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PoD 2 > Mycobacterium > Flashcards

Mycobacterium Flashcards

1
Q

What is a disease caused by mycobacteria?

A

TB

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2
Q

What is the rate of growth of M. tuberculosis? What does it invade? What is its oxygen requirement?

A

Slow growing
Macrophages
Obligate aerobe

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3
Q

What are two forms of TB?

A

primary and secondary

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4
Q

Describe primary TB

A

mild
starts from the lung
formation of granulomas, followed by caseation

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5
Q

Describe secondary TB

A

caused by reactivation of dormant organism.

Delayed-type hypersinsitivity reaction to the reactivated org

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6
Q

How does primary TB differ in immunocompromised individuals?

A

the granuloma/caseation proceeds to miliary TB with dissemination to other body sites, bone marrow, spleen, kidney and CNS

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7
Q

How does the x-ray differ in two forms of TB?

A

primary - outline, macrophage

secondary - apex, mid lung

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8
Q

What is the Ghon complex?

A

Granuloma caused by multinucleated cells, fused macrophages, T cell, fibroblast –> caseous necrosis

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9
Q

What is Miliary TB? What type of patients is this seen in?

A

White nodules, smaller than granulomas. Seen in HIV patients

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10
Q

How are MTB infections transmitted?

A

aerosols

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11
Q

What is significant about MTB cell wall? What does it do?

A

Waxes in cell wall. provides resistance to drying and chemicals, germicides
affects permeability of cell - nutrients can’t get in - slow growth

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12
Q

What is used to ID Mycobacteria?

A

Acid fast stain

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13
Q

What are two main chemicals used in acid fast stain?

A

Carbolfuchsin

Acid alcohol

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14
Q

What color is Mycobacteria seen as after acid fast stain? What is the reason for that?

A

Bright red because of the wax that does not get destained with acid alcohol

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15
Q

What is a medium used to ID M. tuberculosis?

A

Lowenstein-Jensen

Middlebrook 7H10

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16
Q

What component of the acidic wax is toxic?

A

Mycolic acid (beta-hydroxy fatty acid linked to murein)

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17
Q

Where does MTB grow?

A

Macrophages and monocytes

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18
Q

What two things allow MTV to escape phagosomes?

A
  • prevents acidification via NH4 production –> no phagosome/lysosome fusion/acidification
  • Hemolysin
19
Q

What cytokine provoked by cell wall components cause lung damage?

A

TNF-a

20
Q

TB is associated which group of immuno compromised patients?

A

AIDS

21
Q

Patients with AIDS and TB are more likely to develop what?

A

extrapulmonary disease, lymph nodes, genitourinary CNS

22
Q

What is the consequence of reduced CD4+ T cell in AIDS/TB patients? Explain the process

A

no macrophage activation

Macs release IL-12 –> Th1 recruited –> Th1 releases IFN-g –> Mac activation

Without Th1, the activation cannot occur

23
Q

What specific infection are patients with AIDS susceptible to?

A

MAI

24
Q

What is the current therapy for TB/AIDs a combination of ?

A 
Macrolides
Rifabutin
Ethambutol
Clofazimine
FQN
25
Q

What are the four Anti-TB drugs? How long?

A

Isoniazid (INH) *
Rifampin
Streptomycin
Ethambutol

6 months

26
Q

Treatment for TB

A

Anti-TB drugs
Prophylaxis
Vaccine

27
Q

What is MAI?

A

faster growing acid-fast bacilli found in macrophages

28
Q

How does co-infection of MAI occur in AIDS patients?

A

Fruit in GI of immunosuppresant patients can spread – systemic infection

29
Q

What is seen in cultures with MAI?

A

MAC (MAI complex)

- wax, miliary, macs

30
Q

Can M. leprae be grown in lab medium?

A

No

31
Q

How is M. leprae confirmed?

A

skin test reactivity to lepromin

presence of acid-fast bacilli in skin lesions

32
Q

What are the two different presentations of M. Leprae?

A
  • Tuberculoid leprosy: milder, self-limiting disease (cell mediated)
  • Lepratomous leprosy: severest form (not cell mediated)
33
Q

Which T cell is involved in Tuberculoid leprosy? what is the infectivity?

A

Th1

low infectivity

34
Q

What T cell response is seen in Lepromatous Leprosy? what is the infectivity?

A

Th2

High infectivity

35
Q

How does Lepromatous leprosy differ from Tuberculoid in terms of immunity?

A

Lepromatous is Autoimmune

36
Q

Due to lack of Th1 response, Lepromatous leprosy is ______ to lepromin.

A

nonreactive

37
Q

What is analogous to miliary TB?

A

Lepromatous leprosy

38
Q

What is the effect of Lepromatous leprosy?

A

extensive tissue destruction

CNS damage - schwann cells

39
Q

Treatment for M. leprae

how long?

A

Dapsone
rifampin
clofazimine

minimum of 2 years

40
Q

Why is M. kansasii atypical?

A

yellow pigmented in presence of light

41
Q

Who can have M. kansasii?

A

HIV patients with CD4 count less than 200 cells/ml

42
Q

How does M. kansasii present?

A

PPD positive

resembles tuberculosis

43
Q

Treatment of M. kasasii

A

chemotherapy with isoniazid, rifampin, ethambutanol

44
Q

What is the most significant point made in lecture about mycobacterium?

A

HIV co-infection

PoD 2 (14 decks)

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