Mycobacterium Flashcards
1
Q
Morphology of Mycobacterium spp.
A
Slender, slightly curved or straight, rod-shaped (bacilli)
2
Q
Are Mycobacterium spp. motile?
A
No
3
Q
Aerotolerance of Mycobacterium spp.
A
Strict or Obligate aerobes (some are Capnophiles)
4
Q
Mycobacterium spp. are known to be ______ bacteria.
A
acid-fast
5
Q
Mycobacterium spp. exhibits which color when stained using Acid Fast method?
A
Red
6
Q
Incubation period of Mycobacterium spp.
A
2 months or 8 weeks
For slow growers, some species can mature faster (rapid growers)
7
Q
Mycobacterium spp. are ____ growers.
A
slow
8
Q
Which Mycobacterium spp. are rapid growers?
A
Group IV Runyon Classification (Rapid Growers)
* Mycobacterium fortuitum
* Mycobacterium chelonae
* Mycobacterium phlei
* Mycobacterium smegmatis
9
Q
Cell wall components of Mycobacterium spp.
A
High amounts of Lipids and Mycolic acid
10
Q
Do Mycobacterium spp. resist decolorization in Acid Fast Staining?
A
Yes
11
Q
____ that act as storage deposits of nutrients exist in Mycobacterium spp.
A
Inclusion bodies
12
Q
What are inclusion bodies?
A
Storage deposits
13
Q
Which inclusion body is present in Mycobacterium spp.?
A
Much granules
14
Q
Mycobacterium is classified into how many groups?
A
3
15
Q
Mycobacterium spp. are classified into different groups based on ________.
A
Their capability to cause infection
16
Q
Groups under Mycobacterium spp.
A
- Mycobacterium tuberculosis complex
- Mycobacteria other than tuberculosis (MOTT) or Non-tuberculosis mycobacteria (NTM)
- Mycobacterium leprae
17
Q
Members of Mycobacterium tuberculosis complex
A
ACRONYM: TBA
* Mycobacterium tuberculosis
* Mycobacterium bovis
* Mycobacterium africanum
18
Q
What do members of M. tuberculosis complex have in common?
A
They are all causative agents of Tuberculosis
19
Q
Members under this group are the most common causes of Tuberculosis
A
M. tuberculosis complex
20
Q
Mycobacterium tuberculosis is also known as ________.
A
Koch Bacillus
21
Q
“Koch Bacillus”
A
Mycobacterium tuberculosis
22
Q
Mycobacterium tuberculosis was discovered by ______.
A
Robert Koch
23
Q
Robert Koch was the one who discovered ______.
A
Mycobacterium tuberculosis
24
Q
Mycobacterium tuberculosis was discovered in _____.
A
1882
25
*Mycobacterium tuberculosis* requires ____ for growth.
5 - 10% CO2
26
Virulence factors of *Mycobacterium tuberculosis*
* Cord Factor
* Sulfatides
27
How are cord factor and sulfatides virulent?
They produce a sticky response which is responsible for making the mucus very purulent which may trap the bacteria inside, masking it and making it unrecognized by phagocytes
28
Skin test for *Mycobacterium tuberculosis*
PPD or Mantoux Test or Tuberculin
29
Skin test for *Mycobacterium tuberculosis* is measured after _____.
48 hours
30
(+) Result of skin test for *Mycobacterium tuberculosis*
>10 mm
31
To determine whether the quality of the specimen is to be accepted or rejected, we will use the ________.
Bartlett's Classification
32
Bartlett's classification is used to ______.
qualify the specimen
33
Which objective lens is used when viewing epithelial cells?
Low Power Objective (LPO)
34
LPO is used when viewing ______.
Epithelial cells
35
Which objective lens is used when viewing polymorphonuclear cells?
High Power Obejctive (HPO)
36
HPO is used when viewing ______.
Polymorphonuclear cells (PMNs)
37
# **Determine which specimen is present**
>10 EC with <25 PMNs
Saliva
38
# **Determine which specimen is present**
<10 EC and >25 PMNs
Sputum
39
# **Accept or Reject?**
> 10 EC with <25 PMNs
Reject
40
# **Accept or Reject?**
< 10 EC and >25 PMNs
Accept
41
Most common specimen for *Mycobacterium tuberculosis* identification
Sputum
42
Describe the sputum of a patient suspected with Tuberculosis
Sticky and very purulent
43
How many sputum specimens are needed for Direct Microscopic Examination or AFB Identification?
