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PAtho > Self Study 2 > Flashcards

Self Study 2 Flashcards

1
Q

what bact causes TB

A

myobacterium tuberculosis

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2
Q

where does myobacterium TB thrive

A

upper lobe and upper part of lower lobe

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3
Q

why does MBTB thrive in certain areas of the lung

A

they are aerobic bacteria and these areas of the lung have inc o2 content

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4
Q

what makes mbtb resistant to destr

A

outer waxy capsule

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5
Q

what does the outer waxy capsule on mbtb allow

A

to continue prod in dead and calcified lesions

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6
Q

what are mbtb capable of

A

retaining growth

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7
Q

how many new tb cases occur a year

A

8 mill

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8
Q

how many people die from tb a year

A

2 mil

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9
Q

how many new cases of tb occured in canada in 2003

A

1600

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10
Q

how many people in canada died from tb in 2003

A

750

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11
Q

who has inc incidence for tb

A

people living in crowded conditions, foreigners

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12
Q

2 forms of tb

A

m. tuberculosis hominis

m. tuberculosis bovine

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13
Q

another name for m. tuberculosis hominis

A

human tb

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14
Q

how is bovine tb acquired

A

drinking milk from infected cows

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15
Q

what part of the body does m. tb bovine affect first

A

GI tract

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16
Q

how does h. tb hominis travel

A

airborne infc.

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17
Q

mechanism of tb m hominis travel

A

droplets are in air when infected person coughs, sneezes, talks, particles evaporate and are suspended in the air

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18
Q

what happens when a tb bacteria is inhaled

A

travel down bronchial tree and deposit in alveoli

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19
Q

what happens to the bacilli once they are deposited in alveoli

A

alveolar macrophages phacocytose

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20
Q

why are bacilli not killed after alveolar macrophages attack them

A

cell wall blocks the fusion of phagosomes and lysosomes

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21
Q

what happens when the fusion of phagosomes and lysosomes is stopped by the bacilli

A

macrophages initiate cell mediated immune response

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22
Q

how are bacilli antigens presented to t lymphocyte

A

macrophages which have ingested them present them

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23
Q

why is lung tissue damaged in TB

A

lytic enzymes are released by t macrophages

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24
Q

why do t macrophages release lytic enzymes

A

sensitized t lymphocytes stimulate macrophages to produce lytic enzyme

25
Q

Ghon focus

A

granulomatus legion

26
Q

how do ghon focus’ develope

A

increased cell mediated immune response

27
Q

what does a ghon focus contain

A

tubercle bacilli, modified macrophages, other immune cells

28
Q

what causes tissue necrosis

A

when the number of organisms is high, H rxn lt necrosis

29
Q

what lymph nodes do tb bacteria travel down via lympth channels and end up

A

tracheobronchial lymph nodes

30
Q

what happens when tb bacteria is in tracheobronchial lymph nodes

A

cheese like granulations form

31
Q

ghon complex

A

combination of primary lung lesions and lymph node granulomas

32
Q

what happens to a ghon complex over time

A

heals, but dormant bact may remain

33
Q

what happens if somebody with dormant TB becomes immunocompromised later on

A

dormant infc can dev into secondary tb

34
Q

primary tb

A

infc that develops in previously unexposed persons

35
Q

what happens when people with intact immune systems develop a primary infc

A

supressed infc

36
Q

why is the infc in primary tb supressed

A

t lymphocytes and macrophages surround organisms and limit spread

37
Q

do people with tb have an active disease

A

no

38
Q

what happens in primary tb when a pt has compromimsed IR

A

they dev progressive primary tb with destruction of lung tissue that spreads to multiple sites within the lung

39
Q

miliary tb

A

rare form of tb that moves into blood vessel causing lesions

40
Q

secondary tb

A

occurs when pt has laready been exposed to disease

41
Q

what causes secondary tb

A

reinfection from another inhaled droplet or reactivation of a healed primary lesion

42
Q

what is an aggravating factor for secondary tb

A

cell mediated H rxn that causes cavities to merge and create one large cavity

43
Q

what can merging of cavities cause

A

plueral effusion

tb emphysema

44
Q

mnfts primary tb

A 
non spec and insidious
fever
wt loss
fatigue
night sweats
45
Q

what other mnfts may accompany primary tb

A

pleuritis

lymphadenitis

46
Q

mnfts of secondary tb

A 
low grade fevers
night sweats
fatigue
anorexia
wt loss
dry cough
47
Q

what does disease process of secondary tb do to a dry cough

A

turns it into a productive cough with purulent or blood tinged sputum

48
Q

what mnfts occur in later secondary tb

A

dyspnea

orthopnea

49
Q

dx for tb

A

tuberculin skin tests
cxr
culture

50
Q

what does it mean if a person tests positive for skin tb

A

they may not have an active form, they have been exposed to baccillus and cell mediated immunity forms

51
Q

what do cxr’s show in pts with tb

A 
consolodated lesions (active)
lesions, scars (inactive)
52
Q

goal of tx for tb

A

eradicating bacteria while not creating drug resistance in pt

53
Q

types of tx for tb

A

chemo

antimycobacterial tx

54
Q

what drug is used to treat tb in pts >35yo, immunocompromise, peds,

A

isoniazid

55
Q

what drugs are usually used in tb

A 
INH
rifampin
pyrazinamide
ethambutol
streptomycin
56
Q

how do we avoid drug resistance

A

use combinations of drugs

57
Q

what vaccine is used in pts who have high risk of dev infc

A

calmette geurin

58
Q

what does calmette geurin do in skin tests

A

changes ability to detect dormant tb,

59
Q

where does the calmette geurin vaccine inconsistent

A

pulmonary tb

PAtho (31 decks)

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