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Path Week 2 > Mi - TB > Flashcards

Mi - TB Flashcards

1
Q

what % of the world are infected with TB

A

33%

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2
Q

in whom is TB more common in UK

A

homeless
Big towns like London / Leicester

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3
Q

how many new cases of TB are there every year

A

10 million

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4
Q

what is the biggest risk factor of TB

A

poverty

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5
Q

why can TB cause poverty

A

stigmatised - attached to HIV
reduced QoL and working life

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6
Q

where is drug resistant TB most common

A

Russia
Asia

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7
Q

what bacteria causes most TBs

A

mycobacteria tuberculosis

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8
Q

name other bacteria that can cause TB

A

m.tuberculosis (1)
m.bovis
m.africanum
m.microti
m.canetti

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9
Q

who/what gets m.bovis TB

A

cattle / badgers

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10
Q

which mycobacteria do NOT cause TB

A

m.avium
m.chelonae
m.abscessus
m.chimaera

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11
Q

what does TB look like under microscope

A

sputum smear positive bacteria
bascillus

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12
Q

who gets m.abscesus

A

CF pts

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13
Q

who gets m.avium

A

HIV pts

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14
Q

who gets m.chimaera

A

vascular bypass device pts

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15
Q

what does m.chelonae cause

A

ulcerating, crusting skin lesion

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16
Q

how is TB spread

A

via droplet nuclei in the air (aerosol)

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17
Q

what 4 factors does the probability that TB will get transmitted depend on

A

infectiousness of person with TB
environment in which exposure occured
length of exposure
virulence of tubercle bacilli

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18
Q

what is the best way to stop transmission

A

isoaltion
treat infected person

19
Q

what lifetime % of TB infected people go on to become unwell with TB

A

10%

20
Q

what lifetime % of TB infected HIV pts go on to become unwell with TB

A

30-50%

21
Q

how do you prevent latent TB becoming active

A

diagnosis + chemoprophylaxis

22
Q

Sx of TB

A

fever, weight loss, night sweats, 2-3 weeks cough

23
Q

how is latent TB infection diagnosed

A

mantoux with PPD or gamma interferon release assays (IGRA)

24
Q

what is incubation period of TB

A

3-9 months but always UNDER 2 YEARS

25
Q

are most people unwell with TB unwell do to reactivation of latent TB or reinfection?

A

exogenous reinfection

26
Q

what 4 drugs are used in Mx of TB

A

RIPE
rifampicin
isoniazid
pyrazinamide
ethambutol

27
Q

what is the drug Tx regime inc timings for TB

A

RIPE for 2 months
rifampicin and isoniazid for 4 months
(total 6 months)
daily therapy, orally

28
Q

what baseline checks are done when someone is on drug Tx for TB

A

baseline CXR, LFTs, FBC, U&Es, CRP

29
Q

when is the drug Tx regime extended in TB and to how long

A

TB meningitis
12 months Tx

30
Q

what % of TB must be eradicated in a country for that country to be TB free

A

80%

31
Q

what is the turn around time for a microscopy ZN stain for TB detection

A

30 mins

32
Q

what is the turn around time for a solid culture for TB detection

A

4-6 weeks

33
Q

which 3 countries have the highest rates of drug resistant TB

A

india
china
russia

34
Q

what factor influences the prognosis of someone with multidrug resistant TB and HIV

A

whether they get the correct drug regime or not

35
Q

how does TB become multi drug resistant

A

resistance is a natural phenomenon
poor Tx encourages resistance
selection pressures and advantages increase prevalence of the resistance

36
Q

how is drug resistant TB reduced

A

use multiple drugs to treat TB

37
Q

how can drug resistant TB be quickly diagnosed

A

molecular line probe assays using PCR

38
Q

how can whole genome sequencing be used in TB diagnosis

A

speciation - is the mycobacterium TB causing or not
relatedness - transmission and tracking
drug resistant or not

39
Q

give 4 steps in next generation sequencing for whole genome sequencing in TB

A

cultivation of pathogen
DNA extraction
library preparation
sequencing

40
Q

how much more expensive is it to treat multi drug resistant vs drug sensitive TB

A

10x more

41
Q

what % of mutli drug resistance TB can be predicted by WGS

A

90%

42
Q

what is the gene for rifampicin resistance

A

RPOB

43
Q

what is the efficacy of BCG vaccine

A

70%

Path Week 2 (18 decks)

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