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Medicine > Infectious TB > Flashcards

Infectious TB Flashcards

1
Q

Most common and important myco

A

M tuberculosis

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2
Q

TB transmission

A

droplet nuclei

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3
Q

Higher probability of infection in

A

intimacy and duration of contact
degree of infectiousness of case
shared environment of contact

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4
Q

Most likely to transmit infection

A

Smear +
Cavitary disease
Laryngeal TB

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5
Q

Non infectious TB

A

Culture negative

Extra pulmonary TB

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6
Q

Clinical illness directly follows infection
Children and first few years of life
Severe
Non high transmissibility

A

Primary TB

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7
Q

Reactivation after bacteria has persisted for years

More infectious because of cavitation

A

Secondary TB

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8
Q 
LN
Pleura
Genitourinary tract
Bones and joint
Meninges
Peritoneum
Pericardium
A

Extrapulmo TB

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9
Q

Tb pathogenesis

A 
Microorganism inhaled by close bystander
Majority trapped in upper airway 
<10% reach alveoli
Phagocytosis by resident mac
Initiated T cell dysregulated response
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10
Q

A patient who presents with symptoms and signs of TB (radio finding) even without active sx

A

Presumptive TB

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11
Q

A patient from whom a biological specimen is positive by smear microscopy culture of GeneXpert

A

Bacteriologically confirmed case

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12
Q

Patient who does not fulfill criteria of bacteriologically confirmed TB
Dx if started on treatment

A

Clinically diagnosed TB

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13
Q

Cough at least 2 w duration
Unexplained cough of any duration with close contact of known TB case
Chest Xray findings suggesive of TB with or without symptom

A

Presumptive TB

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14
Q

Presumptive TB sc

A 
cough any duration
Weight loss
Fever
Hemoptysis
Chest pain not musculo 
Body malaise
Easy fatigability
Night sweat
Shortness of breath
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15
Q

Proper way of collecting sputum

A

Spontaneous expectoration
2 sputum specimen at least 1 tsp 5-10ml in quanitity
Same day spot-spot strategy using 2 consec specimens collected 1 hr apart for Zirl Neelsen

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16
Q

Preferred type of microscope

A

LED

more sensitive and specific

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17
Q

DSSM +

A

if at least 1 sputum positive

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18
Q

GeneXpert requested if

A

Initial diagnostic in adult with presumptive TB
As follow on test to smear negative px but with chest xray finding suggestive
An initial dx test for presumptive drug resistant case

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19
Q

Gold standard for dx

A

TB culture

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20
Q

Culture if

A

Retreatment
Treatment failure
Known drug resistant

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21
Q

Patient never been treated for TB or has taken anti TB drug for less than 1 month

A

New case

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22
Q

Prophylactic tx

A

Isoniazid

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23
Q

Previously treated, declared cured or tx complete at end of most recent course but now dx with recurrent episode of TB

A

Relapse

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24
Q

Previously tx but declared failed to tx

A

Treatment failure

25
Q

Previously tx declared lost to follow up at end of most recent course

A

Tx after lost to ff up

26
Q

New pulmonary tb
New miliary tb
New EPTB except CNS bones or joint

A

Category I

2HRZE/4HR

27
Q

CNS TB, TB of bone and joint

A

Class Ia

2HRZE/10HR

28
Q

Retreatment of Rif susceptible PTB and EPTB except CNS/bones/joint

A

Category II

2HRZES/1HRZE/5HRE

29
Q

Retreatment of rif susceptible CNS, bones or joint

A

Category IIa

2HRZE/1HRZE/9HRE

30
Q

Pyrodoxine deficiency

A

Isoniazid

31
Q

Rifampin

A

Urine discoloration

32
Q

Pyrazinamide

A

Hepatotoxicity

Hyperuricemia

33
Q

Ethambutol

A

Optic neuritis

34
Q

Streptomycin

A

Ototoxicity

35
Q

Repeat DSSM

A

clinically dx and baceriologically confirmed with first line

At least 1 smear at end of 2 months
Repeat after 3rd month if positive at 2nd month

36
Q

Considered non infectious if

A

Bac confirmed no resistance rf

14d doses of tx with sputum conversion and clinical improvement

37
Q

If clinically dx and no risk factor for drug resistance, px is non infectious after

A

5 daily doses with clinical improvement

38
Q

anti TB drug that does not cause hepatitis

A

ethambutol

39
Q

Isoniazid causes

A

Hepatitis

Peripheral neuropathy

40
Q

Rifampicin can cause

A

Hepatitis
Asymptomatic jaundicr
Red stained urine

41
Q

TST is + (latent) in low risk if tr size is

A

> /= 15 mm

42
Q

TST + in >/= 5mm if

A

HIV
Recent contact
Organ transplant
Immunosupressed

43
Q

TST is read after

A

48-72 hours

Read induration and transverse diameter

44
Q

Most common extrapulmonary tb site

on the

A

lymph nodes

cervical area
scrofula

45
Q

Mc site of primary TB in children

A

mid, lower part of upper lobe, apex of lower lobe

46
Q

Most common site in secondary

A

Apex

47
Q

Caseaous necrosis is caused by

A

phosphatide

48
Q

Caseous necrosis virulence factor

A

cord factor

trehalose dimycolate

49
Q

How long is treatment of Category Ia

A

1 year

50
Q

Category Ia tx

A

2HRZE/10HR

51
Q

1 - 1.5cm gray white inflammatory consolidation with center undergoing caseous necrosis

nodal + parenchymal lesion =

A

Ghon focus

Ghon complex

52
Q

Radiologically detectable calcification of fibrotic ghon complex

A

Ranke complex

53
Q

Lack of tissue hypersensitivity reaction results in

A

absence of caseating granuloma

54
Q

Secondary TB is characteristic of

A

sputum prod

apical cavitation

55
Q

Initial bacterial exposure with resistance and hypersensitivity (+ tuberculin skin test)

A

Primary TB

56
Q

Crucial role in cell mediated immunity against mycobateria

Mediator of inflamm and bacterial containment:

A

CD4 of THI subset

IFN-y, TNF, NO

57
Q

In disseminated MAC, tissue exam reveal

A

foamy histiocyte stuffed with atypical mycobateria

58
Q

Most useful for rapid confirmation of TB in persons with AFB - status

A

NAAT

59
Q

Ethambutol MOA

A

inhibits synthesis of arabinogylcan subunit

Medicine (29 decks)

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