B3.025 - Tuberculosis and Anxiety Disorder Flashcards
Describe mycobacterium TB generally
an acid fast obligate aerobic rod
Whats the difference between primary and secondary TB
Primary - occurs in previously unexposed hosts
Secondary - occurs by reactivated infection due to immunosuppression
What is the most common type of infection of TB
Latent
What is What does the cell wall of M.Tub contain that is . a virulence factor
Mycolic acid
What is cord factor
inhibits macrophage maturation and induces release of TNF alpha
what do sulfatides do
inhibit phagolysosomal fusion
how is TB transmitted
inhalation of droplet nuclei (airborne particles)
When does clinical disease due to M. Tub occur
during immunosuppression
Wha are high risk settings for acquiring M. Tub
Prisons
Hospitals
Homeless shelters
How do patients with TB typically present
Cough for longer than 3 weeks Night sweats/chills Fever Weight loss Hemoptysis
What is the most common extra pulmonary manifestation of TB
cervical lymphadenitis aka scrofula
TB can infect the pleural and pericardial spaces causing what
pleural and pericardial effusion
What is pott disease
infection of the spine that leads to intervertebral discs and vertebral bodies
joint infection can cause what
arthritis
What is miliary TB
disseminated TB
CNS infiltration of M Tub can cause what
meningitis and formation of granulomas at base of brain
how is TB diagnoses
Ziehl-Neelison (carbol fuchsin) culture stained red with red and acid alcohol
How do you diagnose latent TB
PPD skin test, positive for life
How do you isolate M. Tub
Lowenstein-Jensen Agar
What is a Ghon focus
a granuloma located near the pleura in the middle or lower lobes of the lung; center of the Ghon undergoes caseous necrosis
what is a Ghon complex
Ghon focus and regional lymphadenopathy
What is a Ranke complex
a Ghon complex that has undergone progressive fibrosis and subsequent calcification from cell mediated immuniyy
How can you diagnose a primary TB made by CXR
a Ranke complex
What is significant about kidney infection due to TB
a sterile pyuria
What can cause a false positive PPD
BCG vaccine
When can a PPD be falsely negative
steroid use
malnutrition
immunocompromised
What is IGRA
measure IFN-gamma released from T lymphocytes exposed to M Tub antigens
Describe the normal response to MT when it inters the body
local macrophages are activated when bacillary antigens processed by macrophages stimulate T lymphocytes to release a variety of lymphokines. These activated macrophages aggregate around the lesion’s center and effectively neutralize tubercle bacilli without causing further tissue destruction.
An active TB infection is typically treated using
Active Mycobacterium tuberculosis infection is treated with RIPE therapy: Rifampin Isoniazid Pyrazinamide Ethambutol (or streptomycin)
Why is a multi drug regimen recommended
A multi-drug regimen is used to achieve the goals of tuberculosis treatment: to quickly remove active bacteria, to kill as many latent bacteria as possible, and to avoid emergence of drug-resistant strains.
How is TB spread prevented
Respirators and negative-pressure isolation rooms are used to prevent the spread of Mycobacterium tuberculosis infection in healthcare settings.
