NTM

Question 1

What comprises the tuberculous mycobacterium group?

Answer 1

Mycobacterium tuberculosis
Mycobacterium bovis
Mycobacterium africanum
Mycobacterium leprae
Mycobacterium caprae
Microbacterium pinnipedii
Microbacterium canetti

Question 2

Associated with aquifers

Answer 2

M. simiae

Question 3

Associated with pedicure baths

Answer 3

M. fortuitum

Question 4

Associated with metalworking fluids

Answer 4

M. immunogem

Question 5

Human-to-human transmission of NTM in?

Answer 5

Cystic fibrosis

Question 6

M. ulcerans causes this

Answer 6

Buruli ulcer

Question 7

Crucial element in mycobacterial infection control

Answer 7

TNF-alpha

Question 8

Other elements important in defense against NTM

Answer 8

IL-12 and IFN-gamma

Question 9

Best recognized underlying condition for pulmonary infection with NTM

Answer 9

Bronchiectasis

Question 10

Define: hot-tub lung

Answer 10

Pulmonary hypersensitivity to NTM growing in underchlorinated water

Question 11

Rapidly growing NTM and HIV patients

Answer 11

They are rare.

Question 12

Most important step in diagnosis of NTM

Answer 12

Suspect infection with NTM

Question 13

Most common form of NTM infection in the industrialized world

Answer 13

Pulmonary disease

Question 14

Clinical picture of pulmonary NTM picture

Answer 14

Months of throat clearing, nagging cough and slowly progressive fatigue

Question 15

This procedure may be required for pulmonary NTM diagnosis

Answer 15

Bronchoscopy

Question 16

Demographic of MAC infection

Answer 16

Elderly females with or without sputum production or chest pain

Question 17

NTM pulmonary disease, tall and thin lady, and chest wall abnormalities

Answer 17

Lady Windermere syndrome

Question 18

This organism causes a condition similar to tuberculosis

Answer 18

M. kansasii

Question 19

M. abscessus and other fast growing NTM are associated with

Answer 19

Esophageal motility disorders such as achalasia

Question 20

Most common form of NTM infection among young children in NA

Answer 20

Isolated cervical lymphadenopathy

Question 21

Cutaneous NTM infection requires

Answer 21

Break in the skin

Question 22

Cutaneous NTM usually associated with these organisms

Answer 22

Fast growing organisms

Question 23

Presentation of cutaneous NTM

Answer 23

Painful, erythematous, draining subcutaneous nodules

Question 24

M. marinum clinical presentation

Answer 24

Fish-tank granuloma (papules or ulcers)

Nodules similar to sporothrix schenkii

Question 25

Test for detecting NTM

Answer 25

Acid-fast or fluorochrome smears of sputum or other body fluids

Question 26

Most sensitive step in the diagnosis

Answer 26

Include it in the differential

Question 27

Definition of rapidly growing and slow growing

Answer 27

Rapid: < 7 days Slow: > 7 days

Question 28

Amount of time required to consider culture results final for M. tuberculosis

Answer 28

6 weeks (2 weeks for M. tuberculosis to grow)

Question 29

Old categorization of NTM

Answer 29

Photochromogenicity Scotochromogenicity Nonchromogenicity

Question 30

Newer methods of classifying NTM

Answer 30

High-performance liquid chromatography | Mass spectrometry

Question 31

American Thoracic Society general guidelines for diagnosis

Answer 31

1. Disease is clearly demonstrable 2. Repeated isolation of NTM from expectorations 3. Speciated

Question 32

NTM and PPD

Answer 32

NTM can cause false positive PPDs

Question 33

Cut-off value for PPD that signifies tuberculosis

Answer 33

15 mm

Question 34

Assay used to measure elaboration of IFN-gamma response?

Answer 34

IGRAs | Interferon Gamma Release Assays

Question 35

Characteristic lung finding of NTM

Answer 35

Tree-in-bud pattern of bronchiolar inflammation

Question 36

Lobes involved in NTM lung infection

Answer 36

Lingual and right-middle lobes

Question 37

American Thoracic Society criteria for NTM diagnosis

Answer 37

NTM growth from 2 of 3 sputum samples regardless of smear findings Positive bronchoscopic alveolar sample regardless of smear findings Pulmonary parenchyma biopsy sample with granulomatous inflammation or mycobacteria found on section and NTM found on culture

Question 38

Test MAC for susceptibility to?

Answer 38

Clarithromycin

Question 39

Test M. kansasiii for susceptibility to?

Answer 39

Rifampin

Question 40

Prophylaxis of MAC

Answer 40

Azithromycin 1200 mg weekly Clarithromycin 1g daily Rifabutin 300 mg daily

Question 41

Treatment of MAC

Answer 41

Macrolide Ethambutol Rifamycin 3x/week x until 12 months after culture conversion (18 months)

Question 42

Cannot use rifamycin in HIV patients because?

Answer 42

Interaction with protease inhibitors

Question 43

Watch out when using rifabutin in?

Answer 43

Elderly (toxicity)

Question 44

Treatment for cavitary lesions or severely bronchiectatic segments in macro-lie resistant strains

Answer 44

Resection

Question 45

Success of treatment depends on

Answer 45

Early or advanced | Nodular or cavitary disease

Question 46

Treatment for M. kansasii

Answer 46

Isoniazid 300 mg/d Rifampin 600 mg/d Ethambutol 15 mg/kg/day

Question 47

M. kansasii infection lymphadenopathy in mediastinum associated with

Answer 47

GATA2 deficiency

Question 48

Causes of extrapulmonary NTM disease in immunocompetent

Answer 48

Inoculation | Line infection

Question 49

Therapy for extrapulmonary NTM

Answer 49

Macrolide and another drug

Question 50

Therapy for M. abscessus pulmonary disease

Answer 50

Macrolide | IV-administered agent (amikacin, carbapenem, cefoxitin or tigecycline)

Question 51

Easiest NTM to cure

Answer 51

M. marinum (1 - 2 months after clinical resolution)

Question 52

General effective drug classes against NTM

Answer 52

Macrolides and aminoglycosides

Question 53

Optimal duration of treatment for NTM

Answer 53

Unknown