Micro - TB

Question 1

What are the cell walls made of?

Answer 1

Mycolid acid

Gram stain doesn’t work on myco

Question 2

What tests can you use?

Answer 2

Acid Fast - will appear bright red

Question 3

Invasion of bronchial tree, past history of bronchiectasis or cavities

Answer 3

Mycobacterium avium intracellulare

Rx: Clari, Rif, Etham +- amikacin

Question 4

Swimming pool granuloma

Answer 4

Mycobacterium marinum

marine - swimming pool - marinum

Question 5

Skin lesions, ulcerations

Bairnsdale, buruli

Answer 5

Mycobacterium ulcerans

Question 6

Skin and soft tissue infection in hospital setting e.g. vascular catheters and other devices

Hospital!

Answer 6

Mycobacterium abscessus
M. chelonae
M. fortuitum

Question 7

Causes leprosy

Answer 7

Mycobacterium leprae

Question 8

Initial Ix?

Answer 8

CXR - caseating granulomas
Smear test x 3 - Acid fast
Culture - GOLD standard but takes 6 weeks

Bronchoscopy or biopsy if not getting a culture

Question 9

Drug regime for TB

Answer 9

Rifampicin (6 months)

Raised transaminases
Induces cytochrome P450
Orange secretions

Isoniazid (6 months)

Peripheral neuropathy (give pyridoxine 10mg OD) 
Hepatotoxic 

Pyrazinamide (2 months)
Hepatotoxic

Ethambutol (2 months)
Visual disturbance

Question 10

Pott’s disease

Answer 10

Spinal TB

Question 11

What results would you see on CSF with TB meningitis?

Answer 11

HIGH protein

mixed neutrophils and lymphocytes