Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CR2 > Tubercolosis > Flashcards

Tubercolosis Flashcards

1
Q

Why do mycobacteria need to be stained with acid fast stain

A

Thick waxy cell wall prevents other stains being effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the main TB causing mycobacterium

A

M. Tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Do all mycobacteria cause TB

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How many mycobacteria species cause TB

A

5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

TB risk factors

A

Non UK born/ recent migrants from S Asia or sub Saharan Africa
HIV
Immunocompromised
Homeless
Drug use
Prisoners
Close contacts of TB
young adults
Elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What airborne particles transmit TB person to person

A

Droplet nuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is TB spread

A

Inhaling droplet nuclei
Fomites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What actions/behaviours increase TB spread

A

Cough
Sneezing
Speaking
Singing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What affects the probability TB will be transmitted

A

Infectious mess of person with active TB
Environment exposure occurred
Exposure length
Virulence of tubercle bacilli
Host immunity
Host Co morbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can TB transmission be prevented

A

Isolate infected people
Quick Effective treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which area of the lungs do inhaled TB bacteria usually settle in

A

Sub pleural area of mid or lower lung zones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens to inhaled TB bacteria once settled in the lung

A

Engulfed by alveolar macrophages -> Ghon focus formed -> TB laden macrophages travel to local lymph nodes -> Ghon complex formed -> active primary disease or initial containment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ghon focus

A

Primary lesion caused by mycobacterium bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 3 possible outcomes of inhaling TB bacteria

A

Progress to primary active disease
Heals or effectively contained and stays latent
Initially contained then reactivates later - post primary TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is post primary TB

A

Initially contained latent infection reactivated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does the immune system react differently to post primary TB than primary TB

A

Memory cells allow faster response, but immune system can overreact causing complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What % of people infected with Tb will never develop active disease

A

90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TB infection

A

Presence of MTB in body - active or latent
Does not mean the person has TB disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

TB active disease

A

Symptomatic Infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MTB latent infection

A

Living dormant MTB in body with no symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the biggest risk factor for latent TB reactivating

A

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can latent TB be prevented from reactivating

A

Diagnosis
Chemoprophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

TB reactivation risk factors

A

HIV infection
Substance abuse
Prolonged corticosteroid therapy
Immunosuppressive therapy
Tumour necrosis factor alpha antagonists
Organ transplant
Haematological malignancy
Severe kidney disease / haemodialysis
Diabetes mellitus
Silicosis
Low body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What condition is tested for in all suspected and confirmed TB cases

A

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the 3 types of TB

A

Pulmonary Tb
Extra pulmonary TB
Miliary TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where does pulmonary TB occur

A

Lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where can extrapulmonary TB occur

A

Larynx
Lymph nodes
Pleura
Brain
Kidneys + adrenals
Bones
Joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which groups is extrapulmonary TB more common in

A

HIV infected
Immunosuppressed
Young children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where does miliary TB occur

A

Bloodstream - carried to all parts of body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the rarest type of TB

A

Miliary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Features of characteristic TB lesion/ tubercle

A

Spherical granuloma with central caseation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What type of reaction is caused by MBT ingested by macrophages in primary TB

A

Granulomatous reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What cells surround the caseous necrotic core of a primary TB tubercle/lesion

A

Epithelioid macrophages
Langhans multi uncleared giant cells
Lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What makes up the caseous necrosis in the centre of a primary TB tubercle

A

Calcified cellular debris, dead MTB, and dead macrophages

35
Q

What type of lesions are caused by primary TB

A

Spherical granuloma

36
Q

What type of lesion is caused by post primary TB

A

Cavitary lesions

37
Q

Why do post primary TB cavitary lesions usually form in upper lung lobes

A

Better oxygenation aids aerobic MTB

38
Q

Are MTB aerobic or anaerobic organisms

A

Aerobic

39
Q

Pulmonary TB symptoms

A

Fever
Night sweats
Weight loss + anorexia
Tiredness
Malaise
>3 wks cough
Haemoptysis
Dyspnoea

40
Q

What is the most common pulmonary TB symptom

A

Cough lasting 3+ wks

41
Q

Pulmonary TB signs

A

Pyrexia
Crackles in affected areas
Hyperesonnance
Decr lung expansion
Signs of pleural effusion

42
Q

How does pulmonary TB cause hyper resonance

A

Cavitation in severe disease

43
Q

How does pulmonary TB decrease lung expansion

A

Fibrosis in severe disease

44
Q

Which investigations are used to diagnose active pulmonary TB

A

Chest x ray
Microbiology - sputum / induced sputum broncho alveolar lavage fluid samples
Histology

