TB

Question 1

What is a sign of active TB?

Answer 1

damage to lung tissue

also blood-tinged sputum

Question 2

What stain do you use for Tb? Why?

Answer 2

acid-fast due to mycolic acids

Question 3

What virulence factor of TB activates the granuloma?

Answer 3

cord factor

Question 4

What virulence factor of TB inhibits phagolysosomes?

Answer 4

sulfatides

Question 5

Glycolipids in TB

Answer 5

virulence factor

prevent phagolysosome fusion

Question 6

What 3 host factors are critical to killing TB ?

Answer 6

Th1 factors (ex: IFN-y)

CD4 T-cells

Macrophage activation

Question 7

What is a granuloma?

Answer 7

organized structure of macrophages, lymphocytes and neutrophils

Question 8

What is the histopathologic hallmark of TB?

Answer 8

caseating granuloma

Question 9

What surrounds the caseating granuloma?

Answer 9

Langhans giant cells

Question 10

IGRA

Answer 10

test for TB

the same as quantiferon gold test

Question 11

TST

Answer 11

test for TB

the same as PPD

Question 12

What is true of PPD and quantiferon gold?

Answer 12

once infected with TB they are always positive

Question 13

Which TB test does not react with the BCG vaccine?

Answer 13

quantiferon gold

Question 14

Rifampin MOA

Answer 14

inhibit bacterial DNA-dependent RNA polymerase

Question 15

Isoniazid MOA

Answer 15

inhibit mycolic acid synthesis (cell wall synthesis)

Question 16

Pyrazinamid MOA

Answer 16

?

disrupts plasma membrane

Question 17

Ethambutol MOA

Answer 17

inhibits arabinosyl transferase (cell membrane)

Question 18

Which drug can cause rash and red-orange secretions?

Answer 18

Rifampin

Question 19

Which drug can cause optic neuropathy?

Answer 19

ethambutol

Question 20

What are 2 airbone precautions for TB?

Answer 20

N95 masking

negative pressure room

Question 21

What is a problem if you have HIV and TB at the same time?

Answer 21

Rifampin upregulates enzymes that could break down your HIV regimen drugs

Question 22

How do you treat active TB overall?

Answer 22

RIPE

4 for 2 months

2 for 4 months

Question 23

What is a public health aspect of TB?

Answer 23

you are mandated to report a case of TB to your county’s health department

Question 24

DOT

Answer 24

direct observed therapy

required in TB patients

Question 25

cervical lymphadenopathy in toddlers indicates …

Answer 25

MAC: mycobacterium avium …

there is no drug treatment for MAC

Question 26

NTM stands for …

Answer 26

non-tuberculosis mycobacterium

Question 27

Which 2 NTM mycobacterium are rapid growers?

Answer 27

M. abscessus

M. fortuitum

all others are slow growers, including MAC