Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

phase 2a rev > resp - toby and louis > Flashcards

resp - toby and louis Flashcards

1
Q

Which property of mycobacterium tuberculosis makes it resistant to normal staining? Therefore, what are TB bacteria generally described as?

A

Acid-fastness (due to waxy coating)
Acid-fast bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which stain is therefore used to detect TB bacteria and what colour would the bacteria turn? Which medium is used for culture?

A

Zeihl-Neelsen staining
Would turn red
Löwenstein- Jensen medium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

2 groups in which TB is more prevalent?

A

South Asian people and immunocompromised, e.g. HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Granulomas form around the body in a TB infection. Caseous necrosis then occurs to the tissue inside the granuloma. In primary TB, what are these known as in the lung?

A

Ghon focus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A primary Ghon focus and associated lymph node involvement make up which radiological finding?

A

Ghon complex (CXR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Can you name 4 different types/stages of TB?

A

Active = active infection within various areas of body
Latent = progression of disease stopped
Secondary = when latent TB reactivates (5-10%)
Miliary = uncontrolled spread of disease (disseminated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The most common site for TB infections is in the lung as the bacteria have high oxygen demands. Can you name some pulmonary TB symptoms?

A

Cough (dry -> productive, 2-3 weeks)
Haemoptysis
Dyspnoea
PLeuritic chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How about systemic symptoms? [TB]

A

Lethargy
Weight loss
Fever
Night sweats
Anorexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How about systemic symptoms? [TB]

A

Lethargy
Weight loss
Fever
Night sweats
Anorexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is it and what is it caused by? [TB]

A

Infectious disease caused by mycobacterium tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How about some extra pulmonary symptoms of TB?

A

Erythema nodosum (cutaneous TB)
Spinal pain (a.k.a. Pott’s disease of spine) (spinal TB)
Lymphadenopathy
Abdominal pain (GI system)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Can you name 6 different investigation for suspected TB (excluding testing for immune response, i.e. latent TB)?

A

1st line = CXR
Sputum culture = while on treatment, the patient should have sputum cultures performed at least monthly until two consecutive cultures are negative
Sputum smear = +ve for AFB
NAAT = positive for M. tuberculosis
FBC = WBC increased
Biopsy (e.g. lymph node) = caveating granuloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the two investigations for testing to see if there has been an immune response to TB?

A

Mantoux test (tuberculin (collection of tuberculosis proteins) injected into skin, >5mm induration is positive) and interferon-gamma release assays (IGRAs, sample of blood mixed with antigens from TB bacteria + interferon-gamma released)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Can you name 2 CXR findings that may be present in TB? How about miliary TB?

A

Fibronodular opacities in upper lobe
+/- consolidation
Miliary = millet seeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the four antibiotics that can be used to treat acute pulmonary TB?

A

RIPE:
- Rifampicin
- Isoniazid
- Pyrazinamide
- Ethambutol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How about the treatment for latent TB?

A

Otherwise healthy patients don’t need treatment, but those at risk of reactivation can either have isoniazid and rifampicin for 3 months or rifampicin for 6 months

16
Q

What are the side effects of the RIPE antibiotics?

A

Rifampicin = red/orange urine/tears
Isoniazid = peripheral neuropathy, i.e. tingling/numbness
Pyrazinamide = gout
Ethambutol = optic neuritis (colour blindness, reduced visual acuity)

17
Q

A patient is started on RIPE for acute pulmonary tuberculosis. What should also be prescribed? Why?

A

Pyridoxine (vitamin B6)
This is because isoniazid has a side effect of peripheral neuropathy

18
Q

TB is a notifiable disease. Which body does this mean needs to be informed?

A

Public Health England (PHE)

19
Q

Which vaccine offers protection against severe and complicated TB (but not always pulmonary TB)? Give 2 examples of groups that may be offered it.

A

BCG vaccine:
- Neonates born in areas of the UK with high rates of TB
- Neonates with relatives from countries with a high rate of TB
- Neonates with a family history of TB
- Unvaccinated older children and young adults (< 35) who have close contacts with TB
- Unvaccinated children or young adults that recently arrived from a country with a high rate of TB
- Healthcare workers

20
Q

What type of hypersensitivity reaction does a TB infection cause?

