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CMT > Acid Fast Infections > Flashcards

Acid Fast Infections Flashcards

1
Q

what bacteria causes TB?

A

mycobacterium tuberculosis

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2
Q

what bacteria causes leprosy?

A

mycobacterium leprae

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3
Q

Tuberculosis

risk factors for infection

5 ?lifestyle? things

A
  • household exposure
  • crowded housing (prison, immigration)
  • drug use
  • travel to/from endemic area
  • homelessness
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4
Q

Tuberculosis

conditions that are risk factors for TB

5 things

A
  • DM
  • immunosuppressive conditions/meds
  • chronic renal failure
  • hematologic malignancies
  • head/neck cancer
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5
Q

Tuberculosis

what does TST mean?

A

TB skin test

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6
Q

Tuberculosis

what does PPD mean? what type of test is it?

A
  • puriified protein derivative
  • TST
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7
Q

Tuberculosis

what is LTBI

A

latent TB infection

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8
Q

Tuberculosis

what is active TB?

A

when sx occur

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9
Q

Tuberculosis

what is reactivation TB

A

Active TB after LTBI

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10
Q

Tuberculosis

who is considered positive with induration >/= 5 mm

A
  • HIV infection/immunosuppressed pts
  • close contact to active case
  • those with abnormal CXR
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11
Q

Tuberculosis

who is considered TST positive with induration >/= 10mm?

A
  • children younger than 4 y/o
  • Immigrants from countries w/ high incidence
  • residents/employees of high risk settings (prisons, healthcare facilites, homeless shelters)
  • person’s w/ conditions that increase risk of reactivation
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12
Q

Tuberculosis

who is positive with induration >/= 15mm?

A
  • healthy individuals age 4 yrs and older with low likelihood of TB infection
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13
Q

Tuberculosis

pathophys

4 steps

A
  1. inhalation of droplets
  2. bacteria travels to alveoli
  3. infection established if bacilli are not killed by alveolar macrophages
  4. CMI kicks in and T-cells and macrophages surround TB in granuloma (LTBI)
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14
Q

Tuberculosis

Signs & Sx

Constitutional (5), resp (3)

A
  • malaise
  • anorexia
  • unintentional wt loss
  • fever
  • night sweats
  • chronic, productive cough
  • blood-streaked sputum
  • dyspnea (unusual unless severe infection)
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15
Q

Tuberculosis

what is likelihood of extra-pulm TB?

A

20%
can occur anywhere

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16
Q

Tuberculosis

what is Pott’s Disease?

A

TB of the vertebrae

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17
Q

Tuberculosis

What is scrofula

A

TB lymphadenitis of cervical region (think dracula biting neck)

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18
Q

Tuberculosis

difference in CXR between primary & reactivation TB

A
  • primary: middle/lower lobe opacities
  • reactivation: opacities in apices
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19
Q

Tuberculosis

what is a gohn focus?

A

calcified granuloma

20
Q

Tuberculosis

what is a ghon complex?

A

ghon focus + enlarged/calcified hilar nodes

21
Q

Tuberculosis

why should you be cautious with CXR/chest CT?

A
  • they are non-specific to TB
22
Q

Tuberculosis

Describe cavitary lesions

what occurs, how tb spreads to others, how it spreads internally

A
  • necrosis progresses to wall of airway and liquid necrotic material is discharged into bronchial tree
  • this is then coughed up to infect others
  • if swallowed, you could have GI infection
23
Q

Tuberculosis

describe miliary TB

A

massive dissemination of tuberculosis in lungs- many tiny widespread nodules

24
Q

Tuberculosis

Dx

NOT SCREENING

A
  • Sputum AFB smear or NAAT (3 consec samples)
  • Sputum culture
25
Q

Tuberculosis

Screening tests for LTBI

A
  • TST/PPD (skin test, measure induation)
  • IGRA (blood test)
26
Q

Tuberculosis

which screening test will be positive in pts with hx of BCG vaccination?

A

TST/PPD

27
Q

Tuberculosis

who should be screened for TB?

A
  • close contacts of sx pts
  • immigrants from endemic areas
  • those in high risk (crowded) settings
28
Q

Tuberculosis

what don’t screening tests tell us?

A

active vs latent infection

29
Q

Tuberculosis

Managing active TB cases

measures to follow

A
  • pt in negative pressure room
  • pt isolated until 2-3 neg sputum smears/cultures
  • public health involvement
30
Q

Tuberculosis

Tx for active infection

A
  • Rifampin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol
31
Q

Tuberculosis

side effects to remember for tx meds

A
  • Rifampin: red/orange secretions
  • Isoniazid: peripheral neuropathy
  • Pyrazinamide: uric acid stones, photosensitivity
  • Ethambutol: optic neuritis
32
Q

Tuberculosis

which med requires you to supplement B6?

A

isoniazid

33
Q

Tuberculosis

Tx for LTBI

A
  • Rifampin
  • Isoniazid
34
Q

Leprosy

Pathophys

A
  1. preferentially attacks Schwann cells
  2. leads to nerve demyelination
35
Q

Leprosy

Sx

9 sx/signs

A
  1. pale/pink patches of skin
  2. formication (feeling of insects crawling on skin)
  3. erythema patches w/ sensory loss
  4. deformity
  5. paralysis
  6. edema
  7. skin ulceration
  8. muscle weakness
  9. poor eyesight
36
Q

Leprosy

define paucibacillary

A

fiver or fewer poorly pigmented, numb skin patches

37
Q

Leprosy

define multibacillary

A

more than five poorly pigmented, numb skin patches

38
Q

Leprosy

complications

damage to what systems?

A
  1. nerve damage
  2. skin damage
  3. eye damage
  4. resp tract damage
39
Q

Leprosy

Dx

A

AFB identified in skin biopsy

40
Q

Leprosy

Tx for paucibacilliary vs multibacillary

A
  • paucibacilliary: dapsone, rifampicin, clofazimine (6 mo)
  • multibacillary: dapsone, rifampicin, clofazimine (12 mo)
41
Q

NTM

most common cause

A

MAC

42
Q

NTM

who is at risk?

A

immunodeficient pts

43
Q

NTM

signs/sx

6

A
  • chronic/productive cough (+/-) blood tinged sputum
  • fatigue
  • malaise
  • dyspnea
  • fever
  • unintentional wt loss
44
Q

NTM

findings on chest imaging

A
  • nodules, cavities, bronchiectasis
45
Q

NTM

components of dx

3 things

A
  1. clinical compatible sx
  2. lung abnormalities on imaging
  3. Mycobacterium spp isolated from specimen
46
Q

NTM

pos result criteria for sputum cultures vs bronchial washings

A
  • sputum cultures: 2+ pos results
  • bronchial washings: 1 pos result
47
Q

NTM

tx

A
  1. macrolide
  2. rifampin
  3. ethambutol

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