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
Treponemes can be transmitted from an infected mother to her fetus by crossing the placenta.

Question 2

Factors that may 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.

Answer 2

C
Factors that may play a role in pathogenicity include reduced phagocytosis in the host, a soluble hemolysin produced by some virulent strains, cell-mediated sensitivity to leptospiral antigen by the host, and small amounts of endotoxins produced by some strains.

Question 3

An animal attendant at the zoo became ill.Symptoms included fever, chills, headache, severe myalgia, and malaise.This person's urinalysis was abnormal with protein and blood present.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

Answer 3

B
Leptospirosis is a zoonotic disease in humans primarily associated with occupational exposure.In the natural host, leptospira live in the renal tubules and are excreted in the urine.

Question 4

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

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

Question 7

What is the drug of choice for treating Borrelia infections?

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

Question 8

Leptospiral organisms are susceptible to all the following antibiotics except:

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

Question 9

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 10

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

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

Question 11

All of the following diseases are produced by Treponema except:

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

Question 12

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 13

How are Borrelia organisms transmitted to the host?

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

Question 14

An untreated patient develops tertiary syphilis _____ after the initial infection.

A)decades
B)2 to 3 years
C)1 year
D)5 years

Question 15

All of the following symptoms are characteristic of Weil's disease except:

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

Question 16

Spirochetes are made up of all the following except:

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

Question 17

What structure is responsible for motility in spirochetes?

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

Question 18

A young woman notices a bruise that looks like an erythema chronicum migrans lesion 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 begins to feel very bad.She has joint and bone pain, extreme fatigue, and her heart just "doesn't feel right." What disease does she have, and what antibiotic 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

What organism causes relapsing fever?

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

Question 20

A man is taking a shower and notices this lesion on his penis that is not tender but is firm with a clean surface and raised edges.He is quite dismayed, so he goes to his physician.The physician does a rapid plasmin reagin (RPR) and a darkfield microscopy.Both tests are positive.What is the physician's probable diagnosis?

A)Gonorrhea
B)Nongonococcal urethritis (NGU)
C)Syphilis
D)Human papillomavirus (HPV)

Question 21

What is the drug of choice used to treat syphilis?

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

Question 22

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

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

Question 23

What is a confirmatory test for a positive rapid plasmin reagin (RPR)?

A)Venereal Disease Research Laboratory (VDRL)
B)Fluorescent treponemal antibody, absorbed (FTA-ABS)
C)Enzyme immunoassay (EIA)
D)Darkfield

Question 24

What is an example of a nontreponemal test?

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

Question 25

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

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

Question 26

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.