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MLT Syphilis

MLT Study Guide

QuestionAnswer
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