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Chapter 24: Spirochetes and Other Spiral Microorganisms

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A 28-year-old woman who is 10 weeks pregnant presents to the obstetrics clinic for prenatal care. She has a history of treatment for syphilis 7 years previously. The results of serologic tests for syphilis are as follows: nontreponemal test, RPR, nonreactive; treponemal test (TP-PA), reactive. Which of the following statements is most correct?

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(A) The mother’s previous treatment for syphilis was effective.

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(B) The baby is at high risk for congenital syphilis.

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(C) The mother needs to be treated again for syphilis.

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(D) The mother needs a lumbar puncture and a VDRL test of her CSF for neurosyphilis.

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A 12-year-old Boy Scout went to summer camp for 2 weeks in late August at a site located just outside Mystic, Connecticut. When he returned home, his mother noticed a bull’s-eye-shaped rash on the back of her son’s left calf. Shortly after Labor Day, the boy developed a flulike illness that resolved after 4 days of bed rest. Three weeks later, the boy complained to his mother that his body hurt all over whenever he moved. This prompted a visit to the pediatrician, who ordered an infectious disease workup. What is the most likely source of the boy’s infection?

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(A) Respiratory transmission from another sick camper

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(B) Ingestion of urine-contaminated water from a stream

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(C) The bite of a mosquito harboring a parasite

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(D) Ingestion of fecally contaminated food

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(E) The bite of a spirochete-infected tick

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Nontreponemal serological tests:

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(A) Are useful in definitively identifying a Treponema pallidum infection.

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(B) Measure antibodies against Treponema pallidum.

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(C) Can be used to monitor antibiotic treatment of primary or secondary syphilis.

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(D) Measure antibodies against lipids released from damaged cells.

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(E) Are useful in diagnosing a disseminated gonococcal infection.

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A 42-year-old woman went camping in the Sierra Nevada Mountains, where she slept for two nights in an abandoned log cabin. After the second night, a tick was found on her shoulder. Six days later, she developed fever to 38°C, which lasted for 4 days. Ten days later, she had another similar episode of fever. Examination of a blood smear stained with Wright stain showed spirochetes suggestive of Borrelia species. Which of the following statements ...

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