Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
39 Cards in this Set
- Front
- Back
Type of bacteria causing syphilis
|
spirochetes
|
|
More prominent population infected with syphilis
|
Men, especially MSM (72% of all cases in 2011)
|
|
How does syphilis synergize with HIV?
|
Destruction of epithelial in genital ulcers
Viral HIV loads higher in pts with early syphilis Risk of neurosyphilis is 3-5x higher |
|
Length of incubation period of syphilis
|
3 weeks
|
|
Duration of primary syphilis
|
2-6 weeks
|
|
Characterization of primary syphilis
|
genital ulcer, but resolves w/ or w/o tx.
|
|
When can neurosyphilis occur?
|
Any stage, even primary
|
|
Early forms of neurosyphilis affects where?
|
meninges, CSF, CNS vasculature, later brain and SC
|
|
Symptom of primary syphilis exposure
|
painless chancre
|
|
Symptoms of secondary syphilis
|
RASH, malaise, myalgias, fever, lymphadenopathy, HA, sore throat, hair loss, hepatitis
|
|
Cause of secondary syphilis
|
Hematogenous spread of spirochetes early after infection
|
|
Stages of latent syphilis
|
Early: <1 yr, still infectious, short tx
Late: >1 yr, non-infectious, need longer tx Would have to diagnose by blood test |
|
When is tertiary syphilis?
|
10-30 yrs after infection, in absence of therapy after latent syphilis
|
|
Pregnant women with syphilis often lead to...
|
50%-miscarriage
40-70% have congenital syphilis Presents with changes features from bone, eye, ear, and brain damage |
|
Key sign for congenital syphilis absent of immediate symptoms during birth
|
Hutchinson's incisors
|
|
Technology to ID spirochetes
|
Dark field microscopy
|
|
What does the outer membrane of Treponema pallidum lack?
|
LPS, few exposed proteins
|
|
3 other pathogenic spirochetes
|
T.denticola
Leptospira interrogens Borrelia burgdorferi |
|
Why can studying syphilis be difficult?
|
Can't grow in lab; can cultivate in rabbit testes
|
|
What is essential for T. pallidum invasion and dissemination?
|
Active motility
|
|
To what do T. pallidum proteins bind?
|
Laminin and fibronectin
|
|
Innate immune response to T. pallidum
|
Triggered by TLR2, causing inflammatory responses
Lipids may evade response |
|
What causes damage in T. pallidum?
|
host inflammatory responses (no toxins)
|
|
What attacks the early syphilitic lesions? Think 2 waves
|
T-cells (CD4+CD8) with Th1 cytokine and IFN gamma
Macrophages follow, then numbers decline dramatically |
|
2 types of antibodies
|
Those by non-treponemal tests (VDRL, RPR)
Those by treponemal tests (TPPA, TPHA) |
|
What do the non-treponemal tests recognize?
|
Lipid antigens, react with cardiolipin
|
|
What do treponemal tests recognize?
|
T.pallidum protein antigens
|
|
Dx of syphilis?
|
microscope
non-treponemal tests (VDRL, RPR) treponemal tests (TPPA, TPHA) Rapid Tp ab tests (maybe in developing countries) |
|
Tx for penicillin
|
single round of penicillin, some extras, but resistance showing
|
|
Why are numbers vague for trichomoniasis?
|
Not required reporting.
|
|
Associations with Trichomoniasis
|
HIV viral load, risk of other STIs, cervical neoplasia, tubal infertility, atypical PID
|
|
Sites of trichomoniasis infection
|
vagina, eruthra, endocervix
|
|
clinical presentation of trichomoniasis in women
|
frothy discharge, strawberry cervix
|
|
Clinical presentation of trichomoniasis in men
|
non-gonococcal, non-chlamydial urethritis
-can have discharge, dysuria (or asymptomatic) |
|
Trichomoniasis symptoms, which has more, male or female?
|
Femaly
|
|
What does trichomonas do when it contacts epithelial cells?
|
sticks to them
|
|
Immune response to T. vaginalis
|
vaginal/urethral inflammation bc of PMNs
May stim IL-8 production and activates TLR4 Ab detected in serum and genital fluids |
|
Detection of trichomoniasis
|
wet mount
|
|
Tx for trichomoniasis
|
-5-nitroimidazoles (like metronidazole, which treats anaerobic bacteria or other protozoa)
-Drugs activated within hydrogenosomes (their version of Mt) |