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FITZPATRICK'S DERMATOLOGY 9TH EDITION (SHAMMY) > 23 - 157 - TUBERCULOSIS AND INFECTIONS WITH ATYPICAL MYCCOBACTERIA > Flashcards

23 - 157 - TUBERCULOSIS AND INFECTIONS WITH ATYPICAL MYCCOBACTERIA Flashcards

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Dermatology Board Prep flashcards
1
Q

2 most frequent forms of skin tuberculosis

A
  1. Lupus vulgaris
  2. Scrofuloderma
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2
Q

Common in the tropics

A

Srcofuloderma , verrucous

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3
Q

LV is more than twice as common in what gender

A

Women

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4
Q

tuberculosis verrucosa cutis is more often found in what gender

A

Male

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5
Q

miliary tuberculosis common in what age group

A

children, adults w/ AIDS/immunocompromised

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6
Q

Scrofuloderma usually occurs in what age groups

A

Adolescents and elderly

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7
Q

Occurs in all age groups

A

Lupus vulgaris

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8
Q

Cutaneous TB caused by exogenous infection

A
  1. Primary inoculation tuberculosis
  2. Tuberculosis verrucosa cutis
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9
Q

Cutaneous Tuberculosis caused by endogenous spread with high host immune status

A

Lupus vulgaris
Scrofuloderma

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10
Q
A
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11
Q

Mode of transmission-
Scrofuloderma -
Lupus vulgaris -
Acute miliary tuberculosis-

A

Scrofuloderma - Direct extension
Lupus vulgaris - Lymphatics, Hematogenous, Contiguous spread
Acute miliary tuberculosis- Hematogenous

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12
Q

most common cause of disseminated bacterial infections in patients with AIDS in the United States,

A

Mycobacterium avium-intracellulare complex

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13
Q

In AIDS patients, ___________ is more common than M. tuberculosis.

A

Mycobacterium kansasii

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14
Q

T/F. Populations that have been in longstanding contact with tuberculosis are, in general, less susceptible than those who have come into contact with mycobacteria more recently

A

TRUE

presumably reflecting widespread immunity from subclinical infection.

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15
Q

Local tuberculin reaction reaches maximum intensity after __ , consist of ___

A

48 hours
Sharply circumscibed area of erythema and induration

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16
Q

Tuberculin sensitivity usually develops how many weeks after infection?

A

2 to 10 weeks after infection and persists throughout life.

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17
Q

T/F

In patients with clinical tuberculosis, an increase in skin sensitivity usually indicates a worse prognosis, and in tuberculous skin disease accompanied by high levels of skin sensitivity, the number of bacteria within the lesions is large

A

FALSE

In patients with clinical tuberculosis, an increase in skin sensitivity usually indicates a FAVORABLE prognosis, and in tuberculous skin disease accompanied by high levels of skin sensitivity, the number of bacteria within the lesions is SMALL

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18
Q

Quantify tuberculin reaction, measure specific antgen-driven interferon y synthesis by whole blood cells approved by FDA in 2005

A

QuantiFERON-TB Gold (QFT-G)

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19
Q

Specimen for QuantiFERON-TB Gold (QFT-G)

A

Blood

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20
Q

Results based on anount of IFN-y released in response to antigens

A

QuantiFERON-TB Gold (QFT-G)

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21
Q

More sensitive than tuberculin skin test

A

QuantiFERON-TB Gold (QFT-G)

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22
Q

QuantiFERON-TB Gold (QFT-G) negative in ____
Indeterminate in ____

A

early tuberculosis
immunocompromised

23
Q

measures the number of IFN-γ–producing T cells

A

T-SPOT.TB test

24
Q

For QFT-G, the antigens include mixtures of synthetic peptides representing 2 M. tuberculosis proteins:

A

ESAT-6 and CFP-10

After incubation of the blood with antigens for 16 to 24 hours, the amount of interferon (IFN)-γ is measured.

If the patient is infected with M. tuberculosis, their white blood cells will release IFN-γ in response to contact with the TB antigens. The QFT-G results are based on the amount of IFN-γ that is released in response to the antigens.

