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MLT Syphilis
MLT Study Guide
| Question | Answer |
|---|---|
| What is the specimen(s) for RPR? | unheated serum or plasma |
| What does RPR stand for? | Rapid Plasma Reagin |
| What is the test principle for RPR? | Macroscopic flocculation and coagglutination |
| What is detected in the specimen for RPR? | reagin (non-specific) |
| What is the antigen used in RPR? | VDRL cardiolipin modified with choline chloride attached to charcoal |
| Is RPR used for screening or confirmatory? | screening |
| Is RPR specific or non-specific? | non-specific |
| Which is more sensitive: RPR or VDRL? | RPR |
| Which is more specific: RPR or VDRL? | VDRL |
| What does VDRL stand for? | Venereal Disease Reference Laboratory |
| What is the specimen(s) for VDRL? | heat inactivated serum and/or plasma |
| What is the test principle for VDRL? | flocculation |
| What is detected in the specimen for VDRL? | Microscopic reagin (non-specific) |
| What is the antigen used in VDRL? | cardiolipin, lecithin, cholesterol |
| Name 2 nontreponemal tests? | RPR and VDRL |
| Name 3 treponemal tests? | EIA, immunochemoluminescence, and FTA-ABS |
| Is VDRL used for screening or confirmatory? | confirmatory or screen |
| Is VDRL specific or non-specific? | Non-specific except for CSF |
| EIA or immunochemoluminescence: What is the test specimen(s)? | unheated serum |
| EIA or immunochemoluminescence: What is the test principle? | Enzyme or fluorescence attached to Ab that attaches to Ag |
| EIA or immunochemoluminescence: What is detected in the specimen? | Ab (IgG and IgM) against T. pallidum |
| EIA or immunochemoluminescence: What Ag is used in the test? | gelatin and treponema antigen |
| EIA or immunochemoluminescence: Screening or confirmatory? | screen or confirmatory |
| EIA or immunochemoluminescence: Specificity? | specific |
| EIA or immunochemoluminescence: What is used to remove antibody to normal flora treponemes which cause false positives? | Reiter's strain |
| FTA-ABS: What is the test specimen(s)? | diluted, heat inactivated serum |
| FTA-ABS: What is the test principle? | Indirect Immunofluorescence |
| FTA-ABS: What is detected in the specimen? | Ab against T. pallidum |
| FTA-ABS: What Ag is used in the test? | Nichol's strain and T. pallidum |
| FTA-ABS: Screening or confirmatory? | Confirmatory |
| FTA-ABS: Specificity? | Specific |
| What does FTA-ABS stand for? | Fluorescent Treponemal Antibody Absorbed |
| State Sensitivity levels for RPR(screen): primary, secondary and latent/tertiary syphilis | Primary: low Secondary: high L/T: low |
| State Sensitivity levels for VDRL(screen): primary, secondary and latent/tertiary syphilis | Primary: low Secondary: high L/T: low |
| State Sensitivity levels for FTA-ABS: primary, secondary and latent/tertiary syphilis | Primary: high Secondary: high L/T: high |
| State Sensitivity levels for EIA/immunochemo: primary, secondary and latent/tertiary syphilis | Primary: early = low, high Secondary: high L/T: high |
| Interpret results- RPR: reactive FTA-ABS: reactive | Secondary, Primary, early latent |
| Interpret results- RPR: nonreactive FTA-ABS: reactive | early primary, latent/tertiary, prozone effect (secondary) |
| Interpret results- RPR: nonreactive FTA-ABS: nonreactive | Negative |
| Interpret results- RPR: reactive FTA-ABS: nonreactive | Biological false positive |
| Interpret Results- EIA screen: reactive RPR: reactive: reactive RPR titer: (1:32) | RPR titer shows early infection. Secondary, primary |
| Name the organism that causes syphilis: genus and species | Treponema pallidum |
| What other best known disease is caused by a spirochete? | Lyme's disease |
| What is the reservoir for T. pallidum? | No reservoir. Requires a living host. |
| What is the most common spirochete disease in the U.S.? | Syphilis |
| What disease does T. pertenue cause? | Yaws |
| What disease does T. endemicum cause? | Non-venereal syphilis |
| What disease does T. caroteum cause? | Pinta |
| What disease does T. cuniculi cause? | Rabbit syphilis (organism morphologically identical to human spirochete) |
| What is the #1 mode of transmission? | Sexually transmitted (direct contact with lesion) |
| True or False: In the primary stage, pus forms in the chancres. | False. There is no pus formation in the chancres unless a secondary infection sets in. |
| In the Primary Stage: 30% are positive after ___ week(s) 90% are positive after ___ weeks(s) | 30% = 1 week 90% = 3 weeks |
| In what stage is the patient most highly infectious? For this stage, serology tests are nearly ___% positive. | Secondary stage; 100% |
| What are the 3 manifestations for the Tertiary stage? | Gummatous syphilis, cardiovascular syphilis, neurosyphilis |
| True or False: 1/3 of untreated latent individuals develop tertiary syphilis. | True. |
| True or False: Direct examination of the specimen is done with a light microscope. | False. The specimen is observed by dark-field microscopy or fluorescent Ab testing. |
| For VDRL, what is the RPM and minutes? | 180 rpms for 4 minutes |
| For RPR, what is the RPM and minutes? | 100 rpms fo 8 minutes |
| What are 3 causes of Biologic False Positives? | Collagen dz (arthritis, LE), sometimes increased amount of reagin, infectious mononucleosis, malaria, leprosy, pregnancy, measles, drug abuse |
| What are 3 causes of False negatives? | early primary, latent, immunosuppressed patients, consumption of alcohol prior to testing( temporary) |
| What method do you use to test congenital syphilis? | Western blot. Detection of IgM lacks sensitivity. |
| What is the best drug for treatment? | penicillin. If allergic, doxycycline or tetracycline. |
| What test is used to confirm neurosyphilis? | VDRL |
| At what time are tests non-reactive in the primary stage? | After 6 months |
| At what time are tests non-reactive in the secondary stage? | After 12-18 months |
| True or False. Perinatal transmission can occur at any time during pregnancy but only the latent stage of the disease. | False.It can occur at any time during pregnancy and at any stage of the disease. |
| What is the pathogenesis of secondary syphilis? | spread to lymph nodes and then to blood stream |
| True or False. Syphilis cannot be spread by toilet seats, door knobs, swimming pools, shared clothing, or eating utensils. | True |
| What is swabbed to view organism under microscope in the primary stage? | chancre |
| For Treponema pallidum Hemagglutination(TPHA), a button is a positive or negative result? | negative |
| What strain does TPHA use? | Nichol's strain |
| Why is PCR not used? It has 100% specificity and 70% sensitivity. | Lack of commercial kits, standardization |
Created by:
Nuar
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