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Infectious Diseases (4th year) > Tuberculosis and Tuberculous Meningitis - > Flashcards

Tuberculosis and Tuberculous Meningitis - Flashcards

1
Q

Etiology- Mycobacterium tuberculosis:

A

With the exception of M. pinnipedii, all of the species in the Mycobacterium tuberculosis complex have been shown to cause disease in humans

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2
Q

Which Mycobacterium is the most prevalent?

A

M. tuberculosis is by far the most prevalent

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3
Q

How is the mycobacterium found in the environment, and does it cause disease?

A

Mycobacteria commonly found in the environment rarely cause disease in humans and are not spread from person to person

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4
Q

MOTT =

A

Mycobacteria other than tuberculosis

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5
Q

When does MOTT cause disease?

A

Mycobacteria other than tuberculosis (MOTT) most often cause disease in individuals with weakened immune systems

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6
Q

What are the most common MOTT?

A

Mycobacterium avium and M. intracellulare are the more common MOTT sometimes seen in patients co-infected with HIV

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7
Q

Where are the most TBs located?

A

85% of all TB cases are pulmonary

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8
Q

Extrapulmonary TB occurs in places other than the lungs, including the:

A
  • Larynx
  • Lymph nodes
  • Brain and spine
  • Kidneys
  • Bones and joints
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9
Q

When does miliary TB occur?

A

Miliary TB occurs when tubercle bacilli enter the bloodstream and are carried to all parts of the body

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10
Q

How is the transmission of TB?

A
  • Transmission occurs when an infectious person coughs, sneezes, laughs, or sings
  • Prolonged contact needed for transmission
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11
Q

Probability of transmission depends on:

A
  • Infectiousness
  • Type of environment
  • Length of exposure
  • Susceptibility
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12
Q

Long text about transmission. Read it. To lazy to flashcard it at the moment :P

A
  • When a person with TB disease of the lungs or larynx coughs, sneezes or sings, droplet nuclei containing the TB bacilli are expelled into the air
  • These droplets or particles, called droplet nuclei, are about 1 to 5 microns in diameter - less than 1/5000 of an inch
  • Droplet nuclei can remain suspended in the air for several hours, depending on the environment
  • The average TB patient generates 75,000 droplets per day before therapy
  • This falls to 25 infectious droplets per day within two weeks of effective therapy
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13
Q

One cough can release….

A

3,000 droplet nuclei

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14
Q

One sneeze can release…

A

tens of thousands of droplet nuclei

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15
Q

What is the percentage of infected people that will develop TB in their life?

A

10% of infected persons will develop TB disease at some point in their lives

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16
Q

Persons at high risk for developing TB disease fall into 2 categories:

A
  • Those who have been
    recently infected
  • Those with clinical conditions that increase their risk of progressing from LTBI to TB disease
17
Q

LTBI =

A

Latent TB Infection

18
Q

How does Latent TB Infection (LTBI) occur?

A
  • occurs when a person breathes in bacteria and it reaches the alveoli of lung
  • immune system keeps bacilli contained and under control
  • Person is not infectious and has no symptoms
19
Q

When does the TB disease occur?

A
  • Occurs when immune system cannot keep bacilli contained
  • Bacilli begin to multiply rapidly
  • Person develops TB symptoms
20
Q

LOOK AT THE TABLE ON SLIDE 12

A

ABOUT DIFFERENCES BETWEEN LTBI AND TB DISEASE!!!

21
Q

Symptoms of TB

A
  • Productive prolonged cough*
  • Chest pain*
  • Hemoptysis*
  • Fever and chills
  • Night sweats
  • Fatigue
  • Loss of appetite
  • Weight loss

*Commonly seen in cases of pulmonary TB

22
Q

Patients should be considered infectious if they:

A
  • Are undergoing cough inducing procedures
  • Have sputum smears positive for acid-fast bacilli (AFB) and:
    • Are not receiving treatment
    • Have just started treatment,
    • Have a poor clinical or bacterial response to treatment
  • Have cavitary disease
23
Q

Who are not considered infectious?

A

Extrapulmonary TB patients are not infectious

24
Q

Patients are not considered infectious if they meet all these criteria:

A
  • Received adequate treatment for 2-3 weeks
  • Favorable clinical response to treatment
  • 3 consecutive negative sputum smears results from sputum collected on different days
25
Q

Evaluation for TB:

A
  • Medical history
  • Physical examination
  • Mantoux tuberculin skin test
  • Chest x-ray
  • Bacteriologic exam (smear and culture)
  • Nucleic acid amplification technology
  • IFN –gamma release assays
26
Q

The two aims of TB treatment are:

A
  • To prevent morbidity and death by curing TB while preventing the emergence of drug resistance
  • To interrupt transmission by rendering patients noninfectious
27
Q

Treatment of Latent TB Infection:

A
  • Daily Isoniazid therapy for 9 months
    • Monitor patients for signs and symptoms of hepatitis and peripheral neuropathy
  • Alternate regimen - Rifampin for 4 months
28
Q

Treatment of TB Disease:

A
  • slide 19

Infectious Diseases (4th year) (19 decks)

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