25
Q

indicated in diagnosing both TB disease and latent TB infection

A

QuantiFERON-TB Gold (QFT-G)

26
Q

hallmark of tuberculosis and infections with some of the slow-growing atypical mycobacteria

A

tubercle: an accumulation of epithelioid histocytes with Langhans-type giant cells among them and a varying amount of caseation necrosis in the center, surrounded by a rim of lymphocytes and monocytes

27
Q

tuberculosis verrucosa cutis and localized forms of LV without evidence of associated internal tuberculosis may be treated with ______________

A

Isoniazid alone for up to 12 monhs

28
Q

Define Extensively multidrug-resistant TB

A

resistance to at least rifampicin and isoniazid from among the first-line anti-TB drugs (which is the definition of multidrug resistant TB) in addition to resistance to any fluoroquinolone, and to at least 1 of the 3 injectable second-line anti-TB drugs used in TB treatment (capreomycin, kanamycin, and amikacin).

29
Q

Define multidrug-resistant TB

A

resistance to at least rifampicin and isoniazid from among the first-line anti-TB drugs

30
Q

Incubation period of primary inoculation tuberculosis

A

2 - 4 weeks

31
Q

Sites of predilection of PRIMARY INOCULATION TUBERCULOSIS (TUBERCULOUS CHANCRE, TUBERCULOUS PRIMARY COMPLEX)

A

face, including the conjunctivae and oral cavity, as well as the hands and lower extremities

32
Q

Is the ulcer in inoculation tuberculosis painless or painful?

A

Painless

33
Q

Slowly progressive, regional lymphadenopathy develops how many weeks after infection

A

3 - 8 weeks

34
Q

Most prominent histopathologic features of TVC

A

pseudoepitheliomatous hyperplasia with marked hyperkeratosis, a dense inflammatory infiltrate, and abscesses in the superficial dermis or within the pseudoepitheliomatous rete pegs

35
Q

T/F. Typical tubercles or tuberculoid granuloma are uncommon in TVC

A

TRUE

36
Q

postprimary, paucibacillary form of tuberculosis caused by hematogenous, lymphatic, or contiguous spread from elsewhere in the body

A

LUPUS VULGARIS /TUBERCULOSIS LUPOSA

37
Q

Most prominent histopathologic feature of lupus vulgaris

A

Formation of typical tubercles

38
Q

Apple jelly nodules seen in diascopy are highly characteristic of which cutaneous TB?

A

Lupus vulgaris

39
Q

subcutaneous tuberculosis leading to cold abscess formation and a secondary breakdown of the overlying skin

A

Scrofuloderma

40
Q

represents contiguous involvement of the skin overlying another site of infection (eg, tuberculous lymphadenitis, tuberculosis of bones and joints, or tuberculous epididymitis)

A

Scrofuloderma

41
Q

Most common locations of scrofuloderma

A

parotideal, submandibular, and supraclavicular regions

42
Q

rare form of tuberculosis of the mucous membranes and orifices that is caused by autoinoculation of mycobacteria from progressive tuberculosis of internal organs

A

ORIFICIAL TUBERCULOSIS (TUBERCULOSIS ULCEROSA CUTIS ET MUCOSAE, ACUTE TUBERCULOUS ULCER)

43
Q

Most frequently affected area in orificial tuberculosis

A

tongue is most frequently affected, particularly the tip and the lateral margins

44
Q

What entities belong as tuberculids

A

Lichen scrofulosorum
Papulonecrotic tuberculid

45
Q

Entities that are considered facultative tuberculids

A

Nodular vasculitis/ erythema induratum of Bazin

Erythema nodosum

46
Q
A
47
Q

uncommon lichenoid eruption ascribed to hematogenous spread of mycobacteria in an individual strongly sensitive to M. tuberculosis

A

LICHEN SCROFULOSORUM

48
Q

symmetric eruption of necrotizing papules, appearing in crops and healing with scar formation that occurs preferentially in children or young adults

A

PAPULONECROTIC TUBERCULID

49
Q

Cardinal histopath finding of papulonecrotic tuberculid is the involvement of _____________

A

Blood vessels

and consists of an obliterative and sometimes granulomatous vasculitis leading to thrombosis and complete occlusion of the vascular channels.

50
Q

third most frequent mycobacterial pathogen

A

M. Ulcerans

51
Q

The painless nature of the ulcer in M. Ulcerans/ Buruli ulcer disease has been attributed to nerve damage and tissue destruction caused by wha toxin?

A

Mycolactone toxin

52
Q

Buruli ulcer is caused by what Mycobacterial species?

A

M. Ulcerans

53
Q

atypical Mycobacterium most closely related to M. tuberculosis

A

M. Kansasii

FITZPATRICK'S DERMATOLOGY 9TH EDITION (SHAMMY) (122 decks)

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