Question 1

Syphilis is spread by:

Accepted Answer

A)  rodent vectors. 
B)  insect vectors. 
C)  sexual transmission. 
D)  aerosolized respiratory droplets. 
A)  rodent vectors. 
B)  insect vectors. 
C)  sexual transmission. 
D)  aerosolized respiratory droplets. C

Question 2

Using the reverse algorithm method for syphilis diagnosis,a positive initial test and a negative follow-up test could be interpreted as:

Accepted Answer

A)  a false negative in the treponemal test. 
B)  a false positive in the nontreponemal test. 
C)  past syphilis infection with subsequent decline in nontreponemal antibody titers. 
D)  current syphilis, likely in the secondary stage. 
A)  a false negative in the treponemal test. 
B)  a false positive in the nontreponemal test. 
C)  past syphilis infection with subsequent decline in nontreponemal antibody titers. 
D)  current syphilis, likely in the secondary stage. C

Question 3

Which of the following is a cause of a laboratory-induced false-negative result in the screening tests for syphilis?

Accepted Answer

A)  Alcohol ingestion prior to blood draw 
B)  Systemic lupus erythematosus 
C)  Excess serum antibody 
D)  Temperature greater than 30°C 
A)  Alcohol ingestion prior to blood draw 
B)  Systemic lupus erythematosus 
C)  Excess serum antibody 
D)  Temperature greater than 30°C C

Question 4

The RPR and VDRL are similar in which of the following ways?

Accepted Answer

A)  Both are read macroscopically. 
B)  Both are flocculation reactions. 
C)  Both are specific assays for syphilis. 
D)  Both are antigen detection assays. 
A)  Both are read macroscopically. 
B)  Both are flocculation reactions. 
C)  Both are specific assays for syphilis. 
D)  Both are antigen detection assays.

Question 5

The vectors that transmit Borrelia burgdorferi from natural reservoirs to humans are:

Accepted Answer

A)  deer. 
B)  mice. 
C)  ticks. 
D)  birds. 
A)  deer. 
B)  mice. 
C)  ticks. 
D)  birds.

Question 6

A 30-year-old man presents to his physician with a painless ulcer on his penis.An RPR performed on the man is reactive 1:128,and the TP-PA test is positive.This man has an infection with:

Accepted Answer

A)  Neisseria gonorrhoeae. 
B)  Chlamydia trachomatis. 
C)  Treponema pallidum. 
D)  Mycoplasma hominis. 
A)  Neisseria gonorrhoeae. 
B)  Chlamydia trachomatis. 
C)  Treponema pallidum. 
D)  Mycoplasma hominis.

Question 7

A patient presents with a painless genital ulcer.The patient is then diagnosed as having syphilis.In what stage of syphilis is the patient?

Accepted Answer

A)  Primary 
B)  Secondary 
C)  Latent 
D)  Tertiary 
A)  Primary 
B)  Secondary 
C)  Latent 
D)  Tertiary

Question 8

The antibody called reagin that is found in syphilis:

Accepted Answer

A)  reacts with cardiolipin. 
B)  is specific for treponemal antigen. 
C)  appears in all patients within 7 days after exposure to syphilis. 
D)  is detected by the FTA-ABS test. 
A)  reacts with cardiolipin. 
B)  is specific for treponemal antigen. 
C)  appears in all patients within 7 days after exposure to syphilis. 
D)  is detected by the FTA-ABS test.

Question 9

RPR stands for:

Accepted Answer

A)  reagin plasma reactive. 
B)  reactive phosphate reagent. 
C)  rapid plasma reagin. 
D)  random positive reagin. 
A)  reagin plasma reactive. 
B)  reactive phosphate reagent. 
C)  rapid plasma reagin. 
D)  random positive reagin.

Question 10

Select the characteristic associated with Borrelia miyamotoi.

