TB - Worldwide Control, Testing Flashcards

1
Q

What is primary tuberculosis infection?

A

Infection with Mycobacterium tuberculosis
Usually through the respiratory tract
In immunocompetent individuals, usually does not manifest into disease but rather stays latent

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2
Q

Worldwide, TB is the number ________ infectious killer.

A

one or two

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3
Q

________ million people die each year from TB.

A

Two to three

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4
Q

In the 1800s, TB accounted for ____ percent of deaths in metropolitan areas.

A

20

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5
Q

What percent of latent TB reactivates?

A

5% - 15%

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6
Q

M. tuberculosis bacteria can survive macrophage ___________, but not apoptosis.

A

necrotic death

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7
Q

Describe the four steps of tuberculosis infection.

A

1) Ingestion by alveolar macrophages
2) Multiplication of M. tuberculosis and accumulation in macrophages
3) Migration of T cells to site of infection
4a) Latent tuberculosis
4b) Decline in immunity and activation of tuberculosis infection

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8
Q

What is considered the highest risk group for tuberculosis skin tests?

A

HIV-positive individuals
Recent contact with someone who has active TB
Apical fibro-nodular disease consistent with old TB infection
Organ transplant
Anti-TNF-alpha therapy

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9
Q

What is the medium risk group for TB skin tests?

A

Homeless

Immigrants from high-risk countries

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10
Q

Treatment of latent TB is very effective in ____________.

A

preventing reactivation

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11
Q

Cross-reactivity occurs _____ years after BCG vaccination.

A

15

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12
Q

False negativity can occur in skin tests on those with ____________.

A

T cell deficiencies

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13
Q

Most cases of tuberculosis in the U.S. are among __________.

A

foreign-born individuals–both in prevalence per 100,000 and in total numbers

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14
Q

There is evidence that vitamin D deficiency ____________.

A

increases risk of tuberculosis

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15
Q

Why did U.S. TB rates increase in the 80s and 90s?

A
HIV
Increased immigrant population
Decline in public health infrastructure
Increased nosocomial infections
Drug-resistant strains
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16
Q

Describe granulomas from inside to outside.

A

Innermost: dead macrophages
Next ring: live, uninfected macrophages
Outermost ring: T cells

17
Q

What are calcified lung nodules called?

A

Ghon complexes

18
Q

How is latent TB treated?

A

Nine months of isoniazid or rifampin for four months

19
Q

For otherwise healthy healthcare workers, the criteria for INH treatment is __________.

A

greater than 10 mm induration

20
Q

Compared to positive PPD scars, smallpox scars will be ________.

A

sunken