Hdm Test 3: Syphilis And Trichomoniasis

Front 1

Type of bacteria causing syphilis

Back 1

spirochetes

Front 2

More prominent population infected with syphilis

Back 2

Men, especially MSM (72% of all cases in 2011)

Front 3

How does syphilis synergize with HIV?

Back 3

Destruction of epithelial in genital ulcers
Viral HIV loads higher in pts with early syphilis
Risk of neurosyphilis is 3-5x higher

Front 4

Length of incubation period of syphilis

Back 4

3 weeks

Front 5

Duration of primary syphilis

Back 5

2-6 weeks

Front 6

Characterization of primary syphilis

Back 6

genital ulcer, but resolves w/ or w/o tx.

Front 7

When can neurosyphilis occur?

Back 7

Any stage, even primary

Front 8

Early forms of neurosyphilis affects where?

Back 8

meninges, CSF, CNS vasculature, later brain and SC

Front 9

Symptom of primary syphilis exposure

Back 9

painless chancre

Front 10

Symptoms of secondary syphilis

Back 10

RASH, malaise, myalgias, fever, lymphadenopathy, HA, sore throat, hair loss, hepatitis

Front 11

Cause of secondary syphilis

Back 11

Hematogenous spread of spirochetes early after infection

Front 12

Stages of latent syphilis

Back 12

Early: <1 yr, still infectious, short tx
Late: >1 yr, non-infectious, need longer tx

Would have to diagnose by blood test

Front 13

When is tertiary syphilis?

Back 13

10-30 yrs after infection, in absence of therapy after latent syphilis

Front 14

Pregnant women with syphilis often lead to...

Back 14

50%-miscarriage
40-70% have congenital syphilis

Presents with changes features from bone, eye, ear, and brain damage

Front 15

Key sign for congenital syphilis absent of immediate symptoms during birth

Back 15

Hutchinson's incisors

Front 16

Technology to ID spirochetes

Back 16

Dark field microscopy

Front 17

What does the outer membrane of Treponema pallidum lack?

Back 17

LPS, few exposed proteins

Front 18

3 other pathogenic spirochetes

Back 18

T.denticola
Leptospira interrogens
Borrelia burgdorferi

Front 19

Why can studying syphilis be difficult?

Back 19

Can't grow in lab; can cultivate in rabbit testes

Front 20

What is essential for T. pallidum invasion and dissemination?

Back 20

Active motility

Front 21

To what do T. pallidum proteins bind?

Back 21

Laminin and fibronectin

Front 22

Innate immune response to T. pallidum

Back 22

Triggered by TLR2, causing inflammatory responses
Lipids may evade response

Front 23

What causes damage in T. pallidum?

Back 23

host inflammatory responses (no toxins)

Front 24

What attacks the early syphilitic lesions? Think 2 waves

Back 24

T-cells (CD4+CD8) with Th1 cytokine and IFN gamma

Macrophages follow, then numbers decline dramatically

Front 25

2 types of antibodies

Back 25

Those by non-treponemal tests (VDRL, RPR)
Those by treponemal tests (TPPA, TPHA)

Front 26

What do the non-treponemal tests recognize?

Back 26

Lipid antigens, react with cardiolipin

Front 27

What do treponemal tests recognize?

Back 27

T.pallidum protein antigens

Front 28

Dx of syphilis?

Back 28

microscope
non-treponemal tests (VDRL, RPR)
treponemal tests (TPPA, TPHA)
Rapid Tp ab tests (maybe in developing countries)

Front 29

Tx for penicillin

Back 29

single round of penicillin, some extras, but resistance showing

Front 30

Why are numbers vague for trichomoniasis?

Back 30

Not required reporting.

Front 31

Associations with Trichomoniasis

Back 31

HIV viral load, risk of other STIs, cervical neoplasia, tubal infertility, atypical PID

Front 32

Sites of trichomoniasis infection

Back 32

vagina, eruthra, endocervix

Front 33

clinical presentation of trichomoniasis in women

Back 33

frothy discharge, strawberry cervix

Front 34

Clinical presentation of trichomoniasis in men

Back 34

non-gonococcal, non-chlamydial urethritis

-can have discharge, dysuria (or asymptomatic)

Front 35

Trichomoniasis symptoms, which has more, male or female?

Back 35

Femaly

Front 36

What does trichomonas do when it contacts epithelial cells?

Back 36

sticks to them

Front 37

Immune response to T. vaginalis

Back 37

vaginal/urethral inflammation bc of PMNs
May stim IL-8 production and activates TLR4
Ab detected in serum and genital fluids

Front 38

Detection of trichomoniasis

Back 38

wet mount

Front 39

Tx for trichomoniasis

Back 39

-5-nitroimidazoles (like metronidazole, which treats anaerobic bacteria or other protozoa)
-Drugs activated within hydrogenosomes (their version of Mt)