Accepted Answer

A)  Usually causes a ring-shaped rash 
B)  Does not induce antibodies in patients that cross-react in Lyme disease assays 
C)  Causes relapsing fevers 
D)  Can be easily cultured in diagnostic procedures 
A)  Usually causes a ring-shaped rash 
B)  Does not induce antibodies in patients that cross-react in Lyme disease assays 
C)  Causes relapsing fevers 
D)  Can be easily cultured in diagnostic procedures

Question 11

Lyme disease is caused by:

Accepted Answer

A)  Treponema pallidum. 
B)  Borrelia recurrentis. 
C)  Leptospira autumnalis. 
D)  Borrelia burgdorferi. 
A)  Treponema pallidum. 
B)  Borrelia recurrentis. 
C)  Leptospira autumnalis. 
D)  Borrelia burgdorferi.

Question 12

The clinical hallmark of early Lyme disease infection is:

Accepted Answer

A)  a chancre. 
B)  erythema migrans. 
C)  chronic fatigue. 
D)  a gumma. 
A)  a chancre. 
B)  erythema migrans. 
C)  chronic fatigue. 
D)  a gumma.

Question 13

What type of test identifies the presence of the reagin antibody that forms against cardiolipin?

Accepted Answer

A)  Treponemal test 
B)  Nontreponemal test 
C)  Fluorescent antibody testing 
D)  Dark-field microscopy 
A)  Treponemal test 
B)  Nontreponemal test 
C)  Fluorescent antibody testing 
D)  Dark-field microscopy

Question 14

A 25-year-old patient presents with a fine rash on his chest,palms,and feet; fever; and malaise.The RPR is reactive with a titer of 1:64,the VDRL is nonreactive,and the TP-PA is positive.What is the diagnosis?

Accepted Answer

A)  Primary syphilis 
B)  Secondary syphilis 
C)  Tertiary syphilis 
D)  Latent syphilis 
A)  Primary syphilis 
B)  Secondary syphilis 
C)  Tertiary syphilis 
D)  Latent syphilis

Question 15

A patient is suspected of having latent syphilis.Which set of test results for RPR,TP-PA,and CSF-VDRL best confirms this diagnosis?

Accepted Answer

A)  RPR = reactive 1:8; TP-PA = reactive; VDRL = reactive 1:4 
B)  RPR = nonreactive; TP-PA = reactive; VDRL = nonreactive 
C)  RPR = nonreactive; TP-PA = nonreactive; VDRL = nonreactive 
D)  RPR = reactive 1:2; TP-PA = nonreactive; VDRL = nonreactive 
A)  RPR = reactive 1:8; TP-PA = reactive; VDRL = reactive 1:4 
B)  RPR = nonreactive; TP-PA = reactive; VDRL = nonreactive 
C)  RPR = nonreactive; TP-PA = nonreactive; VDRL = nonreactive 
D)  RPR = reactive 1:2; TP-PA = nonreactive; VDRL = nonreactive

Question 16

A patient has a reactive RPR at a titer of 1:128 and a reactive TP-PA.What do these results indicate?

Accepted Answer

A)  True-positive result; diagnosis of syphilis 
B)  False-positive result; diagnosis of syphilis 
C)  True-negative result; ruling out syphilis 
D)  False-negative result; ruling out syphilis 
A)  True-positive result; diagnosis of syphilis 
B)  False-positive result; diagnosis of syphilis 
C)  True-negative result; ruling out syphilis 
D)  False-negative result; ruling out syphilis

Question 17

A 32-year-old heterosexual male presents to a physician with a 3-day history of multiple skin lesions located all over his body and on his mucous membranes.He hasn't felt well and has a low-grade fever.The patient cuts down trees in Massachusetts for a living.He has had multiple sex partners and does not use condoms.Here are the results of his laboratory tests: RPR = reactive 1:128; TP-PA = reactive; Borrelia burgdorferi IgM = less than 1:8; Rickettsia rickettsii IgM less than 1:8.This patient most likely has:

Accepted Answer

A)  primary syphilis. 
B)  secondary syphilis. 
C)  Lyme disease. 
D)  Rocky Mountain spotted fever. 
A)  primary syphilis. 
B)  secondary syphilis. 
C)  Lyme disease. 
D)  Rocky Mountain spotted fever.

