TB

Question 1

Latent tuberculosis infection (LTBI)

Answer 1

+ Tuberculin skin test (TST) or interferon-γ release assay (IGRA)

The QFT-GIT assay is an ELISA-based, that uses peptides from three TB antigens (ESAT-6, CFP-10, and TB7.7) in an in-tube format. An individual is considered positive for M. tuberculosis infection if the IFN-gamma response to TB antigens is above the test cut-off (after subtracting the background IFN-gamma response in the negative control).

Question 2

TB general facts

Answer 2

One-fourth of the world’s population has latent TB.
[14]
Countries with the highest incidence of TB: India, Indonesia, China, the Philippines, Bangladesh, Nigeria, Pakistan, and South Africa
The incidence of multidrug-resistant TB is steadily rising

Question 3

mycobacterium,overview. species.

Answer 3

Mycobacterium-tuberculosis-Komplex mit den Hauptvertretern
Mycobacterium tuberculosis (sensu stricto)
Mycobacterium africanum
Mycobacterium bovis
Mycobacterium leprae
Mycobacterium lepromatosis
Nicht-tuberkulöse Mykobakterien (NTM, Atypische Mykobakterien)
Type: facultative intracellular rod-shaped bacteria
Gram stain: does not stain well

The presence of high lipid content (mycolic acid) in the mycobacterial cell wall prevents entry of the Gram stain

Question 4

acid fast bacilli AFB or acid and alcohol fast bacililli AAFB-

Answer 4

due to the ability of the lipid rich cell to retain the red carbol fuchsin stain in the presence of acid and alcohol during the Ziehl Neelsen staining process.

Question 5

primary + secondary resistance

Answer 5

Primary drug resistance – Infected with MTB strain which is already drug resistant 50 %

Secondary (acquired) drug resistance – Drug resistance develops during treatment

Question 6

MDR TB

Answer 6

Multidrug-resistant TB (MDR TB) is caused by an organism that is resistant to at least isoniazid and rifampin, the two most potent TB drugs.

Question 7

Extensively drug resistant TB (XDR TB)

Answer 7

Extensively drug resistant TB (XDR TB) is a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin

Question 8

Rifampicin NW

Answer 8

Hepatotoxizität
CYP-Induktionen mit Interaktionspotenzial (v.a. CYP3A4, CYP2C9) - das höchste potential überhaupt.
Rotfärbung des Urins und anderer Körperflüssigkeiten
Seltener: Allergische Hautreaktionen, Übelkeit, Thrombopenie,

am riff hatcc vc sich eine leber aufgespießt und alles ist rot, da wird mir übel

Question 9

Ethambutol NW

Answer 9

Optikusneuritis
Seltener: Arthralgie, Hyperurikämie,

TB Therapie: Initialphase mit 4-fach-Therapie: über 2 Monate Isoniazid (INH) + Rifampicin (RMP) + Pyrazinamid (PZA) + Ethambutol (EMB), dann 4 Monate Rifampicin + Isoniazid

Question 10

Isoniazid NW

Answer 10

Hepatotoxizität ,
Neurotoxizität: Periphere Polyneuropathie
Reduktion der Nebenwirkungen: Gabe von Vitamin B6, Akne

iacd wie

Question 11

Hepatotoxizität tuberkulose medis

Answer 11

3 der 4 Wirkstoffe sind potenziell hepatotoxisch: INH , RMP und PZA
( isoniazid, rifampicin, pyrazinamid)

ethambutol dafür optikusneuritis

Question 12

tuberkulose MDR Zweitregime Gruppe A

Answer 12

alle dieser gruppe
Fluorchinolon (FQ): Moxifloxacin oder Levofloxacin
Bedaquilin (BDQ)
Linezolid (LZD)

Question 13

MD Zweitregime Gruppe B

Answer 13

Eine oder zwei Substanzen sollten zusätzlich ergänzt werden
Clofazimin (CFZ)
Cycloserin (CS) oder Terizidon (TRD)

Question 14

tb Meningitis Therapiedauer

Answer 14

Gesamttherapiedauer 12 Monate

Question 15

Esbl resistent gegen..

Answer 15

Definitionsgemäß: Penicilline und Cephalosporine

Question 16

aspergillose Behandlung

Answer 16

voriconazol