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CP > Mycobacterial diseases > Flashcards

Mycobacterial diseases Flashcards

1
Q

In what way is mycobacteria different to other bacteria in terms of staining?

A

poor take up of gram stains (referred to as ghost cells when taking up gram +ve stain)
acid fast bacilli - retains ziehl neelsen and phenol auramine stain without decolourisation by acid/alcohol

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2
Q

How does mycobacteria replicate and get into the bloodstream?

A

most commonly in the lung midzone
ingested by macrophages and replicates within them
interacts with hosts immune response
goes to hilar lymph nodes - ‘ghon focus’
multiplies and disseminates into the bloodsteam

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3
Q

How does mycobacteria present?

A

chronic

latent - when immune system weakens then becomes active again

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4
Q

What are the 2 organisms that cause TB?

A

M. tuberculosis

M. bovis

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5
Q

What is the microorganism that causes leprosy?

A

M. leprae

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6
Q

What is the transmission of tuberculosis?

A

inhalation of droplets

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7
Q

What disease the TB usually cause?

A

pulmonary disease

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8
Q

how does the body respond to acquiring TB?

A

forms granulomas/tubercles
centrally have epithelioid and giant cells - can caseous necrose
caseous necrosis then fibrosis/calcifies to trap organism - some die and some remain dormant
cell mediated responses

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9
Q

What are the signs and symptoms of primary TB?

A

‘influenza like’
normal chest x ray
tuberculin skin test conversion normal until after 6-8 weeks

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10
Q

What causes reactivation of TB?

A 
lowered immunity
over 50 years old
men
malnutrition
alcoholism
illness/chronic disease
HIV infection/immunocompromised
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11
Q

Where in the lung is TB most likely to reactivate?

A

lung apices - highest oxygen levels

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12
Q

What are the symptoms of symptomatic TB?

A

chronic productive cough - haemoptysis
weight loss
fever
night sweats

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13
Q

What is extra pulmonary TB called?

A

disseminated/ miliary TB - not controlled by the immune system

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14
Q

Who is most likely to acquire disseminated TB?

A

Very young
very old
immunocompromised

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15
Q

What processes occur in disseminated TB?

A

disease
erosion of necrotic tubercles into blood vessels
widespread infections i.e. meningitis

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16
Q

when should sputum for TB be taken?

A

3 taken with 8 hours apart, including one at early morning

17
Q

what is a ‘smear positive’ in acid fast bacilli test?

A

> 5000 organisms per ml of sputum

18
Q

what culture mediums are used to culture TB?

A

lowenstein-jensen solid medium

broth culture

19
Q

What can to done to collect culture when there is a lack of sputum?

A

induce sputa via nebulised saline - irritant so makes you cough
bronchial aspirates
gastric asperates - used in young children

20
Q

what is sterile pyuria?

A

is urine which contains white blood cells while appearing sterile by standard culturing techniques

21
Q

what is the standard treatment for pulmonary TB?

A

2/4 months - isozianid, rifampicin

22
Q

What is the standard treatment for other sites of TB (except meningeal)?

A

6 months of isozianid, rifampicin

23
Q

What is the standard treatment for other sites of TB meningitis?

A

initially corticosteroids then 12 months of isozianid, rifampicin

24
Q

is TB a notifiable disease?

A

yes - pulmonary or extra pulmonary

25
Q

What is the mantoux test?

A

screening test for TB - purified protein derivative added onto the skin and read 48h-72h later

26
Q

What blood test is done for someone with suspected TB?

A

interferon gamma release assay

27
Q

What microorganism is in the BCG vaccine?

A

attenuated strain of M bovis

28
Q

What does BCG stand for?

A

Bacille calmetta guerin

29
Q

What does mycobacterium avium complex do in HIV compromised patients?

A

Disseminated disease

30
Q

What does mycobacterium avium complex do in non HIV compromised patients?

A

pulmonary tuberculosis like

cervical lymphadenitis in young children

31
Q

What is the treatment for atypical mycobacterium and mycobacterium avium complex?

A

combined
prolonged
macrolide i.e. clarithromycin/azithromycin

32
Q

What is another word for leprosy?

A

Hansens disease

33
Q

What are the two clinical forms of leprosy?

A

Tuberculoid

lepromatous

34
Q

What is tuberculoid leprosy?

A

can deal with microorganisms
macules/plaques
inflammation around the ulnar and common peroneal nerve

35
Q

What is lepromatous leprosy?

A

cannot deal with microorganisms
subcutaneous tissue accumulation
Leonine facies: a face that resembles that of a lion

36
Q

what is the treatment for leprosy?

A

dapsone
rifampicin
clofazimine

CP (50 decks)

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