  • ataxia, wide based gait, foot slap
  • loss of sensation
66
Q

Ataxia

A

without coordination (tabes dorsalis, late neurosyphilis)

67
Q

Recently, syphilis cases have been:

A

Increasing

68
Q

Those who use ____ are at higher risk of contracting syphilis

A

Methamphetamine; injection drugs

69
Q

Congenital syphilis cases must be reported within:

A

24 hours

70
Q

40% of syphilis pregnancies result in:

A
  • miscarriage
  • stillbirth
  • infant death
71
Q

If a baby survives with congenital syphilis, they may develop:

A
  • developmental delays, seizures (due to meningitis)
  • craniofacial anomalies
72
Q

A newborn with congenital syphilis is:

A

Infectious (fluid is contagious - syphilistic rhinitis snuffles)

73
Q

How is congenital syphilis prevented?

A

Antibiotic treatment of mother

74
Q

What craniofacial anomalies can result from congenital syphilis?

A
  • Hutchinson’s teeth
  • Mulberry (Moon’s) molars
  • mucous patches
  • perforated palate
  • saddle nose
  • keratitis
75
Q

Hutchinson’s teeth affects:

A

Permanent incisors

76
Q

Describe Hutchinson’s teeth phenotype

A
  • incisor crown wider in cervical portion than incisal edge
  • incisal edge has crescent shaped notch
  • incisors can also have triangular shaped deformity
77
Q

Mulberry (Moon’s) molars can affect:

A

First permanent molars

78
Q

What do Mulberry molars look like?

A

Occlusal surface is composed of an aggregate of enamel nodules

79
Q

Syphilis diagnosis involves:

A

2-tiered serology: non-treponemal and treponemal

80
Q

Non-treponemal serology is ____ to treponemes

A

Non-specific

81
Q

Non-treponemal serology tests for:

A
  • cellular damage
  • antibodies to cardiolipin
82
Q

Examples of non-treponemal tests

A
  • Wassermann test
  • VDRL (Venereal disease research laboratory)
  • RPR (rapid plasma reagin)
83
Q

Wassermann test tests for

A

Complement fixation

84
Q

VDRL tests for:

A

Neurosyphilis in CSF

85
Q

Non-treponemal serology can show _____ for other diseases

A

False positive results

86
Q

Which non-treponemal serology tests are agglutination assays?

A
  • VDRL
  • RPR
87
Q

For RPR, mix ____ with patient’s blood. They will agglutinate bith blood ____

A

cardiolipin antigen; Reagin (antibodies to materials released by damaged cells)

88
Q

Treponemal serology is for

A

Syphilis disease confirmation

89
Q

Treponemal tests (Identification of T. pallidum)

A
  • PCR
  • FTA-ABS (fluorescent treponemal antibody absorption)
  • TPPA (Treponema pallidum particle agglutination)
  • MHA-TP (micro hemagglutination to T. pallidum)
90
Q

TPPA allows for clotting of:

A

Ab:Ag

91
Q

Treponemal serology - Antibodies in spinal fluid is highly suggestive of:

A

Active neurosyphilis

92
Q

2-tiered syphilis testing - which test is first?

A

Either can be first (non-treponemal or treponemal)

93
Q

If non-treponemal test is first:

A
  • RPR or VDRL first
  • then confirmatory TT (TPHA or TPPA)
94
Q

2 tiered syphilis testing - it is less expensive but has high rates of false negatives to do which test first?

A

Non-treponemal

95
Q

When first test is treponemal test:

A
  • first TT immunoassay
  • then NTT (RPR or VDRL) if there is previous history of treatment
96
Q

Syphilis DOC

A

Penicillin - single dose intramuscular

97
Q

Treatment of late latent syphilis or latent syphilis of unknown duration; or pregnant women

A

Three doses of penicillin recommended

98
Q

Possible complication of Syphilis antibiotics therapy

A

Jarisch-Herxheimer reaction - similar to endotoxic shock; Allergic reaction from rapid release of treponemal antigen from cell wall

99
Q

All patients with syphilis must be tested for

A

HIV

100
Q

Other treponemes

A
  • Yaws (skin disease in Africa)
  • Pinta (skin disease in South america)
  • Normal oral flora (Treponema denticola): associated with periodontal disease, ANUG
101
Q

Borrelia is ___ than treponemes

A

Larger

102
Q

Some Borrelia sp are visualized by:

A

Giemsa staining

103
Q

What causes Lyme disease?

A

Borrelia burgdorferi

104
Q

Borrelia species that causes epidemic relapsing fever

A

Borrelia recurrentis

105
Q

What is relapsing fever?

A
  • febrile illness that goes away and comes back
106
Q

Borrelia hermsii is endemic in:

A

Western US

tick vector, rodent reservoir

107
Q

Borrelia miyamotoi is endemic in

A

NE uS

deer tick vector, rodent reservoir

108
Q

Relapsing fever DOC

A

Tetracyclines

109
Q

B. burgdorferi reservoir

A

White tailed deer

110
Q

B. burgdorferi vector

A

Tick (can transfer pathogen to others)

Eastern US - Ixodid deer tick
Western US - black legged ticks

111
Q

Is the nymph or adult tick responsible for majority of Lyme disease cases?

A

Nymph

112
Q

Early infection of lyme disease involves localized ____

A

Erythema migrans (bulls eye rash)

113
Q

Patients with untreated Lyme disease can progress to early disseminated stage, which involves:

A

arthritis, neurologic manifestations (Bell’s palsy), cardiac dysfunction

114
Q

Late Lyme disease involves:

A
  • arthritis
  • chronic skin involvement
  • carditis
115
Q

Muscle weakness on one side can be due to

A

Bell’s palsy caused by untreated Lyme disease

116
Q

Lyme disease - what does rash look like

A

Bulls-eye

117
Q

Diagnosis of Lyme Disease

A

Serology 2-tiered

  1. ELISA or immunofluorescence
  2. Western blot to confirm
118
Q

Early stage Lyme disease treatment

A

Tetracycline

119
Q

Disseminated/late stage Lyme disease treatment

A

IV ceftriaxone

120
Q

Acrodermatitis chronica atrophicans

A

Skin rash/fibrosis that can occur during late disseminated Lyme disease

121
Q

Leptospira interrogans is a:

A

Human pathogen

122
Q

Leptospira sp. is an ____ spirochete with ____

A

aerobic; hooked ends

123
Q

Leptospira interrogans causes what disease

A

Leptospirosis

124
Q

Tx for Leptospirosis

A

Doxycycline

125
Q

How can you get infected by Leptospira?

A
  • Rodent urine can contaminate water/soil/food and becomes more of an issue after natural disaster
  • infects eyes, ingestion, wound contamination

DEN 7102 Micro & Immuno Concepts (26 decks)

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