Acid Fast diseases

Question 1

Acid fast stain steps

Answer 1

1) Carbolfuschin and heat
2) strong decolorizer acid
3) blue counterstain

Question 2

3 phases of TB

Answer 2

Primary - active symptoms, abnormal chest x ray and positive sputum smear, middle loung
Latent - no symptoms not contageous, positive PPD read
Reactivated - macrophages housing mycobacterium as reservoir allow for reactivation, immunocompetent low chance of reactivation, seen in upper lobes

Question 3

Primary TB is seen in the ___ lobe but reactivated in the ____

Answer 3

Middle lung, upper lung

Question 4

Miliary Tb

Answer 4

Widespread Tb that looks like a snowstorm on the x ray

Question 5

Mycobacterium tuberculosis

Answer 5

Aerobic slow growing acid fast, resistance to common antibiotics, intracellular growth within macrophages

Question 6

Langhans giant cells

Answer 6

recruited by macrophages in the lungs to engulf Tb and form a necrotic mass

Question 7

Ghon lesion

Answer 7

Necrotic mass of Tb, macrophages, and langhans giant cells on the lung tissue

Question 8

Ghon complex

Answer 8

Presence of a ghon lesion with lymphoadenopathy on the same side

Question 9

Ranke complex

Answer 9

Presence of a ghon lesion that has been calcified with lymphoadenopathy on same side

Question 10

TB transmission

Answer 10

Tiny droplets from one with active TB to another individual

Question 11

TB and HIV

Answer 11

TB is most commonc cause of death in patients with AIDS, AIDS patients won’t get positive ppd even if have active TB infection

Question 12

3 types of TB

Answer 12

Pulmonary - dry cough, fever
Extrapulmonary - other organs, pott’s disease
Miliary - disseminated

Question 13

Pott’s disease

Answer 13

Skeletal muscle disorder for spinal TB where a child comes in limping with a curve like scholiosis

Question 14

TB testing

Answer 14

PPD test can screen for exposure (induration diameter NOT redness), chest x ray, 3 sputum samples , quanti-feron tests, culturing still gold standard, AFB smear - positive for all mycobacterium

Question 15

Booster phenomenon

Answer 15

In 2 step ppd if 1st test is negative but 2nd is positive

Question 16

Quanti-feron test

Answer 16

Blood test specific and sensitive for TB done in a single visit with results available in 24 hours avoiding booster effect and prior BCG vaccination, but expensive, and low data

Question 17

Active Tb treatment

Answer 17

Isolate patient until at least 2 weeks after treatment or until 3 sequential sputum speciments return negative, treat with isoniazid and rifampin

Question 18

Mycobacterium leprae

Answer 18

Hansen’s disease, spread exact same way as Tb via droplets, can treat contagiousness but not deformities, comes in 2 major forms

Question 19

Tuberculoid leprosy

Answer 19

More nervous involvement, muscle weakness, numbness in hands and feet, eventual loss of digits

Question 20

Lepromatous leprosy

Answer 20

More discolred patches of skin, growth of noduels,

Question 21

Leprosy diagnosis

Answer 21

Skin or nerve biopsies

Question 22

Leprosy treatment

Answer 22

Rifampin, Dapsone, clofazimine

Question 23

Mycobacterium avium

Answer 23

AIDS defining illness, nontuberculus mycobacteria that naturaly occur everywhere, opportunistic

Question 24

Mycobacterium avium diagnosis

Answer 24

Chest X ray, AFB staining and culture

Question 25

Mycobacterium avium treatment

Answer 25

Macrolides, multiple

Question 26

ALL mycobacterium require

Answer 26

Multi drug therapy