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micro 5 Flashcards

1
Q

charact of mycobacteria

A

aerobic
non spore
immotile
gram positive

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2
Q

what does mycobacteria have in its cell wall

A

hydrophobic material (mycolic acid)

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3
Q

hydrophobicity gives mycobacteria what charac

A

slow grower
chronic disease
resist drugs
resist decolorization

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4
Q

mycobacteria classified into

A

m.tb complex
m.leprae
non tuberculous mycobacteria (NTM) : stypical mycobacteria

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5
Q

MAC : m.avium and m.intracellular what group

A

type 3 slow grower

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6
Q

classification of NTM

A

Slow grower and rapid grower on lowenstein jensen (LJ)

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7
Q

slow grower classified according to ability to produce yellow carotenoid pigment what are the types

A

type 1 : photochromogens (only in light)
type 2 : scotochromogens (dark and light)
type 3 : nonchromogens

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8
Q

progression of TB depend on

A

balance between virulence and immune system

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9
Q

virulence factors of mycobacteria

A

catabolism of oxidants

prevent phagolysosome fusion

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10
Q

immune system factors against TB

A

IL-12 : TH1 diffrentiation that secrete interferon gamma
IFN gamma: enhance phagolysosome fusion
TNF alpha: reactive nitrogen species (RNS)

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11
Q

In response to TB infection what type of sensitivity develops

A

delayed type HS (DTH)
epitheloid cells that enhance secreting
langhans giant cells enhanced phagocytic activity

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12
Q

two possible outcomes when bacilli attacked by immune system

A

immediate eradication

development of specific immunity

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13
Q

immediate eradication what happens

A

bacteria eliminated by innate immune system (macrophages)

body not sensitized to bacteria

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14
Q

specific immunity what happens

A

DTH in regional LN (ghon focus)

ghon focus and LN its called ghon complex or primary complex this is called primary TB

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15
Q

Outcomes of primary tb

A

progressive primary tb

latent tb

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16
Q

progressive primary tb

A

host immune response is weak leading to active disease
pneumonia like ( middle and lower lobe with LAP hilar and pleural effusion)
segmental tb
hemorragic
obstruction
bacteremia

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17
Q

latent tb

A

host immune response is strong to keep microbe in dormant

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18
Q

when there is a resume in microbial activity what is it called

A

post primary or secondary

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19
Q

secondary tb

A

reactivation of old strain or reinfection with new one

20
Q

features of secondary tb / open tb

A

in apex
fibrosis and cavitation
aspergilloma

21
Q

distant spread in secondary TB occurs through

A

tracheobronchial tree
pulmonary vein : systemic miliary tb
pulmonary artery ; ;localized pulmonary miliary tb
lymphatic system ; diffuse pulmonary miliary tb

22
Q

immunodiagnosis of tb

A

tuberculin skin test

in vitro interferon gamma assay (IGRA) : QUANTIFERON TB (GOLD)

23
Q

Microscopy for tb

A

carbol fuchsin stain : zn and kinyoun under brightfield

auramine rhodamine ; florescent microscope

24
Q

PCR for tb

A

increased sensitivity and specificity

predicts MDR

25
Q

culture of tb

A

early morning sample for 3 consecutive days
decontamination by an alkali (2% NaOH)
medium used : LJ medium or middlebrook and needs 4 weeks
liquid medium needs 2 weeks and for MODS

26
Q

FIRST LINE TB DRUG

A

Isoniazid
rifampin
ethambutol
pyrazinamide

27
Q

second line tb

A

p-aminosalicylic acid
cycloserine
aminoglycoside
capreomycin

28
Q

MDR TB

A

To isoniazid and rifampin

29
Q

XDR TB

A

MDR TB with resistance to one injectable second line and 1 floroquinolone

30
Q

treatment course phases

A

initiation and continuation

31
Q

immunoprophylaxis using what

A

BCG (m.bovis)

32
Q

immunoprophylaxis decrease risk of

A

tb meningitis and disseminated disease in children

pulmonary TB in adults

33
Q

BCG vaccine contraindicated in

A

immunocompromised

34
Q

MAC causes

A

disseminated disease in AIDS

35
Q

how is mac transmitted

A

ingestion

36
Q

mac causes what in immunocompetent

A

tb like cavitation in middle or elderly man with history of lun disease
bronchiectasis, middle lobe or lingular infiltrate in non smoker elderly women
solitary pulmonary nodule

37
Q

chemoprophylaxis for mac in HIV patients with CD4 below 50 by

A

macrolide

38
Q

rapidly growing mycobacteria (RGM) organisms

A

M. fortuitum
M.chelonae
M.abscessus

39
Q

RGM can be found on body surfaces without causing disease but can also cause chronic diseases with multiple recurrences

A

yes

40
Q

RGM can acuse

A

pulmonary infection without cavitation and multilobar or iatrogenic or opportunistic infec

41
Q

RGM treated by

A

clarithromycin

42
Q

what drug is an arabinogalactan syn inhib

A

ethambutol

43
Q

what drug is mycolic acid syn inhib

A

isoniazid

ethionamide and prothionamide

44
Q

what is the MOA of pyrazinamide

A

distrubts cell emmbrane eneergy function

45
Q

what is the MOA of rifampin

A

inhibitor on DNA dependent RNA pol

46
Q

what is a peptidoglycan syn inhib

A

cycloserine

RS (13 decks)

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