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Pulmonology > Pulmonary Tuberculosis > Flashcards

Pulmonary Tuberculosis Flashcards

1
Q

Facilitate the survival of M. Tuberculosis with macrophage (Harrison pp 1103)

A

Lipoarabinomanan

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2
Q

Responsible for the acid fastness of the M. Tuberculosis (Harrison pp 1103)

A

Mycolic Acid

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3
Q

What country has the highest proportions of MDR disease among NEW TB cases (Harrison pp 1104)

A

Former Sovient Union

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4
Q

Resistance to 2nd line Anti TB drugs (Harrison pp 1104)

A

Extended drug resistant TB

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5
Q

2nd line Anti-TB drugs (Harrison pp 1105)

A

Fluoroquinolones
Amikacin
Kanamycin
Capreomycin

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6
Q

Countries that are resistance to ALL Anti-TB drugs (Harrison pp 1105)

A

I^3
I ndia
I taly
I ran

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7
Q

Tuberculosis is most commonly transmitted through _____ (Harrison pp 1105)

A

Droplet nuclei

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8
Q

What are the important determinants of the likelihood of transmission? (Harrison pp 1105)

A 
IDS
Intimacy
Duration of exposure
Degree of infectiousness
Shared environment
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9
Q

Most infectious patients with M. Tuberculosis are the following: (Harrison pp 1105)

A

Cavitary TB
Laryngeal TB
10^5 - 10^7 AFB/ml sputum containing

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10
Q

One of the most important factors in the transmission of tubercle bacilli (pp 1105)

A

Crowding in poorly ventilated rooms

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11
Q

Important determinant of risk of disease AFTER infections (Harrison pp 1105)

A

AGE

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12
Q

Risk factors for ACUTE tuberculosis in patient who have been infected with tubercle bacilli (Harrison pp 1005)

A

Post transplantation
HIV infection
Jejunoileal bypass

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13
Q

Most potent risk factor for TB among infected individuals (Harrison pp 1105)

A

HIV co-infection

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14
Q

This is the key in attenuating mutation and also seen absence in BCG vaccine (Harrison pp 1106)

A

Region of difference 1 (RD1)

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15
Q

It is ______ critical at the early stage of macrophage activating response (Harrison pp 1107)

A

Cell Mediated Immunity (CMI)

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16
Q

Tissue damaging response (Harrison pp 1106)

A

Delayed-Type hypersensitivity (DTH)

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17
Q

TH1 cells produces _____ (Harrison pp 1107)

A

Macrophage

Monocytes

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18
Q

TH2 cells produces ______ (Harrison pp 1107)

A

IL-4, IL-5, IL-10, IL-13

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19
Q

Uses primarily for the detection of M. Tuberculosis infection in person without symptoms (Harrison pp 1107)

A

Tuberculin Skin Test (TST)

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20
Q

Primary pulmonary TB affects what lobes? (Harrison pp 1108)

A

Middle and lower lung zones

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21
Q

Lesion after initial infection that usually peripheral and accompanied by transient hilar or paratrachael lymphadenopathy (Harrison pp 1108)

A

Ghon Focus

22
Q

Ghon focus is associated with the following disease (Harrison pp 1108)

A

Erythema nodosum

Phlyctenular conjunctivitis

23
Q

Ghon focus w/ or w/o overlying pleural reaction thickening and regional lymphadenopathy (Harrison 1108)

A

Ghon complex

24
Q

What is usually affected segments with post primary (adult type) disease? (Harrison pp 1108)

A

Apical and posterior upper lobe

Superior segments of lower lobe

25
Q

If left untreated, 1/3 succumb to severe pulmonary TB w/in a few months after onset (Harrison pp 1108)

A

Classic galloping consumption

26
Q

Rupture of dilated vessel in a cavity (Harrison pp 1108)

A

Rasmussen’s aneursym

27
Q

What is the common hematologic findings in post primary (Adult) disease? (Harrison pp 1109)

A 
Mild anemia
Leukocytosis 
Thrombocytopenia
Î ESR 
Î CRP
28
Q

Extrapulmonary sites most commonly involved in TB (Harrison pp 1109)

A
  1. Lymph nodes
  2. Pleura
  3. Genitourinary tract
  4. Bones/joints
  5. Peritoneum
  6. Pericardium
29
Q

Painless swelling of the lymph nodes most commonly at _____ and ________. (Harrison pp 1109)

A

Posterior cervical

Supraclavicular sites

30
Q

Necrotizing histocytic lymphadenitis (Harrison pp 1109)

A

Kikuchi’s disease

31
Q

Nearly always complication of advanced cavitary pulmonary TB (Harrison pp 1110)

A

TB of the upper airways

32
Q

TB of the upper airway involved the following (Harrison pp 1110)

A

Larynx
Pharynx
Epiglottis

33
Q

In female genitourinary TB, it is usually involved which sites (Harrison pp 1110)

A

FEmale
F allopian Tubes
E ndometrium

34
Q

In male genitourinary TB, it is usually affects which site? (Harrison pp 1110)

A

Epididymis

35
Q

Most commonly involved in skeletal TB (Harrison pp 1110)

A

Spine 40% (Potts Disease)
Hips 13%
Knees 10%

36
Q

In children, the commonly involved spine would be _______. (Harrison pp 1110)

A

Uppper thoracic spine

37
Q

In adults, the commonly involved spine would be _____ (Harrison pp 1110)

A

Lower thoracic

Upper lumbar vertebrae

38
Q

The most catastrophic complication of Pott’s disease (Harrison pp 1110)

A

Paraplegia

39
Q

Tuberculosis meningitis is spread via (Harrison pp 1110)

A

Hematogenous spread

Rupture of a subependymal tubercle

40
Q

What nerve is frequent findings of tuberculosis meningitis? (Harrison pp 1111)

A

Ocular Nerve

41
Q

What is the cornerstone of diagnosis for TB meningitis? (Harrison pp 1111)

A

Lumbar puncture

42
Q

In TB of the gastrointestinal which is usually involved? (Harrison pp 1111)

A

Terminal ileum

Cecum

43
Q

In pericardial TB, it is usually affected or seen in patients ______ and _______. (Harrison pp 1111)

A

Elderly

HIV infected

44
Q

What is the definitive diagnosis of pericardial tuberculosis? (Harrison pp 1111)

A

Pericardiocentesis

45
Q

What is the pathogonomic of miliary TB? (Harrison pp 1112)

A

Choroidal tubercles

46
Q

Rare presentation seen in elderly that is characterized by mild intermittent fever anemia and meningeal involvement. (Harrison pp 1112)

A

Cryptic miliary TB

47
Q

It is more common among patient w/ advanced immunosuppression and extrapulmonary TB after taking adminstration of ART. (Harrison pp 1112)

A

Immune reconstitution inflammatory syndrome

TB immune reconstitution disease

48
Q

False negative reaction in PPD (Harrsion pp 1112)

A

Immunosuppression patient

Overwhelming TB

49
Q

False positive reaction in PPD (Harrison pp 1112)

A

Nontuberculous mycobacteria

BCG vaccination

50
Q

Spurious TST conversion resulting from boosting of reactivity on subsequent TST 1-5 weeks after initial test (Harrison pp 1112)

A

Boosting phenomenom

51
Q

What are the 3rd line agents for TB? (Harrison pp1115)

A 
Clofazimine 
Linezolid 
Amoxicillin/Clavulanic
Clarithromycin 
Carbapenem
Imipenem
Meropenem

Pulmonology (9 decks)

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