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What are prevention, immunity and treatment for Syphilis?
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Prevention: unspecific (screening of mothers, practicing safe sex)
Immunity: latent/active syphilis -> prevents superinfection; after treatment no antibodies
Treatment: antibiotics
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How is treponema spp. classified?
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- Treponema pallidum pallidum
  -> Body produces specific anti-treponemal antibodies against polypeptide antigen
  -> they can be used for Indirect Immunoflourescence
  -> Antibodies immobilize and kill actively motile treponema
  -> Fixing complement in presence of suspension of treponema pallidum
      - non-specific antibody like structure: reagin; attaches to cardiolipin of treponema (non-treponemal tests)
- Treponema pertnue -> yaws
- Treponema endemicum -> bejel
- Treponema carateum -> pinta

Lösung ausblenden
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What are the properties of Treponema pallidum pallidum?
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- resistance low to drying, 42°C, sun light
- in blood plasma stays alive for 24h at 4°C (potential transmission!)
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What is the antigenic structure of Treponema pallidum pallidum?
(can also be mentioned at Morphology!)
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- outer membrane surrounding periplasmic space + peptidoglycan-cytoplasmic membrane complex
- membrane proteins are bound to lipids at their amino site (= inaccessible to antibodies)
-> anchor proteins attach to cytoplasmic/outer membrane
- endoflagella: 3 core proteins, homologous to other bacterias flagellin
- cardiolipin = important antigenic structure
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How is treponema pallidum pallidum transmitted? (Syphilis)
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- sexually transmitted disease
- skin/mucous membrane lesions of genitalia (intrarectal, perianal, oral)
- Human are only reservoirs = Antroponosis
(via blood transfusions)
 
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What is the pathogenesis of treponema pallidum pallidum?
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- low effeciveness -> 10 %
- Hyaluronidase cleaves hyaluronic acid -> bacteria can enter deeper tissues 
- stays at site of entry 
-> later spreads via blood and lymphatics to different organs
Lösung ausblenden
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What is the Morphology of Treponema spp./pallidum?
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- Gr negative, but without LPS structure, helically coiled (6-25 coils),
spiral (regular curves), cork-skrew shaped 
- can‘t be stained by aniline stains, but only by silver impregnation staining
- pathogenic species can‘t be cultivated on artificial media/fertile eggs/tissue cultures
- non pathogenic species can be cultured anaerobically in vitro
- replicates by transverse fission 
Lösung ausblenden
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What are the second and third stages of treponemal infection?
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Second stage „secondary lesion“      Duration: 2-3 weeks
- Red Maculopapular rash, fever; syphylitic nephritis, hepatitis, meningitis
-> caused by Immune complexes (Hypersensitivity 3)
-> rapidly heals itself (2-3 weeks)
- Patient: seropositive and infectious
-> can undergo first and second stage asymptomatic (2-5 years) 
Untreated: 30% self-limited, 30% latent infection, 40% undergo third stage 

Third stage „Gummas stage“ - Granulomas lesions   
- Lesions in Liver, skin and bones
- Degenerative changes in CNS (meningovascular syphilis)
- Cardiovascular lesions (aorthitis, aorthic aneursim, arrythmia)
- Treponema itself rarely found except for eye and CNS; symptoms from Hypersensitivity
- Patient: seropositive, non-infectious  

Lösung ausblenden
TESTE DEIN WISSEN
What is congenital syphilis?
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Congenital syphilis:
- Foetus is infected through mother via placenta in 10th to 15th gestation week
- leading to death of foetus, miscarriage, stillbirth at term
- in case of living birth, child has: Hutchinsons teeth, saddlenose, CNS abnormalitis, periostitis, intestinal keratitis
- can be prevented by adequate treatment of mother 
Lösung ausblenden
TESTE DEIN WISSEN
What are the identification methods at the first stage of syphilis ?
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First stage: (and second)
- specimen: transudate of lesions of genitalia 
-> Microscopy: Indirect Immunoflourescence, Silver impregnation staining, dark field 
- patient: seronegative 
Lösung ausblenden
TESTE DEIN WISSEN
What are the identification methods for Syphilis in 2nd and 3rd stage ?
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TESTE DEIN WISSEN
Second and third stage:
- specimen: blood (serum) -> patient: seropositive
- (1) Non treponemal tests (as screening or check if antibiotic is working):
VDRL, RPR, TRUST
Mixing unknown antibodies with known antigen: cardiolipin from Bovis heart (resemble treponema)
-> test is non specific, highly sensitive
-> Test positive primary syphilis (70%), secondary syphilis (99%) = acute infection
false positive in case of Autoimmun disease (HIV), pregnancy, liver disease, drugs
- (2) Treponemal tests : if non treponemal tests were positive 
TPPA, TPHA, MHA-TP, FTA-ABS
tests are responding to IgM and IgG -> if +, theoretically Western blot
-> IgM can be found for 1-2 years, IgG forever
Lösung ausblenden
TESTE DEIN WISSEN
How is Neurosphilis diagnosed and in which stage can it occur?

