08.21 - TB (Cross) - Questions Flashcards Preview

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Flashcards in 08.21 - TB (Cross) - Questions Deck (55):
1

TB culture in liquid media will show results in

2 weeks

1

How does IGRA work

Blood cells from patient are exposed to antigens from MTB and amount of IFN-gamma released from cells is measured

2

Secondary infection usually involves

Apices of lungs (higher oxygen content)

3

What protein is thought to play major role in inhibiting phagosome-lysosome function

PknG

3

What stains tears

Rifampin and related

3

What is positive PPD if no know risk factors?

>15 mm

3

What is positive PPD if HIV, recent contact, immunosuppressed?

5-10mm

4

Only evidence of primary infection in majority of patients is

Calcified lung nodule

4

Possible NRAMP1 mutation -->

Unchecked bacillary proliferation --> Bacteremia, seeding of multiple sites

5

How do TH1 cells activate macrophages

IFN-gamma

5

Why not take rifampin and pyrazinamide together

Liver toxicity

6

In XDR TB, resistance is to

INH, RIF, Fluoroquinolone, at least one other

7

Adverse effects of Ethambutol

Optic Neuritis, Vision Discrimination, Hyperuricemia

9

Function of Sulfatides (Surface Glycolipids)

Inhibit phagolysosome function

10

Rifampin and other Rifamycins are __ inducers

CYP inducers

11

Agar used for TB culture

Lowenstein-Jensen Agar

12

Progressive primary TB initially looks like

Acute bacterial pneumonia: Lobar consolidation, Infiltrates, Adenopathy

12

What is positive PPD if "at risk": homeless, nursing home, immigrant, children

10-15 mm

13

Can't drink alcohol with

INH

15

TB remains dormant until

Immune defense are lowered

17

Spread of strep

Person-to-person (coughing)

18

Virulent strains grow in characteristic ____ pattern, avirulent strains don't

cord-like

18

Most important virulence factor of MTB

Cell wall

19

Common adverse effect of Ethambutol and Pyraziniamide

Hyperuricemia

20

___ following primary infection can result in miliary/disseminated TB

Lymphohematogenous Dissemination

21

Importance of TNF-alpha

TNF-alpha inhibitor will allow granuloma to degrade, freeing and reactivating the TB

21

Common toxicity of Rifampin and Pyrazinimide

Hepatotoxic

23

RIPE =

Rifampin, Isoniazid, Pyrazinamide, Ethambutol

24

__ is produced by TH-1 cells and enables macrophages to contain the infection

IFN-gamma

25

Inhibits macrophage maturation and induces TNF-alpha release

Cord-Factor

26

When can PPD be false positive

Immunization with BCG; Infection with nontuberculous MB

28

What percent of patients who contract TB will contract from smear-negative patients

20%

29

___ response leads to granuloma formation and caseous necrosis

TH1 response

29

Rifampin could cause drug-drug interactions in ___ patients

HIV

30

__ % of patients with primary TB will develop clinically significant disease

5%

31

Which component of MTB retains AF stain?

Mycolic Acid

32

Most important determinant of whether over disease occurs

Adequacy of host's cell-mediated immune response

33

Anterior leg rash seen in TB

Erythema Nodosum

34

Cavitation / Bronchial damage more severe in

Immunocompetent patients

35

TB tx in HIV patients

RIPE for 9-12 months

37

What cell mediates tuberculin positivity on skin test

TH1

39

Vision discrimination probs

Ethambutol

41

Function of Cord Factor

Inhibits macrophage maturation and induces TNF-alpha release

42

When do we use 4 drug cocktail

Active disease, HIV

44

Hyperuricemia

Pyrazinamide, Ethambutol

45

With reduced immune response as in HIV, there are few ___ in sputum

AFB

46

Hetpatoxic

Rifampin, Pyrazinimide

47

PPD injection stimulates

Delayed type hypersenstivity by T lymphocytes

48

In HIV patients with TB, there is incr freq of ___, and absence of ___ in tissues

Incr freq of false negative sputum smears; and absence of granulomas in tissues

49

How does alveolar macrophage activate T Cell

Class 2 MHC + IL-12

50

T/F: Mycolic acid cleaves antibiotics to render them ineffective

FALSE

52

Optic neuritis

Ethambutol

53

Initial test for TB:

Acid fast; but culture should be done at same time

54

PPD and IGRA in HIV patients

False negatives in both can occur

55

In MDR TB, most common resistance is to ___; in ___ patients

INH and RIF; AIDS patients