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97 Cards in this Set
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What is the Order? Family? Genus? For Treponema, Borellia, and Leptospira
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Order: Spirochaetales
Family: Spirochaetaceae Genus: Treponema and Borrelia Family: Leptospiraceae Genus: Leptospira |
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General overview of Spirochaetales:
Gram results and shape |
Gram negative spirochaetes
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Spirochete is greek for...
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Coiled hair
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General overview of Spirochaetales:
How do they look? |
Tightly coiled helical cells with tapered ends
-super thin and can be very long |
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General overview of Spirochaetales:
Are they motile? |
Yes, by periplasmic flagella
(axial fibrils of endoflagella) |
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General overview of Spirochaetales:
What does the outer sheath enclose? |
Axial fibrils that are wrapped around protoplasmic cylinder
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General overview of Spirochaetales:
Do all geni have the same number of endoflagella? |
No, there are differing numbers depending on the Genus and species
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Spirochaetale diseases:
Treponema pallidum |
-Syphilis
- Bejel - Yaws -Pinta |
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Spirochaetale diseases:
Borrelia burgdorferi |
-Lyme disease
-Epidemic relapsing fever - Endemic relapsing fever |
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Spirochaetale diseases:
Leptospira interrogans |
Leptospirosis
-Well's disease |
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General Characteristics of Treponema pallidum:
How is it that they look under a light microscope? |
They are too thin to be seen with light microscopy
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General Characteristics of Treponema pallidum:
How is it that you can see the motile spirochaetes? |
They can be seen with darkfield microscopy
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General Characteristics of Treponema pallidum:
What type of pathogen is this? |
Intracellular
-have outer sheath and high lipid content |
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General Characteristics of Treponema pallidum:
Can you grow it in vitro? |
No
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General Characteristics of Treponema pallidum:
How well do they grow outside of the host? |
Not at all
-you have to take care during the testing procedure -very difficult to study |
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General Characteristics of Treponema pallidum:
What pH conditions does it require? Oxygen? |
pH 7.2-7.4
Microaerophilic |
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Epidemiology of T. pallidum:
How is it transmitted? |
From direct sexual contact or from mom to fetus
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Epidemiology of T. pallidum:
Is it contagious? |
Not highly contagious (~30% chance of getting it after getting exposed to it)
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Epidemiology of T. pallidum:
What is the transmission rate dependent on? |
The stage of the disease
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Epidemiology of T. pallidum:
How long is the incubation period? |
Very long (10 days-3 months)
- in this time period the host is non-infectious |
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Epidemiology of T. pallidum:
How is the incubation period useful? |
This is useful for contact tracing and administration of therapy
-typically found in prostitution |
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Epidemiology of T. pallidum:
What is an interesting statistic of syphilis? |
~10% of gonorrhea patients have siphilis
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Epidemiology of T. pallidum:
When looking at the Siphilis cases you notice that there was a huge drop, why is that? |
The mass production of PENICILLIN
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Pathogenesis of T. pallidum:
What is it that causes the tissue destruction and lesions? |
It is actually the person's own immune system
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Pathogenesis of T. pallidum:
Siphilis is a disease of... |
Blood vessels and of the perivascular areas
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Pathogenesis of T. pallidum:
Is infection fully controlled? |
No, it hasn't been eradicated
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Pathogenesis of T. pallidum:
What is it that the inhibition of CMI reduces in.. |
late stages of the disease
-the lesions are therefore more localized |
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Virulence Factors of T. pallidum:
The outer membrane proteins promote... |
adherence
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Virulence Factors of T. pallidum:
_____ may facilitate perivascular infiltration |
Hyaluronidase
- it allows it to get in deeper into tissues |
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Virulence Factors of T. pallidum:
There is antiphagocytic coating of... |
Fibronectin
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Virulence Factors of T. pallidum:
Again, The tissue destruction and lesions are a result of... |
Primarily the result of the hosts immune system
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Pathogenesis of T. pallidum, Primary Syphilis:
After how many days may an incoculated individual get symptoms? |
Few days after contact
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Pathogenesis of T. pallidum, Primary Syphilis:
What is one symptom that a person may get? |
HARD CHANCRE
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Pathogenesis of T. pallidum, Primary Syphilis:
Why does the hard chancre look like that? |
This is because there is a swelling of capillary walls
- release of spirochetes |
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Pathogenesis of T. pallidum, Primary Syphilis:
In what stages may a person be able to contaminate? |
1-2 stages
- it is important to get treated early even if symptoms aren't too bad |
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Pathogenesis of T. pallidum, Secondary Syphilis:
Secondaru disease happens how long after that first chancre? |
2-10 weeks after
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Pathogenesis of T. pallidum, Primary Syphilis:
What is a symptom that a person may get? |
Mucocutaneous rash
- an all over body rash |
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Pathogenesis of T. pallidum, Primary Syphilis:
Where is the mucocutaneous rash typically concentrated at? |
Typically on the feet
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Pathogenesis of T. pallidum, Primary Syphilis:
Are the secondary lesions of the skin and mucous membranes contagious? |
HECK YES!
