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47 Cards in this Set

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Treponema Pallidum:

- size
- LPS?
- growth limitation
- replication rate
- disease
Very slender

Doesn't have one

Cannot in cell-free culture

Very slow

Syphilis
Can you view a T. pallidum on a gram stain?

If not, what can you view it on?
No. too thin for that.

Must use darkfield microscopy
T. pallidum is sensitive to what? x3
Drying
Disinfectants
PCN
TP is sensitive to those who have been Double Dildo Penetrated
What is the most general, common method of transmission?

How effect is this transmission?
Direct mucosal contact with primary/secondary lesion.

1/3 results in transmission
Primary lesions can occur where?
Oral or rectal mucosa
What type of tissues do Syphilis transmit through? x3
1. Intact mucosa

2. Damaged epithelium

3. Placental
PID
Primary syphilis:

- incubation period
- symptomatic initial formation
- pain location
- time to heal
10-90 days

Chancre formation

Painless regional adenopathy

4-6 weeks
What is a "hard chancre?"
Lesion that is:

Raised
Regular border
Hard base
Ulceration
Painless
Highly infectious
Primary spread:

- spreading chronology
Local penetration of mucous membrane,

Spread to local lymph nodes

Blood stream
Primary syphilis virulence factors and their functions. x3
1. Outer membrane - adherence to host

2. Hyaluronidase - penetration of tissue by "ungluing" connective tissue

3. Fibronectin coating - inhibits phagocytosis
HO Fibin' is dangerous
What type of toxins are associated with T. Pallidum?
No toxins involved
Secondary Syphilis symptoms x3
- CNS involvement
- Rash to palm and soles
- Condylomata lata
CRC
Secondary Syphilis:

- titers
High titers of treponemal/nontreponemal antibodies present
Latency Stage of Syphilis:

- symptoms
- period length
- transmission probability
Asymptomatic

Variable length

No sexual transmission
Fetal transmission possible
Tertiary Syphilis:

- occurs when?
- transmission probability
- symptoms x2
- prognosis
Months or years after infection

Not infectious

Gummas
CNS involvement
(HA, fever, stiff neck, dementia, and possible paralysis)

CNS involvement may be fatal or cause permanent disability.
Gummas:

- describe
- locations
- prognosis
Soft granulomatous masses with central necrosis.....that can become a widespread tissue destruction.

Skin, bones, joints, heart, CNS.....

Rarely heal spontaneously
"Granule mat" dragging
Congenital Syphilis

- transmission?
- prevention?
- prognosis?
Transplacental transmission can occur anytime

Can be prevented by antibiotic treatment

Most die in utero
What happens to surviving infants of congenital syphilis? x8
Symptoms of secondary and tertiary syphilis.

"Snuffles"

Severe rash with desquamation

Tooth/bone malformation

Mental retardation

Blindness

Abnormalities of CNS

Deafness
SSS
Mr. T
BAD
Give three examples of bone/tooth malformation seen as a result of congenital syphilis.
1. Saber shins
2. Saddle nose
3. Tooth malformations
Natural infection affects immunity how?

Treatment with Ab affects immunity how?
Leads to long-lasting immunity

Shortens immunity
What type of antibodies arise during infection?
Treponemal antibodies
Nontreponemal antibodies target what?
Host cardiolipin
List the two Non-treponemal tests.
VDRL test
(Venereal Disease Research Lab)

and

RPR Test
(Rapid Plasma Reagin)
What are the advantages of Non-trepenomal tests? x3
Fast

Easy to perform

Reverts to negative 6-18 months after successful treatment.
What are the disadvantages of Non-trepenomal tests?
Prone to false positives
What are the limitations of using Darkfield microscopy for diagnosis?
Only useful on genital lesions if done immediately.
List two Trepenomal tests of serology.
FTA-ABS Test

TPHA test
FTA-ABS

- composed of what?
Killed T. pallidum

Serum (preabsorbed with Reiter spirochetes)

Flourescent antihuman gamma globulin
"Ser" Reiter
Killed
FAGGs
FTA-ABS

- advantage x2
- disadvantage x2
High specificity/sensitivity
Becomes positive early in infection

Requires whole T.pallidum
Costly - thus not useful for monitoring therapy
T. Pallidum Hemagglutination (TPHA)

- advantages x2
- disadvantages x2
High specificity/sensitivity
Becomes positive early in infection (but not positive quite as early as FTA-ABS)

Requires whole T. Pallidum
Costful (not useful for monitoring therapy)
Nontreponemal tests:

- reasons for false positive x4
Pregnancy

Acute febrile illness

Recent immunization

Autoimmune disease
Treponemal tests:

- reasons for false positives x3
Pregnancy

Elevated immunoglobulins

Autoimmune disease
In serology tests, how can false positives be resolved?
Wester blot assay
Syphilis:

- Drug of choice
- Alternative drugs x2
- Contraindications x2
- Vaccine
PCN

Tetracycline/Doxycycline

Tetracycline/Doxycycline contraindicated for pregnant women, and not effective for neurosyphilis

None
What is the Jarisch-Herxheimer reaction?

Symptoms?

Cause?
Worsening of conditions following antibiotic treatment.

Symptoms include fever, HA, malaise.

Due to lysis of organisms.
Consequence of buying a cure in a JAR
Bejel disease is caused by what organism?

What is the disease also known as?
Treponema endemicum

Endemic syphilis
BJ

"And-a-me-cum" (endemicum)

"SIPpin and gettin' HI on LISterine" (SYPHILIS)
Bejel's disease:

- spread how?
- symptoms?
- affects what population group?
Contaminated eating utensils

Lesions begin in mouth and spread to trunk and legs.

Inflammation of leg bone common.

Gummas of nose and soft palate develop later.

Children
Yaws disease is caused by what organism?

What is this disease also known as?
Treponema pertenue

Frambesia
Ten yawns "per ten ewes"
Yaws disease:

- spread by? x2
- affects what organ systems x2
- symptoms x2
Contact with lesions
Contact with eye gnats

Skin and bones

Raspberry-like growth on skin (may exude watery, infectious fluid)

Subcutaneous growths may occur later and cause deformtiy.
What is the organism that causes Pinta disease?
Treponema Carateum
Pinta disease:

- spread by
- systems affected
- symptoms
Contact with lesions

Skin only

Initially raised papules,
followed by flat, reddened areas,
changes in skin pigmentation
(blue or depigmentation)
Syphilis:

- Drug of choice
- Alternative drugs x2
- Contraindications x2
- Vaccine
PCN

Tetracycline/Doxycycline

Tetracycline/Doxycycline contraindicated for pregnant women, and not effective for neurosyphilis

None
What is the Jarisch-Herxheimer reaction?

Symptoms?

Cause?
Worsening of conditions following antibiotic treatment.

Symptoms include fever, HA, malaise.

Due to lysis of organisms.
Bejel disease is caused by what organism?

What is the disease also known as?
Treponema endemicum

Endemic syphilis
Bejel's disease:

- spread how?
- symptoms?
- affects what population group?
Contaminated eating utensils

Lesions begin in mouth and spread to trunk and legs.

Inflammation of leg bone common.

Gummas of nose and soft palate develop later.

Children
Yaws disease is caused by what organism?

What is this disease also known as?
Treponema pertenue

Frambesia
Is there a vaccine for Treponema species?
Yes, but requires 60 injections so impractical.