44 Questions
What are spirochetes?
Gram-negative, motile, spiral bacteria
What is the length range of spirochetes?
3 to 500 m
What is one of the instructional objectives related to spirochetal diseases?
Differentiate spirochetal diseases by epidemiology, etiologies, risk factors, genetic influences, pathophysiology, signs/symptoms, physical examination
Which competency outcome (CO) is associated with distinguishing spirochetal diseases as acute, chronic, urgent, or emergent?
CO3, CO4
What is the treatment of choice for early syphilis without evidence of neurosyphilis?
Benzathine penicillin G, 2.4 million U IM in a single dose
How is late latent and tertiary syphilis without evidence of neurosyphilis treated?
IM injection of 2.4 million units penicillin G benzathine given one time each week x 3 weeks
What is the appropriate treatment for neurosyphilis, ocular, or otic syphilis?
IV penicillin G administered 3-4 million units every 4 hours for 10-14 days
What should be done if a patient misses a dose of penicillin G for syphilis treatment?
If more than 14 days have elapsed since the prior dose, the course should be reinitiated
How is congenital syphilis transmitted from mother to fetus?
Via the placenta
What are the potential abnormalities resulting from congenital syphilis?
Abnormalities in the skin or mucous membranes, nasal discharge (snuffles), hepatosplenomegaly, anemia, and osteochondritis
What may children with untreated congenital syphilis develop?
Interstitial keratitis, Hutchinson teeth, saddle nose, deafness, and/or CNS abnormalities
What is the significance of monitoring the effectiveness of syphilis treatment?
To identify treatment failures
What is the most common vector-borne disease in the US?
Lyme disease
Which test is used as a confirmatory test for Lyme disease?
Western blot assay
What is the recommended treatment for early localized Lyme disease?
Doxycycline
How is syphilis most frequently transmitted?
Through sexual contact
What is characteristic of primary syphilis?
Painless chancre
What stage of syphilis may present with condyloma lata?
Early latent syphilis
Which test is recommended for diagnosing syphilis?
VDRL
When do nontreponemal antigen tests become positive after syphilis infection?
4-6 weeks post-infection
What is the purpose of the FTA-ABS test in diagnosing syphilis?
To detect specific antibodies
What is the most common route of transmission for Lyme disease?
Tick bites
Which stage of Lyme disease is characterized by erythema migrans?
Early localized infection
What is the recommended treatment for acute neurologic disease in Lyme disease?
Ceftriaxone
What are spirochetes?
Gram-negative, motile, spiral bacteria
What is the length range of spirochetes?
3 to 500 $ ext{ extmu}$m
How are spirochetal diseases distinguished?
By epidemiology, etiologies, risk factors, genetic influences, pathophysiology, signs/symptoms, and physical examination
What is the most appropriate clinical criteria and diagnostic tests available to classify the types of spirochetal diseases?
Clinical criteria and diagnostic tests
What is the recommended approach in the treatment of spirochetal diseases?
Current and emerging evidence-based practices
What is the purpose of age-appropriate health screening and health promotion/disease prevention strategies for spirochetal diseases?
To identify and prevent spirochetal diseases
Which method is recommended for diagnosing syphilis?
Nucleic acid amplification test (NAAT)
What is the most common vector-borne disease in the US?
Lyme Disease
What is characteristic of primary syphilis?
Painless chancre
What is the recommended treatment for early localized Lyme Disease?
Doxycycline
How is late latent and tertiary syphilis without evidence of neurosyphilis treated?
Penicillin G
What stage of Lyme Disease is characterized by early disseminated infection?
Stage 2
What is the recommended treatment for early syphilis (primary, secondary, and early latent syphilis) without evidence of neurosyphilis?
Benzathine penicillin G, 2.4 million U IM in a single dose
How is neurosyphilis, ocular, or otic syphilis treated?
IV penicillin G administered 3-4 million units every 4 hours for 10-14 days
What are the potential abnormalities resulting from congenital syphilis?
