Tuberculosis

Question 1

Tuberculosis is caused by which bacteria?

Answer 1

Mycobacterium Tuberculosis

Question 2

The most characteristic phenotypic feature of the Mycobacterium Tuberculosis complex is the:

Answer 2

“Acid-fastness” the ability to withstand decolorization with an acid alcohol mixture after coloration

Question 3

Where do the mycobacterium primarily reside?

Answer 3

Inside the cell (Intracellular pathogens)

Question 4

Mycobacterium’s relation to oxygen is _________

Answer 4

Obligate aerobes

Question 5

Mycobacterium, in the presence of a normal immune response, induce a ________ in the tissues

Answer 5

Granulomatous response

Question 6

Microbiologically, M. Tuberculosis is a:

Answer 6

Rod-shaped, non-spore-forming, thin aerobic bacterium measuring 0.5 to 3 Micro meters

Question 7

M. Tuberculosis appear _______ on Gram stain

Answer 7

Neutral

Question 8

the 3 Mycobacterial pathogens that cause tuberculosis are:

Answer 8

M. Tuberculosis
M. Bovis
M. africanum

Question 9

Other than the 3 main pathogens of the Mycobacterium complex, other members which rarely cause disease include:

Answer 9

M. Microti
M. pinnipedii
M. caprae

Question 10

_________ is not part of the TB complex but it has been identified to cause TB in a small number of patients from or with connection to east africa

Answer 10

M. Canettii

Question 11

____ % of cases of TB are estimated to be HIV infected

Answer 11

10

Question 12

Person-to-person transmission of TB occurs via:

Answer 12

Inhalation of droplet nuclei (Airborne particles 1-5 Microns in diameter)

Question 13

A person with infectious pulmonary TB often transmits the disease by

Answer 13

Coughing, sneezing or speaking, as it makes the disease particles airborne quickly

Question 14

A person with TB coughing may have as many as ______ infectious nuclei per cough

Answer 14

3000

Question 15

Factors associated with risk for TB transmission via droplet nuclei include:

Answer 15

Presence of active untreated pulmonary or laryngeal TB
Presence of cavitary disease
Presence of sputum with positive NAA test for M. TB complex
Presence of sputum with positive smear for acid-fast bacilli [AFB]
Presence of sputum with positive M.TB culture [Even with negative AFB]
Short time [<9 days] to positive M.TB culture

Question 16

Procedures that can result in the dispersal of droplet nuclei-associated risk for TB transmission include:

Answer 16

Endotracheal intubation
Bronchoscopy
Nebulizer

Question 17

Inhalation of M.TB and deposition in the lungs can lead to 4 possible outcomes

Answer 17

1. immediate clearance of the organism
2. primary disease [Rapid progression to active disease]
3. Latent infection [with or without subsequent reactivation disease]
4. reactivation disease [following a period of latent infection]

Question 18

TB affects the lungs in about ___% of cases

Answer 18

80

Question 19

about ___% of TB cases involve extrapulmonary sites [with or without concomitant lung disease]

Answer 19

30

Question 20

In relation to the site of TB infection, up to two thirds of HIV infected patients with TB may have:

Answer 20

Both Pulmonary and extrapulmonary, or extrapulmonary alone

Question 21

The most common extrapulmonary site infected by TB?

Answer 21

Lymph nodes

Question 22

In relation to age, primary TB was considered to be mainly a disease of _______

Answer 22

Childhood

Question 23

Symptoms and Signs of TB

Answer 23

Fever

Pleuritic or retrosternal chest pain

Question 24

Describe TB fever

Answer 24

Gradual onset and low grade but could be as high as 39C and lasts an average of 14 to 21 days. It is resolved in 98% of patients by 10 weeks

Question 25

___% of patients with TB fever developed pleuritic or retrosternal chest pain

Answer 25

25

Question 26

half of pleuritic chest pain TB patients had evidence of _________

Answer 26

Pleural effusion

Question 27

Radiographic findings in primary pulmonary TB

Answer 27

Chest radiograph is often normal
Hilar adenopathy in 65%
Pleural effusion in 1/3 of patients
Pulmonary infiltrates were observed in 27 percent of patients
Perihilar and right sided infiltrates
Contralateral hilar changes