Pulmonary Tuberculosis

Question 1

Pulmonary Tuberculosis was nearly eradicated worldwide, but reemerged ___

Answer 1

in 1985 due to HIV/AIDS

Question 2

How many people worldwide are infected with tuberculosis

Answer 2

~2.3 billion persons (1/3)

Question 3

each year how many people become ill with Tb

Answer 3

over 9 million

Question 4

there are ____ deaths due to Tb each year

Answer 4

1.4 million

Question 5

In the US ___ persons live with Tb

Answer 5

10-12 million

Question 6

what is the etiological agent of Pulmonary Tuberculosis

Answer 6

Mycobacterium tuberculosis

Question 7

Describe the etiological agent of Pulmonary Tuberculosis

Answer 7

Acid-fast, rod-shaped, and can be grown in lab

Question 8

who discovered the Mycobacterium tuberculosis

Answer 8

Koch in 1882

Question 9

Visible growth takes ___ on solid nutrient medium

Answer 9

3-8 weeks

Question 10

what are the only reservoirs for Mycobacterium tuberculosis

Answer 10

Humans

Question 11

Describe stage one of Pulmonary Tb

Answer 11

Mycobacterium tuberculosis is in droplet nuclei and inhaled and travels to alveolar sacs and are ingested by macrophages. Bacteriostatic influence is minimal but bacilli replication is unrestrained.

Question 12

Describe stage two of Pulmonary Tb

Answer 12

Tuberculosis bacilli grow w/in alveolar macrophages developing granuloma (tubercle). Blood borne macrophages are recruited and added to the granuloma and now contain bacilli that continue to multiply

Question 13

Describe stage three of Pulmonary Tb

Answer 13

DTH responses leads to tissue necrosis that tends to be incomplete. This results in the formation of a solid/semisolid material referred to as caseous. This caseous centered bacilli does not multiply

Question 14

Describe Stage four of Pulmonary Tb

Answer 14

The caseous solid liquefies and spreads through the bronchial tree producing a tuberculosis cavity. Infectious bacilli sloughed from cavity results in new foci in other parts of the lungs can be expelled and infect other persons

Question 15

In 1667, ___ of deaths in London were attributed to consumption

Answer 15

25%

Question 16

What were the two other names tuberculosis was known by and who gave the names.

Answer 16

Sylvius named it Consumption and Hippocrates named it phthisis, meaning “to melt” or “ to waste away”

Question 17

Oliver Wendell Holms used the term ____ to bring attention to the effects of consumption on society

Answer 17

The White Plague

Question 18

What era of time did Tuberculosis have the largest effect

Answer 18

The Renaissance

Question 19

Tuberculosis emerged as a major plague of which centuries

Answer 19

18th and 19th

Question 20

___ established the first tuberculosis sanatorium in Germany in ____

Answer 20

Hemann Brehmer ; 1854

Question 21

Who established the first tuberculosis sanatorium in the US and when

Answer 21

Edward Trudeau 1885

Question 22

By 1931, US had ___ specialized tuberculosis hospitals w/ total bed capacities of >80,000

Answer 22

633

Question 23

___ produced a tuberculin and was thought to be a cure but proved no positive results but used today as diagnostic skin test

Answer 23

Koch

Question 24

How is a Purified Protein Derivative test shown to be positive

Answer 24

diameter of induration (hard, raised area with clearly defined margins) recognized within 48-72 hours

Question 25

Modern era of tuberculosis treatment began in ___when antibiotic ____ was found to be effective against mycobacterium tuberculosis

Answer 25

1946 ; streptomycin

Question 26

why is it difficult to diagnose tuberculosis in a HIV/AIDS patient

Answer 26

Chest x-ray looks normal due to lack of cavitation; PPD skin test negative due to loss of DTH responses (anergic)

Question 27

The incidence of pulmonary Tb is ___ higher in persons infected w/ HIV-1 compared to general population

Answer 27

500x

Question 28

____ is the leading cause of death among persons with HIV/AIDS

Answer 28

Pulmonary Tuberculosis

Question 29

what is BCG

Answer 29

Bacillus Calmette-Guerin, a live attenuated vaccine prepared from Mycobacterium bovis

Question 30

BCG vaccination of children results in ____ decrease in incidence of tuberculosis

Answer 30

60-80%