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9 Cards in this Set
- Front
- Back
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Which is the test preferred at BH-D for screening patients for syphilis?
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RPR
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If the RPR were positive, what two things should happen in the lab?
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1. The lab should provide a "quantitative" RPR for follow-up use. 2. The lab, without being asked, should do a much more expensive "treponemal" test to confirm the diagnosis. |
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Name the treponemal test used at BH-D to confirm that a positive RPR really is caused by syphilis and not something else.
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FTA-ABS
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RPR is a "non-treponemal" test that can react to many other conditions as well. Name 4 viral infections known to cause "false positive" results.
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1. EBV (mononucleosis) 2. Hepatitis (which one not said) 3. Varicella 4. Measles |
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RPR is a "non-treponemal" test that can react to many other conditions as well. Name 4 NON-viral infections known to cause "false positive" results.
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1. Lyme disease (also caused by spirochete!) 2. Endocarditis 3. TB 4. Malaria |
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RPR is a "non-treponemal" test that can react to many other conditions as well. Name 3 clinical entities, not related to infection at all, known to cause "false positive" results.
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1. Pregnancy, all by itself (!) 2. IV drug abuse (though infections CAN be involved) 3. Connective tissue diseases (e.g., lupus) |
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1. How are the results of the quantitative RPR reported?
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They are given as "titers," with the levels increasing with the denominator in steps, i.e., 1:2 < 1:4 < 1:8 < 1:16 < 1:32 < 1:64 < 1:128 < etc. (Some labs write out the result as 1/2, 1/4...etc., or else throw out the numerator altogether, e.g., 2, 4, 8, 16, 32, 64, 128, etc., etc.) |
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1. If RPR really isn't specific for Treponema, what is it measuring? 2. Of what importance is THAT in the management of patients with syphilis? |
1. It measures antibody against cardiolipin, a glycolipid that leaks out of tissues injured for many different reasons 2. The higher the titer, the greater the tissue damage caused by the disease. Therefore, a quantitative RPR is highly useful in following the current activity of the disease in patients known to have had syphilis in the past. |
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If an esteemed attending, or learned author, or intrepid researcher mentions a "four-fold increase or decrease in RPR titer," what in hades do they mean?
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They mean that the current level of antibody measured by RPR has changed by 2 steps or more (i.e., 2 test-tubes or more). A four-fold increase: (past) 1:8 --> (present) 1:32 Four-fold decrease: (past) 1:256--> (present) 1:64 (Pay attention, this will be important later) |
