Deck 44: The Spirochetes

Question 1

A patient has a reactive RPR result and a positive FTA-ABS test.The drug of choice to treat this infection is:

A)penicillin G.
B)tetracycline.
C)clindamycin.
D)erythromycin.

Answer 1

A
For all treponemal infections,penicillin G is the drug of choice.Ceftriaxone is also highly active in most cases of syphilis other than early syphilis.Tetracycline or doxycycline is often the treatment of choice when patients are allergic to penicillin.Treatment varies,depending on the stage of disease and the host (e.g. ,children or adults,human immunodeficiency virus [HIV]-infected or congenital syphilis).

Question 2

Systemic symptoms,such as fever,weight loss,malaise,and a loss of appetite,along with a widespread rash,can be observed in patients suffering from _________ syphilis.

A)primary
B)secondary
C)tertiary
D)latent

Answer 2

B
The clinical presentation of venereal syphilis is varied and complex,often mimicking many other diseases.This disease is divided into stages: incubating,primary,secondary,early latent,latent,and tertiary.During secondary syphilis,the patient is ill and seeks medical attention.Systemic symptoms such as fever,weight loss,malaise,and loss of appetite are present in approximately one-half of the patients.The skin is the organ most commonly affected in secondary syphilis,with patients exhibiting a widespread rash.

Question 3

The most common vector-borne disease in North America and Europe transmitted by the bite of Ixodes ticks is caused by:

A)Leptospira interrogans.
B)Borrelia burgdorferi.
C)Treponema carateum.
D)Rickettsia rickettsii.

Answer 3

B
Although at least 10 different Borrelia species have been currently found within the Borrelia burgdorferi sensu lato complex,only Borrelia burgdorferi sensu stricto (the strict sense of Borrelia burgdorferi),as well as Borrelia garinii,Borrelia afzelii,Borrelia spielmanii,Borrelia lusitaniae,and Borrelia valaisiana,are agents of Lyme disease and are transmitted by the bite of Ixodes ticks.Lyme disease is the most common vector-borne disease in North America and Europe and is an emerging problem in northern Asia.

Question 4

The most severe illness associated with leptospirae,with symptoms of liver,kidney,and/or vascular dysfunction with lethal pulmonary hemorrhage and sometimes death,is called:

A)icteric leptospirosis.
B)anicteric leptospirosis.
C)Vincent's disease.
D)syphilis.

Question 5

A destructive lesion of the gums,also known as acute necrotizing ulcerative gingivitis,that is caused by oral spirochetes and other bacteria is known as:

A)Vincent's disease.
B)primary syphilis.
C)chancres.
D)Weil syndrome.

Question 6

A stage of venereal syphilis characterized by the appearance of a chancre is known as __________ syphilis.

A)primary
B)secondary
C)late
D)tertiary

Question 7

An automated system uses bead-capture technology in the detection of which of the following spirochetes?

A)Treponema
B)Borrelia
C)Leptospira
D)Brachyspira

Question 8

Long,slender,helically curved,gram-negative bacilli with hooked ends are identified as belonging to which species?

A)Treponema
B)Leptospira
C)Borrelia
D)Coxiella

Question 9

A specific treponemal serologic test performed by overlaying whole treponemes that are fixed to a slide with serum from patients suspected of having syphilis and using fluorescein-conjugated antihuman antibody reagent to detect specific antitreponemal antibodies is called the _________ test.

A)RPR
B)FTA-ABS
C)VDRL
D)TP-PA

Question 10

A test that uses gelatin particles sensitized with T.pallidum subsp.pallidum antigens to detect specific antitreponemal antibodies in patient serum is called the __________ test.

A)RPR
B)FTA-ABS
C)VDRL
D)TP-PA

Question 11

A stage of venereal syphilis,characterized by tissue destruction,central nervous system disease,cardiovascular abnormalities,eye disease,and granuloma-like lesions,is known as ________ syphilis.

A)primary
B)secondary
C)tertiary
D)quaternary

Question 12

Treponemal antibodies are those that are:

A)produced against antigens of the organisms themselves.
B)produced by infected patients against components of mammalian cells.
C)produced by the organism that causes the systemic destruction of the disease.
D)also called reaginic antibodies.

Question 13

The Jarisch-Herxheimer reaction is associated with the clearance of organism from the bloodstream and the release of cytokines within hours of antibiotic treatment.With which spirochete is this condition associated?

A)Treponema
B)Borrelia
C)Leptospira
D)Brachyspira

Question 14

Long,slender,helically curved,gram-negative bacilli with tight coils are identified as belonging to which species?

A)Treponema
B)Leptospira
C)Borrelia
D)Coxiella

Question 15

A widely used nontreponemal serologic assay is the ________ test.

A)rapid plasma reagin (RPR)
B)Treponema pallidum passive particle agglutination (TP-PA)
C)fluorescent treponemal antibody absorption test (FTA-ABS)
D)microhemagglutination test for antibody to T.pallidum (MHA-TP)

Question 16

Nontreponemal antibodies are those that are:

A)produced against antigens of the organisms themselves.
B)produced by infected patients against components of mammalian cells.
C)produced by the organism that causes the systemic destruction of the disease.
D)also called heterophile antibodies.

Question 17

The Centers for Disease Control and Prevention (CDC)recommendations for testing in suspected cases of Lyme disease are to screen with ______ and confirm with ________.

A)RPR;FTA-ABS
B)enzyme-linked immunosorbent assay (ELISA);immunofluorescent antibody (IFA)
C)IFA;immunoblotting
D)ELISA;TP-PA

Question 18

A nontreponemal flocculation serologic test in which soluble antigen particles are coalesced to form larger particles that are visible as clumps when they are aggregated by antibody is called the __________ test.

A)nontreponemal flocculation (NTF)
B)FTA-ABS
C)VDRL
D)TP-PA

Question 19

A self-limiting illness and the most common clinical syndrome associated with leptospirae that includes fever,headache,myalgia,and aseptic meningitis in the immune stage is called:

A)icteric leptospirosis.
B)anicteric leptospirosis.
C)Weil's disease.
D)syphilis.

Question 20

MATCHING
Match the component with the assay with which it is associated.
a.TP-PA
b.MHA-TP
c.PaGIA
d.Enzyme immunoassay (EIA)
e.Magnetic beads
Recombinant antigens

Question 21

MATCHING
Match the component with the assay with which it is associated.
a.TP-PA
b.MHA-TP
c.PaGIA
d.Enzyme immunoassay (EIA)
e.Magnetic beads
Erythrocytes

Question 22

MATCHING
Match the component with the assay with which it is associated.
a.TP-PA
b.MHA-TP
c.PaGIA
d.Enzyme immunoassay (EIA)
e.Magnetic beads
Gel immunoassay

Question 23

MATCHING
Match the component with the assay with which it is associated.
a.TP-PA
b.MHA-TP
c.PaGIA
d.Enzyme immunoassay (EIA)
e.Magnetic beads
Gelatin particles

Question 24

MATCHING
Match the component with the assay with which it is associated.
a.TP-PA
b.MHA-TP
c.PaGIA
d.Enzyme immunoassay (EIA)
e.Magnetic beads
Isoluminol-antigen conjugate