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RES Biweekly 3 > Fouty- Latent TB infections > Flashcards

Fouty- Latent TB infections Flashcards

1
Q
A

acid fast bacilli (mycobacteria)

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2
Q

Robert ____ developed Tuberculin in 1890

A

Koch

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3
Q

_____ testing of cows and pasteurization of milk eliminated bovine transmission of TB

A

tuberculin

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4
Q

precipitated protein fraction from a single strain of human tubercle bacillus; purified and potent; non-sensitizing

A

PPD test

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5
Q

high strength PPD increases _____ positive rate

A

false

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6
Q

main symptoms of active TB

A

coughing and night sweats

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7
Q

if patient has a reaction to PPD test, what does it mean

A

they have been exposed to tuberculosis before

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8
Q

Tools required for chemoprophylaxis of TB

A

skin test
chest x-ray
meds

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9
Q
A

unable to control initial infection

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10
Q
A

controlled infection to some degree

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11
Q

what factors of TB bacilli contribute to primary infection

A

amount and how strong (virulence)

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12
Q

____ indicates they have activated adaptive immune response and have T cells that will react to the proteins in PPD

A

+ PPD

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13
Q

travels to tissue and lymph nodes and dissemination
continued replication in non active monocytes
onset of cell-mediated immunity and delayed type hypersensitivity

A

MTB

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14
Q

location of primary calcified foci

A

lower lobes

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15
Q

location of re-infection tuberculosis

A

upper lobes

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16
Q

cavitary TB location

A

upper and lower lobes

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17
Q

______ occurs while CMI/DTH controls initial infection

A

dissemination

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18
Q

____disease progresses while primary foci is controlled

A

distal

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19
Q

infection
logarithmic growth
cell mediated immune response
primary complex controlled (dormant)
bacillemia

A

active TB

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20
Q

TB alive but controlled (through granulomas)

A

dormant

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21
Q

what can cause reactivation of TB in patient

A

medications for Crohn’s, HIV, cancer (suppresses immune system)

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22
Q

breakdown of _____ due to decreased immune response and cavitary pulmonary TB in upper lobes forms

A

granulomas

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23
Q
A

cavitary TB (reactivation)

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24
Q

most common reactivation spot for TB

A

RUL

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25
Q

how to control TB

A

find infected patients and treat them and isolate them

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26
Q

HIV infected or at risk
close contacts of newly diagnosed tuberculosis
fibrotic lesions on CXR c/w old healed TB
what is considered + PPD test

A

> /= 5mm induration

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27
Q

what is considered a + PPD test

A

> /= 10 mm induration

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28
Q

low risk groups
what is considered a + PPD test

A

> /= 15 mm

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29
Q

_____ groups should not be skin tested

A

low risk groups

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30
Q

Does the skin test represent a true Tuberculosis Infection?
Infected without clinical symptoms and with negative cultures

A

latent disease

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31
Q

What is the risk of progressing to Tuberculosis Disease?
Infected with clinical symptoms with positive cultures

A

active disease

32
Q
A

no treatment (low risk, <15 mm)

33
Q

along with IBD and Rheumatoid arthritis; increase likelihood of what

A

increase likelihood that TB infection will become TB disease

34
Q

2 things to consider when asking “does the skin test represent a true TB infection”

A

size of induration
risk of exposure

35
Q
A

treatment (high risk due to exposure; >5 mm)

36
Q
A

treat (high risk of exposure; >5 and 10 mm) she’s a recent converter

37
Q

when is the risk of developing TB disease after infection with MTB the highest

A

within the first 2 years after infection

38
Q

Highest TB outbreak ever reported in the world

Prevalence was so high everyone was infected

A

Bethel, Alaska

39
Q

____ decreased progression to TB disease

A

Isoniazid (INH)

40
Q

goal when there is a +PPD test:

A

decrease risk of developing TB disease

41
Q
A

treatment (came from high prevalence country and >10 mm)

42
Q

_____ have the same rate of progression to TB disease as that of their native country for the first 5 years

A

immigrants

43
Q

high-risk _____ treated with chemoprophylaxis if in US less than 5 years

A

immigrants

44
Q
A

treat (exposure and >10mm; but low risk of developing TB disease)

45
Q

after 5 years, the TB disease rate of immigrants is similar to TB infected US citizens which is what

A

within 2 years

46
Q

age with an increased risk for INH-induced hepatitis

A

50-64

47
Q

risk of INH-induced hepatitis increases with _____ therapy

A

longer

48
Q

Immigrants from high-risk countries treated if in US less than ____ years.

A

5

49
Q

Immigrants from high-risk countries in US greater than _____ years are only treated if another risk is present

A

5

50
Q

treat or not

A

treat

51
Q

A lot of _____ in patients with previous TB infection went on to develop active TB even though they were culture negative at time you screened them

A

scarring

52
Q
A

calcified granuloma (Ghon focus)

53
Q

granuloma + ipsilateral calcified lymph node

A

Ranke Complex

54
Q
A

RUL (treat)

55
Q

treat patient with _____ lesions to decrease progression to TB disease

A

fibrotic

56
Q
A
  1. no treatment
  2. treat
  3. treat
57
Q

what to do if children have been exposed but PPD test is pending

A

treat until get results back

58
Q
A

treat (regardless of BCG status)

59
Q

Most non-infected people vaccinated with BCG are PPD ____

A

negative

60
Q

attenuated but live strain of M.bovis
used to prevent TB disease in developing countries

A

BCG vaccine

61
Q

used in the US
determines if person has been exposed to TB
measures ____ release from sensitized T cells in patient’s blood

A

IFNgamma (assay)

62
Q

If the T cells have never seen TB antigens before they won’t release _____

A

IFNgamma

63
Q

does a negative PPD or IFNgamma assay rule out TB

A

NO

64
Q

goal of PPD and IFNgamma assay

A

to identify patients infected w/ mycobacterium tuberculosis

65
Q

inhale it and itrs trouble from the beginning (active TB)
initial infection replicates and replicates
no granulomas, no control (no activation of adaptive immune response)
happens in children and immunocompromised patients
die 2 months later

A

primary disease

66
Q

granulomas present but no active TB disease

A

latent TB infection

67
Q

re-activation of TB due to immune system being repressed

A

TB disease

68
Q

important test to determine if someone has TB

A

chest x-ray

69
Q

don’t test low risk individuals unless what

A

they are going into high-risk environment

70
Q

if TB infected (+PPD or IFNgamma), make sure they do not have TB disease (active disease) by

A

asking about sx’s
CXR
sputum

71
Q

The worst thing you can do is treat a patient for TB Infection if they have _____

A

TB disease (active disease)

72
Q
A

treat for TB infection

73
Q

approved treatment regimens for TB infection

A

Isoniazid + Rifampin for 3 months

74
Q

Don’t repeat ____ if they already have +PPD test

A

skin test

75
Q

only do CXR if patient has what

A

symptoms

RES Biweekly 3 (11 decks)

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