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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
# Tuberculosis Screening tests for LTBI
* TST/PPD (skin test, measure induation) * IGRA (blood test)
26
# Tuberculosis which screening test will be positive in pts with hx of BCG vaccination?
TST/PPD
27
# Tuberculosis who should be screened for TB?
* close contacts of sx pts * immigrants from endemic areas * those in high risk (crowded) settings
28
# Tuberculosis what don't screening tests tell us?
active vs latent infection
29
# Tuberculosis Managing active TB cases | measures to follow
* pt in negative pressure room * pt isolated until 2-3 neg sputum smears/cultures * public health involvement
30
# Tuberculosis Tx for active infection
* Rifampin * Isoniazid * Pyrazinamide * Ethambutol
31
# Tuberculosis side effects to remember for tx meds
* Rifampin: red/orange secretions * Isoniazid: peripheral neuropathy * Pyrazinamide: uric acid stones, photosensitivity * Ethambutol: optic neuritis
32
# Tuberculosis which med requires you to supplement B6?
isoniazid
33
# Tuberculosis Tx for LTBI
* Rifampin * Isoniazid
34
# Leprosy Pathophys
1. preferentially attacks Schwann cells 2. leads to nerve demyelination
35
# Leprosy Sx | 9 sx/signs
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
# Leprosy define paucibacillary
fiver or fewer poorly pigmented, numb skin patches
37
# Leprosy define multibacillary
more than five poorly pigmented, numb skin patches
38
# Leprosy complications | damage to what systems?
1. nerve damage 2. skin damage 3. eye damage 4. resp tract damage
39
# Leprosy Dx
AFB identified in skin biopsy
40
# Leprosy Tx for paucibacilliary vs multibacillary
* paucibacilliary: dapsone, rifampicin, clofazimine (6 mo) * multibacillary: dapsone, rifampicin, clofazimine (12 mo)
41
# NTM most common cause
MAC
42
# NTM who is at risk?
immunodeficient pts
43
# NTM signs/sx | 6
* chronic/productive cough (+/-) blood tinged sputum * fatigue * malaise * dyspnea * fever * unintentional wt loss
44
# NTM findings on chest imaging
* nodules, cavities, bronchiectasis
45
# NTM components of dx | 3 things
1. clinical compatible sx 2. lung abnormalities on imaging 3. *Mycobacterium* spp isolated from specimen
46
# NTM pos result criteria for sputum cultures vs bronchial washings
* sputum cultures: 2+ pos results * bronchial washings: 1 pos result
47
# NTM tx
1. macrolide 2. rifampin 3. ethambutol

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