3 specimens (1 per day consecutively)
44
How many sputum specimens are needed for Culture?
1 only
45
# **Interpret the Scenario**
The patient submitted a sputum specimen for 3 consecutive days. Out of all three, 2 specimens turned out to be positive.
The patient is definitive for Pulmonary tuberculosis
46
# **Interpret the Scenario**
The patient submitted a sputum specimen for 3 consecutive days. Out of all three, only 1 specimen turned out to be positive.
Request for a 4th specimen
| (+) = Definitive of Pulmonary Tuberculosis
47
# **Interpret the Scenario**
A patient whose sputum was submitted for testing has 1 out of 3 specimens positive for Tuberculosis. After submitting a 4th specimen, it also turned out to be positive.
The patient is definitive for Pulmonary tuberculosis
48
# **Interpret the Scenario**
The patient submitted a sputum specimen for 3 consecutive days. The 4th specimen submitted was negative.
Request for repetition of the entire process
49
Specimens of Tuberculosis
* Sputum
* Secretions
* Blood
* Urine
* CSF
* Pleural, Pericardial, and Peritoneal fluid
50
How are specimens collected if a patient is not able to exudate his/her own sputum?
Their secretions are collected through bronchoscopy
51
Presence of tuberculosis in the CSF is indicated by ______.
Pellicle of web-like clot
52
Presence of tuberculosis in the ____ is indicated by a pellicle of web-like clot.
CSF
53
Presence of tuberculosis in PPP fluid is indicated by ______.
Increased Adenosine Deaminase (ADA)
54
Presence of tuberculosis in ____ is indicated by increased Adenosine Deaminase (ADA).
Pleural, Pericardial, and Peritoneal Fluid
55
DOTS stands for ______.
Directly Observed Treatment Short-course
56
According to DOTS, how many days are sputum sample collected?
2 days
57
How many sputum specimens per patient are collected by DOTS?
3
58
How many sputum specimens are collected in the 1st day according to DOTS?
2
59
How many sputum specimens are collected in the 2nd day according to DOTS?
1
60
When is the first specimen collected according to DOTS?
First thing in the morning after the patient's mouth is washed
61
When is the second specimen collected according to DOTS?
Upon arrival in the laboratory
62
When is the third specimen collected according to DOTS?
First thing in the morning after the patient's mouth is washed
63
Prior to culture, the sputum sample must be _________.
Digested, decontaminated, and liquefied
64
The removal of normal flora and contaminating organisms
Decontamination
65
Decontamination means ______.
The removal of normal flora and contaminating organisms
66
The breaking of sulfide bonds in the mucus of *Mycobacterium tuberculosis*
Digestion
67
Digestion means _______.
The breaking of sulfide bonds in the mucus of *Mycobacterium tuberculosis*
68
Digestant and Decontaminating agents
* 2-4% NaOH
* Benzalkonium Chloride (Zephiran)
69
A liquefying agent that speeds up the digestion process
N-acetyl-L-cysteine (NALC)
70
What is the purpose of NALC in terms of digestion?
A liquefying agent that speeds up the digestion process
71
The most common combination for digesting and decontaminating *Mycobacterium* spp. causing tuberculosis
NALC or Dithiothreitol + 2 - 4% NaOH
72
Which is substituted for NALC?
Dithiothreitol
73
A digestant-decontaminant that shortens exposure time
Benzalkonium Chloride (Zephiran)
74
What is the purpose of Benzalkonium Chloride (Zephiran) in digestion-decontamination?
It is a digestant-decontaminant that shortens exposure time
75
It liquefies sputum but requires longer time of exposure
Trisodium Phosphate
76
What is the purpose of Trisodium Phosphate in digestion-decontamination?
It liquefies sputum but requires longer time of exposure
77
Another combination for digestion-decontamination
Benzalkonium Chloride (Zephiran) + Trisodum Phosphate
78
It decontaminates specimens contaminated with *Pseudomonas aeruginosa*
5 - 6% Oxalic acid
79
What is the purpose of 5 - 6% Oxalic acid in digestion-decontamination?
