Spiral bacteria

Question 1

What is the marker of primary syphilis?

Answer 1

Chancre

Question 2

What are the markers of secondary syphilis?

Answer 2

Rash involving palms & soles
Lymphadenopathy

Question 3

What are the markers of late-quaternary syphilis?

Answer 3

Cardiovascular syphilis
Neurosyphilis

Question 3

What is the marker of tertiary syphilis?

Answer 3

Gummatous lesions

Question 4

What is the hallmark of secondary syphilis rash?

Answer 4

Rash on the palms and soles

Question 5

What is the ‘Hutchinson’s Triad’ of congenital syphilis

Answer 5

1. Cranial nerve VIII deafness
2. Corneal clouding
3. Notched teeth

Question 6

What are the clinical presentations of congenital syphilis?

Answer 6

1. Rash resembling secondary syphilis
2. Hutchinson’s triad

Question 7

How to diagnose syphilis?

Answer 7

Serology or Dark Ground Illumination (DGI) on primary/secondary lesions

Question 8

Can Treponema pallidum be seen on Gram stain or culture?

Answer 8

No

Question 9

What serological tests should be done to confirm syphilis diagnosis?

Answer 9

1. Non-specific tests - VDRL/RPR
2. Specific tests - tests that use treponemal antigens (EIA, LIA, TPHA, FTA-Abs)

Question 10

What is the treatment for syphilis?

Answer 10

Penicillin G IM

If neurosyphilis, use aqueous Penicillin G IV

Question 11

What is the main virulence factor of B. recurrentis and what is its clinical presentation?

Answer 11

Antigenic variation causing relapsing fever

Question 12

How is Borrelia spp. diagnosed?

Answer 12

Stained blood film

Question 13

How is Borrelia spp. treated?

Answer 13

Doxycycline

Question 14

What disease does B. burgdorferi cause?

Answer 14

Lyme disease

Question 15

What is the hallmark of Lyme disease?

Answer 15

Erythema chronicum migrans (ECM)

Question 16

What is Leptospirosis spp. associated with?

Answer 16

Rat’s urine

Question 17

Weil’s disease is caused by which bacteria?

Answer 17

Leptospirosis spp.

Question 18

How are Campylobacter spp. and Helicobacter spp. identifiable?

Answer 18

Gram-negative short spirals

Question 19

What is the main source of transmission for C. jejuni?

Answer 19

Poultry faeces

Question 20

What are the clinical presentations of C. jejuni infection?

Answer 20

1. Abdominal pain
2. Diarrhoea
3. Fever

Question 21

What are the post-infectious complications caused by C. jejuni infection?

Answer 21

1. Guillain Barre syndrome
2. Reactive arthritis

Question 22

How is C. jejuni infection diagnosed?

Answer 22

Stool culture on selective medium

Question 23

Why does C. jejuni cause Guillain Barre syndrome?

Answer 23

C. jejuni uses molecular mimicry to express surface antigens that mimic components of human nerve tissues, leading to cross-reactivity of antibodies

Question 24

How is **H. pylori** able to infect the gastric epithelium?

Answer 24

Produces urease which neutralizes stomach acid

Question 25

How might we non-invasively confirm **H. pylori** diagnosis?

Answer 25

1. **Stool antigen test** 2. **Urea breath test** 3. Serology - will continue to be positive after cure

Question 26

How might we invasively confirm **H. pylori** diagnosis?

Answer 26

1. Biopsy followed by 2. Rapid urease test 3. Culture

Question 27

How to treat **H. pylori** infection?

Answer 27

Clarithromycin-containing triple therapy **for 2 weeks**

Question 28

What are the 2 non-specific syphillis serology tests?

Answer 28

VDRL RPR

Question 29

What can H. pylori infection lead to?

Answer 29

1. Peptic ulceration 2. Gastric cancer 3. Gastric MALT lymphoma