A

Type IV hypersensitivity

21
Q

What is it and what is its inheritance pattern? [CF]

A

Autosomal recessive condition affecting the mucus glands

22
Q

What is it caused by? [CF]

A

It is caused by a genetic mutation of the CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATORY (CFTR) GENE on chromosome 7

23
Q

What is the most common mutation that causes this? [CF]

A

Delta-F508 mutation

24
Q

General pathophysiology (helps with understanding)? [CF]

A

CFTR gene codes for CFTR protein, a CL- channel present in numerous epithelial tissues -> Cl- cannot be transported into lumen + therefore water does not move out by osmosis, making the mucus thick + sticky -> Na+ also moves into cell via electrochemical gradient = makes mucus more thick + sticky

24
Q

General pathophysiology (helps with understanding)? [CF]

A

CFTR gene codes for CFTR protein, a CL- channel present in numerous epithelial tissues -> Cl- cannot be transported into lumen + therefore water does not move out by osmosis, making the mucus thick + sticky -> Na+ also moves into cell via electrochemical gradient = makes mucus more thick + sticky

25
Q

Both parents are healthy, one sibling has cystic fibrosis and a second child does not have the disease, what is the likelihood of the second child being a carrier of cystic fibrosis?

A

2/3 - we know that the child doesn’t have the condition (both parents must be carriers, however, as AR - 2 carrier parents have a 25% of CF baby)

26
Q

Why is CF a multi system disease?

A

Affects all duct that produce mucus e.g. airway, pancreas, reproductive tract

27
Q

What are the three key consequences of cystic fibrosis?

A

THICK PANCREATIC AND BILIARY SECRETIONS - cause blockage of the ducts, resulting in a lack of digestive enzymes, e.g. pancreatic lipase
THICK AIRWAY SECRETIONS - reduce airway clearance = bacterial colonisation + susceptibility to airway infections
CONGENITAL BILATERAL ABSENCE OF THE VAS DEFERENS in males. Healthy sperm but no way of getting from testes to the ejaculate -> male infertility

28
Q

Which investigation typically diagnoses most cystic fibrosis cases?

A

NEWBORN BLOODSPOT TEST (Guthrie test) - CF is screened for at birth

29
Q

What is often the first sign of cystic fibrosis?

A

MECONIUM ILEUS (20%) - first stool (always black) is thick + sticky, causing it to get stuck and obstruct the bowel - presents as not passing meconium within 24 hours, abdominal distension + vomiting

30
Q

If not diagnosed at birther, how does cystic fibrosis present later on in childhood?

A
  • RECURRENT LOWER RESPIRATORY TRACT INFECTIONS
  • FAILURE TO THRIVE
  • PANCREATITIS
  • Chronic cough + thick sputum production
  • Steatorrhoea (loose, greasy stool due to lack of lipase)
  • Rectal prolapse
  • Clubbing
  • ‘SALTY’ to kiss -concentrated salt in sweat
31
Q

Three complications of cystic fibrosis in adulthood?

A

Diabetes mellitus
Infertility (males)
Pancreatic insufficiency

32
Q

Cystic fibrosis patients struggle to clear their airway, creating a perfect environment for bacteria to grow. What are the two most common types of infection that cystic fibrosis patients are susceptible to?

A

Staphylococcus aureus and pseudomonas aeruginosa (also haemophilia influenza, klebsiella pneumoniae etc.)

33
Q

What are the four key methods for establishing a diagnosis of cystic fibrosis?

A

NEWBORN BLOOD SPOT TESTING
GOLD STANDARD = SWEAT TEST - Na + Cl >60mmol/L
GENETIC TESTING for CFTR gene can be performed during pregnancy by amniocentesis or CVS
Faecal elastase - low due to pancreatic insufficiency

34
Q

Can you name 3 ways in which cystic fibrosis can be managed non-pharmacologically?

A

Chest physiotherapy several times a day is essential to clear mucus and reduce the risk of infection and colonisation
Exercise improves respiratory function and reserve, and helps clear sputum
High calorie diet is required for malabsorption, increased respiratory effort, coughing, infections and physiotherapy

35
Q

Can you name some ways in which cystic fibrosis can be managed pharmacologically?

A

Prophylactic antibiotics - flucloxacillin for staph. aureus, amoxicillin for haemophilus influenza
Nebulised DNase (dornase alfa) - clears airway of mucus
CREON tablets - pancreatic enzyme replacement
Bronchodilators, e.g. salbutamol to treat bronchoconstriction
Fat-soluble vitamin supplements (A, D, E, K)
Nebulised hypertonic saline

phase 2a rev (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions