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Micro Unit 4 > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

What bug causes TB?

A

Mycobacterium tuberculosis

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2
Q

TB was almost eradicated until what epidemic brought about a whole new population of predisposed hosts?

A

AIDS

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3
Q

What strains of TB are particularly concerning?

A

MDR and XDR

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4
Q

Are mycobacteria gram + or gram -?

A

NEITHER! They stain poorly with gram stain but they stain with ACID-FAST

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5
Q

What are the steps in the acid fast staining procedure?

A

1-stain with carbolfuchsin
2-acid/alcohol decolorization
3-methylene blue counter stain
acid fast+ will be carbolfuchsin color

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6
Q

TB transmission is almost always to lung by _______, to lymph nodes, kidney, bones, CNS by ___________, to GI by _____________.

A

inhalation
hematogenous spread
swallowing infected sputum

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7
Q

In an immunocompetant host, what will happen with TB infection?

A

strong CMI will keep the infection latent for a long time until their immune system is rendered senescent or suppressed and it becomes reactivated

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8
Q

in TB hematogenous spread, what types of cells carry the TB?

A

naive macrophages, activated macrophages kill the TB

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9
Q

how does a TB granuloma form?

A

CD8 cells kill infected macrophages and establish caseating granulomas in whcih infection is contained

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10
Q

What immunity factor is important for containing TB?

A

TNF-a

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11
Q

What is the classic presentation of pulmonary Tb?

A

75% of TB
cough, weight loss, fever, night sweats, hemoptysis, chest pain
sample sputum + CXR

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12
Q

M. tuberculosis is _________ aerobe

A

obligate aerobe

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13
Q

what structural component of M. tuberculosis makes it acid fast?

A

mycolic acids

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14
Q

what toxins does mycobacteria create?

A

NONE

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15
Q

What is the reservoir for TB?

A

HUMANS!

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16
Q

transmission of TB?

A

P2P, resp droplets

17
Q

how does M. tuberculosis survive in macrophages?

A

prevents fusion of phagosome with lysosome

18
Q

Define Ghon complex

A

exudative lesion in lungs at site of initial infection, plus draining lymph node (TB)

19
Q

what are older granulomas surrounded by fibrous tissue that have central casseation necrosis and some calcification?

A

tubercule

may erode and erupt contents

20
Q

define scrofula

A

cervical adenitis, UNILATERAL, may be Tb or M. scrofulaceum

dx: fine needle aspiration

21
Q

What is Pott’s disease?

A

disseminated TB in spine, may cause paralysis

22
Q

when might you see erythema nodosum in TB?

A

primary infection, they are immunogenic from strong CMI

23
Q

what is Miliary TB?

A

multiple disseminated lesions in lung –> may be deadly

dx: CXR / bright spotlight, lat. XR, chest CT

24
Q

If TB spreads to the GU system, how do you dx?

A

IV urography, urine culture

25
Q

MRI and spinal tap is used to dx TB when it has infected what part of the body??

A

CNS

26
Q

how do you dx skeletal TB? GI TB?

A

skeletal: MRI, joint fluid aspiration
GI: Xray, chest CT

27
Q

how does GI TB present and how do you get it?

A

abd pain, diarrhea, obstruction or hemorrhage in ileocecal region, may be TB or M. bovis from unpasteurized milk

28
Q

When might you see pediatric TB?

A

recently acquired (trace the source), watch for miliary or meningitis, culture for gastric lavage

29
Q

how do you determine TB exposure?

A

PPD, TST, IGRA

30
Q

When you determine a patient has TB how long do you wait to preform abx resistance testing?

A

ASAP, dont wait!

31
Q

How do you treat TB?

A

isolation for the first 2 wks + 4 drug regimen with added ones depending on resistance always includes isoniazid
Direct observed therapy ALWAYS!

32
Q

why don;t we vaccinate for TB in the US?

A

the BCG vaccine vaccine (live attenuated M. bovis) is used abroad, not cost-effective here, can create weak-moderate false positive TST

33
Q

What is the simplest and most effective way to reduce TB everywhere?

A

good diet and housing –> keep people healthy so if they are exposed the TB will stay latent which is not infectious!

Micro Unit 4 (8 decks)

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