Clinical Cases

Question 1

Student tested positive for TB. After screening school, 162 found to have “latent” TB. Short course treatment was used. –Why did so many people get it?

Answer 1

AIRBORNE DISEASE! 
1/3 of people with one class had TB
1/2 of people with 1+ class had TB

Question 2

Preferred way to confirm detection of M. TB

Answer 2

PCR

Question 3

Latent TB diagnosis. Is treatment needed?

Answer 3

Positive skin/blood test without symptoms.

YES TREAT IT! Needs to be treated with Isoniazid for 9 months OR Rifampin for 4 months.

Question 4

Chest x-ray with pulmonary cavity=

Answer 4

TB- dark hollow spot (caseum that dies)

Question 5

Positive TB sputum smear=

Answer 5

advanced TB- must have had it for a while

Question 6

Can you spread latent TB?

Answer 6

No. So, you can’t force treatment. Guess all the other students are SOL if it comes out of latency (can happen spontaneously)

Question 7

What aren’t good treatments for mycobacterium tb?

Answer 7

Beta lactams. Myco TB has beta lactamase blaC

Question 8

Give 3 virulence factors for mycoplasma

Answer 8

proline rich protein= specific for lung epithelial cells
Protein M= prevents antigen/antibody recognition
Makes H202