Syphilis

Question 1

Causative agent of syphilis

Answer 1

Treponema pallidum subsp. pallidum

Question 2

syphilis is transmitted by?

Answer 2

direct contact

sexual and perinatal (across the placenta)

Question 3

early asymptomatic phase lasts?

Answer 3

10 days to 10 weeks

Question 4

after T. pallidum enters the body, what’s next?

Answer 4

it reaches the bloodstream and is disseminated to all organs

Question 5

identify the stage

chancre appears

Answer 5

primary syphilis

Question 6

painless initial lesion, nonbleeding ulcer

“punched out” appearance with a red and smooth based and visible scant serous secretions

Answer 6

chancre

appears after the initial infection

Question 7

chancre appears — after the initial infection

days/weeks

Answer 7

2 - 3 weeks after initial infection

Question 8

primary syphilis

what’s next after the chancre appears?

Answer 8

lymph nodes enlarge

Question 9

identify the stage

antibodies are produced

Answer 9

primary

Question 10

antibodies are produced — after the infection

days/weeks

Answer 10

1-4 weeks

Question 11

darkfield analysis of lesion demonstrates?

Answer 11

spirochetes

Question 12

enumerate the symptoms that starts to appear during the secondary stage

7 symptoms

Answer 12

• skin rash
• low-grade fever
• malaise
• pharyngitis
• weight loss
• arthralgia
• lymphadenopathy

Question 13

symptoms during secondary syphilis last?

Answer 13

4-6 weeks

Question 14

identify.

spirochetes are present throughout the body during this stage

Answer 14

secondary syphilis

Question 15

identify the stage

ulcer develop on mucous membranes

Answer 15

secondary

Question 16

identify the stage

serologic tests are positive

Answer 16

secondary

Question 17

identify the stage

condyloma lata

Answer 17

secondary

Question 18

formed by coalescence of large, pale, flat-topped papules. occur in warm, moist areas

Answer 18

condyloma lata

Question 19

condyloma lata occur in warm, moist areas such as — and are highly infectious

Answer 19

perianal

Question 20

identify

stage of syphilis with no signs or symptoms

Answer 20

latency

Question 21

identify the stage

nontreponemal and treponemal serologic tests are positive

Answer 21

latency

Question 22

identify the stage

one in four individuals relapses into secondary syphilis

Answer 22

early latency

Question 23

identify the stage

the patient is resistant to reinfection and to relapses

Answer 23

late latency

Question 24

symptoms of tertiary occur — after initial infetion

Answer 24

2 - 40 years

Question 25

this refers to the syphilis lesions due to *hypersensitivity* reaction to treponemal antigens and are found throughout the body

Answer 25

gummas

Question 26

# identify the stage gummas

Answer 26

tertiary

Question 27

this diseases/symptoms can occur during tertiary stage | enumerate!

Answer 27

- syphilitic aortitis - aortic valve insufficiency - thoracic aneurysm

Question 28

neurosyphilis can cause?

Answer 28

blindness and senility

Question 29

most common complication of late syphilis

Answer 29

gummas | it may be single or multiple. ## Footnote indolent, slowly progressive, and indurated granulomata, with central healing and atrophic scar surrounded by hyperpigmented borders.

Question 30

# true or false gummas are destructive and hard to treat

Answer 30

FALSE | gummas responds rapidly to treatment

Question 31

# true or false T. pallidum can cross the placenta during any stage of the disease

Answer 31

TRUE | congenital syphilis

Question 32

# congenital syphilis infection of the fetus causes --- | enumerate

Answer 32

- late abortion - stillbirth - neonatal death/disease - latent infection

Question 33

# 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

Answer 33

FALSE | it DOES depend

Question 34

Congenital syphilis is avoided if the mother received the treatment during ---

Answer 34

first 4 months of pregnancy

Question 35

congenital syphilis presents in the neonate as? | enumerate the 7

Answer 35

- maculopapular desquamatous rash (mouth, palm, soles) - hemolytic anemia - jaundice - hepatosplenomegaly - abnormal cartilage and bone involvement - mental retardation

Question 36

definitive diagnosis is made by detection of T. pallidum in --- | enumerate the 4

Answer 36

- CSF - umbilical cors - skin - mucous membrane lesions | depending on the stage of the disease

Question 37

T. pallidum is detected using?

Answer 37

darkfield microscopy or silver stain

Question 38

used to detect T. pallidum in lesions

Answer 38

fluorescence labeled antibody | Direct Fluorescent antibody-Z pallidum (DFA-TP) test

Question 39

# 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

Answer 39

nontreponemal antigen tests

Question 40

# nontreponemal test SLE, autoimmune disease, pregnancy, and some chronic infections such as hepatitis these conditions can result in?

Answer 40

false positives

Question 41

enumerate the nontreponemal antigen tests

Answer 41

- Venereal Disease Research Laboratory (VDRL) - unheated serum reagin (USR) - rapid plasma reagin (RPR) assays

Question 42

all reactive results must be confirmed using a test called?

Answer 42

treponemal antigen tests

Question 43

uses T. pallidum cells as antigen source and these assays are highly specific | identify what test

Answer 43

treponemal antigen test

Question 44

identify the treponemal antigen tests

Answer 44

- fluorescent treponemal antibody absorption (FTA-ABS) - T. pallidum particulate agglutination (TP-PA) - microhemmaglutination T. pallidum tests

Question 45

this test measures the antibody (reagin) a patient has formed against cardiolipin, cholesterol, and lecithin

Answer 45

VDRL test | Venereal Disease Research Laboratory

Question 46

VDRL tests are read microscopy for?

Answer 46

flocculation | nonreactive NR, weak reactive WR, reactive R

Question 48

this test is positive 1-3 weeks after the chancre appears

Answer 48

VDRL test | limited to use on CSF ## Footnote the only serologic test approved for testing CSF

Question 48

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

Answer 48

USR test | unheated serum reagin

Question 49

# 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

Answer 49

RPR test | rapid plasma reagin

Question 50

# RPR test dilutions are made to semi quantify the?

Answer 50

amount of antibody present | this test can be quali or semiquantitative

Question 51

# identidy what test treponemal antigen is combined with liposomes. if antibodies are present, a mat of agglutination forms in wells of a microtiter plate

Answer 51

TP-PA test | T. pallidum particulate agglutination

Question 52

principle of FTA-ABS test

Answer 52

indirect antibody test

Question 53

# FTA-ABS test --- of T. pallidum subsp. pallidum is affixed into wells of microscope slides

Answer 53

Nichol's strain | patient serum is **heated inactivated**

Question 53

# FTA-ABS nontreponemal antibody is absorbed from patient serum with a sorbent of --- of nonpathogenic treponeme

Answer 53

Reiter's strain

Question 54

# FTA-ABS fluorescent reactions are graded ---

Answer 54

1 - 4+ | FITC-labeled antihuman antibody is added