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Diagnostic Micro(dylan) > Mycobacterium > Flashcards

Mycobacterium Flashcards

1
Q

why do we report out M. Avium-intracellulare or M.avium complex (MAC)?

A

M. avium and M. intracellulare are actually two seperate organisms but so far routine clinical testing can not tell them apart

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2
Q

T or F

Maldi-ToF has been shown to distinguish M. avium and M. intracellulare

A

T

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3
Q

Mycobacterium are typically gram___
There cell wall contains ___
and because of there high lipid content they are___,
which means they resist decoloration with acid alcohols

A
  • gram positive
  • mycolic acid
  • acid fast
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4
Q

Mycobacterium are obligate____ and are slow growing which can take from___ days to__ days

A

anaerobes

-2-60 days

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5
Q

Mycobacterium should be staied using what 2 methods?

A

-Ziehl-neelsen and Kinyoun methods

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6
Q

2 major Groups of Mycobacterium are

A

Mycobacterium Tuberculosis complex and

and NMT

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7
Q

3 characteristics of the group Mycobacterium Tuberculosis complex.

A

1) slow growers
2) non-pigmented
3) not-normal flora

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8
Q

NTM is broken up into ___ groups (classification) they are 1)___2)___3)___4)___

A
  • Runyons groups
    1) Phtochromogens
    2) scotochromogens
    3) nonphotochromogens
    4) rapid growers
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9
Q

Photochromgens are___ and include: 1)__2)__3)__

A

NTM’s that require light to form pigment following incubation in the dark

1) M. kansasii
2) M. marinum
3) M. asiaticum

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10
Q

Scotochromogens are __ and include: 1)__2)__3)__ which species causes cervical adenitis?

A

NTM’s that produces pigment in dark or light conditions

1) M. scrofulaceum (cause of cervical adenitis in children).
2) M. szulgai
3) M. gordonae

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11
Q

Nonphotochromogens are__ and include: 1)__2)__3)__4)__

Which specie(s) is found in hot water taps in hospitals and causes pulmonary infections?

A

non-pigmented regardless of incubation in dark or light conditions

1) M.avium/intracellulare complex (MAC)
2) M.shimoidae
3) M. xenopi – found in hot water taps in hospitals, causes pulmonary infections and disseminated disease\
4) M. genavense

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12
Q

which mycobacterium spp. causes lymphadentitis and Pulmonary infections but is not consided TB because patients rarely presents with granulomas or tissue death?

A

Mycobacterium avium Complex

MAC

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13
Q

Important pathogen in AIDS patients.

Not spread from person to person, (which is different than TB).

A

Mycobacterium avium Complex (MAC)

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14
Q

Pateints infected by MAC often aquire bronchitis, why?

A

-increased mucous production puts miechanical stress on the bronchioles that results in inflamation.

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15
Q

Rapid growers are__ and include 1)__2)__

They will grow on 3)___ and appear 4)___ on that media
How many days are the plates innoculated 5)__ and when will you see growth?(6)

A

1) M. fortuitum
2) M. chelonae
3) MacConkey’s
4) It has crystal violet omitted
5) 7 days
6) 5 days

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16
Q
  • Has not been grown in vitro
  • it is an obligate intracellular bacteria
    2) what are the natural reservour of this?
    3) what disease does this orginism cause?
A

M. leprae

2) armadillos and mice
3) leprosy

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17
Q

what is the most common sample for Mycobacterium? when should it be collected?

A
  • sputum

- early morning for 3 cons. days

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18
Q

for the processing of sputum specimens for acid fast bacteria what special steps are required?
2) is this necissary with specimens from sterile sites?

A
  • digestion (lyse mucin to release agents)
  • decontamination (elimination of mixed bacterial flora using NaOH)
  • neutralization (with buffer or water)
  • centrifugation
    2) no
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19
Q

what is the preferred method for digestion/ decontamination?

2)what agent is the mucolytic agent?

A

N-acetyl-L-cysteine (NALC) NaOH method – NaOH reduced to 2% when mixed with NALC
2) NALC

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20
Q

ATS level I____1)
ATS level II____2)
ATS level III____3)
which levels can only be performed in a BSL3 Lab?

A

1)grow mycobacterium and stain but do not ID
2)Identify TB only.
3)Identify all mycobacteria spp. and perform susceptibility testing.
II and III

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21
Q
  • BSC & centrifuge room should have nonpermeable walls and work surfaces.
  • Directional air flow.
  • BSL space air vented through HEPA filters directly to outside.

what BSL level is this?

A

3

22
Q

Mycobacerium staining methods:

1) (cold) method- uses a higher concentration of __ in the primary stain to accelerate the staining process and thus does not require heat.
3) Hot method

A

1) Kinyoun method
2) phenol
3) Ziehl-neelsen

23
Q

‘fast’ in Acid-‘fast’ here means___1)

due to high lipid cell content mycobacterium binds___2)dye and resist____3)

A

1) firmly fixed, or securely attached
2) fuchsin dye
3) destaining of acid alcohols

24
Q

the ____ stain saves time in examination and is equivalent to ___ fields of view vs. 300 for acid fast

A
  • fluorochrome

- 30

25
Q
  • For optimal recovery of Mycobacteria spp. should use at ____
  • Two solid media (tubed or plates) should be used:
    1) ____ 2)___
A
  • least one solid media and a liquid medium
    1) one with agar base
    2) one with egg- potato base
26
Q

2 examples of egg potato base solid medium is?

