Brainscape's Knowledge GenomeTM

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


See full index

Respiratory and Cardio > Tuberculosis > Flashcards

Tuberculosis Flashcards

1
Q

Regions with highest cases of TB

A

China

India

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

Regions with highest incidence of TB

A

Sub-Saharan Africa

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

What populations is TB concentrated in the uk?

A 
Urban poor
IVDUs
Poor
Alcoholics
Inmates
Alcoholics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk factors/social risk factors for TB

A 
Urban homeless
IVDU
AIDS/HIV
Alcohol misuse
Prison
Deprivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many main mycobacterial species are in the ‘Mycobacterium tuberculosis complex’

A 
4:
M.Tuberculosis
M.bovis
M.aricanum
M.microti
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does TB grow inside of, and what does this make it?

A

Macrophages

Obligate intracellular parasite

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

What stains TB red?

A

Zeheil-Neilson stain

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

Shape of TB:

A

Rod-shaped

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

Is TB anerobic or aerobic?

A

Strict aerobe

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

Why does TB have a waxy cell wall?

A

Mycolic acid

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

Once inhaled, what happens to TB?

A

Taken up by alveolar macrophages

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

What can happen to TB once taken up by alveolar macrophages (4)

A
  1. Cleared
  2. Heal with scaring
  3. Lie dormant
  4. Primary progressive disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What cell primarily makes up granuloma?

A

Macrophages

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

Gohn focus =

A

Primary lesion. Small area of granulomatous inflammation

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

When is a Gohn focus detectable on CXR?

A

When it calcifies

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

Gohn complex =

A

Gohn focus + infection of lymphatics

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

Ranke complex =

A

Gohn focus undergoes fibrosis and calcification

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

Milliary TB =

A

Widespread dissemination of TB via hematogenous route

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

When is miliary TB more common?

A

Immunosuppressed patients

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

What is very important in Tb immunity?

A

Cell mediated immune response

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

What cytokines are important in TB/markers of infection

A

TNF-a

INF-y

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

Name some clinical conditions which increase risk of TB infections

A

HIV
SIlicosis
Diabetes
Chronic renal failure

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

What treatments can increase risk of TB infection

A

TNF-a therapy

Solid organ transplants

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

How does silicosis increase TB risk?

A

Disrupts macrophages/granulomas

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

How does HIV, diabetes and chronic renal failure increase TB risk?

A

Impairs cell mediated response

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

How can infectious particles be aerosolised?

A

Coughing
Sneezing
Talking (if laryngeal)

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

What secretions aren’t too important for infection?

A

Large secretions

fomites

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

Fomites =

A

Inanimate objects that carry disease

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

How long does unrestrained TB multiplication occur before cell mediated response kicks in?

A

Weeks (2-3 weeks)

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

What do alveolar macrophages do when infected with TB?

A
  • Form granuloma: release TNF, adhesion molecules
  • Cellular influx: chemokine secretion
  • IL-6 secretion
  • MHC II expression - CD4+ cells
  • IL-10 secretion: limit inflammatory response
31
Q

Function of IL-10

A

Limit inflammatory response

32
Q

Tissue necrosis occurs if antigen load is

A

High

33
Q

Necrosis in TB =

A

Caseous

34
Q

Symptoms of TB

A

Productive, chronic cough
Chest pain
Haemoptysis
Systemic: chills, fecer, night sweats, appetite loss, weight loss, fatigue

35
Q

Standard view of CXR =

A

PA (posterior-anterior)

36
Q

What can trigger post-primary tuberculosis?

A 
Age
Immunosuppression
Disease
Alcohol
Drugs
37
Q

What is post-primary TB?

A

Reactivation of latent TB

38
Q

Extra-pulmonary TB occurs in what % of cases?

A

50%

39
Q

Whats more infectious, pulmonary or extra-pulmonary TB

A

Pulmonary

40
Q

Examples of metastatic organ spread:

A 
Kidneys
Bone 
Brain 
Muscle 
Retina
Lymph nodes
41
Q

Features of metastasis to kidneys:

A

Hematuria
Proteinuria
Back pain

42
Q

Potts disease =

A

Vertebral TB

43
Q

Features of metastasis to brain

A

Tuberculomas in brain

44
Q

In muscle, TB may cause a

A

Cold abscess

45
Q

How many/when should sputum specimens be collected?

A

3 specimens, 3 consecutive days

46
Q

If patient not producing enough sputum, what can be used to induce it?

A

Hypertonic saline solution

47
Q

If patient cannot induce sputum, what can be used for specimen?

A

Gastric aspirate

Bronchoscopy

48
Q

Baseline diagnostic exams for TB:

A

CXR
Sputum specimen - AFB microscopy and mycobacterial cultures
Drug-susceptibility testing

49
Q

CEPHAID test

A

Detects DNA sequences specific for M.tuberculosis and rifampicin resistance by PCR

50
Q

How long does a CEPHAID test take?

A

90 mins

51
Q

Ways to diagnose latent TB/corroborate active TB

A

Heaf test
Mantoux test
INF-y test

52
Q

Mantoux test looks for

A

Immune response to mycobacteria antigens

53
Q

What can the mantoux test react to that the INF-y test doesn’t?

A

BCG vaccine

54
Q

INF-y test measures what

A
  • Amount of INF-y (ELIZA)

- Number of T cells producing INF-y (ELISPOT)

55
Q

More specific test =

A

INF-y test

56
Q

When should you consider treating for TB:

A

Postive AFB smear
Hx of cough and weight loss
Characteristic CXR findings
Emigration from country of high incidence

57
Q

Once treatment stats, what should you do:

A
  • HIV test
  • CD$+ count for HIV+
  • Liver and vision baselines
58
Q

4 1st line TB treatments:

A

Isonazid
Rifampin
Pyrazinamide
Ethambutol

59
Q

Ex of 2nd line TB class

A

Fluoroquinolones

60
Q

Fluoroquinolones suffix

A

-floxacin

61
Q

Moa of fluororquinoles

A

Topoisomerase II inhibitor (DNA gyrase)

62
Q

MOA rifampin =

A

RNA polymerase inhibitor

63
Q

MOA Ethambutol

A

Cell wall inhibitor

64
Q

MOA pyrazinamide

A

Cell membrane

65
Q

MOA isoniazid

A

Cell wall inhibitor

66
Q

Combos for Tb treatment:

A
  1. first 2 months –> rifampicin + isonazid + pyrazinamide +/- ethanmbutol
  2. 4 months (OR 7 IF SMEAR +VE) –> rifampicin + isoniazid
67
Q

Pyridoxine =

A

B6

68
Q

What should B6 be given with

A

Isonazid

69
Q

What can turn urine orange

A

Rifampicin

70
Q

Why does rifampicin interact with other drugs strongly

A

Potent cytochrome p450 inducer

71
Q

Ex of drugs rifampicin can interact with

A

Warfarin
Contraception
Analgesia

72
Q

MDR-TB =

A

Multi-drug resistant TB. Resistant to isoniazid and rifampicin

73
Q

At risk of MDR-TB

A
  • Hx of treatment
  • Contact with or from country with MDR-TB
  • Smears +ve despite 2 months treatment
  • Lack of compliance
  • Single drug therapy
  • Dispencing error
74
Q

XDR-TB =

A

Extensively drug resistant TB

Resistant to any flurorquinole and at lead 1 of 3 injectable 2nd line drugs

Respiratory and Cardio (14 decks)

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