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Flashcards in Syphilis Deck (39)
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1

What is the etiologic agent of syphilis?

A spirochete, Treponema pallidum

2

Can T. pallidum be grown in the lab?

No, but it can be propagated in rabbit testes

3

Does syphilis have distinct sequential phases?

Yes, including latent phases

4

Can T. pallidum cross the placenta?

Yes, resulting in congenital syphilis

5

What is the pathology of syphilis largely due to?

Host's cellular inflammatory response, it resembles and AI response

6

What is the hallmark feature of primary syphilis?

Non-painful ulcer called a chancre, developing at site of entry of treponeme

7

Secondary syphilis is what kind of infection?

Systemic, characterized by fever, swollen LNs, mucous membrane lesions, and sometimes a skin rash that eventually includes soles and palms and/or wart-resembling lesions (condylomata kata)

8

What is Lab Dx of syphilis done by?

Serology, and by microscopic examination of scrapings

9

What are all forms of syphilis treated with?

Penicillins, most commonly Pen G; prevention with abstinence and use of condoms

10

What type of bacterium is T. Pallidum?

Helical/spiral-shaped bacterium

11

T. pallidum is very thin, what does this mean?

Too thin to be seen by standard direct light transmission microscopy (gram stain useless)

12

What method is T. pallidum seen by?

Indirect light microscopy method called darkfield microscopy

13

What is dark field useful for?

Useful Dx method early in disease process, before antibodies develo

14

What do spirochetes resemble?

gram negative bacteria

15

What membranes to spirochetes have?

An inner membrane, a periplasm with peptidoglycan and an outer sheath/membrane

16

What is different about the outer sheath in spirochetes?

It's proteins are mainly lipoproteins and lipids (not LPS) that probably contribute to the pathogenic inflammatory process

17

What is the immune response to spirochetes?

Rigorous humoral and cellular response that does not eliminate the infection; Host's cellular immune response probably controls the infection but also responsible for pathology (tert sylph)

18

Does T. pallidum have a latent phase?

Yes, unknown mechanism and if untreated infection and continue for life/can progress to tertiary stage

19

What is the incubation time and symptom resolution time of primary syphilis?

2-3 week incubation w/ resolution in 3-6 weeks

20

What is the manifestation and resolution time of 2ndary syphilis?

1-2 months after infection; resolve in a month or so w/o tx

21

What is early latent syphilis?

The 1-2 yr period after resolution of 2ndary syphilis

22

What is late latent syphilis?

Begins 1-2 years post infection, may last lifetime, may progress to tertiary or resolve spontaneously

23

What can be affected in tertiary syphilis?

Almost any organ system can be affected

24

Will symptoms be present at birth with congenital syphilis?

Sometimes, stigmata may develop 2 yrs or more after birth

25

What are the signs/sx of primary syphilis?

Painless ulcer (chancre) at sight of entry, nontender inguinal LAD

26

What are the signs/sx of secondary syphilis?

Disseminated infection, hyperpigmented maculopapular rash over entire body that with time extends to palms and soles; mucous membrane patches in mouth and genitals a.k.a. snail track lesionsl condylomata lata; and the patient is sick (fever, headache, diffuse LAD); may also have mild meningitis

27

What 4 diseases have a rash on palms and soles?

Secondary syphilis, RMSF, hand foot mouth dz, and rarely meningococcemia

28

What are the signs/sx of early latent Syphilis?

No symptoms, positive serology, may relapse to secondary (can spread in utero)

29

What are the signs/sx of late latent syphilis?

No symptoms, positive serology, no relapse to secondary (not infectious even to fetus)

30

What are the signs/sx of tertiary syphilis?

Progressive, inflammatory disease that may take years to develop; Tertiary S in endarteritis, few spirochetes can be detected in lesions, Gummas, CV and CNS S can take years to develop (Any organ system can be involved here... LOTS of symptoms)