It decontaminates specimens contaminated with *Pseudomonas aeruginosa*
80
Gram stain of *Mycobacterium tuberculosis*
Gram ghost or none (gram positive)
81
Stains for *Mycobacterium tuberculosis*
* Acid Fast Stain
* Fite Faraco's Stain
* Auramine-Rhodamine Fluorochrome Stain
* Spengler's Stain
* Pappenheim's Stain
* Baumgarten's Stain
82
AFB smear size
2 cm x 3 cm
83
It uses hematoxylin instead of methylene blue as a counterstain
Fite Faraco's Stain
84
What is the difference between Fite Faraco's and Acid Fast Stain?
Fite Faraco's uses hematoxylin instead of methylene blue (in AFS) as counterstain
85
Appearance of *Mycobacterium tuberculosis* using Auramine-Rhodamine Stain
Bright, yellowish-orange against a dark background
86
Which kind of microscope is used for Auramine-Rhodamine Stains?
Fluorescent microscope
87
A stain used by color blind individuals
Spengler's Stain
88
Appearance of *Mycobacterium tuberculosis* using Spengler's Stain
Black
89
Appearance of *Mycobacterium tuberculosis* using Pappenheim's Stain
Red
90
Appearance of *Mycobacterium smegmatis* using Pappenheim's Stain
Blue
91
Which species appears blue using Pappenheim's Stain?
*Mycobacterium smegmatis*
92
Appearance of *Mycobacterium tuberculosis* using Baumgarten's Stain
Blue
93
Appearance of *Mycobacterium leprae* using Baumgarten's Stain
Red
94
Which species appears red using Baumgarten's Stain?
*Mycobacterium leprae*
95
Requirement of *Mycobacterium tuberculosis* for Culture
Increased amount of protein
96
Colonial appearance of *Mycobacterium tuberculosis*
* Tan to buff colonies
* Dry, warty, rough, and granular
* Resembles cauliflower
97
*Mycobacterium tuberculosis* resembles ________.
Cauliflower
98
Which form of media is *Mycobacterium tuberculosis* cultured?
Tubed Media
99
Why is *Mycobacterium tuberculosis* cultured in tubes?
* Moisture does not easily evaporate
* Small opening = less chance of contaminats and transmission
100
Primary drugs for *Mycobacterium tuberculosis*
**ACRONYM: RIPES**
* **R**ifampicin
* **I**soniazid
* **P**yrazinamide
* **E**thambutol
* **S**treptomycin
101
Secondary drugs for *Mycobacterium tuberculosis*
**ACRONYM: CROCKER**
* **C**apreomycin
* **R**ifabutin
* **O**floxacin
* **C**iprofloxacin
* **K**anamycin
* **E**thionamide
* **R**ifabutin (ulit hehe)
102
Agar-based Media for *Mycobacterium tubereculosis*
* Duboi's Oleic Acid Albumin Medium
* Mitchinson's Medium
* Middlebrook 7H10-7H11
103
Which medium is used for AST in *Mycobacterium tuberculosis*?
Middlebrook 7H10-7H11
104
Egg-based Media for *Mycobacterium tubereculosis*
* Petragnani Medium
* Lowenstein-Jensen Medium
* American Thoracic Society
* Dorset Egg Medium
105
Liquid Media for *Mycobacterium tubereculosis*
* Bactec 12B
* Septi-Check
* Middlebrook 7H9
106
Inhibitor present in egg-based media for *Mycobacterium tubereculosis*
Malachite green
107
A medium used for heavily contaminated specimen (with increased concentration of malachite green)
Petragnani Medium
108
Ma'am Christy's medium of choice for *Mycobacterium tubereculosis*
Lowenstein-Jensen Medium
109
Niacin Test Principle
Niacin + Niacin Ribonucleotide + Aniline Dye + Cyanogen Bromide
110
(+) Result for Niacin Test
Yellow color
111
Which organism is (+) for Niacin Test?
*Mycobacterium tuberculosis*
112
(-) Result for Niacin Test
No color change
113
Which organism is (-) for Niacin Test?
*Mycobacterium bovis*
114
Catalase Test at 68 C Principle
Tween 80 + Mycobacteria + 30% H2O2 + Heat at 68 C (20 mins)
115
Medium for Catalase Test
Tween 80
116
Reagent for Catalase Test
30% H2O2
117
(+) Result for Catalase Test
45 mm height of gas bubbles
118
Which organism is (+) for Catalase Test?
*Mycobacterium kansasii*
119
(-) Result for Catalase Test
No bubbles
120
Which organism is (-) for Catalase Test?
