| Term | Definition |
|---|---|
Non-treponemal tests detect? | Anticardiolipin/reagin antibodies |
Non-treponemal antibodies? | IgG and IgM |
Non-treponemal tests reaction | Flocculation - precipitation reaction |
Non-treponemal antigens? | Cardiolipin, cholesterol, lecithin |
Non-treponemal tests become positive? | ~1-4 weeks after chancre |
Prozone phenomenon? | False negative from excess antibody |
Prozone is especially associated with? | Secondary syphilis |
How to fix prozone | Serial dilutions |
RPR false-negative causes? | Prozone, poor rotation, wrong volumes, cold reagents, poor mixing |
RPR false-positive causes? | Dried specimen, long rotation, poor humidity, hot reagents |
RPR stands for? | Rapid Plasma Reagin |
RPR is a modified? | VDRL |
RPR antigen? | Cardiolipin + charcoal |
Why charcoal in RPR? | Allows macroscopic reading |
RPR serum volume? | 0.05 mL |
RPR antigen needle gauge? | 20 gauge |
RPR rotation time? | 8 min |
RPR rotation speed? | 100 rpm ± 5 rpm |
RPR reagent temperature? | 73-85°F (23-29°C) |
RPR reading method? | High-intensity lamp |
RPR advantage in primary syphilis? | More sensitive |
RPR titers reflect? | Disease activity |
RPR can detect? | Recurrence |
VDRL stands for? | Venereal Disease Research Laboratory |
VDRL serum preparation? | 56°C for 30 min |
VDRL reading? | Microscopic |
VDRL results reported as? | Reactive, weakly reactive, nonreactive |
VDRL is preferred for? | CSF |
VDRL is used to diagnose? | Neurosyphilis |
Treponemal tests detect? | Antibodies to T. pallidum |
Examples of treponemal tests? | EIA/CLIA, FTA-ABS |
Treponemal tests are mainly used for? | Confirmation |
Treponemal tests may become positive when? | Before non-treponemal tests |
Treponemal tests stay positive after treatment? | Usually yes; may remain positive for life |
FTA-ABS stands for? | Fluorescent Treponemal Antibody Absorption |
FTA-ABS is what type of test? | Indirect fluorescent antibody test |
FTA-ABS strain? | Nichols strain |
FTA-ABS absorption uses? | Reiter strain sorbent |
FTA-ABS incubation time? | ~30 minutes |
FTA-ABS result is read by? | Fluorescence grading |
Traditional syphilis algorithm starts with? | Non-treponemal test |
Reverse syphilis algorithm starts with? | Treponemal test |
Traditional algorithm: confirm positive RPR/VDRL with? | Treponemal test |
Congenital syphilis = ? | Mother-to-child transmission |
Congenital syphilis symptoms? | Runny nose, rash, lymphadenopathy, hepatosplenomegaly, jaundice |
Congenital syphilis bone abnormality? | Saddle nose |
Congenital syphilis can cause? | Deafness |
Congenital syphilis death rate in lecture? | ~10% |
Syphilis treatment listed for primary/secondary adults? | Benzathine penicillin G |
Benzathine penicillin G dose? | 2.4 million units IM once |
Lyme disease is caused by? | Borrelia burgdorferi |
B. burgdorferi is what type of bacterium? | Spirochete |
Lyme disease discovered? | 1975 |
Lyme disease vector? | Ixodes tick |
Early Lyme disease key rash? | Erythema migrans |
Erythema migrans appearance? | Bull's-eye rash |
Localized erythema migrans lasts? | ~3-30 days |
Early disseminated Lyme symptoms? | Joint pain/swelling, cardiac issues, facial palsy, headache |
Lyme cardiac symptoms? | Palpitations, irregular heartbeat |
Lyme disease can be asymptomatic early? | Yes |
Lyme PCR detects what? | Bacteremia |
Lyme antibodies rise when? | Later |
Why does PCR/antibody overlap decrease? | Bacteremia decreases as antibodies develop |
Main basis of Lyme diagnosis? | Clinical presentation |
Lyme lab testing includes? | Serology, PCR, culture |
Routine Lyme culture? | Not preferred (lecture marks X) |
Routine Lyme PCR? | Not preferred (lecture marks X) |
Recommended Lyme testing approach? | CDC two-tier serology |
Lyme first-tier test? | EIA or IFA |
Positive/equivocal first-tier Lyme test → ? | Western blot |
Lyme symptoms ≤30 days: Western blots? | IgM + IgG |
Lyme symptoms >30 days: Western blot? | IgG only |
Negative first-tier Lyme test? | Report negative |
If early Lyme still suspected after negative test? | Test convalescent serum |
Lyme false positives can occur with? | RA, SLE, infectious mononucleosis |
Western blot detects? | B. burgdorferi antibodies |
Late disseminated Lyme: key feature? | Arthritis |
Late Lyme neurological findings? | Nerve damage, facial paralysis, memory loss |
Late Lyme eye findings? | Conjunctivitis, double vision, blindness |
Late Lyme CNS complication? | Brain/spinal cord inflammation |
Adult Lyme treatment: doxycycline? | 100 mg PO BID × 10-14 days |
Adult Lyme treatment: amoxicillin? | 500 mg PO TID × 14 days |
Adult Lyme treatment: cefuroxime? | 500 mg PO BID × 14 days |