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Preresidency > NTM > Flashcards

NTM Flashcards

1
Q

What comprises the tuberculous mycobacterium group?

A 
Mycobacterium tuberculosis
Mycobacterium bovis
Mycobacterium africanum
Mycobacterium leprae
Mycobacterium caprae
Microbacterium pinnipedii
Microbacterium canetti
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2
Q

Associated with aquifers

A

M. simiae

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3
Q

Associated with pedicure baths

A

M. fortuitum

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4
Q

Associated with metalworking fluids

A

M. immunogem

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5
Q

Human-to-human transmission of NTM in?

A

Cystic fibrosis

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6
Q

M. ulcerans causes this

A

Buruli ulcer

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7
Q

Crucial element in mycobacterial infection control

A

TNF-alpha

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8
Q

Other elements important in defense against NTM

A

IL-12 and IFN-gamma

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9
Q

Best recognized underlying condition for pulmonary infection with NTM

A

Bronchiectasis

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10
Q

Define: hot-tub lung

A

Pulmonary hypersensitivity to NTM growing in underchlorinated water

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11
Q

Rapidly growing NTM and HIV patients

A

They are rare.

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12
Q

Most important step in diagnosis of NTM

A

Suspect infection with NTM

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13
Q

Most common form of NTM infection in the industrialized world

A

Pulmonary disease

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14
Q

Clinical picture of pulmonary NTM picture

A

Months of throat clearing, nagging cough and slowly progressive fatigue

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15
Q

This procedure may be required for pulmonary NTM diagnosis

A

Bronchoscopy

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16
Q

Demographic of MAC infection

A

Elderly females with or without sputum production or chest pain

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17
Q

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

A

Lady Windermere syndrome

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18
Q

This organism causes a condition similar to tuberculosis

A

M. kansasii

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19
Q

M. abscessus and other fast growing NTM are associated with

A

Esophageal motility disorders such as achalasia

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20
Q

Most common form of NTM infection among young children in NA

A

Isolated cervical lymphadenopathy

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21
Q

Cutaneous NTM infection requires

A

Break in the skin

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22
Q

Cutaneous NTM usually associated with these organisms

A

Fast growing organisms

23
Q

Presentation of cutaneous NTM

A

Painful, erythematous, draining subcutaneous nodules

24
Q

M. marinum clinical presentation

A

Fish-tank granuloma (papules or ulcers)

Nodules similar to sporothrix schenkii

25
Q

Test for detecting NTM

A

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

26
Q

Most sensitive step in the diagnosis

A

Include it in the differential

27
Q

Definition of rapidly growing and slow growing

A

Rapid: < 7 days
Slow: > 7 days

28
Q

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

A

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

29
Q

Old categorization of NTM

A

Photochromogenicity
Scotochromogenicity
Nonchromogenicity

30
Q

Newer methods of classifying NTM

A

High-performance liquid chromatography

Mass spectrometry

31
Q

American Thoracic Society general guidelines for diagnosis

A
  1. Disease is clearly demonstrable
  2. Repeated isolation of NTM from expectorations
  3. Speciated
32
Q

NTM and PPD

A

NTM can cause false positive PPDs

33
Q

Cut-off value for PPD that signifies tuberculosis

A

15 mm

34
Q

Assay used to measure elaboration of IFN-gamma response?

A

IGRAs

Interferon Gamma Release Assays

35
Q

Characteristic lung finding of NTM

A

Tree-in-bud pattern of bronchiolar inflammation

36
Q

Lobes involved in NTM lung infection

A

Lingual and right-middle lobes

37
Q

American Thoracic Society criteria for NTM diagnosis

A

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

38
Q

Test MAC for susceptibility to?

A

Clarithromycin

39
Q

Test M. kansasiii for susceptibility to?

A

Rifampin

40
Q

Prophylaxis of MAC

A

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

41
Q

Treatment of MAC

A

Macrolide
Ethambutol
Rifamycin

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

42
Q

Cannot use rifamycin in HIV patients because?

A

Interaction with protease inhibitors

43
Q

Watch out when using rifabutin in?

A

Elderly (toxicity)

44
Q

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

A

Resection

45
Q

Success of treatment depends on

A

Early or advanced

Nodular or cavitary disease

46
Q

Treatment for M. kansasii

A

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

47
Q

M. kansasii infection lymphadenopathy in mediastinum associated with

A

GATA2 deficiency

48
Q

Causes of extrapulmonary NTM disease in immunocompetent

A

Inoculation

Line infection

49
Q

Therapy for extrapulmonary NTM

A

Macrolide and another drug

50
Q

Therapy for M. abscessus pulmonary disease

A

Macrolide

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

51
Q

Easiest NTM to cure

A

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

52
Q

General effective drug classes against NTM

A

Macrolides and aminoglycosides

53
Q

Optimal duration of treatment for NTM

A

Unknown

Preresidency (17 decks)

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