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Pathogenesis of T. pallidum, Latent Stage Syphilis:
During the first 4 years, what stage are you at? After? |
first 4 years: Early latent
After 4 years: Late Latent |
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Pathogenesis of T. pallidum, Primary Syphilis:
What % of people with late latent eventually make it to late tertiary syphilitic disease? |
40%
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Pathogenesis of T. pallidum, Tertiary (late) Syphilis:
How much later do you get this? |
Can be 20-30 years later
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Pathogenesis of T. pallidum, Primary Syphilis:
What is Gummae? |
They are lesions on the skin and mucous membranes
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Pathogenesis of T. pallidum, Primary Syphilis:
There is damage to what organs? |
The internal organs, cardiovascular, and even nervous system damage
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Pathogenesis of T. pallidum, Primary Syphilis:
Why is it that you get gummae? |
The body is trying to wall off the chronic infection!
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How is it that a Granuloma looks like?
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It is just a walling off of the bacteria by T cells
-AKA Gumma |
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Pathogenesis of T. pallidum, Congenital Syphilis:
What does it result from? |
Transplacental infection
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Pathogenesis of T. pallidum, Congenital Syphilis:
T. pallidum gives what to the fetus? |
They get septicemia and widespread dissemination
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Pathogenesis of T. pallidum, Congenital Syphilis:
What are the consequences of this? |
Abortion, neonatal mortality, and late mental or physical problems
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Clinical Disease: Congenital Syphilis
Where is it acquired? |
In utero
-gives long term deformities |
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Prevention and treatment of Syphilis:
What is the drug of choice? |
Penicillin
-for 7-21 days depending on how progressed the infection has gone |
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Prevention and treatment of Syphilis:
How can it be prevented? |
Some condoms!!
Prevention is key! |
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Diagnostic tests for Treponoma:
Direct ___ Antibody staining |
Fluorescent
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Diagnostic tests for Treponoma:
What does the Wasserman test look for? |
Antibodies against the lipin
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Lab diagnosis of Syphilis:
Nontrepomonal serological test |
VDLR test
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Diagnostic tests for Treponoma:
What is the VDRL? |
Venereal Disease Resistance Lab test
-tests for Antibody response -this is simple and inexpensive |
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Diagnostic tests for Treponoma:
Treponomal serological test |
ELISA
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Nonvenereal Treponemal Diseases:
Where may you find them? |
In primitive tropical and subtropical regions
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Nonvenereal Treponemal Diseases:
Who typically gets them? |
Impoverished children :(
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Nonvenereal Treponemal Diseases:
BEWEL: what is it? Name of orgs? |
Endemic syphilis
- caused by T. pallidum subsp. endemicum |
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Nonvenereal Treponemal Diseases:
Yaws, it is what kind of disease? |
Granulomatis disease
- T. pallidum subsp. pertenue |
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Nonvenereal Treponemal Diseases:
Pinta, caused by what orgs.? |
T. carateum
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Treponema pallidum ssp. endemicum:
Bejel is also known as? |
Endemic syphilis
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Treponema pallidum ssp. endemicum:
What are the inital symptoms? |
Initial lesions
-they are nondescriptive oral lesions |
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Treponema pallidum ssp. endemicum:
What is the secondary thing to happen? |
Secondary lesions
-oral papules and mucosal patches |
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Treponema pallidum ssp. endemicum:
What is the LATE thing to happen? |
GUMMA (granulomas)
- on the skin, bones, and nasopharynx |
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Treponema pallidum ssp. endemicum:
How is it transmitted? |
Person-2-person
eating contaminated utensils hands with broken skin |
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Treponema pallidum ssp. endemicum:
Where may you find this? |
In primitive tropical and subtropical ares
-Africa, asia, Australia |
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Treponema pallidum ssp. endemicum:
Is it transmitted sexually? |
No. Just through contact
- skin may be first to be infected then it moves to the bones |
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Treponema pallidum ssp. pertenue:
Yaws, is also known as... |
Granulomatous disease
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Treponema pallidum ssp. pertenue:
What are the early and late symptoms? |
Early: Skin leasions
Late: Destructive lesions of the skin, lymph nodes and bones |
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Treponema pallidum ssp. pertenue:
How is it transmitted? |
Direct contact with the lesions?
