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Clinical Micro > Acid Fast Bacteria > Flashcards

Acid Fast Bacteria Flashcards

1
Q

Process for acid fast staining

A

Carbolfushsin (red), heat, acid alcohol, methylene blue counter stain.

Acid fast organisms are red

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2
Q

Why are HIV patients at high risk for TB?

A

Reduced cell mediated immuntiy

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3
Q

Basic description of Mycobacterium tuberculosis

A

Acid fast
Obligate aerobe
Grows slowly
Hydrophobic lipid cell wall

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4
Q

What are the virulence factors of TB?

A

1) mycolic acid / mycosides - all below are mycosides
2) cord factor (damages mitochondria, releases tumor necrosis factor)
3) sulfatides- prevent phagocytosis
4) wax d- enhances antibody formation

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5
Q

Pathogenesis of TB

A

Inhaled via lungs, survives in macrophages (facultative intracellular growth) and invades other sites

Cell mediated immunity, necrosis of lung tissue

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6
Q

Term for necrosis of lungs from tb

A

Caseous necrosis

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7
Q

How long does it take for hypersensitivity reaction in PPD test to develop

A

48 hours

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8
Q

What are the cut points for TB ppd test induration

A

5 mm- HIV positive or immunosupressed

10 mm- from high incidence country, HCP, prior incarceration, high risk medical condition (diabetes)

15 mm- all others

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9
Q

What does a positive PPD result mean?

A

Person was exposed and infected at some time in the past

Positive for active, latent, and cured

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10
Q

What may cause a false positive TB ppd?

A

Bacillus calmette-guerin (BCG) vaccine

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11
Q

What may cause a false negative PPD test?

A

Anergic patients (lack normal immune response due to steroid use, malnutrition, AIDS, etc

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12
Q

Second test for tb

A

interferon gamma release assay (IGRA)

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13
Q

What is the risk of developing TB if infected with mycobacterium tuberculosis?

A

10 %

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14
Q

Stages of tb

A

1) primary (subclinical infection in lungs
2) latent - cell mediated immunity walls off bacteria
3) secondary or reactivation TB

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15
Q

Transmission of TB

A

Aerosolized droplet nuclei from adult with pulmonary tb

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16
Q

Describe the asymptomatic primary infection of TB

A

Tubercles form in lungs (walled off bacterium) and calcify (ghon focus)

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17
Q

Calcified tubercle in middle or lower lung zone

A

Ghon focus

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18
Q

Ghon focus accompanied by perihilar lymph node calcified granulomas

A

Ghon complex

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19
Q

Who is typically effected by symptomatic primary TB?

A

Children
Elderly
Immunocompromised

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20
Q

Clinical symptoms symptomatic primary tb

A

Chest radiograph shoes enlargement if mediastinal or hilar lymph nodes, sometimes chest infiltrates

Usually resolves with formation of tubercle granulomas

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21
Q

Most common site for tuberculosis reactivation

A

Pulmonary tb

22
Q

Clinical symptoms of pulmonary tb

A

Chronic low grade fever, night sweats, weight loss, productive cough that may have blood

23
Q

Describe pleural and pericardial TB infections

A

Fluid collection around the lungs or heart

24
Q

Most common extra pulmonary tb infection

A

Lymph node infection, called scrofula

25
Q

Another name for secondary TB if kidneys

A

Sterile pyuria

26
Q

What is the disease causes by secondary TB in the skeleton?

A

Pott’s disease

27
Q

How can secondary TB impact the joints?

A

Chronic arthritis in 1 joint

28
Q

How can secondary TB effect the CNS

A

Meningitis and granulomas of the brain

29
Q

Form of secondary TB, usually in children and elderly, where tiny
Millet seed shaped tubercles (granulomas) are disseminated all over the body

A

Military tuberculosis

30
Q

What are the diagnostic test for tb?

A

Chest x-ray
Sputum acid fast stain and culture
Rapid molecular detection

31
Q

Describe resistance in MDR-TB

A

Resistant to isoniazid and rifampin

32
Q

What is the resistance in XDR-TB

A

Resistant to isoniazid and rifampin, a fluoroquinolone, and an injectable agent (like and aminoglycosides)

33
Q

Basic description mycobacterium leprae

A

Acid fast rod
Impossible to feel on artificial media

34
Q

Transmission of mycobacterium leprae

A

Respiratory secretion or skin lessions, unknown why certain people are susceptible

35
Q

Types of leprosy based on severity

A

Lepromatous leprosy (most severe)
Tuberculosis leprosy
Borderline leprosy

36
Q

Expansive group of acid fast organisms that are ubiquitous in the soil and water

A

Nontuberculosis mycobacteria (NTM)

37
Q

Opportunistic Nontuberculosos mycobacteria that is common in people with AIDS

A

Mycobacterium avium-complex (MAC)

38
Q

CD4 Cell count typically associated with mycobacterium avium complex infections

A

<50 CD4 per mm^3

39
Q

Symptoms Mycobacterium avium-complex

A

Fever
Weight loss
Diarrhea
General malaise
Increase in alkaline phosphatase in routine labs

40
Q

Organism that most commonly causes NTM lung diesase

A

Mycobacterium avium-complex

41
Q

In an immunocompromised host, what illness can mycobacterium avium complex cause?

A
  1. Upper lung cavitary disease in elderly smokers
  2. Middle and lower lung nodular and bronchial disease in middle aged female non-smokers
  3. Lymphadenitis in children
42
Q

What diseases can Mycobacterium kansasii cause?

A
  1. Upper lung cavitary disease
  2. Disseminated disease in immune compromised patients
43
Q

Diseases caused by mycobacterium abcessus

A
  1. Pulmonary disease
  2. Skin, soft tissue, and bone disease
44
Q

Diseases caused by mycobacterium fortuitum

A

Skin, soft tissue, and bone disease

45
Q

What NTM is a common lab contaminant?

A

Mycobacterium fortuitum

46
Q

What mycobacterium is associated with foot baths

A

Mycobacterium fortuitum

47
Q

What diseases does mycobacterium chelonae cause?

A
  1. Skin, soft tissue, bone disease
  2. Disseminated disease immunocompromised
  3. Keratitis associated with contact use
48
Q

What NTM is associated with fish tanks and is usually found in fresh and salt water

A

Mycobacterium marinum

49
Q

What disease does mycobacterium marinum caus

A

Fish tank granuloma

50
Q

What disease does mycobacterium ulcercans cause

A

Buruli ulcers (progressive necrotic skin ulcerations)

51
Q

This NTM is found in tropical rain forests

A

Mycobacterium ulcerans

52
Q

This species of MAC caused two outbreaks in prosthetic valve infections And disseminated infection tied to heating and cooling units in cardiac bypass procedures

A

Mycobacterium chimera

Clinical Micro (12 decks)

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