45
Q

How does TB appear on CXR

A

Defined patchy consolidation
Cavitation
Fibrosis
Pleural effusion

46
Q

Disadvantages of TB microscopy

A

Can’t differentiate MTB from non tubercolosal mycobacteria infection
Can’t differentiate live and dead bacteria
May be negative even in active disease

47
Q

Why might microscopy for a patient with active TB still come up negative

A

Early disease
Specimen collection technique
Poor cough reflex
HIV AIDS

48
Q

What is the gold standard for TB diagnosis

A

Culture

49
Q

What test must be done before a suspected TB case can be declared negative

A

Culture must come back negative

50
Q

Why are both solid and liquid media used in a Tb culture

A

Liquid faster
Solid more sensitive

51
Q

Which test can be used to detect multi drug resistant and extrpensively drug resistant TB in smear samples

A

Nucleus acid amplification tests

52
Q

What group receives the BCG vaccine

A

Babies in high prevalence communities
New entrants from high risk areas
Health care workers
Close contact ps of active respiratory TB

53
Q

How does protection from BCG vaccine change over time

A

Decrease over time
Little evidence for protection in adults

54
Q

How is latent pulmonary TB diagnosed

A

Tuberculin sensitivity test
Interferon gamma assays

55
Q

What does the tuberculin sensitivity test measure

A

Cell mediated immune response

56
Q

How is the tuberculin sensitivity test carried out

A

Tuberculin injected Intradermally and induration measured 48-72 hrs later

57
Q

How is tuberculin injected in tuberculin sensitivity test

A

Intradermally

58
Q

Can the tuberculin sensitivity test and interferon gamma assays distinguish between latent and active MTB infection

A

No

59
Q

What does an interferon gamma essay measure

A

Interferon gamma - Cell mediated immune responses of T cells to MTB antigens

60
Q

Are sputum smears and cultures positive or negative in a person w latent TB

A

Negative

61
Q

Is latent Tb infectious

A

No

62
Q

Latent TB first line treatment

A

Isoniazid + pyridoxine/ vit B6
Isoniazid + pyridoxine + rifampicin

63
Q

Why should active Tb not be treated with a single drug

A

Increase drug resistance

64
Q

How many drugs are used in standard active TB treatment

A

4

65
Q

First line active TB drugs

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
RIPE

66
Q

Second line active TB drugs

A

Quinolones
Injectable capreomycin, kanamycin, amikacin
Ethionamide/prothionamide
Cycloserine
PAS
linezolid
Clofazamine

67
Q

Rifampicin side effects

A

Incr transaminases - liver enzyme
Affects other drugs inc oral contraceptive
Orange secretions

68
Q

Isoniazid side effects

A

Peripheral neuropathy - pyridoxine/b6 prevents
Hepatotoxicity

69
Q

Pyrazinamide side effects

A

Hepatotoxicity

70
Q

Ethambutol side effects

A

Visual disturbance

71
Q

Why is pyridoxine given with isoniazid

A

Prevents peripheral neuropathy from isoniazid

72
Q

How long is TB treatment if no drug resistant suspected

A

6 months

73
Q

How is TB treatment adherence ensured

A

Directly observed theraoy
Video observed therapy

74
Q

Why is TB treatment adherence supervised

A

Prevent transmission
Lots of pills and side effects makes non adherence likely

75
Q

Multi drug resistant TB

A

Resistant to rifampicin and isoniazid

76
Q

Extremely drug resistant TB

A

Resistant to rifampicin, isoniazid, fluroquinolones, + 1+ injectable

77
Q

Why does Miliary tb affect multiple organs

A

Bacilli spread through blood

78
Q

How can extrapulmonary TB reach the gut

A

Swallowing tubercles in coughed up mucous

79
Q

Where does extra pulmonary TB occur in Potts disease

A

Spine

80
Q

Types of extrapulmonary Tb

A

Lymphadenitis
Gastrointestinal
Genitourinary
Bone + joint
Tuberculous meningitis

81
Q

When should TB be notified

A

Any suspected or made diagnosis

82
Q

Which group is BCG vaccine not effective in

A

HIV

83
Q

Why should people with HIV not receive the BCG vaccine

A

Not effective with HIV
prevents future use of tuberculin sensitivity test

84
Q

What could cause a positive tuberculin sensitivity test in a person without TB infection

A

Preciously received BCG vaccine

CR2 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions