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Infectious diseases > Mycobacteria > Flashcards

Mycobacteria Flashcards

1
Q

Mycobacterium leprae - area of infection

A

it likes cool temperatures (infect skin and superficial nerves - glove and stocking loss of sensation

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2
Q

Leprosy (Hansen disease) - how many forms and which

A
  1. Lepromatous

2. Tuberciloid

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3
Q

Leprosy (Hansen disease) - lepromatous form - clinical manifestation

A

presents diffusely over the skin, with leonine (lion-like) facies, and is communicable

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4
Q

Leprosy (Hansen disease) - Tuberciloid form - clinical manifestation

A

limited to few hypoesthetic. hairless skin plaques

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5
Q

primary tuberculosis - lesion

A

Ghon complex: Hilar nodes + Ghon focus (calcified TB granuloma forming a nodule) usually in lower to middle lung

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6
Q

secondary tuberculosis after reactivation - lesion

A

fibrocaseous cavitary lesion (usually upper lobes)

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7
Q

TB - PDD negative if

A
  1. no infection
  2. anergic (steroids, malnutrition, immunocompromised)
  3. sarcoidosis
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8
Q

tests to diagnose TB

A
  1. PPD

2. Interferon-γ release assays (IGRA)

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9
Q

Mycobacteria - bugs?

A
  1. Mycobacterium tuberculosis
  2. Mycobacterium avium-intracellulare
  3. Mycobacterium scrofulaceum
  4. Mycobacterium marinum
  5. Mycobacterium leprae
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10
Q

Mycobacteria - bugs and diseases

A
  1. Mycobacterium tuberculosis –> TB
  2. Mycobacterium avium-intracellulare –> disseminated non-TB disease in AIDS
  3. Mycobacterium scrofulaceum –> cervical lymphadenitis in children
  4. Mycobacterium marinum –> hand infection in aquarium handlers
  5. Mycobacterium leprae –> Leprosy (Hansen disease)
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11
Q

M. tuberculosis - prophylaxis and treatment

A

prophylaxis: isoniziad
treatment: 1. rifampin 2. Isoniazid 3. Pyrazinamide 4. Ethambutol (RIPE)

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12
Q

M. intracellulare-avium - prophylaxis and treatment

A

prophylaxis: azithromycin, rifabutin
treatment: Azithromycin or clarithromycin + ethambutol
Can add rifabutin or ciprofroloxacin

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13
Q

M leprae - prophylaxis and treatment

A

prophylaxis: N/A
treatment: Long-term treatment with dapsone and rifampin for tubrrculoid form. Add clofazimine for Lepromatous form

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14
Q

Antimycobacterial drugs - groups and drugs

A
  1. Mycolic acid synthesis –> isoniazid
  2. Arabinoglycan synthesis (Arabinosyl tranferase) –> ethambutol
  3. mRNA synthesis (DNA-dependent RNA polymerase) –> Rifamycins (rifabutin, rifampin)
  4. Intracellular (unclear mechanism) –> pyrazinamide
  5. streptomycin
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15
Q

Rifamycins - drugs and clinical use

A

Rifampin, rifabutin

  1. Mycobacterium tuberculosis treatment
  2. Leprosy: delay resistance to dapsone
  3. Meningicoccal prophylaxis
  4. Chemoprophylaxis in contacts of children with H. influenzae type B
  5. Can add in M. Avium-intracellulare (rifabutin)
  6. M. Avium-intracellulare prophylaxis
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16
Q

Rifamycins - toxicity

A
  1. Minor hepatotoxicity
  2. Drug interactions (increases cytochrome P-450) - esp rifampin
  3. orange body fluids (nonhazardous side effect)
17
Q

Isonizid (INH) - clinical use

A
  1. Mycobaterium tuberculosis prophylaxis

2. Mycobaterium tuberculosis treatment

18
Q

Isonizid (INH) - toxicity

A
  1. hepatotoxicity
  2. P-450 inhibition
  3. drug induced SLE
  4. vitamin 6 - pyridoxine (B6) deficiency (–> peripheral neuropathy, siderblastic anemia)
19
Q

Pyrazinamide - clinical use / toxicity

A

treatment of Mycobacterium Tuberculosis

  1. hyperuricemia
  2. hepatotoxicity
20
Q

Ethambutol - clinical use / toxicity

A
  1. treatment of Mycobacterium Tuberculosis
  2. treatment of Mycobacterium acium-intracellulare
    Optic neuropathy (red green color blindness)
21
Q

Streptomycin - clinical use / adverse effects

A

M. tuberculosis

  1. Tinnitus
  2. Vertigo
  3. ataxia
  4. nephrotoxicity
22
Q

positive skin test for TB –> next

A

Chest xray –> if (-) –> isonizid and B6 for 9 months

23
Q

mild hepatotoxicity after 1 month of TB treatment with isoniazid - next step

A

nothing (it is self limited)

but if enzymes more than 100 –> replace it

24
Q

neuropathy due to B6 def

A

numbness and tingling in a “stocking-glove” distribution

25
Q

isoniazid - it is easier to develop B6 deficiency if

A

malnourishment, pregnancy, DM

26
Q

miliary TB - chest X-ray

A

reticulonodular pattern

27
Q

TB - PPD - when is (+) at 5 or more mm

A
  1. HIV (+), recent contacts of known TB case
  2. Nodular of fibrotic changes on chest x-ray (previous healed TB)
  3. organ transplant or other immune
28
Q

TB - PPD - when is (+) at 10 or more mm

A
  1. recent immigrants from TB areas (lessthan 5 years)
  2. IV users
  3. Residents + employees of high risk (prosin, hospital etc)
  4. Mycobact lab personel
  5. Higher risk for TB reactivation (DM, leukemia, ESRD, chronic malabsorption
  6. children under than 4, or those exposed to adults in high risk catefories
29
Q

leprosy - diagnosis and treatment

A

diagnosis: full thickness biopsy of skin lesion
treatment: dapsone + rifampin, add clofazimine if sever

Infectious diseases (13 decks)

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