1. What organism has never been cultured in the lab on artifical media? What does it grow on?

    -tissue culture cells of cottontail rabbit epithelium
  2. What is the host for syphilis / Treponema?
  3. How is syphilis transferred?
    intimate sexual contact
  4. What is Treponema normally transferred with?
    N. gonorrhoeae
  5. What was Syphilis known as in the 1700s?
    "Great Pox" (large sores compared to smallpox)
  6. Which physician injected himself with liquid discharge to study Syphilis and Gonorrhea?
    John Hunter
  7. What is a virulence factor of Treponema Pallidum?
    -ability to transit epithelia to invade body 

    ends of the bacteria attach to hyaluronic-acid containing extracellular matrix that joins capillary endothelial cells 
  8. What is a virulence factor of Treponema Pallidum?
    corkscrew motility, cross tissue layers and enter & exit bloodstream
  9. What is a virulence factor of Treponema Pallidum?
    ability to cross the placenta
  10. What are the virulence factors of Treponema Pallidum?
    • ability to transit epithelia to invade body
    • Ends of the bacteria attach to the hyaluronic-acid containing extracellular matrix that joins capillary endothelial cells
    • Corkscrew motility, cross tissue layers and enter and exit bloodstream
    • Ability to cross the placenta
  11. What are the 3 stages of Progression of Syphilis?
    • Primary Syphilis (infection occur thru tiny breaks in epidermal layer caused during sexual activity then multiplies and forms chancres)
    • Secondary Syphilis (bacteria spread to membranes, eyes, joints, bones, CNS)
    • Tertiary Syphilis (Immune response-chronic inflammation (destruction of virtually any organ/tissue))
  12. What is congenital syphilis and what stage does it occur?
    when Treponema Pallidum crosses the placenta and infects the fetus 

    1st stage!
  13. What are the first symptoms of syphilis?
    rhinitis (irritation and inflammation of the nose) and then rash
  14. What are chronic infections of syphilis during the primary stage?
    • teeth and bone malfunctions, often seen in archeological excavation 
    • blindness, deafness, cardiovascular syphilis are common in untreated infants who survive.
  15. Where can syphilis hide in the body?
    on scalp under hair, vagina, anus or mouth
  16. It's possible for chancres to disappear after a few wks and heal spontaneously; but this is a false sense of relief for patient!
  17. What are key features of Syphilis ?
    hypersensitivity rxn, rash that covers entire body - highly contagious !
  18. What occurs during the Secondary Syphilis stage ?
    • bacteria penetrate mucosal membranes and enter bloodstream
    • bacteria spread to mucous membranes, eyes, joints, bones or CNS 
    • body mounts immune response (flu-like symptoms--sore throat, headache,  fever, swollen, lymph glands)
    • rash symptoms gradually resolve spontaneously 
    • patients enters clinically inactive / latent phase 
    • patients may think he/she is cured but may not be true
  19. What occurs during the Tertiary (Late) Syphilis stage?
    • range of symptoms 4rm mild-fatal infections 
    • Immune response-Chronic inflammation : destruction of virtually any organ / tissue. Disabling fatigue, disfiguring skin lesions, bone malformation (archeological info)
    • fatal infections if vital systems/ organs are affected cardiovascular and CNS
  20. What is the Wassermann Test and what is it used for?
    • it's based on antigen produced by host not the bacterium, Cardiolipin - released 4rm mitochondria membranes from lysing cells, not normally seen by immune sys and processed as foreign. 
    • sample of blood / cerebrospinal fluid is taken and introduced to antigen, intensity of rxn indicates severity 
    • but can be produced in response to other conditions, viral, protozoan, autoimmune diseases -- false positives
  21. There are 2 tests that are more sensitive and specific than the Wassermann Test. What are they?
    Fluorescent Antibody Test - anti-treponemal antibodies 

    T. pallidum Inactivation Test - based on fact that organism lose motility when incubated w/ serum containing anti-treponemal antibodies. 

  22. What does the Fluorescent Antibody Test and the T. pallidum Inactivation Test  require?
    LIVE organisms and sophisticated microscopes
  23. What test is preferred as the confirmatory test?
    Western Blot
  24. What is Syphilis treated by?
  25. Is there a vaccine available for Syphilis ?
  26. What was the Tuskegee Experiment?
    one treated and one untreated group of Africans to study natural progression of syphilis
  27. What's the theory of origin of Syphilis?
    prob acquired 4rm animals in Africa, treponema mutated and crosses the species barrier to Yaws--skin disease
  28. Where was the Yaws maintained?
    in warm-moist areas of South America
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