Syphilis Diagnosis and Testing

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Questions and Answers

What is the most likely result of cardiolipin and antitreponemal antibody tests in a patient with secondary syphilis?

Both tests are weakly positive

Cardiolipin antibody tests are positive, while antitreponemal antibody tests are negative

Cardiolipin antibody tests are negative, while antitreponemal antibody tests are positive

Both tests are strongly positive (correct)

Which of the following is NOT a characteristic of chancroid infection?

Painful chancre in men

Fever and headache (correct)

Swollen and tender inguinal lymph nodes

Soft papule at the point of contact

What is the preferred alternative to penicillin for treating early and late latent syphilis?

Erythromycin

Doxycycline (correct)

Azithromycin

Ceftriaxone

What is the laboratory diagnosis method that is NOT mentioned in the text?

ELISA Signup and view all the answers

What is the significance of a positive treponemal antibody test in a patient with old syphilis or partially treated syphilis?

It confirms the diagnosis of syphilis Signup and view all the answers

What is the requirement for treating syphilis associated with HIV infection?

No enhanced antimicrobial therapy is required Signup and view all the answers

What is the primary reason for bleeding being avoided during the collection of specimens from a chancre?

To prevent masking of spirochetes by RBCs Signup and view all the answers

What is the primary purpose of using fluorescein-labeled anti-treponemal serum in the diagnosis of primary syphilis?

To stain the spirochetes for immunofluorescence microscopy Signup and view all the answers

What is a common complication of tertiary syphilis?

Cardiovascular syphilis Signup and view all the answers

What is the primary mode of transmission of congenital syphilis?

Trans-placental transmission Signup and view all the answers

What is the primary purpose of using a nucleic acid probe in the diagnosis of primary syphilis?

To detect the presence of Treponema pallidum Signup and view all the answers

What is a common symptom of congenital syphilis?

All of the above Signup and view all the answers

What is the primary purpose of using a serology test in the diagnosis of primary syphilis?

To detect the presence of cardiolipin antibodies Signup and view all the answers

What is the primary reason why cardiolipin antibodies may be negative in early primary syphilis?

Because they can only be detected after the appearance of the chancre by about 10-14 days Signup and view all the answers

What is the typical incubation period for Primary Syphilis?

9 days to 3 months Signup and view all the answers

What is a common symptom of Secondary Syphilis?

Fever and sore throat Signup and view all the answers

What is the name of the lesion that appears in Primary Syphilis?

Chancre Signup and view all the answers

What is the purpose of Serology tests in Syphilis diagnosis?

To detect antibodies in patient serum Signup and view all the answers

What is a complication of Tertiary Syphilis?

All of the above Signup and view all the answers

What is the name of the virus that causes Genital Herpes?

Herpes simplex virus 2 Signup and view all the answers

During which stages of Syphilis is it transmissible?

Primary and secondary stages Signup and view all the answers

What is the name of the laboratory diagnosis method that amplifies specific DNA sequences?

Polymerase chain reaction (PCR) Signup and view all the answers

Study Notes

Syphilis

Caused by Treponema pallidum
Three distinct clinical stages: primary, secondary, and tertiary stages
Latent periods of varying duration occur between secondary and tertiary stages
Transmissible during the primary and secondary stages, and the early latent period
Non-transmissible during late latent and tertiary stages

Primary Syphilis

Appearance of a hard chancre (papule that ulcerates with a clean indurated base) at the site of entry of the pathogen
Chancre filled with spirochetes
Chancre heals spontaneously in 3 to 6 weeks, but by then the spirochete has moved into the circulation
Lymph nodes draining the affected region become enlarged and firm

Secondary Syphilis

Occurs 3 weeks to 6 months after the chancre heals
Generalized symptoms of infection: fever, headache, sore throat
Generalized lymphadenopathy
Maculo-papular rash on all skin surfaces
Mucous patches, and condyloma lata (papules) in moist warm areas
Hair often falls out
Lesions contain viable spirochetes and disappear spontaneously in a few weeks
Major complications occur in bones, joints, liver, eyes, and brain

Latent Syphilis

Serum samples: all serological tests are positive, although the patient appears well
can last for 20 years or longer

Late Syphilis

Cardiovascular syphilis: weakens the arteries (aortic aneurysm) and neurosyphilis
Gummas develop in tissues such as the liver, skin, bone, and cartilage
Major complications occur by this stage

Congenital Syphilis

Spirochetes pass trans-placenta to fetus
Inhibits fetal growth
Some die through miscarriage or stillbirth
Others develop Congenital Syphilis: interstitial keratitis, Hutchinson's teeth, saddle nose, and CNS anomalies

Laboratory Diagnosis of Syphilis

Primary stage:
- Specimens: exudate from a chancre
- Detection of Treponema: dark ground microscopy, immunofluorescent microscopy, and nucleic acid probe and PCR techniques
- Serology: cardiolipin antibodies (reagin) and fluorescent treponemal antibody (FTA) test
Secondary stage:
- Specimens: exudate from skin lesions, mucous patches or condyloma lata
- Detection of Treponema: nucleic acid probes and PCR techniques
- Serology: to detect antibodies in patient serum

Chancroid

Caused by Haemophilus ducreyi
Infection usually begins as a soft papule at the point of contact
Develops into a soft chancre (painful in men, but may be unnoticed in women)
Inguinal lymph nodes can become swollen and tender

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Description

This quiz covers the diagnosis and testing of syphilis, including microscopy, PCR techniques, serology, and antibody tests.