Interstitial keratitis, Hutchinson teeth, saddle nose, deafness, and/or CNS abnormalities
What is the treatment for late latent and tertiary syphilis without evidence of neurosyphilis?
IM injection of 2.4 million units penicillin G benzathine given one time each week x 3 weeks
How is congenital syphilis transmitted from mother to fetus?
Via the placenta
What is the importance of monitoring the effectiveness of syphilis treatment?
To identify treatment failures
What should be done if a patient misses a dose of penicillin G for syphilis treatment?
If more than 14 days have elapsed since the prior dose, the course should be reinitiated
What is the characteristic of early syphilis (primary, secondary, and early latent syphilis)?
It does not show evidence of neurosyphilis
Study Notes
Lyme Disease and Syphilis: Key Facts and Treatment
- Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by Ixodide ticks, with the tick needing to feed for more than 24-36 hours to transmit the spirochete.
- It is the most common vector-borne disease in the US, with up to 75% of patients not recalling being bitten by a tick.
- Lyme disease has three stages: early localized infection (characterized by erythema migrans), early disseminated infection, and late persistent infection.
- Diagnosis involves detecting antibodies through immunofluorescent assay or ELISA techniques, with a Western blot assay used as a confirmatory test.
- Treatment for early localized disease includes doxycycline, amoxicillin, cefuroxime, cetriaxone, or cefotaxime, and prophylactic antibiotic therapy is not recommended unless specific criteria are met.
- Acute neurologic disease and arthritis without neurological involvement in Lyme disease also have specific treatment regimens.
- Syphilis, caused by Treponema pallidum, is transmitted most frequently through sexual contact and can also be vertically transmitted during pregnancy.
- Primary syphilis is characterized by a painless chancre at the site of inoculation, and secondary syphilis may involve various organs and present with a relapsing rash.
- Early latent stage of syphilis may present with condyloma lata, and late latent and tertiary syphilis can involve gummatous lesions, cardiovascular disease, nervous system, and ophthalmic lesions.
- Serologic testing is recommended for diagnosing syphilis, with nontreponemal antigen tests becoming positive 4-6 weeks post-infection, and treponemal antibody tests used to detect specific antibodies.
- The fluorescent treponemal antibody absorption (FTA-ABS) test is useful in determining whether a positive nontreponemal antigen test is a true positive and remains positive after acute infection is treated.
- Syphilis diagnostic studies include VDRL and RPR tests and FTA-ABS, aiding in accurate diagnosis and treatment planning.
Lyme Disease and Syphilis: Key Information
- Spirochetes have endocellular flagella, with 2 to more than 100 per organism, depending on the species
- Lyme Disease is transmitted to humans by the Ixodide tick and is the most common vector-borne disease in the US
- Up to 75% of patients with Lyme disease do not recall being bitten by a tick
- Lyme Disease has three stages: early localized infection, early disseminated infection, and late persistent infection
- Diagnostic studies for Lyme Disease include immunofluorescent assay, ELISA techniques, and Western blot assay
- Treatment for early localized Lyme Disease includes doxycycline, amoxicillin, cefuroxime, or cetriaxone
- Prophylactic antibiotic therapy with doxycycline is not recommended unless specific criteria are met
- Syphilis is caused by Treponema pallidum and is most frequently transmitted during sexual contact
- Primary syphilis is characterized by a painless chancre with firm, indurated margins and resolves without treatment
- Secondary syphilis may involve skin, mucous membranes, eyes, bones, kidneys, CNS, or liver
- Late latent and tertiary syphilis can lead to various symptoms and complications, including gummatous lesions and neurosyphilis
- Serologic testing, including nontreponemal antigen tests and treponemal antibody tests, is the recommended method for diagnosing syphilis
Test your knowledge of Lyme disease and syphilis with this quiz covering key facts and treatment options for these two important infectious diseases. Learn about the stages, diagnosis, and treatment of Lyme disease, as well as the clinical manifestations, testing, and treatment for syphilis.
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