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D&T3 Pulm > TB and CF > Flashcards

TB and CF Flashcards

1
Q

What cells are seen with acute inflammation?

A

Neutrophils

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2
Q

What cells are seen with chronic inflammation?

A

Monocytes and Macrophages

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3
Q

What is the inheritance pattern of CF?

A

Autosomal Recessive

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4
Q

What is the mutation responsible for CF?

A

Deletion of Phenylalanine 508 on Chromosome 7 –> deficient CF Transmembrane Conductance Regulator (CFTR)

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5
Q

What organs are affected by CF?

A
  1. Lungs
  2. Pancreas
  3. SI (exocrine glands)
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6
Q

15% of CF patients experience moconium ileus- what is this condition?

A

Intestinal Blockage

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7
Q

What percent of CF patients are pancreatic insufficient?

A

85%

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8
Q

What disease is characterized by salty tasting skin, chronic cough w/ sputum, wheezing, moconium ileus, pan sinusitis, nasal polyposis, liver disease, staph pneumo infections and delayed puberty?

A

CF

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9
Q

What is the X-Ray finding of CF?

A

Interstitial infiltration of Neutrophils and Pulmonary Edema

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10
Q

Due to the immunodeficiency seen with CF, what bacterial infections are common? Which is common into adulthood?

A

B. cepacia, H. flu, S. aureus

Adulthood- Pseudomonas aeruginosa

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11
Q

Describe the characteristics of Pseudomonas

A
  1. Gram Negative
  2. Aerobic/Anaerobic
  3. Rod
  4. Motile
  5. Grape odor
  6. Simple growth requirement
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12
Q

What is the main component in the biofilm of Pseudomonas?

A

Alginate (exopolysaccharide)

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13
Q

Alginate producing Pseudomonas have what phenotype of biofilm?

A

Mucoid, unstable

***Requires a lot of ATP

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14
Q

What are the advantages of a biofilm?

A
  1. Abx resistance

2. Enable chronic infections

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15
Q

Why does CF result in a chronic Neutrophil infiltration?

A

Because there is a non-constant supply of antigens due to the biofilm

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16
Q

Why do CF patients not die from septicemia?

A

Because the infections are confined to the bronchi and bronchioles and there is not invasion of the blood stream

17
Q

What is the cause of the lung tissue damage in CF?

A

IC-mediated inflammation (Type III hypersensitivity) in response to chronic infections

18
Q

What abx are used as suppressive therapy for CF?

A

Tobramycin and Azithromycin

19
Q

What combination therapy may be used for resistant Pseudomonas?

A
  1. Anti-Pseudomonas Penicillin
  2. Ticarcillin
  3. Piperacillin
  4. Gentamicin/Amikacin
20
Q

What are risk factors for TB?

A
  1. Poverty
  2. HIV
  3. Drug Resistance
21
Q

Describe the pathogenesis of TB

A

Inhalation of bacteria –> enters lungs –> invades macrophages –> multiplies in macrophages –> lesions begin to form –>

Option 1 –> lesions calcify –> latent infection –> possible reactivation

Option 2 –> lesion liquifies –> spread to other organs –> Infectious Stage –> Death

22
Q

After 6 weeks of a TB infection granulomas begin to form- describe the features of a granuloma (caseous granuloma)

A

Epitheloid macrophages and Langhan Cells (fused macrophages) containing the bacteria, surrounded by lymphocytes (CD4 T) and an outer layer of fibroblasts

23
Q

What bacteria is a slow-growing obligate aerobic rod that is resistant to drying chemicals due to its waxy-like cell wall ?

A

TB

24
Q

What accounts for the slow growth of TB?

A

The very long hydrocarbons needed for formation of its waxy cell wall take time to synthesize

25
Q

What makes TB acid fast? What are the consequences?

A

The acidic waxes composed of my colic acid (B-Hydroxy FA linked to Murein)

Resistant to drying chems and germicides and has a slow growth rate

26
Q

How is TB transmitted?

A

Aerosals or prolonged person-person contact

27
Q

What enables TB to escape from phagocytic vesicles?

A

LLO Homologue (Hemolysin)

28
Q

How does TB prevent acidification of the phagocytic vesicle?

A

Production of NH4 to counteract the ATPase dependent acidification

29
Q

What feature of TB stimulates the immune response?

A

The toxic my colic acids

30
Q

How does TB cause lung damage?

A

TNFa production

31
Q

What is a Ghon Complex?

A

An area of caseous necrosis seen in TB

32
Q

What is seen with miliary TB?

A

White nodules which are smaller granulomas

33
Q

Describe the features of TB with AIDS

A
  1. Kills more rapidly
  2. Usually Miliary TB
  3. Reduced CD4 T Count so Macrophages are not activated
  4. Multiple Organs
  5. Drug resistant
34
Q

What patient group may have a negative PPD even if infected with TB?

A

AIDS pts

35
Q

Which group of people may have false positive PPD?

A

Foreigners who received the BCG vaccine

36
Q

How is TB diagnoses?

A

Examination of Sputum w/ Acid Fast Stain, CXR

37
Q

What is the treatment of TB?

A
  1. Rifampin
  2. Isoniazid
  3. Streptomycin
  4. Ethambutol

**for 6 months

D&T3 Pulm (5 decks)

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