1) coagulated whole eggs, glycerol__(does what)__1.5), potato flour, Malachite green
2) coagulated whole eggs, egg yolks, whole milk, potato, potato flour, Malachite green.

A

1) Löwenstein-Jensen
1. 5) enhances growth
2) Petragnani

27
Q

skin specimens should be incubated at___ C
what species of mycobacterium is this typically for??

Mycobacterium tuberculosis takes on average__3)weeks to grow and susceptibility testing takes and additional __4)weeks for a total of 4-8 weeks on average

A

1) 25-30
2) M. marinum M.ulcerans
3) 2-4
4) 2-4

28
Q

1) scotochromogens tend to be a ___ pigment

2) non pigmented tend to be __ pigment

A

1) deep yellow to orange

2) buff tan to pale yellow

29
Q

All mycobacterium produce___1) but some species lack the enzyme to cover___ 1) to __1) ribonucleotide resulting in an accumulation in ___1) in the culture medium

A

1) niacin

30
Q

Spp. that lack the enzyme to convert niacin into niacin ribonucleotide and there for would be considered ___ for niacin accumulation

is this test enough for ID of mycobacterium?

A
  • M. tuberculosis, M. simile and occasionally (M. bovis, M. africanum, M. marinum)
  • positive
  • no
31
Q

M. tuberculosis and M. Kansasii are nitrate reduction__1)
and
__ 2) are quick positive 3-6hrs for Tween 8 hydrolysis test
3) those in Mycobacterium Tuberculosis complex tend to be Tween Hydrolysis___ and do not produce___

A

positive

  • M. kansasii
  • negative
  • heat stable catalase
32
Q

T or F
GenoType Mycobacteria direct test (Germany)- is possibly more sensitive than other molecular methods in smear negative samples.

A

T

33
Q

Enhanced Amplified Mycobacterium Tuberculosis Direct Test is possibly more sensitive than other molecular methods in smear negative samples

A

F

34
Q

M. Tuberculosis ID

  • Culture growth w/in 4 – 8 weeks
  • Rough, dry, buff, non-pigmented on ___1)
  • Strong Acid-fast +, ___2) appearance.
  • niacin & nitrate reduction___3).
  • 68 degree Catalase ___4).
A

1) Lowenstein-Jensen media.
2) slightly curved rods, beaded
3) positive
4) negative

35
Q

TB is ___ resistant

A

rifampin

36
Q

inoculate organism to media with varying known concentrations of antibiotic and looks for inhibition providing MIC.

A

absolute concentration

37
Q

T or F

Everyone that is exposed to TB will progress to active TB disease

A

F

38
Q

T or F

not everyone that is exposed to TB will progress to active TB disease

A

T

39
Q

person with latent TB that manifests as disease at later time (immune system becomes compromised for some reason)

A

secondary (reactivation) TB

40
Q

form of TB:

spread to other organs hematogenously.

A

Military TB

41
Q

form of TB:
the initial infection in a previously unexposed individual, 2 potential outcomes: Latent TB infection(have antibodies but no disease) and Active infection/disease

A

Primary TB

42
Q

Why are Macrophages unable to kill mycobacteria?

A

Mycobacteria block the proteins that mediate the fusion of the phagosome with the lysosome.

43
Q

TH1 cells also recruit monocytes to the infection site and they differentiate into ___1) like cells which are the hallmark of___2) formation effectively walling off the bacteria. This formation allows for ___(type TB infection)__

A

1) “epithelioid”
2) granuloma
3) secondary TB

44
Q 
Mimics others – asymptomatic  to symptomatic
Low grade fevers
Anorexia and weight loss 
Fatigue & night sweats
Productive cough
Fever/chills
A

Clinical Presentation for Pulmonary TB

45
Q

Clinical screening for TB:
Blood test utilizing 3 proteins derived from Mycobacteria tuberculosis complex and tests for interferon-gamma released by the patients T cells in response to the 3 proteins (memory) using ELISA technology.

A

QuantiFERON-TB Gold In-Tube test

46
Q

Clinical screening for TB:

  • Delayed appearance of indurated (raised, hard) reaction with/wo erythema.
  • Positive test does not distinguish between present & past infection.
  • Recent conversion of a negative to a positive reaction demands clinical attention.
  • Results Interpretation
A

Purified Protein Derivative (PPD) – intradermally

47
Q

TB resistance to isoniazid and rifampin.

A

Multidrug Resistant TB-

48
Q

TB resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line aminoglycosides (i.e., amikacin, kanamycin, or capreomycin).

A

Extensively Drug Resistant TB-

49
Q

association between Johne’s disease in cattle (inflammatory bowel disease) and Crohn’s disease in humans

A

M. avium subsp. paratuberculosis

50
Q

Leprosy aka ___

A

Hansen’s Disease

Diagnostic Micro(dylan) (2 decks)

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