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TESTE DEIN WISSEN
Diagnostics:
specimen: CSF 
1. confirming syphilis infection
2. serological test (CSF-VDRL) (FTA-ABS)

Neurosyphilis can occur at any stage
Lösung ausblenden
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Q:
What are prevention, immunity and treatment for Syphilis?
A:
Prevention: unspecific (screening of mothers, practicing safe sex)
Immunity: latent/active syphilis -> prevents superinfection; after treatment no antibodies
Treatment: antibiotics
Q:
How is treponema spp. classified?
A:
- Treponema pallidum pallidum
  -> Body produces specific anti-treponemal antibodies against polypeptide antigen
  -> they can be used for Indirect Immunoflourescence
  -> Antibodies immobilize and kill actively motile treponema
  -> Fixing complement in presence of suspension of treponema pallidum
      - non-specific antibody like structure: reagin; attaches to cardiolipin of treponema (non-treponemal tests)
- Treponema pertnue -> yaws
- Treponema endemicum -> bejel
- Treponema carateum -> pinta

Q:
What are the properties of Treponema pallidum pallidum?
A:
- resistance low to drying, 42°C, sun light
- in blood plasma stays alive for 24h at 4°C (potential transmission!)
Q:
What is the antigenic structure of Treponema pallidum pallidum?
(can also be mentioned at Morphology!)
A:
- outer membrane surrounding periplasmic space + peptidoglycan-cytoplasmic membrane complex
- membrane proteins are bound to lipids at their amino site (= inaccessible to antibodies)
-> anchor proteins attach to cytoplasmic/outer membrane
- endoflagella: 3 core proteins, homologous to other bacterias flagellin
- cardiolipin = important antigenic structure
Q:
How is treponema pallidum pallidum transmitted? (Syphilis)
A:
- sexually transmitted disease
- skin/mucous membrane lesions of genitalia (intrarectal, perianal, oral)
- Human are only reservoirs = Antroponosis
(via blood transfusions)
 
Mehr Karteikarten anzeigen
Q:
What is the pathogenesis of treponema pallidum pallidum?
A:
- low effeciveness -> 10 %
- Hyaluronidase cleaves hyaluronic acid -> bacteria can enter deeper tissues 
- stays at site of entry 
-> later spreads via blood and lymphatics to different organs
Q:
What is the Morphology of Treponema spp./pallidum?
A:
- Gr negative, but without LPS structure, helically coiled (6-25 coils),
spiral (regular curves), cork-skrew shaped 
- can‘t be stained by aniline stains, but only by silver impregnation staining
- pathogenic species can‘t be cultivated on artificial media/fertile eggs/tissue cultures
- non pathogenic species can be cultured anaerobically in vitro
- replicates by transverse fission 
Q:
What are the second and third stages of treponemal infection?
A:
Second stage „secondary lesion“      Duration: 2-3 weeks
- Red Maculopapular rash, fever; syphylitic nephritis, hepatitis, meningitis
-> caused by Immune complexes (Hypersensitivity 3)
-> rapidly heals itself (2-3 weeks)
- Patient: seropositive and infectious
-> can undergo first and second stage asymptomatic (2-5 years) 
Untreated: 30% self-limited, 30% latent infection, 40% undergo third stage 

Third stage „Gummas stage“ - Granulomas lesions   
- Lesions in Liver, skin and bones
- Degenerative changes in CNS (meningovascular syphilis)
- Cardiovascular lesions (aorthitis, aorthic aneursim, arrythmia)
- Treponema itself rarely found except for eye and CNS; symptoms from Hypersensitivity
- Patient: seropositive, non-infectious  

Q:
What is congenital syphilis?
A:
Congenital syphilis:
- Foetus is infected through mother via placenta in 10th to 15th gestation week
- leading to death of foetus, miscarriage, stillbirth at term
- in case of living birth, child has: Hutchinsons teeth, saddlenose, CNS abnormalitis, periostitis, intestinal keratitis
- can be prevented by adequate treatment of mother 
Q:
What are the identification methods at the first stage of syphilis ?
A:
First stage: (and second)
- specimen: transudate of lesions of genitalia 
-> Microscopy: Indirect Immunoflourescence, Silver impregnation staining, dark field 
- patient: seronegative 
Q:
What are the identification methods for Syphilis in 2nd and 3rd stage ?
A:
Second and third stage:
- specimen: blood (serum) -> patient: seropositive
- (1) Non treponemal tests (as screening or check if antibiotic is working):
VDRL, RPR, TRUST
Mixing unknown antibodies with known antigen: cardiolipin from Bovis heart (resemble treponema)
-> test is non specific, highly sensitive
-> Test positive primary syphilis (70%), secondary syphilis (99%) = acute infection
false positive in case of Autoimmun disease (HIV), pregnancy, liver disease, drugs
- (2) Treponemal tests : if non treponemal tests were positive 
TPPA, TPHA, MHA-TP, FTA-ABS
tests are responding to IgM and IgG -> if +, theoretically Western blot
-> IgM can be found for 1-2 years, IgG forever
Q:
How is Neurosphilis diagnosed and in which stage can it occur?

A:
Diagnostics:
specimen: CSF 
1. confirming syphilis infection
2. serological test (CSF-VDRL) (FTA-ABS)

Neurosyphilis can occur at any stage
Treponema ssp.

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