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BCPID Review > DS: Tuberculosis and Other Mycobacterial Infection > Flashcards

DS: Tuberculosis and Other Mycobacterial Infection Flashcards

1
Q

Risk factor for infection

A

Recent exposure to person with active TB
Lab personnel
Immigrants from high burden country
Homeless, incarcerated, institutionalized

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2
Q

Risk factor for disease

A

Child <5 years
HIV infected
Abnormal chest radiography
DM, Chronic renal failure, IVDA

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3
Q

Diagnosis of symptomatic patient

A

Chest radiograph
Sputum smear for AFB
Sputum for mycobacteria
Sputum NAAT for M. tuberculosis
Evidence of systemic M tuberculosis ifnection:
—-Interferon gamma release assay
—-TB skin test

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4
Q

Screening of Latent M. tuberculosis infection

A
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5
Q

Treatment of Latent M. tuberculosis infection

A
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6
Q

Oral Drug therapy option for pulmonary tuberculosis found to be pan susceptible

A

daily administration has higher efficacy then other regimen

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7
Q

Diagnosing Active TB

A

Acid-fast bacilli (AFB) microscopy on 3 or more specimen
Liquid +/- solid cultures of each spectrum
NAAT on initial specimen
Sputum collection:
—Expectorated sputum
—Induced sputum
—Flexible bronchscopy

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8
Q

Consideration for initial therapy for TB

A
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9
Q

Antitubercular Drugs: Isoniazid (INH)

A
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10
Q

Antitubercular Drugs: Rifampin (RIF)

A
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11
Q

Antitubercular Drugs: Pyrazinaimide (PZA)

A
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12
Q

Antitubercular Drugs: Ethambutol (EMB)

A
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13
Q

Daily and intermittent dosing of 1st line Antituberculosis drugs

A
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14
Q

Pyrazinamide Oral Dosing - Normal renal function

A
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15
Q

Ethambutol Oral dosing - Normal renal function

A
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16
Q

Antimycobacterial dosing with CrCl <30 ml/min

A
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17
Q

DDI - Rifabutin (RFB)

A
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18
Q

DDI - Isoniazide (INH )

A
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19
Q

DDI - Rifampin ( alot of DDI)

A
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20
Q

Baseline/Follow up Testing

A
21
Q

Adverse Effect from Antimycobacterial Drugs - General

A
22
Q

Adverse Effect from Antimycobacterial Drug - Specific

A
23
Q

Hepatotoxicity ffrom Antimycobacterial drugs4

A
24
Q

Handling interruption in TB therapy

A
25
Q

Duration of TB Therapy

A
26
Q

Failure of initial antitubercular therapy

A
27
Q

Treatment of other types of M. tuberculosis disease

A
28
Q

Treatment duration of extrapulmonary tuberculosis

A
29
Q

Treatment of drug -resistant tuberculosis

A
30
Q

Definition of drug resistance Tuberculosis

A
31
Q

Implication of drug resistance tuberculosis

A
32
Q

Treatment option of drug resistance by WHO
(longer duration regimen)

A
33
Q

Treatment option of drug resistance by WHO
(longer duration regimen)

A

total duration 18-20 months

15-17 months after culture conversion

Regimen containing amikacin or streptomycin, intensive phase of 6-7 months is suggested

34
Q

Treatments option of drug resistance by Steps
(ATS/CDC/ERS/IDSA)

A
35
Q

Treatment option of drug resistance by WHO
(Shorter duration regimen)

A
36
Q

Treatment option of drug resistance by WHO
(Shorter duration regimen) - CONT

A
37
Q

XDR-TB or intolerant or non responsive TB treatment

A
38
Q

Treatment of isonazid-resistant TB

A

Add moxifloxacin or levaquin to daily riifampin, pyrazinamide and ethambutol

Pyrazinamide may be shortened to 2 months if
- Non cavitary disease, lower burden disease
-Pyrazinamide toxicity

39
Q

Special consideration for drugs to treat MDR TB

A
40
Q

Nontuberculosis Mycobacteria (NTM)

A

rapidly and slowly growing strains
most infection are asymptomatics and /or self limited in nature

Risks for infection:
- Direct inoculation/inhalation
- Compromised immune status (lymphopenia, genetic andiatrogenic supression of interferon gamma, tumor necrosis factor alpha or IL12

41
Q

Nontuberculosis Mycobacteria (NTM) : Rapid growers vs. Slow growers

A
42
Q

Spectrum of disease due to nonTB mycobacteria (NTM)

A
43
Q

Diagnostic work up for NTM

A
44
Q

Treatment infection due to mycobacterium avium

A
45
Q

Mycobacterium Kansasli.

A
46
Q

Mycobacterium Abscessus Treatment

A
47
Q

Mycobacterium Abscessus

A
48
Q

Mycobacterium Ulcerans

A
49
Q

Special consideration for drugs used to treat NTM

A

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