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RES Biweekly 3 > Fouty- Mycobacteria and TB > Flashcards

Fouty- Mycobacteria and TB Flashcards

1
Q

acid fast stain for mycobacteria

A

Ziehl-Neelsen

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2
Q

India, China, Africa, Indonesia

A

highest rate of TB

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3
Q

slow growing
waxy outer coat
acid fast
aerobic bacilli

A

mycobacterium

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4
Q

part of cell wall structure that is stained with Z-N stain

A

Mycolic acid

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5
Q

mycobacteria infection in HIV patients consists of what

A

MAC (M.avium)

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6
Q

slow growing
non-pigmented

A

MTB complex

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7
Q

develop slowly and elicit a granulomatous response

A

Mycobacterial infection

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8
Q

Mycobacteria infection elicits what 2 host responses

A

delayed type hypersensitivity
cell-mediated immunity

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9
Q

host response with non-activated macrophages

A

delayed type hypersensitivity

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10
Q

host response with activated macrophages

A

cell-mediated immunity

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11
Q

human host only
most common cause of mycobacterial infection

A

M. tuberculosis

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12
Q

can be transmitted to humans by milk; basis of MTB vaccine

A

M. bovis

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13
Q

spread from person to person by aerosol

A

M. tuberculosis

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14
Q

has evolved to evade innate immune response (escapes to replicate in cytoplasm through non-activated alveolar macrophages)

A

M. tuberculosis

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15
Q

Infects tissue monocytes; widespread inflammation; get into lymph nodes and disseminate to other parts of the body

A

MTB

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16
Q

in most cases, activation of ____ immune response eventually controls initial MTB infection

A

adaptive

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17
Q

control of TB is mostly a _____ immune response

A

adaptive (Th1)

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18
Q

____ release IFNgamma that activate infected macrophages and help them kill TB bacilli

A

Th1 cell

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19
Q

_____ immune response leads to formation of granulomas that controls initial infection but rarely totally clears all infection

A

adaptive

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20
Q

Most common cause of calcified granuloma in the US

A

Histoplasmosis

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21
Q

Most common cause of calcified granuloma in the world

A

TB

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22
Q

aka calcified granuloma, indicates site of primary infection

A

Ghon Focus

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23
Q

calcified granuloma + Ipsilateral lymph node calcification

A

Ranke Complex

24
Q

Immediate clearance of inhaled MTB bacilli without activating adaptive response

A

no TB infection

25
Q

Uncontrolled Primary infection
Primary infection (active disease) seen in who

A

in children and immunocompromised

26
Q

Delayed control of infection after induction of adaptive immune response:

A

latent infection

27
Q

bilateral hilar adenopathy
HIV, children, immunocompromised

A

primary TB infection

28
Q

2 outcomes with latent TB infections

A

lifelong dormancy
reactivation

29
Q

reactivation of latent disease usually w=in what lobes of lung

A

upper lobes

30
Q

_____ disease is most contagious (due to reactivation of latent disease)

A

cavitary disease

31
Q
A

miliary tuberculosis (hematogenous spread)

32
Q

Initially infection was controlled in granuloma; then the immune response dropped for whatever reason; bacilli broke through and disseminated into blood stream

A

miliary TB

33
Q

due to drop in immunity
cough and night sweats
most commonly in lungs

A

MTB reactivation

34
Q

In people co-infected with M. tuberculosis and HIV the rate they will develop tuberculosis is ____% per year.

A

10%

35
Q

diagnose latent TB infection

A

TB skin test
IFN-gamma assay

36
Q

diagnose active TB

A

positive culture
NAAT

37
Q

_____ staining can indicate presence of Mycobacterium but cannot discriminate between species

A

Zieh-Neelsen

38
Q

Rx active TB

A

Begin with 2 months of Isoniazid, ethambutol, pyrazinamide, rifampin
Followed by 4-6 months of isoniazid and rifampin

39
Q

how to treat active TB

A

watch patient take the medicine everyday

40
Q

inhibits mycolic acid synthesis; give with pyridoxine (vitamin B6)

A

Isoniazid (INH)

41
Q

inhibits RNA polymerase
SE: orange colored body fluids
induces CYP450 enzymes

A

Rifampin

42
Q

____ + oral contraceptive = baby

A

Rifampin

43
Q

inhibits transferases of cell wall
SE: retrobulbar neuritis
CI in children too young to notice vision problems

A

Ethambutol

44
Q

disrupts cell membrane metabolism and transport

A

Pyrazinamide (PZA)

45
Q

MTB drug resistance that causes problems

A

resistant to INH and Rifampin

46
Q

found in soil and water
mycobacterial disease in HIV patients
inhaled or swallowed

A

M. avium complex (MAC)

47
Q

most common mycobacterial disease in AIDS patients in the US

A

MAC

48
Q

Recommended treatment regimen: clarithromycin or azithromycin combined with ethambutol and rifampin

A

MAC

49
Q

Slowly evolving cavitary disease that resembles tuberculosis on chest radiography

A

MAC pulmonary disease

50
Q

observed in elderly, female non-smokers
chronic cough, shortness of breath, fatigue and other less specific symptoms
lingular or middle lobe infiltrates with a patchy, nodular appearance on radiography and associated bronchiectasis (chronically dilated bronchi)

A

Lady Windermere syndrome (MAC pulmonary disease)

51
Q

formation of a solitary pulmonary nodule

A

MAC pulmonary disease

52
Q

can sometimes clear on its own
+ PPD test may result from this infection

A

M. kansasii

53
Q

____ and ____ are critical in controlling TB infection

A

Th1 CD4 cells and INF gamma

54
Q

main risk factor for TB

A

immunocompromised

55
Q

main thing to remember to treat TB

A

multiple drugs for a prolonged period of time

RES Biweekly 3 (11 decks)

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