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PULMONOLOGY > PTB > Flashcards

PTB Flashcards

1
Q

Which of the following is considered the most infectious form of pulmonary tuberculosis?

A

C: Cavitary TB

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2
Q

Which of the following conditions has the highest relative risk for developing active tuberculosis after infection with tubercle bacilli?

A

D: HIV infection

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3
Q

T/F. A person should maintain a distance of three meters from anyone who is symptomatic of TB.

A

F: False

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4
Q

The following are the clinical findings of Primary PTB Disease, except:

A

A: Symptomatic

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5
Q

The following are the clinical findings of Post-Primary PTB Disease, except:

A

D: Often abnormal chest PE

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6
Q

It is often seen in young children. (+) evidence of pulmonary TB in 50% cases. The neurologic symptoms are headache, fever, nuchal rigidity, irritability, and altered sensorium.

A

A: TB meningitis

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7
Q

It is straw-colored or sanguineous. Usually reflects primary disease. The PF analysis are exudative, high protein, and lymphocytic predominance.

A

C: Pleural TB

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8
Q

Which of the following is correctly matched:

A

B: Detecting Presence of Infection: X-ray

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9
Q

Which of the following statements is TRUE:

A

E: AOTA

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10
Q

If a patient has no risk factors for tuberculosis, what TST reaction size might the patient have?

A

C: TST ≥15mm

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11
Q

Which treatment category indicates CNS TB, TB of Bones or joints?

A

B: Category Ia

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12
Q

What is the etiologic agent of Tuberculosis (TB)?

A

Mycobacterium tuberculosis

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13
Q

What is the shape and structure of Mycobacterium tuberculosis?

A

Rod-shaped, non-spore-forming, thin and slender, aerobic, acid-fast bacilli

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14
Q

What is a unique structural feature of Mycobacterium tuberculosis that enhances its virulence?

A

Its cell wall has mycolic acids, arabinogalactan, and peptidoglycan, which reduce antibiotic effectiveness and enhance survival within macrophages.

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15
Q

How is TB primarily transmitted?

A

Through airborne droplet nuclei from a person with active TB, especially when coughing or sneezing.

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16
Q

What are the most infectious forms of TB?

A

Cavitary pulmonary TB and laryngeal TB

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17
Q

Which population has a higher TB incidence according to WHO’s 2019 report?

A

Males, and mostly in low- and middle-income countries

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18
Q

What increases the risk of TB reactivation?

A

HIV infection, which compromises the immune system

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19
Q

True or False: Cavitary pulmonary TB is less infectious than laryngeal TB.

A

False, cavitary TB is highly infectious, though laryngeal TB is also infectious.

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20
Q

What kind of immune response does TB primarily stimulate?

A

T-cell mediated immune response that leads to granuloma formation and caseous necrosis

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21
Q

How does TB infection begin in the body?

A

Tubercle bacilli enter macrophages in the lungs, where they can multiply if not destroyed by the immune system.

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22
Q

True or False: Latent TB infection has a low chance of reactivating in HIV-positive patients.

A

False, HIV-positive patients have a high risk of TB reactivation.

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23
Q

What diagnostic test is used to detect TB antibodies in the skin?

A

The Tuberculin Skin Test (TST) or Mantoux test

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24
Q

What is the primary mode of transmission for TB in crowded environments?

A

Airborne transmission through droplet nuclei that stay suspended in the air for hours

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25
Q

What social factor often leads to delayed TB treatment?

A

Stigma associated with the disease, causing people to seek private treatment instead of government health services.

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26
Q

In what type of environment is TB transmission more likely?

A

In poorly ventilated, crowded places such as dormitories or households with many residents

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27
Q

True or False: Tuberculosis is inherited.

A

False, TB is not hereditary but is transmitted from person to person.

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28
Q

What is a common symptom of TB due to lymphokine release?

A

Fever, malaise, anorexia, and weight loss

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29
Q

Which immune response directly contributes to tissue damage in TB?

A

Delayed hypersensitivity reaction, leading to caseating necrosis

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30
Q

What is the second leading cause of mortality worldwide?

A

Tuberculosis (TB), particularly in low- and middle-income countries

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31
Q

What is granuloma formation, and what triggers it in TB?

A

A host immune response where macrophages surround TB bacteria, often leading to caseous necrosis, triggered by T-cells.

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32
Q

Which diagnostic technique involves visualizing TB bacteria in sputum samples?

A

AFB Microscopy or Direct Sputum Smear Microscopy (DDSSM)

33
Q

Which type of TB occurs outside the lungs?

A

Extrapulmonary TB, affecting organs like lymph nodes, pleura, and bones

34
Q

How long can TB droplet nuclei remain airborne in a room?

A

Up to seven hours

35
Q

True or False: Acid-fast bacilli like Mycobacterium tuberculosis can be stained with Gram stain.

A

False, M. tuberculosis does not stain with Gram stain but is acid-fast.

36
Q

What is the approximate size of Mycobacterium tuberculosis?

A

0.5 to 3 μm

37
Q

What is latent TB infection?

A

“Latent TB infection (LTBI) is a state where M. Tb antigens stimulate an immune response without active disease or symptoms. Patients with LTBI can be treated to prevent progression to active TB.”

