19 - Mycobacteria and Antimycobacterial Drugs (Schlievert)

Question 1

mycobacterium characteristics

Answer 1

acid fast rods
aerobes
high wax content in cell walls 
resistant to drying
intracellular pathogens of PMN and macrophages
grow slowly

Question 2

what type of intracellular pathogens are mycobacterium

Answer 2

facultative except for M. leprae which is obligate

Question 3

what causes TB

Answer 3

M. tuberculosis and M. bovis

Question 4

why is there drug resistant TB

Answer 4

black market selling of medications and improperly treating themselves

Question 5

M. tuberculosis transmission

Answer 5

droplet infection
human to human
causes TB

Question 6

M. bovis transmission

Answer 6

from milk

causes TB

Question 7

first granuloma is called what

Answer 7

Ghon complex

Question 8

BCG

Answer 8

Bacille Calmette Guerin

attenuated vaccine strain for TB

Question 9

what type of vaccine is needed for TB

Answer 9

live attenuated, not killed because you wont get the Th1 response

Question 10

M. leprae transmission

Answer 10

human to human contact

Question 11

virulence factors of mycobacterium

Answer 11

wax d
cord factor
tuberculin
mycobactin
sulfoglyco and sulfo lipids

Question 12

wax d function

Answer 12

acid fastness, mycolic acid

Question 13

cord factor function

Answer 13

leukocyte toxicity

Question 14

tuberculin function

Answer 14

delayed hypersensitivity (Th1 activating macrophges), PPD

Question 15

mycobactin function

Answer 15

iron chelator

Question 16

sulfoglyco and sulfolipid function

Answer 16

prevent fusion of phagosome and lysosome

MOST IMPORTANT virulence factor

Question 17

disease progression of TB

Answer 17

begin with Ghon complex and productive cough
spread systemically (miliary TB) to spleen, kidney, and lymph nodes and millet bodies to liver
return to apical/subapical lungs
tubercules form granulomas with caseating centers
contained or continue to spread

Question 18

delayed hypersensitivity of TB symptoms

Answer 18

cough, fever, chronic wasting, night sweats

Question 19

treatment of tb

Answer 19

isoniazid, rifampin, ethambutol, pyrazinamide for 2 months

isoniazid, rifampin for 4 months

Question 20

isoniazid targets

Answer 20

mycolic acid synthesis (cell wall)

Question 21

rifampin targets

Answer 21

RNA synthesis

Question 22

ethambutol targets

Answer 22

cell wall

Question 23

pyrazinamide targets

Answer 23

membrane, energy metabolism

Question 24

prevention of TB

Answer 24

BCG vaccine
skin testing (Mantoux)

Question 25

side effects of treating TB

Answer 25

resistance | hepatitis

Question 26

photochromogens atypical mycobacteria

Answer 26

pigmented in light | M. kansasii

Question 27

scotochromogens atypical mycobacteria

Answer 27

always pigments but intensify in light | M. scrofulaceum

Question 28

non pigmented atypical mycobacteria

Answer 28

m. avium intracellulare | HIV association

Question 29

rapid growers atypical mycobacteria

Answer 29

m. fortuitum | hospital associated infection

Question 30

atypical mycobacteria characteristics

Answer 30

derived from nature non contagious resistant to most anti TB drugs

Question 31

atypical mycobacteria symptoms

Answer 31

abcesses and granuloma

Question 32

atypical mycobacteria treatment

Answer 32

macrolides | fluoroquinolones

Question 33

M. ulcerans

Answer 33

makes non protein toxin that causes buruli ulcer | does not heal, must be surgically removed

Question 34

leprosy spectrum

Answer 34

indeterminate tuberculoid lepromatous

Question 35

indeterminate leprosy

Answer 35

one hypo or hyper pigmented lesion | no nerve sensation loss

Question 36

tuberculoid leprosy

Answer 36

pauci bacillary multiple lesions peripheral nerve damage and loss of sensation

Question 37

lepromatous leprosy

Answer 37

mutli bacillary no immune response, nerve damage, skin thickening, loss of eyebrows, destruction of nasal septum localized on surface blindness traumatic tissue loss lots of lepra cells (macrophages full of mycobacteria)

Question 38

lepromatous leprosy patients develop what

Answer 38

erythema nodosum leprosum

Question 39

erythema nodosum leprosum is a type of what

Answer 39

type 3 hypersensitivity (immune complex disease)

Question 40

diagnosis of leprosy

Answer 40

test pain, temp, and touch sensation rash acid fast rods on skin

Question 41

leprosy treatment

Answer 41

dapsone, rifampin, clofazimine