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Bloc B - Respiration > TB and non-TB mycobaterium Oct18 M1 > Flashcards

TB and non-TB mycobaterium Oct18 M1 Flashcards

1
Q

TB examples of symptoms

A

fever, cough, minimal sputum

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2
Q

TB CXR finding

A
  • opaque -abnormality
  • blunting of costophrenic angle
  • straight line at bottom of lung (air-fluid interface)
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3
Q

what can counfound TB with

A

lung abcess

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4
Q

easy test for TB detection + gold standard

A

sputum analysis for acid-fast smear microscopy and culture

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5
Q

strongly positive smear for TB: what’s the diagnosis

A

active contagious pulmonary TB

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6
Q

TB level of contagion

A

highly contagious

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7
Q

2 evolving challenges with TB today

A 
Global phenomenon (migration)
Increasing antibiotic resistance
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8
Q

mycobacterium TB description

A

Aerobic slightly curved rod

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9
Q

mycobacterium TB: mechanism to survive certain conditions

A

survives in dormant state if adverse conditions (low oxygen, dry)

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10
Q

best conditions for TB growth and what it explains

A

high oxygen tension. explains why lung apices affected

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11
Q

TB physical protection it has

A

thick waxy outer layer (cell wall): protects from light, heat, dryning. + gives acid fast property

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12
Q

TB hosts known

A

humans only

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13
Q

TB transmission routes

A

airborne only

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14
Q

how to evaluate prob of inhaling TB

A

proportional to its conc. in air (essentially prob of inhaling a viable bacterium)

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15
Q

how to evaluate conc. of TB in air (2)

A

1) volume of air it’s diluted in (inside vs outisde, room size)
2) production vs elimination (ventilation. sunlight and drying kills it)

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16
Q

contagious TB CXR findings and smear findings

A

Cavities

AFB smear positivity

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17
Q

why TB prevalent in Inuit communities and northern Qc communities

A

Lot of people live in same house, no ventilation, isolation. higher TB conc. in air

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18
Q

primary infection def

A

when exposure to TB results in new infection

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19
Q

how good body responds to primary infection

A

initial immune response is highly ineffective

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20
Q

what determines if exposure results in new infection or no infection

A

innate immunity

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21
Q

1st phase of progression of TB and length

A

local alveolus (1-2 weeks)

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22
Q

2nd phase of progression of TB and length

A

TB drains/spreads to regional lymph nodes (2-4 weeks)

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23
Q

3rd phase of progression of TB and length

A

Hematogeneous dissemination (4+ weeks)

24
Q

what kind of immunity against TB

A

cell mediated (not humoral) (T cells)

25
Q

result of immune reaction to TB (on microscopy what we see)

A

hard shells called granulomas

26
Q

what determines if disease will develop or become dormant after primary infection

A

the development of effective cell mediated immunity

27
Q

who is most likely to get developing TB after primary infection

A

Young people, immunosuppressed, comorbidities, HIV

28
Q

when effective cell mediated immunity to TB is developed

A

4-7 weeks after initial infection

29
Q

if CMI defective, when TB becomes symptomatic

A

3-6 months after primary infection

30
Q

TB risks 2 things to note if primary infection occured

A

1) More likely to get disease if young but less likely to get disease than not get it overall
2) infants vulnerable to severe TB (disseminated TB or TB meningitis)

31
Q

what we mean by latent, dormant TB

A

contained in granulomas but keeps fighting to get out. Active immune response

32
Q

how latent TB infection diagnosed LATENT

A

immune tests based on the cell immunity to TB

33
Q

strongest risk factor for dev active TB

A

HIV/AIDS

34
Q

risk factor of importance for active TB

A

time since infection. (greater risk in 1-2 years aftrer infection)

35
Q

granuloma: what happens when active TB

A

hard shell breaks down and tubercle escapes and multiplies

36
Q

when latent TB, risk for active TB if have no risk factor

A

10% over lifetime

37
Q

when latent TB, risk for active TB if infected with HIV

A

7-10% per year

38
Q

why younger children more at risk to progress to active TB

A

immature immune system

39
Q

symptoms of active TB

A

fever, nigh sweats, cough, sputum, hemoptysis if advanced, lymph node,

40
Q

3 tests for active TB

A

microscopy (look for acid fast org)
culture (gold standard)
nucleic acid amplification

41
Q

what tests have no utility to detect latent TB

A

cultures, chest X ray, all routine tests (smear, nucleic acid amplif.)

42
Q

2 tests for latent TB

A

immune based:
Tuberculin Skin Test (Purified protein derivative or PPD)
IF gama release assays (IGRAs)

43
Q

TB treatment: what

A

2-4 drugs (if 1, TB develops resistance)

44
Q

TB treatment: how long

A

minimum 6 months

45
Q

3 TB drugs

A

isoniazid (INH), rifampin (RIF), pyrazinamide (PZA)

46
Q

TB treatment if latent: what

A

1 drug: no risk of drug resistance

47
Q

serious adverse effect to consider in TB treatment

A

liver toxicity

48
Q

how TB incidence changing in Canada vs in Inuit communities precisely

A

decreasing overall

increasing in Inuit communities

49
Q

why Inuit have high incidence of TB

A

housing conditions, smoking, diabetes, genetic factors, history of colonization and role of TB

50
Q

most important causes of TB worlwide

A

HIV, smoking and alcohol, malnutrition, chronic illnesses (e.g. diabetes)

51
Q

T-F: TB deaths started declined after first treatment

A

False, already in decline before

52
Q

non-tuberculous mycobacteria definition

A

all mycobacteria except mycobacteria TB and mycobacteria leprae

53
Q

T-F: TB infection must be reported toauthorities

A

True

54
Q

main diff between TB and non-TB mycobacterium

A

non-TB mycobacterium is not contagious

55
Q

non-TB myco that is most associated with human disease in Canada

A

mycobacterium avium

56
Q

non-TB myco symptoms and chest X ray

A

symptoms: cough, sputum, weight loss
CXR: nodular infiltrates associated with bronchiectasis
cavitary lung disease (mimics TB)

57
Q

non-TB myco treatment

A

No treatment if simply found in sputum

Bloc B - Respiration (36 decks)

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