Question 18

Advantages of polymerase chain reaction testing for Lyme disease include which of the following?

Accepted Answer

A)  High sensitivity 
B)  High specificity 
C)  Ease of sample collection and preparation 
D)  All of the above 
A)  High sensitivity 
B)  High specificity 
C)  Ease of sample collection and preparation 
D)  All of the above

Question 19

In areas endemic for Lyme disease:

Accepted Answer

A)  residents (especially children) should be screened by EIA. 
B)  EIA screening is effective only for adults. 
C)  the only acceptable screening method is IFA. 
D)  no one should be screened unless they exhibit clinical signs and symptoms. 
A)  residents (especially children) should be screened by EIA. 
B)  EIA screening is effective only for adults. 
C)  the only acceptable screening method is IFA. 
D)  no one should be screened unless they exhibit clinical signs and symptoms.

Question 20

At which stage of syphilis is the RPR the most sensitive?

Accepted Answer

A)  Primary 
B)  Secondary 
C)  Tertiary 
D)  Latent 
A)  Primary 
B)  Secondary 
C)  Tertiary 
D)  Latent

Exam 21: Spirochete Diseases

Syphilis is spread by:

Using the reverse algorithm method for syphilis diagnosis,a positive initial test and a negative follow-up test could be interpreted as:

Which of the following is a cause of a laboratory-induced false-negative result in the screening tests for syphilis?

The RPR and VDRL are similar in which of the following ways?

The vectors that transmit Borrelia burgdorferi from natural reservoirs to humans are:

A 30-year-old man presents to his physician with a painless ulcer on his penis.An RPR performed on the man is reactive 1:128,and the TP-PA test is positive.This man has an infection with:

A patient presents with a painless genital ulcer.The patient is then diagnosed as having syphilis.In what stage of syphilis is the patient?

The antibody called reagin that is found in syphilis:

RPR stands for:

Select the characteristic associated with Borrelia miyamotoi.

Lyme disease is caused by:

The clinical hallmark of early Lyme disease infection is:

What type of test identifies the presence of the reagin antibody that forms against cardiolipin?

A 25-year-old patient presents with a fine rash on his chest,palms,and feet; fever; and malaise.The RPR is reactive with a titer of 1:64,the VDRL is nonreactive,and the TP-PA is positive.What is the diagnosis?

A patient is suspected of having latent syphilis.Which set of test results for RPR,TP-PA,and CSF-VDRL best confirms this diagnosis?

A patient has a reactive RPR at a titer of 1:128 and a reactive TP-PA.What do these results indicate?

Advantages of polymerase chain reaction testing for Lyme disease include which of the following?

In areas endemic for Lyme disease:

At which stage of syphilis is the RPR the most sensitive?

Introduction to Immunity and the Immune System

Nature of Antigens and the Major Histocompatibility Complex

Innate Immunity

Adaptive Immunity

Antibody Structure and Function

Cytokines

Complement System

Safety and Quality Management

Principles of Serological Testing

Precipitation and Agglutination Reactions

Labeled Immunoassays

Molecular Diagnostic Techniques

Flow Cytometry and Laboratory Automation

Hypersensitivity

Autoimmunity

Transplantation Immunology

Tumor Immunology

Immunoproliferative Diseases

Immunodeficiency Diseases

Serological and Molecular Detection of Bacterial Infections

Serological and Molecular Diagnosis of Parasitic and Fungal Infections

Serology and Molecular Detection of Viral Infections

Laboratory Diagnosis of HIV Infection

Immunization and Vaccines

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