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Treponema pallidum ssp. pertenue:
Where may you find this? |
Primitive tropical areas (S. america, Central Africa, etc)
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Treponema pallidum ssp. pertenue:
The lesions of Yaws, where are they on the body? |
They are painless nodules that are widely distributd over the body with many contagious spirochetes
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Treponema pallidum ssp. pertenue:
How can you treat it? |
Penicillin
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Treponema carateum
Pinta, where may you find it? |
Primarily restricted to skin
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Treponema carateum:
How long is the incubation period? |
1-3 weeks
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Treponema carateum:
How many stages are there? |
3, Initial, Secondary, and Late
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Treponema carateum:
What are the symptoms of Initial infection? |
Initial lesions
-small pruritic papules |
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Treponema carateum:
What are the secondary infection symptoms? |
Enlarged plaques that persist for months to years
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Treponema carateum:
What are the late infection symptoms? |
Disseminated, recurrent hypopigmentation or depigmentation of skin lesions
- they get lighter |
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Treponema carateum:
How is it transmitted? |
Through direct contact with skin lesions
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Treponema carateum:
Where may you find it? |
In primitive tropical area
- Mexico, Central, and S. america |
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Treponema carateum:
Does this infection go deeper into the organs? |
No, this is only a cutaneous infection
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How do you get Borrelia
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Body lice and tick pathogens
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Borrelia characteristics
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Grow well in 30 to 35 degrees in specialized media. Have 3-10 loose coils
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How Borrelia is found in the lab
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Borrelia are often noted on Wright’s-stained smears of peripheral blood. So, the lab may detect the organism on a review of white blood cells during a CBC.
-thick blood films -serology, antigen may be found in blood 3 weeks after -ELISA detects IgG and IgM; IgM rise at 2 weeks IgG rise at 6-8 weeks. |
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Borrelia recurrentis
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-only disease with lice vector
-reoccurs 3-10 times lasting 4-5 days -fever, chills, malaise -followed by 4-10 days afebile where spirochetes are absent from the blood. |
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vBorrelia burgdorferi disease
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-Lyme disease
-small part stays on skin for 24 hours after locked on -causes arthritis -can cause congestive heart failure in babies from pregnant woman. -begins in skin, then disseminates -disseminates in the blood causing all body system problems |
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vBorrelia burgdorferi if untreated
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Can exist in csf, skin, and joint fluid for years
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Primary stage of Lyme disease
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vEarly Lyme Borreliosis is usually associated with fatigue, chills, fever, muscle and joint pain, swollen lymph nodes or characteristic skin rash called erythema migrans. (Primary disease) Erythema migrans usually appears in about 3-4 weeks after the tick bite and near the site of the bite-red circular patch with a bull’s eye center. This occurs in about 80% of cases
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Secondary stage of Lyme disease
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Symptoms associated with secondary Lyme disease may not appear for days. Symptoms include arthritis (brief period of pain and swelling most likely of one of the large joints); nervous system abnormalities (pain, numbness, Bell’s palsy, and meningitis); irregular heart beat (uncommon)-they are flulike symptoms.
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Tertiary stage of Lyme disease
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This is late disseminated disease (month to years later) arthritis, encephalopathy (CNS), chronic fatigue skin infection
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General treatment of Borrelia burgdorferi
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vLyme disease can be identified through serological testing and successfully treated in any stage with broad spectrum antibiotics
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Best treatment for Lyme disease in adults
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The best treatment for adults is doxycycline because it has good brain barrier penetration
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Best treatment for Lyme disease in pregnant woman or children
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Penicillin
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How to confirm suspected Lyme disease in the lab
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vThe Western Blot assay is available and is strongly recommended to confirm all positive ELISA.
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