157 - Tuberculosis and Infections with Atypical Mycobacteria Flashcards
Main cause of death in patients infected with HIV
TB
Highest burden of TB in the following countries
India Indonesia China Philippines Pakistan
In contrast to the obligate pathogens, _____ pathogens do not cause disease by person-to-person spread
Facultative
2 most frequent forms of skin tuberculosis
Lupus vulgaris
Scrofuloderma
In the tropics, LV is rare, wherease _____ lesions predominate
Scrofuloderma
Tuberculosis verrucosa cutis
Exogenous infection with naive host immune status
Primary inoculation tuberculosis
Exogenous infection with immune host status
Tuberculosis verrucosa cutis
Endogenous spread with high host immune status
Lupus vulgaris
Scrofuloderma
Endogenous spread with low host immune status
Acute miliary tuberculosis
Orificial tuberculosis
Metastatic tuberculous abscess (tuberculous gumma)
Tuberculosis caused by bacille Calmette-Guerin
Normal primary complex-like reaction
Perforating regional adenitis
Postvaccination lupus vulgaris
Tuberculids: conditions in which Mycobacterium tuberculosis/Mycobacterium bovis appears to play a significant role
Lichen scrofulosum
Papulonecrotic tuberculid
Facultative tuberculids: conditions in which M. tuberculosis/M. bovis may be one of several pathogenic factors
Nodular vasculitis/erythema induratum of Bazin
Erythema nodosum
Most common cause of disseminated bacterial infection in patients with AIDS
Mycobacterium avium-intracellulare complex
In AIDS patients, Mycobacterium _____ is more common than M. tuberculosis
kansasii
Cutaneous disease in AIDS is frequently caused by Mycobacterium _____
Other than Mycobacterium tuberculosis
A large number of bacteria can be found in the lesions of
Primary chancre
Acute miliary tuberculosis
Delayed-type hypersensitivity reaction induced by mycobacteria during primary infection
Tuberculin reaction (Koch phenomenon)
Maximum intensity of tuberculin reaction after
48 hours
QuantiFERON-TB Gold test measures specific antigen-driven _____ synthesis
Interferon-gamma
Tuberculin sensitivity usually develops _____ after infection and persists throughout life
2 to 10 weeks
In patients with clinical tuberculosis, an increase in skin sensitivity usually indicates a (favorable/poor) prognosis
Favorable
In tuberculous skin disease accompanied by high levels of skin sensitivity, the number of bacteria within the lesions is (small/large)
Small
Although more sensitive than the tuberculin skin test, _____ may be negative in patients with early active tuberculosis and indeterminate results are more common in immunocompromised individuals and young children
QFT-G
Measures the IFN-gamma producing T cells
T-SPOT TB test
Procedure that has been used to ascertain the presence of mycobacterial DNA in skin specimens
Polymerase chain reaction
PCR showed _____% sensitivity in multibacillary disease. In paucibacillary disease, PCR testing showed _____% sensitivity and specificity
100
55
Multidrug resistant TB is defined as
Resistance to at least rifampicin and isoniazid
Regimen for extrapulmonary tuberculosis
Initial Phase
INH, RIF, PZA, EMB
7 days per week for 56 doses (8 weeks) or
5 days per week for 40 doses (8 weeks)
Continuation Phase
INH/RIF
7 days per week for 128 doses (18 weeks) or
5 days per week for 90 doses (18 weeks)
Doses of medications (maximum dose) when given daily
EMB 18 mg/kg (1600 mg)
INH 5 mg/kg (300 mg)
PZA 25 mg/kg (2000 mg)
RIF 10 mg/kg
Tuberculosis verrucosa cutis and localized forms of LV without evidence of associated internal tuberculosis may be treated with
Isoniazid alone for up to 12 months
Because viable mycobacteria have been found in clinically healed lesions, treatment should be continued for at least _____ after complete involution of the lesion
2 months