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MTB Flashcards

(56 cards)

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1
Q

gram stain morphology of MTB?

A

acid fast

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2
Q

describe the cell wall of MTB?

A

gram negative cell wall

stains acid fast

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3
Q

what are the key virulence factors of MTB?

A 
mycolic acids (cause acid fast)
trehalos mimycolate (cord factor)
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4
Q

what are the growth requirement for MTB?

A

facultative intracellular of macrophages

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5
Q

what are the oxygen growth requirements for MTB?

A

obligate aerobe

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6
Q

how long does it take to culture MTB?

A

2-3 weeks

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7
Q

what is MTB sensitive to?

A 
UV light
moist heat (pasteurization)
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8
Q

what is the transmission for MTB?

A

from person with pulmonary or laryngeal TB via inhalation of airborne droplets

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9
Q

is MTB highly contagious?

A

no, not highly contagious

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10
Q

what is the reservoir for MTB?

A

humans

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11
Q

what age group is most susceptible for MTB infection?

A

children <4 yo immunocompetent

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12
Q

what age group is most susceptible for reactivation of pulmonary TB?

A

elderly >65 yo

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13
Q

what percent of MTB patients remain LTBI for life?

A

90%

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14
Q

what groups are particularly high risk for MTB infx?

A

foreign
poor
HCW

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15
Q

what groups are high risk for TB after MTB infx?

A

young, old
CMI compromise
HIV
IVDU

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16
Q

what are common seeding sites for MTB?

A

apical-posterior areas of lung

lymph nodes

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17
Q

does MTB produce toxins?

A

no, tissue damage is caused by CMI

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18
Q

what causes caseation necrosis (soft tubercles) in MTB infx?

A

granuloma formation

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19
Q

is a granuloma evident in CXR?

A

no, only in tissue biopsy

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20
Q

how does LTBI progress to TB?

A

weak CMI allows dormant MTB in tubercles to reseed the body

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21
Q

what causes primary pulmonary TB?

A

weak immune response, fails to localize primary infx

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22
Q

what causes reactivation pulmonary TB?

A

systemic immunosuppression (HIV, old age)

-most common form of TB in US

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23
Q

what differentiates extrapulmonary TB?

Study These Flashcards
A

involves any other organ system

24
Q

what is miliary TB?

Study These Flashcards
A

massive disseminated infx involving multiple organs

25
what is the key clinical factors in reactivation TB?
- air-liquid filled cavities | - hemoptysis, caseium release
26
are there any symptoms of LTBI?
no, asymptomatic
27
how is LTBI proven?
- positive PPD test | - positive quantiferon test
28
if S/S of TB are present, then what kind of TB is going on?
fuckin TB, of course
29
how far along is the disease if S/S of TB are noted?
pretty fucking far along, d/t slow growth rate of pathogen
30
what are some fucking buzz words for TB?
slow, insidious onset/progression flu like symptoms anorexia w/ weight loss (fucking redundant)
31
what are some stupid-ass, barely-usable buzz words for TB?
chronic, persistant cough pleuritic pain dyspnea
32
who's not as fucked as a TB pt, but still pretty god damn fucked?
close contacts d/t slow onset of symptoms. the dude's been infectious for a while so there's a pretty good chance they have an infx (but not necessarily a disease)
33
what type of pulmonary lesions are usually seen with HIV patients who get MTB?
diffuse pulmonary infiltrates d/t poor CMI response -therefore, coin-like lesions aren't common (jeez, how fuckin bad do you have to treat your body that you can't even get sick right...fuck)
34
can a PPD or quantiferon test differentiate between TB and LTBI?
nope, of course not, that would be too easy
35
is a negative PPD skin test a guaranteed rule out for TB?
no, 20% of MTB infx don't show positive PPD tests once again, that would be too fuckin easy
36
when does a patient seroconvert in order to give a positive PPD test?
3-8 weeks after primary infx
37
what is the minimum PPD measurement for normal people?
>15 mm
38
what is the minimum PPD measurement for other assholes?
>10 mm
39
what is the minimum PPD measurement for people stupid enough to get HIV or live with TB pts?
>5 mm
40
what vaccination can cause false positives in PPD test?
BCG vaccination
41
why is quantiferon gold test better than PPD?
basically shits all over PPD's potential for false negatives, particularly for HCW's -damn, I gotta get the quantiferon test next time. fuck this 3 visit BS
42
do you have to report TB to local health department?
yeah, shit head, it's a super infectious disease
43
if you find a single, solitary pulmonary nodule "by chance" in an asymptomatic patient, what's your DDx?
``` MTB Nocardia Actinomyces systemic mycoses lung cancer hamartoma/adenochondroma ```
44
what's the first lab indicator of MTB?
acid fast bacilli in sputum
45
what else besides sputum culture is needed when MTB is suspected?
blood cultures to see if MTB is tearing shit up around the body (hematogenous dissemination)
46
what the fuck is nucleic acid amplification (NAA) testing?
don't care, but it's quicker than culture
47
what are first line MTB drugs?
isoniazid rifampin pyrazinamide ethambutol
48
what is MDR in MTB?
doesn't respond to: rifampin INH
49
what is XDR MTB resistant to?
rifampin INH fluoroquinolones and basically every other fucking drug ever
50
what's the general treatment for LTBI?
INH for sick bastard rifampin for close contacts (and pussies who can't handle INH)
51
what is the general treatment for drug senstive TB disease?
isoniazid 18 months | isoniazid + rifampin 9 months
52
what is the general treatment for drug resistant TB disease?
chemo resistant: shit load of drugs MDR: fuck ton of drugs (more than shit load)
53
treatment for XDR MTB?
cut that shit out
54
when is treatment started?
only after Dx confirmed. that shit sucks too much to start needlessly
55
how is spread of TB prevented?
cover your fucking mouth when you cough/sneeze. fucking sick fucks, I swear
56
is BCG used in US?
nope

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