Med Micro: TB

Question 1

What is the 2 common causes of TB

Answer 1

Mycobacterium tuberculosis complex
Mycobacterium bovis

Question 2

What is the appearance of the bacilli

Answer 2

Immobile & slow growing aerobic bacilli

Question 3

What is characteristic about TB

Answer 3

It is acid fast due to thick mycolic & lipoarabinomannan
Resistant to change in color

Question 4

What is the function of the cell wall in TB

Answer 4

Virulence factor & immune evasion

Question 5

How is TB transmitted

Answer 5

Airdroplets

Question 6

What is the epidemiological triad of TB

Answer 6

Host: immunocompromised
Agent: TB
Environment: low SES & overcrowded

Question 7

What is the pathogenesis of TB

Answer 7

Diagram

Question 8

What is the 4 classifications of TB

Answer 8

Latent vs active
Primary vs secondary
Lab confirmed vs not
Drug resistance vs drug susceptibility

Question 9

What is the characteristics of primary TB

Answer 9

Lower lobes of lungs & pulmonary lymphadenopathy

Question 10

What is characteristics of secondary TB

Answer 10

Upper lobes of long due to high oxygen availability causing necrosis & cavities

Question 11

What is the 4 treatment strategies for TB

Answer 11

Medication for TB & HIV
Adherence
Sputum monitoring
Treat side effects

Question 12

What is 3 non specific history clinical features

Answer 12

Fever
Night sweats
Weight loss

Question 13

What is 2 clinical feature of pulmonary TB

Answer 13

Cough longer than 2 weeks
W/ blood or sputum present

Question 14

What is the 4 most commonest sites of EPTB

Answer 14

Lymph nodes
Peritoneal
Pleural
Meningitis

Question 15

What is 4 important clinical feature during examination of TB patient

Answer 15

Muscle wasting
SOB
Enlarged lymph nodes
Not much on auscultation

Question 16

What is the 6 lab diagnostic test for TB

Answer 16

Sputum
Microscopic
Culture
Molecular diagnosis
Immunological test
EPTB

Question 17

What is the 4 types of sputum tests

Answer 17

Expectorated
Induced
Gastric washing
Tracheal aspirate

Question 18

What is the 2 types of microscopic staining

Answer 18

Ziehl-Neelsen
Auramine (fluorescent stain)

Question 19

What is the culture test names

Answer 19

MGIT

Question 20

Why is culture not done routinely for TB

Answer 20

Expensive
Long waiting period, 6 weeks
Biohazardous

Question 21

What is the 2 types of molecular testing

Answer 21

1. Gene Expert (rifampicin R)
2. BD Max & Roche (rifampicin & isoniazid R)

Question 22

When is immunological testing done for TB

Answer 22

Latent TB

Question 23

What is the 2 types of immunological testing

Answer 23

1. Interferon-gamma release says: WBC release in response to TB Ag
2. Mantoux: intradermal purified protein derivative that can have a false + if BCG vaccine

Question 24

What is the diagnostic criteria for Mantoux

Answer 24

Bigger the circle the less likelihood of infection

Question 25

What is 4 test for EPTB

Answer 25

Biopsy
Fluid
Imaging
LAM urine test

Question 26

What is non-TBM

Answer 26

Range of infection w/ similar symptoms to TB but it is not TB & not respond to treatment

Question 27

What is 2 examples of non-TBM

Answer 27

MAC
Leprosy

Question 28

What is 4 prevention strategies for TB

Answer 28

1. Improve living conditions
2. INH preventative treatment for latent or prevention for people living w/ other w/ TB
3. ARV adherence
4. BCG vaccine at birth