Deck 23: The Spirochetes

Question 1

How is congenital syphilis transmitted from the mother to her unborn child?

A) During birth from the birth canal
B) During the microhemorrhages that occur as the placenta breaks away from the uterus
C) Crossing the placenta
D) None of the above

Answer 1

C

Question 2

When does an untreated patient develop tertiary syphilis?

A) Decades after the initial infection
B) 2 to 3 years after the initial infection
C) 1 year after the initial infection
D) 5 years after the initial infection

Answer 2

A

Question 3

A man is taking a shower and notices a lesion on his penis that is not tender but is firm with a clean surface and raised edges. He goes to his physician. The physician orders a rapid plasmin reagin (RPR) and a dark-field microscopy. Both tests are positive. What is the probable diagnosis?

A) Gonorrhea
B) Nongonococcal urethritis
C) Syphilis
D) Human papillomavirus

Answer 3

C

Question 4

What structure is responsible for motility in spirochetes?

A) Axiles
B) Periplasmic flagella
C) Flexible cell wall
D) Compressed nucleus

Question 5

What diseases do Borrelia spp. cause?

A) Undulant and hemorrhagic fevers
B) Lyme disease and parrot fever
C) Rocky Mountain spotted fever and relapsing fever
D) Lyme disease and relapsing fever

Question 6

What medium is used in the laboratory to grow leptospiral organisms?

A) MacConkey
B) Fletcher's
C) Sheep blood agar
D) None of the above

Question 7

What organism causes relapsing fever?

A) Borrelia recurrentis
B) B. burgdorferi
C) Leptospira interrogans
D) C. psittaci

Question 8

All of the following diseases are produced by Treponema, except

A) syphilis.
B) elephantiasis.
C) yaws.
D) pinta.

Question 9

Where on the body is the secondary syphilis rash typically seen?

A) Chest and back
B) Back and soles
C) Buttocks and palms
D) Palms and soles

Question 10

Spirochetes are made up of all the following, except

A) Helicobacter.
B) Leptospira.
C) Borrelia.
D) Treponema.

Question 11

What is the drug of choice for treating Borrelia infections?

A) Aminoglycosides
B) Macrolides
C) Tetracyclines
D) Penicillins

Question 12

Acceptable specimens during the first week of leptospirosis include which of the following:

A) Cerebrospinal fluid (CSF)
B) Blood
C) Urine
D) A and B

Question 13

Leptospiral organisms are susceptible to all the following antimicrobial agents, except

A) streptomycin.
B) tetracycline.
C) penicillin.
D) macrolides.

Question 14

What is a Leptospira infection called when it becomes a severe systemic disease?

A) Niemann-Pick
B) Bordet-Gengou
C) Gaucher disease
D) Weil disease

Question 15

Factors that can play a role in pathogenicity of Leptospira include all the following, except

A) hemolysin
B) endotoxins
C) pancytopenia in host
D) decreased phagocytosis in host

Question 16

How are Borrelia organisms transmitted to the host?

A) Respiratory droplets
B) Arthropods
C) Birds
D) Blood or body fluids

Question 17

An animal attendant at the zoo developed symptoms that included fever, chills, headache, severe myalgia, and malaise. His urinalysis revealed the presence of protein and blood. A couple of weeks earlier, the attendant was handling the chimpanzees, and one of the chimps urinated on him. What is the most likely cause of illness?

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

Question 18

A young woman notices a red bruiselike lesion that looks like a target on her lower leg. She cannot remember getting bruised, even though she went hiking through the woods last weekend. The bruise goes away in about a week and she thinks nothing more about it. About 2 weeks later, she develops joint and bone pain, extreme fatigue, and her heart just "doesn't feel right." What disease does she have, and what antimicrobial agent is used to treat it?

A) Lyme disease and doxycycline
B) Relapsing fever and macrolides
C) Parrot fever and penicillin
D) Hemorrhagic fever and gentamicin

Question 19

All of the following are symptoms of tertiary syphilis, except

A) gummas in the skin, bones, and liver.
B) encephalitis.
C) aortitis.
D) aortic valve insufficiency.

Question 20

All of the following symptoms are characteristic of Weil disease, except

A) pneumonia.
B) renal failure.
C) hepatic failure.
D) intravascular disease.

Question 21

Early-onset congenital syphilis is characterized by all the following symptoms, except

A) osteochondritis.
B) anemia.
C) hepatosplenomegaly.
D) encephalitis.

Question 22

What is the drug of choice used to treat syphilis?

A) Tetracycline
B) Fluoroquinolones
C) Penicillin
D) Macrolides

Question 23

What is an example of a nontreponemal test?

A) RPR
B) Fluorescent treponemal antibody, absorbed (FTA-ABS)
C) Treponema pallidum particle agglutination (TPPA)
D) Microhemagglutination-Treponema pallidum (MHA-TP)

Question 24

Once infected with Borrelia recurrentis, a 2- to 15-day incubation period follows where high numbers of organisms are found in the blood. The infected individual experiences high fever, rigors, severe headache, muscle pains, and weakness. This febrile period lasts for about 3 to 7 days, but ends quickly with the induction of an immune response. However, a similar but less severe course of symptoms recurs several days to weeks later. What causes this relapse?

A) The organism systematically changes its surface antigens during the course of a single infection.
B) The organism produces extracellular toxins that cause the symptoms.
C) This organism survives inside infected cells and once the cell dies, the organism is released into the blood, causing this relapse.
D) This relapse occurs as the host is trying to mount the secondary antibody response.

Question 25

What is the primary method used to screen for syphilis infections?

A) Serology
B) Microscopy
C) Culture
D) Enzyme immunoassay (EIA)

Question 26

The microscopic method of choice in detecting treponemes in clinical specimens

A) Gram stain.
B) Giemsa stain.
C) unstained wet mounts.
D) dark-field microscopy.