Tuberculosis and Leprosy

Question 1

Mycobacteria (4)

Answer 1

M.tuberculosis
M.leprae
M.bovis
M.avium

Question 2

Tuberculosis

- contagious?

Answer 2

• latent or active

- YES, through air

Question 3

Extrapulmonary TB

- infects?

Answer 3

• miliary tuberculosis

- infects multiple organ systems

Question 4

M.tuberculosis

• intra/extracellular?
• lives?
• generation time?

Answer 4

• intracellular
• in macrophages
• slow

Question 5

M.tuberculosis = ​Cell Envelope

• high concentration ___
• ____ to stains
• gram __ acid fast stain (test for ___)

Answer 5

• mycolic acid
• impermeability
• gram POSITIVE
• test for mycolic acid

Question 6

Tuberculosis - Progression (4)

Answer 6

1) Transmission
2) Phagocytosis
3) Granulomas form. T-cell Activated Macrophage
4) Tubercle grows

Question 7

Transmission

Answer 7

• inhalation from infect host

Question 8

Phagocytosis

• TB cells blocks ___
• TB inhibits _____
• TB multiplies in ____

Answer 8

• blocks acidification of phagosome
• inhibits fusion of lysosome
• macrophages

Question 9

______ Form

• ___ destroy pathogens
• balance between pathogen + host = ___

Answer 9

• Granulomas
• tubercles
• latent TB

Question 10

____ Activated Macrophage

• secrete ___, activate ___
• chronic ___ –> ____

Answer 10

• T-Cell
• cytokines, macrophages
• inflammation –> necrosis

Question 11

___ Grows

• why?
• ____ erosion = route of transmission
• no host immunity?
• cavitation?

Answer 11

• Tubercle
• some macrophages inactivated or infected
• granuloma erosion
• ACTIVE TB
• center liquefy

Question 12

ESX Secretion Systems

• how many exist in Mtb?
• transport ___ across Mtb _____
• damage ____
• inhibit ___

Answer 12

• 5 ESX Systems
• bacterial molecules, cell envelope
• phagosome
• immune responses

Question 13

Multi-drug resistant TB

- resistant to?

Answer 13

1st line drugs

Question 14

Extensively-drug resistant TB

- resistant to?

Answer 14

2nd line drugs

Question 15

What test for TB?

• inject with?
• look for?
• infected goes from

Answer 15

Tuberculin Test

• purified protein M.tuberculosis
• T cell-mediated response
• goes from negative to positive if infected

Question 16

Tuberculin Test

- negative result

Answer 16

• not infected

Question 17

Tuberculin Test

- positive result

Answer 17

• latent/active TB
• BCG vaccinated
• infected before

Question 18

Diagnosis of TB (3)

Answer 18

• Chest X-ray
• Staining –> acid fast
• IFN-y response assay

Question 19

Treatment of TB

• 2/3 die from?
• which antibiotics?

Answer 19

• untreated active TB

- Rifampin + Isoniazid

Question 20

BCG

• what is it?
• attenuated ___?
• lacks?
• effective against?

Answer 20

• living vaccine
• attenuated M.bovis
• lacks ESX-1 secretion system
• miliary TB

Question 21

Leprosy

• bacteria?
• progression?
• lesions?

Answer 21

• mycobacterium leprae
• slow progression (5 years)
• lesions visible (less infectious)

Question 22

2 Types of Leprosy

Answer 22

1) Tuberculoid

2) Lepromatous

Question 23

Tuberculoid Leprosy

• cell mediated immunity?
• macrophage ____?
• loss of?

Answer 23

• YES cell-mediated immunity
• macrophage contain bacteria
• lose hair + pigment

SELF LIMITING = immune wins

Question 24

Tuberculosis Lepromatous

• cell mediated immunity?
• macrophage ___?
• __ damage + loss of ___ = traumatic ___

Answer 24

• NO cell-mediated immunity
• macrophage not activated
• nerve damage + loss of sensation = traumatic lesions

Question 25

Tuberculosis Lepromatous

- bacteria ______ to ____

Answer 25

• reprograms macrophages

- cause damage to nervous tissue

Question 26

Mycobacterium leprae

• gram?
• waxy ___?
• cultivated in vitro?
• infects macrophages of __ and ___

Answer 26

• gram POSITIVE
• cell envelope
• cannot in vitro
• skin and Schwann cells

Question 27

Spread of Leprosy

Answer 27

transmission NOT well understood

Question 28

Treatment of Leprosy

- drugs?

Answer 28

• Dapsone

- Multidrug Therapy (3 antibiotics)