38
Q

What is the difference between latent TB infection and TB disease?

A

“Latent TB infection has no symptoms

39
Q

What new evidence is there about latent TB infection?

A

“Bacilli form biofilms in necrotic areas

40
Q

Should latent TB infection be treated?

A

“Yes

41
Q

What is the most common symptom of pulmonary TB?

A

“Chronic cough. If ‘chronic cough’ is not an option

42
Q

What are common symptoms of pulmonary TB?

A

“Night sweats

43
Q

What is primary TB and who does it commonly affect?

A

“Primary TB occurs soon after infection

44
Q

What are Ghon’s focus and Ghon complex?

A

“Ghon focus is the primary site of TB infection

45
Q

What are typical findings in reactivation (secondary) TB?

A

“Symptoms include chronic cough

46
Q

What are the signs of extrapulmonary TB?

A

“Extrapulmonary TB commonly affects lymph nodes

47
Q

What is scrofula?

A

“A presentation of lymph node TB with painless swelling in the cervical and supraclavicular lymph nodes

48
Q

What are the features of pleural TB?

A

“Pleural TB has straw-colored or bloody fluid

49
Q

What is skeletal TB (Pott’s disease)?

A

“Skeletal TB affects weight-bearing joints

50
Q

What is TB meningitis and who is at risk?

A

“TB meningitis is often seen in young children and adults with HIV. It presents with headache

51
Q

What are symptoms of genitourinary TB?

A

“Urinary frequency

52
Q

What are signs of gastrointestinal TB?

A

“Abdominal pain

53
Q

What is pericardial TB?

A

“Pericardial TB presents with fever

54
Q

What is miliary TB?

A

“Miliary TB results from hematogenous spread of TB

55
Q

Q: What is the preferred radiographic examination for tuberculosis?

A

“A: Chest radiograph.”

56
Q

Q: Where are infiltrates with cavitation commonly found in tuberculosis on a chest radiograph?

A

“A: In the upper and middle lobes of the lungs.”

57
Q

Q: Are abnormal findings on a chest radiograph diagnostic for tuberculosis?

A

“A: No

58
Q

Q: What are the sensitivity and specificity of a chest radiograph for detecting tuberculosis?

A

“A: Sensitivity - 87% ,Specificity - 89%

59
Q

Q: What should be asked in a patient’s history when suspecting tuberculosis?

A

“A: Ask about history of TB.”

60
Q

Q: What is the Xpert MTB/RIF assay used for?

A

“A: It is a diagnostic tool for TB with sensitivity of 85% and specificity of 98%. It detects TB and Rifampicin resistance.”

61
Q

Q: What is the specimen requirement for Xpert MTB/RIF assay?

A

“A: Depends on the infected organ (e.g. if there is pleural TB (effusion) then, submit pleural fluid for Xpert MTB; if genitourinary TB then, urine is submitted; if lymphadenitis, then tissue.

62
Q

Q: What molecular method does Xpert MTB/RIF use?

A

“A: Polymerase Chain Reaction (PCR).”

63
Q

Q: What is the sensitivity range for AFB microscopy (DSSM)?

A

“A: 40-60%.”

64
Q

Q: What staining method is used in AFB microscopy?

A

“A: Ziehl-Neelsen Stain.”

65
Q

Q: What are the advantages and disadvantages of Ziehl-Neelsen Stain?

A

“A: Advantage - Cheap and easy to perform. Disadvantage - Requires 5000-10000 AFB/ml.”

66
Q

Q: What is the gold standard for mycobacterial culture?

A

“A: Mycobacterial Growth Indicator Tube (MGIT) - WHO recommended.”

67
Q

Q: How long does mycobacterial culture typically take?

A

“A: 10 days to 2-3 weeks with liquid media; 4-8 weeks with solid media.”

68
Q

Q: What are advantages of mycobacterial culture over other TB tests?

A

“A: Higher specificity (~99%) and sensitivity

69
Q

Q: What diagnostic tools are used for extrapulmonary tuberculosis?

A

“A: Fluid analysis

70
Q

Q: What is the sequence of TB diagnosis?

A

“A: Sputum exam

71
Q

Q: What does drug susceptibility testing assess in TB patients?

A

“A: Sensitivity to at least Rifampicin

72
Q

Q: What factors may lead to a false negative TB result?

A

“A: Age

73
Q

Q: What is the interpretation threshold for a tuberculin skin test (TST) reaction of ≥5mm?

A

“A: Positive in HIV-positive patients

74
Q

Q: What is the adult daily dose for Isoniazid in TB treatment?

A

“A: 5 mg/kg

75
Q

Q: What is the primary aim of TB treatment?

A

“A: To prevent morbidity and death

76
Q

Q: How soon after starting TB treatment is bacterial activity reduced by 50%?

A

“A: Within the first 72 hours.”

77
Q

Q: What is the standard treatment regimen for new pulmonary TB cases?

A

“A: 2 months of HRZE followed by 4 months of HR (2HRZE/4HR).”

78
Q

Q: Why is HIV screening required before TB treatment?

A

“A: Due to potential impact on immune response and treatment success.”

79
Q

Q: What does DOTS stand for?

A

“A: Directly Observed Treatment Strategy for tuberculosis.”

PULMONOLOGY (4 decks)

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