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PA22 > mycobacterial infections > Flashcards

mycobacterial infections Flashcards

1
Q

greek term for consumption/wasting

A

Pthisis

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2
Q

wasting disease, vampirism

A

TB

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3
Q

TB (who)

A

Robert Koch

obligate aerobe
15-20 hrs doubling time
acid-fastness

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4
Q

stain: TB

A

Ziehl Nielssen (bright red)

non-motile
weakly gram (+)
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5
Q

responsible for acid fastness

A

mycolic acid

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6
Q

glycolipid molecule responsible for pathogenicity of TB

A

cord factor

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7
Q

found in the cell walls of mycobacteria that interlock to form an asymmetrical bilayer

A

Lipoarabinomannan (LAM)

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8
Q

inhibit macrophage activation

A

Lipoarabinomannan (LAM)

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9
Q

Microbial stains

A
  1. acid fast bacili stain
    a. Ziehl Nielssen
    b. Kinyoun/Cold method
  2. Flourochrome stain (Auramine-Rhodamine stain)
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10
Q

most sensitive and reliable stain and easier to read

A

fluorochrome stain

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11
Q

causes TB

A

M. tuberculosis

M.bovis (intestinal TB)

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12
Q

TB tx length

A

6-9months

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13
Q

diseases that predispose TB infection

A 
diabetes mellitus
hogkins lymphoma
chronic lung disease
chronic renal failure
malnutrition
alcoholism
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14
Q

malignancy of hematopoietic system

A

hodgkins lymphoma

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15
Q

Dx of TB

A

skin test (mantoux test/tuberculin test) purified protein derivatives peaks in 48-72hours

delayed type hypersensitivity reaction
only a screening not not absolute dx

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16
Q

Categories/pathophysiologic types

A
  1. primary TB
  2. Secondary TB
  3. Miliary TB
  4. Progressive Pulmonary TB
  5. Other forms: endobranchial, endotracheal, large TB; systemic miliary TB; isolated TB; lymphadenitis; MDR-TB
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17
Q

most commonly affect the lungs

occurs in unexposed unsensitized px

A

Primary TB

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18
Q

nonspecific or pneumonia-like then disappears

A

primary TB

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19
Q

nodules in the lungs where bacteria hide in macrophages

A

ghon focus

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20
Q

where does the infection drain into? (primary TB)

A

hilar lymph nodes (can be infected)

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21
Q

center of Ghon focus udnergoes ___ necrosis

A

caseous necrosis

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22
Q

parenchymal lung lesion + nodal involvement

A

Ghon complex

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23
Q

radiologically detectable calcification of ghon complex

A

ranke complex

Ghon complex -> progressive fibrosis -> ranke complex

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24
Q

primary TB in childen

A

primary complex

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25
Q

3 essential elements for Dx TB

A 
epitheloid macrophages (granuloma)
langhans type giant cells
caseation necrosis
26
Q

hallmark of healing

A

granulation tissue

27
Q

latent infection reactivates

highly infectious state

A

secondary TB

28
Q

2 weeks cough + intermittent fever
cavitary lesions at the apex of the lungs
bloody cough

A

secondary TB

29
Q

millet seeds bec they cause lesions in small blood vessels (TB)

A

Miliary TB

30
Q

occurs when organisms draining through lymphatics enter venous blood and circulate back to the lungs

A

Miliary TB

31
Q

progressive pulmonary TB + miliary TB

A

tuberculous emphysema

32
Q

T/F miliary TB affects at least 5 major organs

A

F

miliary TB affects at least 3 major organs (brain, lungs, liver, ovaries, omentum, nostril, larynx etc)

33
Q

TB: older adults and immunocompromised people

A

progressive pulmonary TB

34
Q

apical lesion exands into the adjacent lung and eventually erodes into bronchi and vessels which evacuate the caseous center –> irregular cavity

A

progressive pulmonary TB

35
Q

TB: lesions expand and coalesce resulting in consolidation of large regions or even whole lobes of the lungs

A

miliary TB

36
Q

hemoptysis

A

coughing up of blood due to erosion of BV

37
Q 
isolated TB
meninges
kidneys
adrenals
bone
fallopian tube 
vertebrae
A

meninges: tuberculous meningitis
kidneys: renal TB
adrenals: Addison disease
bone: osteomyelitis
fallopian tube: salpingitis
vertebrae: Pott’s disease

38
Q

criteria for MDR-TB

A

must be resistant to at least rifampicin and isoniazid

39
Q

TB identification

A

sputum acid-fast bacillus testing
molecular testing
PCR identification
QuantiFERON

40
Q

gold standard in TB indentification

A

sputum acid-fast bacillus testing

41
Q

simple blood test that aids in detection of M. tuberculosis
>95% sensitivity
highest specificity
results are obtained after 2 hours

A

QuantiFERON

42
Q

Hansen disease

A

Leprosy

43
Q

affects skin and peripheral nerves resulting in disabling deformities

A

leprosy/hansen disease

44
Q

cultured in what animal (leprosy)

A

armadillo (core temp 32-34)

45
Q

types (leprosy)

A

tuberculoid leprosy

lepromatous leprosy

46
Q

T/F leprosy has high communicability and endemic among people living

A

F

low communicability and yes endemic

47
Q

less severe form of leprosy
dominated by neuronal involvement
hyperpigmented margins and depressed pale ceters (central healing)

A

tuberculoid leprosy

48
Q

dry scaly skin lesions (asymmetric) that lack sensation

A

tubercucloid leprosy / paucibacillary leprosy

49
Q

granulomatous lesions closely resembling TB and bacilli are almost NEVER found

A

TB leprosy / paucibacillary leprosy

50
Q

more severe form of leprosy

A

lepromatous leprosy

51
Q

leprosy: symmetric skin lesions

A

lepromatous leprosy

involves skin, peripheral nerves, anterior chamber of eye, upper airways down to larynx, testes, hands, feet (cold areas)

52
Q

lesions contain large aggregates of lipid-laden macrophages filled with masses of acid-fast bacilli

A

lepromatous leprosy

multibacillary leprosy

53
Q

unresponsiveness of the host immune system

A

anergic leprosy /lepromatous leprosy

54
Q

tests for leprosy

A

lepromin test

skin punch biopsy

55
Q

lepromin test procedure

A

performed by injecting a small sample of inactivated m.leprae under your skin (usually forearm) –> small lump –> examined 3 days after –> if no reaction, wait 28 days again

56
Q

lepromin test positive test

A

redness, swelling and other skin changes indicate the presence of tuberculoid and borderline TB leprosy

no skin reaction: may be lepromatous leprosy

57
Q

considered the primary technique to obtain diagnostic, full-thickness skin specimens

A

skin punch biopsy

58
Q

performed using a circular blade or TREPHINE attached to a pencil-like handle

A

skin punch biopsy

rotated down through the epidermis and derpmis and into the subcutaneous fat

59
Q

responsible for the loss of farm animals (bovines) during the first half of 18th century

A

mycobacterium bovis

60
Q

mycobacterium bovis: route

A

ingestion but may also spread through aerosol droplets

61
Q

mycobacterium bovis: human infection

why is it rare?

A

pasteurization process kills bacteria in the milk

62
Q

abudant acid-fast bacilli within macrophages
target the mononuclear-phagocyte system
granulomas and tissue destrustion are rare

A

mycobacterium avian-intracellulare complex

PA22 (4 decks)

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