*Mycobacterium tuberculosis*
121
Nitrate Reduction Test Principle
HCL + Sulfanilamide + n-napthtylethylene diamine
122
(+) Result for Nitrate Reduction Test
Pink or Red color
123
Which organism is (+) for Nitrate Reduction Test?
* *Mycobacterium kansasii*
* *Mycobacterium szulgai*
* *Mycobacterium fortuitum*
* *Mycobacterium tuberculosis*
124
(-) Result for Nitrate Reduction Test
No color change
125
Which organism is (-) for Nitrate Reduction Test?
*Mycobacterium intracellulare*
126
(+) Result for Tween 80 HOH Test
Red color
127
Which organism is (+) for Tween 80 HOH Test?
*Mycobacterium kansasii*
128
(-) Result for Tween 80 HOH Test
No red or amber color
129
Which organism is (-) for Tween 80 HOH Test?
*Mycobacterium avium*
130
(+) Result for Tellurite Reduction Test
Smooth, fine, black precipitate
131
Which organism is (+) for Tellurite Reduction Test?
*Mycobacterium avium*
132
(-) Result for Tellurite Reduction Test
Gray clumps
133
Which organism is (-) for Tellurite Reduction Test?
*Mycobacterium kansasii*
134
What test is conducted for rapid growers?
Aryl Sulfatase Test
135
Aryl Sulfatase Test Principle
Tripotassium phenolphthalein disulfide or sulfate is acted upon by aryl sulfatase to produce free phenolphthalein
136
(+) Result for Aryl Sulfatase Test
Pink or Red color
137
Which organism is (+) for Aryl Sulfatase Test?
**Group IV Rounyon Classification: Rapid Growers**
* *M. fortuitum*
* *M. chelonae*
* *M. phlei*
* *M. smegmatis*
138
Which organism is (+) or Susceptible for TCH Susceptibility Test?
*Mycobacterium bovis*
139
Which organism is (-) or Resistant for TCH Susceptibility Test?
*Mycobacterium tuberculosis*
140
TCH stands for ______.
Thiophene-2-Carboxylic Acid-Hydrazide
141
Iron Uptake Test Principle
To convert ferric ammonium citrate to iron oxide
142
(+) Result for Iron Uptake Test
Rusty brown colonies
143
Which organism is (+) for Iron Uptake Test?
Rapid growers
144
(-) Result for Iron Uptake Test
No color formation
145
Which organism is (-) for Iron Uptake Test?
*Mycobacterium chelonae*
146
Pyrazinamidase Test Principle
Pyrazinamidase hydrolyzes pyrazinamide to produce pyrazinoic acid and ammonia in 4 days
147
(+) Result for Pyrazinamidase Test
Red pigment
148
Which organism is (+) for Pyrazinamidase Test?
* *Mycobacterium tuberculosis*
* *Mycobacterium marinum*
149
(-) Result for Pyrazinamidase Test
No color formation
150
Which organism is (-) for Pyrazinamidase Test?
* *Mycobacterium bovis*
* *Mycobacterium kansasii*
151
Urease Test Principle
Detection of urease activity
152
Which organism is (+) for Urease Test?
*Mycobacterium scrofulaceum*
153
Which organism is (-) for Urease Test?
*Mycobacterium gordonae*
154
Sodium Chloride Tolerance Test Principle
High salt concentration (5% NaCl) in egg-based media inhibits the growth of most Mycobacteria
155
(+) Result for Sodium Chloride Tolerance Test
Growth
156
Which organism is (+) for Sodium Chloride Tolerance Test?
* *M. flavescens*
* *M. trivìale*
* Most rapid growers
157
Group 1 Runyon's Classification
**Photochromogens: KMSA**
* *M. **k**ansasii*
* *M. **m**arinum*
* *M. **s**imiae*
* *M. **a**siaticum*
158
Group 1 Runyon's Classification is ____ with the presence of light.
pigmented
159
Group 1 Runyon's Classification is ____ without the presence of light.
non-pigmented
160
# **Which Organism is It?**
* **"Yellow Bacillus"**
* Has beta-carotene
* Nitrate (+)
*Mycobacterium kansasii*
| **Group 1: Photochromogens**
161
*M. kansasii* is also called as _____.
Yellow bacillus
162
Why is *M. kansasii* termed as "yellow bacillus"?
Because it has beta carotene
163
# **Which Organism is It?**
Swimming pool granuloma
*Mycobacterium marinum*
| **Group 1: Photochromogens**
164
*M. marinum* is associated with ______.
