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13 Cards in this Set

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Treponema pallidum causes the well known STD, ________.

Syphilis

AKA- what?

the great immitator

T/F: syphilis is more common than chlamydia or gonorrhea.

FALSE... especially not now-a-days! but more recently it has seen a slight rise in incidence

it is ______-shaped

spiral

Lab technique used for identifying treponema pallidum with light microscopy?

Darkfield microscopy needed for direct visualization of the organism. (darkfield galaxy) :)




FOr this we need to take a direct sample from a lesion on the patient... but this is not commonly used...

What is the more commonly used screening test?

VDRL- venereal disease research laboratory - NOT SPECIFIC FOR TREP> PAL just tests for antibody reactivity in a patient's serum to a particular antigen (cardiolypin cholesterol antigen)




Rapid Plasmin Reagent (RPR)




Several reasons for a false positive due to cross-reactivity with diff antigens


-Mono, RF, SLE, LEP, DRG (iv drug user)

Confirmatory test?

FTA antibody test - is a treponema test - specific to confirm a positive screening result.

Stages of syphilis? yes all of them...

EARLY - Occur in first year




Primary: painless genital chancre that appears a few weeks after inoculation. Heals in 3-6 weeks on its own... if untreated progresses to secondary stage




Secondary: systemic disease. Maculopapular rash occurs on palms and soles of feet weeks to months after infection. Rash actually develops everywhere, but the presence of the rash here is key do diagnosis!!! Condyloma lata (more flat-topped than HPV) (has a lot a bumps) - on mucous membranes. can visualize spirochetes via darkfield microscopy from the condyloma lata.




Early latent:






LATE




Tertiary: Formation of gummas (craterred moon)- soft growths within firm necrotic center that can occur anywhere (internal organs, bone, skin). Aortitis - can lead to an ascending thoracic aortic aneurysm **Tree-barking - looks thick and wrinkled. Tabes Dorsalis (demyelination of nerves in the the dorsal collumns in the spinal cord) - leads to loss of vibration sense, proprioception, and discriminative touch, pain, and an odd gait. Can also see ocular effects: argyll robertson pupils - accomodate but do not react to light




Late Latent:





How does the chancre form?

locally invades small blood vessels and damages them - leading to small areas of necrosis - making a chancre

How does syphilis cause an aortic aneurysm?

it destroys the vaso vasorum that supplies the thick walls of the aorta.

Congenital syphilis

- standard to screen pregnant women so not common anymore.




Constellation of symptoms: Saber shins - anterior bowing of the tibia and saddle-shaped nose. Hutchinson's teeth (notched incisors) and mulberry molars (molars with several enamel outgrowths). Congenital deafness... also others that are non-specific - hepatomegaly, rhinitis, etc...

Treatment?

penicillin for all stages




desensitize them if they are allergic... don't use something else...

What is the Jarisch-Herxheimer reaction?

may occur hours after treatment - dieing spirochetes releaseing a bunch of LPS that leads to an increase of cytokines - fever, chills, and headache... used to be a good indicator the treatment was working.