Anti-mycobacterial agents

Question 1

for mycobacteria and Norcardia what type of stain is used

Answer 1

Acid-fast stain

Question 2

T/F: Mycobacteria and Norcardia grow extremely slowly

Answer 2

True

Question 3

What are the two mycobacteria that cause tuberculosis

Answer 3

M. tuberculosis and M. abscessuss (animals)

Question 4

What symptoms that would raise suspicion that someone may have tuberculosis

Answer 4

coughing up blood and cough persists for weeks,

Question 5

How long is latent and active TB treated

Answer 5

6 months

Question 6

What drugs are multi drug resistant TB resistant to, what drugs are extensively drug resistant TB resistant to

Answer 6

isoniazid and rifampin/ isoniazid, rifampin, floriquinolones, and injectables

Question 7

T/F: Places with higher rates of HIV can be associated with higher rates of tuberculosis

Answer 7

True

Question 8

What are characteristics mycobacterium tuberculosis

Answer 8

Complex cell wall, aerobic/ anaerobic, intracellular/extracellular, resistant to many common antibiotics, no environmental reservoir

Question 9

T/F: M. Tuberculosis is gram negative

Answer 9

False: M. Tuberculosis is neither gram positive or gram negative

Question 10

What are the components of the cell wall for M. tuberculosis

Answer 10

small peptidoglycan component, polysacchride reigon made up of rabinose and galactose, long mycolic acid capped off with Trehatose (a sugar)

Question 11

What is the first line of defense that M. tuberculosis will encounter, what occurs

Answer 11

Macrophages, M. tuberculosis is engulfed but does not die leading to a gathering of defensive cells

Question 12

What is a granuloma

Answer 12

Defensive tissue formed by M. tuberculosis, has a core of infected macrophages covered by other immune systems, macrophages die and the bacteria survive and are dormant but may be reactivated

Question 13

T/F: Latent Tuberculosis infections are new to the patient and do lead to a large amount of symptoms

Answer 13

False: Latent tubeculosis infections are present before they become latent, they are asymptomatic, the only was to know is by taking a purified protein derivative test

Question 14

How often does latent tuberculosis become active tuberculosis

Answer 14

10% of the time

Question 15

What are the two tests to find out whether a patient has tuberculosis

Answer 15

Tuberculin Skin Test and Quantiferon

Question 16

What is the most specific way to know if a patient has tuberculosis

Answer 16

Quantiferon test

Question 17

What is the advantage of a quantiferon test over a tuberculin skin test

Answer 17

Results are available after 24 hours while the tuberculin skin test requires a 48 hour follow up

Question 18

What is the machine that is used to test TB, what are its advantages

Answer 18

Xpert MTB/RIF, takes 2 hours and tells whether the TB is resistant to rifampin

Question 19

What are the two phases for treatment months of TB that is drug sensitive, how long are they

Answer 19

Intensive phase/two months daily, Continuation phase/ four months daily

Question 20

What drugs are given during the intensive phase

Answer 20

Rifampin, isoniazid, pyrazinamide, ethambutol

Question 21

What drugs are given during the continuation phase

Answer 21

isoniazid and rifampin

Question 22

What drugs are used to kill dormant TB

Answer 22

pyrazinamide (acid enviornment only), rifampin

Question 23

How does M. TB become drug resistant

Answer 23

Spontaneous mutations

Question 24

What are the ways spontaneous mutations aid TB in drug resistance

Answer 24

Change the target of the drug, change the amount of the drug, change enzymes that activate the drug, changing how long drug is in cell or exited, mutations change mutation rate

Question 25

T/F: TB can be treated with a single drug

Answer 25

False: TB should always be with at least a three drug regimen

Question 26

What is the best way to prevent development of drug resistance

Answer 26

Directly Observed Therapy Short-course (DOTS/ drug compliance)

Question 27

T/F: Never add 1 drug to a failing regimen

Answer 27

True

Question 28

T/F: Best practice is to get a drug susceptibilty test before starting a regimen in order to know exactly what will work

Answer 28

True