Swimming Pool Granuloma
165
# **Which Organism is It?**
Niacin (-)
* *Mycobacterium simiae*
* *Mycobacterium asiaticum*
| **Group 1: Photochromogens**
166
Group 2 Runyon's Classification
**Scotochromogens**
* *M. scrofulaceum (scrofula)*
* *M. szulgai*
* *M. xenopi*
* *M. gordonae*
* *M. flavescens*
* *M. thermoresistable*
167
Group 2 Rounyon's Classification is ____ with the presence of light.
pigmented
168
Group 2 Rounyon's Classification is ____ without the presence of light.
pigmented
169
# **Which Organism is It?**
* Cervical lymph adenitis
* Nitrate (-)
* Niacin (+)
*Mycobacterium scrofulaceum*
| **Group 2: Scotochromogens**
170
*Mycobacterium scrofulaceum* is associated with _________.
cervical lymph adenitis
171
# **Which Organism is It?**
* **"Tap water Bacillus"**
* Tween 80 (+)
*Mycobacterium gordonae*
| **Group 2: Scotochromogens**
172
*Mycobacterium gordonae* is also known as _____.
Tap water Bacillus
173
Group 3 Runyon's Classification
**Non-photochromogens**
* *M. avium-intracellulare complex*
* *M. avium*
* *M. ulcerans*
* *M. xenopi*
* *M. triviale*
* *M. haemophilum*
* *M. terrae*
* *M. malmoense*
* *M. gastri*
174
Group 3 Rounyon's Classification is ____ with the presence of light.
non-pigmented
175
Group 3 Rounyon's Classification is ____ without the presence of light.
non-pigmented
176
# **Which Organism is It?**
* **"Battey Bacillus"**
* Tuberculosis in AIDS patients
*Mycobacterium avium-intracellulare complex*
| **Group 3: Non-photochromogens**
177
*M. avium-intracellulare complex* is also known as _______.
Battey Bacillus
178
# **Which Organism is It?**
Tuberculosis in birds and chickens
*Mycobacterium avium*
| **Group 3: Non-photochromogens**
179
# **Which Organism is It?**
* **"Innert Bacillus"**
* Buruli ulcers in skin
*Mycobacterium ulcerans*
| **Group 3: Non-photochromogens**
180
*M. ulcerans* is also known as _______.
Innert Bacillus
181
# **Which Organism is It?**
Hot, cold water taps at 42 C
*Mycobacterium xenopi*
| **Group 3: Non-photochromogens**
182
# **Which Organism is It?**
"Radish Bacillus"
*Mycobacterium terrae*
| **Group 3: Non-photochromogens**
183
# **Which Organism is It?**
"J Bacillus"
*Mycobacterium gastri*
| **Group 3: Non-photochromogens**
184
Group 4 Runyon's Classification
**Rapid Growers**
* *M. fortuitum*
* *M. chelonae*
* *M. phlei*
* *M. smegmatis*
185
# **Which Organism is It?**
Grows on MAC without crystal violet
* *Mycobacterium fortuitum*
* *Mycobacterium chelonae*
| **Group 4: Rapid Growers**
186
# **Which Organism is It?**
Provides CO2
*Mycobacterium phlei*
| **Group 4: Rapid Growers**
187
# **Which Organism is It?**
Confused with Mtb in urine
*Mycobacterium smegmatis*
| **Group 4: Rapid Growers**
188
The causative agent of Hansen's Disease or Leprosy
*Mycobacterium leprae*
189
*Mycobacterium leprae* is the causative agent of ______.
Hansen's Disease or Leprosy
190
Leprosy is formally known as ____.
Hansen's Disease
191
The appearance of *Mycobacterium leprae* is described to be as ______.
Cigarette packet or Picket-fence
192
Specimen for *Mycobacterium leprae*
Earlobe or Nasal scraping
193
Culture for *Mycobacterium leprae*
Armadillo pads
194
Stain for *Mycobacterium leprae*
Fite-Faraco
195
Treatment for *Mycobacterium leprae*
* Dapsone
* Sulfone
196
Skin test for *Mycobacterium leprae*
Lepromin Test
197
Early reaction
Fernandez
198
24-48 hours
Fernandez or Early reaction
199
Late reaction
Mitsuda
200
3-4 weeks
Mitsuda or Late reaction
