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Infectious > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

pathognomonic of miliary TB

A

choroidal tubercles

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2
Q

most common site of GI TB

A

ileum and terminal cecum

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3
Q

gold std of TB meningitis

A

CSF culture (Positive in 80%)

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4
Q

CNS TB contrast enhanced ring lesions

A

tuberculoma

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5
Q

induced by ESAT-6

A

MMP9 (recruits naive macromphages)

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6
Q

most potent risk factor for TB among affected individuals

A

HIV co infection

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7
Q

host responses that develop 2-4 weeks after MTB infection

A

1) macrophage-activating response

2) tissue damaging response

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8
Q

antigens of MTB that play a protective role

A

20kDa or 85B

ESAT-6

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9
Q

size of MTB

A

0.5 x 3 um

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10
Q

exacerbation in s and s in lab and xray manifestations of TB in adminisration of ART

A

Immune reconstitution inflammatory syndrome (IRIS)

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11
Q

when does IRIS occur

A

1-3 mos after administration of ART

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12
Q

patho IRIS

A

immune response elicited by antigens as bacilli are killed (in an improving immune function)

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13
Q

First priority in face of IRIS

A

ensure that this is not a failure of TB treatment, or development of another infection

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14
Q

Recommended daily dose

Isoniazid

A

5 mg/kg

max 300 mg

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15
Q

Recommended daily dose

Rifampin

A

10 mg/kg

max 600 mg

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16
Q

Recommended daily dose

Pyrazinamide

A

25 mg/kg

max 2 g

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17
Q

Recommended daily dose

Ethambutol

A

15 mg/kg

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18
Q

Age: highest incidence of TB

A

late adolescence

early adulthood

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19
Q

Molecular mechanism by which M tuberculosis induces granuloma formation

A

Mycobacterial protein ESAT-6

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20
Q

Two types of cells essential in the CMI response to TB

A

1) macrophages

2) T cells

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21
Q

The Ghon focus

A

Lesion forming after initial TB infection which is peripheral and accompanied by transient hillier or paratracheal lymphadenopathy

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22
Q

Ghon complex

A

Ghon focus with or without overlying pleural reaction and thickening and regional lymphadenopathy

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23
Q

Location of Post primary (Adult type) Tb disease

A

Apical and posterior segments of the upper lobes

**Superior segments of the lower lobes

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24
Q

“consumption”/ “phthisis”

A

classic galloping consumption of the past in TB

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25
Q

Most common presentation of extra pulmonary TB in both HIV seronegative and HIV patients

A

Tuberculous lymphadenitis

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26
Q

Most common location of Lymph node TB

A

posterior cervical and supraclavicular sites

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27
Q

% of Lymph node TB with concomitant pulmonary TB

A

50%

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28
Q

Culture positivity of Lymph node TB biopsy

29
Q

20% of extra pulmonary TB cases in US

A

pleural Tb

30
Q

Most common complication of pulmonary TB

A

tuberculous empyema

31
Q

Pleural fluid tests MTB

A

Adenosine deaminase

Interferon gamma

32
Q

10-15% of extra pulmonary TB

A

geunitourinary TB

33
Q

Frequency of abnormal urinalysis results in genitourinary TB

A

90% abnormal

34
Q

10% of pulmonary TB

A

Pott’sdisease

35
Q

Most common site of spinal TB in children

36
Q

Most common site of spinal TB in adults

37
Q

first affected in port’s disease

A

anterior superior of inferior angle of the vertebral body

38
Q

Catastrophic complication of Pott’s disease

A

paraplegia

39
Q

5% of extra pulmonary TB in the US

A

TB of the CNS

40
Q

Uncommon extra pulmonary TB, only 3.5% of extra pulmonary cases

41
Q

Case fatality rate of pericardial TB

42
Q

This is pathognomonic of military TB in 30% of the cases

A

choroidal tubercles

43
Q

Miliary TB rare presentation seen in elderly, chronic course with intermittent fever, anemia, meningeal involvement preceding death

a) cryptic miliary TB
b) nonreactive miliary TB

A

cryptic miliary TB

44
Q

Acute septicaemic form of military TB due to massive hematogenous dissemination of the tubercle bacilli

a) cryptic miliary TB
b) nonreactive miliary TB

A

nonreactive miliary TB

45
Q

less common extra pulmonary form of TB which is a soldering disease with nodules plaques and fissures

A

Lupus vulgaris

46
Q

Where does tuberculous mastitis spread from?

A

retrograde lymphatic spread from the axillary lymphatics

47
Q

Tb is responsible for ___% HIV related mortality

48
Q

Exacerbations in systemic or respiratory signs and symptoms signs and lab or radiographic manifestations of TB

A

IRIS or TB immune reconstitution disease

49
Q

% HIV infected patients where IRIS occurs

50
Q

First drug for TB

A

streptomycin

51
Q

Introduction of this drug shortened TB course to 12 months

A

Rifampicin

52
Q

Discovery of this drug allowed the TB treatment course to be 6 months

A

Pyrazinamine

53
Q

Rx hyperuricemia and arthralgia caused by pyrazinamide

54
Q

Resistance due tours gene

A

aminoglycosides resistance

55
Q

First line drug for ART for TB patients

A

2 NRTI

1 NNRTI

56
Q

TB regimen for pregnant women

A 
2 HRE (pyrazinamide contraindicated)
7 HR
57
Q

why is streptomycin contraindicated in pregnancy

A

8th cranial nerve damage to the foetus

58
Q

Units of PPD for TST

A

5 tuberculin units

59
Q

Cut off PPD of low risk persons

A

> 15 induration

60
Q

Cut off PPD is >=5

A 
HIV infected
Recent contacts of patient with TB
Organ transplant patient
Persons with fibrotic lesions consistent with old TB
Immunosuppressed
HR medical conditions
61
Q

Treatment of latent TB

A

9 months isoniazid

62
Q

Treatment of TB intolerant to Z

63
Q

Treatment of TB relapses and treatment default with pending susceptibility testing

A

3HRZES 5HRE

64
Q

define treatment failure

A

when sputum is positive after 3 months treatment

65
Q

Mechanism for congenital TB

A

1) transplacental

2) drinking of amniotic fluid

66
Q

2 extrapulmonary TB sites where adjunct steroids are given

A

Pericardial TB

TB meningitis

67
Q

Gold standard for TB meningitis

A

CSF culture

68
Q

Pathyphy of pleural TB

A

hypersensitivity response to MTB antigens

69
Q

Acid fast Bacilli organisms other than mycobacteria

A 
Isospora
Crytosporidium
Nocardia
Rhodococcus
Legionella

Infectious (11 decks)

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