03 - Microbe 36 - Mycobacterium tuberculosis LOTS OF INFO

Question 1

Acid-fast bacilli – large amounts of mycolic acids and lipids in cell wall impairs staining with aqueous stains

Answer 1

Mycobacterium tuberculosis and related mycobacteria

Question 2

look at picture on page 28 of PDF for exterior of Mycobacterium tuberculosis

Answer 2

sweet & neat

Question 3

Causes tuberculosis – world’s leading infectious disease (hundreds of millions of cases)

Answer 3

Mycobacterium tuberculosis

Question 4

Mycobacteria other than M. tuberculosis are collectively referred to as

Answer 4

MOTT

Question 5

(1) Pulmonary lesions

2) Disseminated (kidney, liver, testes, CNS

Answer 5

Description of tuberculosis caused by Mycobacterium tuberculosis

Question 6

Transmission and epidemiology of Mycobacterium tuberculosis

Answer 6

(1) Highly communicable via aerosols or dust particles containing tubercle bacilli
(2) Prevalent in AIDS patients, crowded populations (e.g. prisons), and street people
(3) Transmission in American society has been greatly affected by changes in building codes (e.g. reduced fresh air circulation) and social mores (e.g. lack of quarantine, including HIV-infected persons).

Question 7

(1) Highly communicable via aerosols or dust particles containing tubercle bacilli
(2) Prevalent in AIDS patients, crowded populations (e.g. prisons), and street people
(3) Transmission in American society has been greatly affected by changes in building codes (e.g. reduced fresh air circulation) and social mores (e.g. lack of quarantine, including HIV-infected persons).

Answer 7

Transmission and epidemiology of Mycobacterium tuberculosis

Question 8

Study page 29 of PDF in detail about Mycobacterium tuberculosis

Answer 8

did you do it? …..

seriously don’t be a turd and put down the sweet treats

Question 9

Pathogenesis of

(1) Primary tuberculosis

Answer 9

(a) Mild and often asymptomatic (flu-like symptoms possible)
(b) Bacteria are breathed into alveoli where they multiply
(c) Tubercle bacilli are ingested by resident macrophages in the pulmonary alveoli
(d) Bacteria multiply within the macrophages
(e) Macrophages containing the bacteria migrate to local lymph nodes where they encounter T-lymphocytes of the cell mediated immunity
(f) Cell Mediated Immunity slows the growth and causes inflammation – process takes about 30 days from initiation of infection
(g) Tuberculin skin test becomes positive
(h) Chest X-ray may reveal growing patches of density in the lung
(i) Bacteria are contained within tubercles – small granulomas consisting of epithelioid and giant cells. Granuloma formation is partly caused by cord factor.
(j) Spontaneous healing – calcified tubercles – occurs in about 75% to 90% of the cases

Question 10

Which phase of tuberculosis is Cell Mediated Immunity effective?

Answer 10

Primary tuberculosis

Question 11

in which phase of tuberculosis will the Mycobacterium tuberculosis be contained to TUBERCLES?

Answer 11

Primary tuberculosis

Question 12

tubercles

Answer 12

– small granulomas consisting of epithelioid and giant cells. Granuloma formation is partly caused by cord factor

Question 13

– small granulomas consisting of epithelioid and giant cells. Granuloma formation is partly caused by cord factor

Answer 13

tubercles

Question 14

in which phase of Tb will we most likely see calcified tubercles?

Answer 14

Primary tuberculosis – occurs in about 75% to 90% of the cases

Question 15

(a) No clinical symptoms
(b) No shedding of bacteria
(c) Skin test positive; chest xray probably negative
(d) No true medical disease, just potential presence of live bacteria within tubercules

Answer 15

Latent phase of Tb

Question 16

clinical disease of Tb?

Answer 16

Secondary tuberculosis

Question 17

After some time (often years after infection begins), cell mediated immunity fails to contain the infection

Answer 17

Secondary tuberculosis

Question 18

The centers of the tubercles become necrotic and advance to form acellular masses of cheesy debris – caseous material. Ghon complex – combination of tubercles in the lung and caseation in lymph nodes

which phase?

Answer 18

Secondary tuberculosis

Question 19

Ghon complex

Answer 19

– combination of tubercles in the lung and caseation in lymph nodes

Question 20

(a) After some time (often years after infection begins), cell mediated immunity fails to contain the infection
(b) The centers of the tubercles become necrotic and advance to form acellular masses of cheesy debris – caseous material. Ghon complex – combination of tubercles in the lung and caseation in lymph nodes

(c) Macrophages become more activated
i. Interleukin-1 – mediator of fever
ii. Tumor necrosis factor (cathectin) – interferes with lipid metabolism (leads to weight loss)

(d) Ghon complex enlarges and tubercles rupture into airways and blood vessels – clinical tuberculosis (about 6% of cases)
i. Caseous material coughed up
ii. Major organ involvement

(e) Rapid failure of Cell Mediated Immunity may lead to disseminated miliary tuberculosis – rapidly progressive systemic disease and death (about 3% of cases)
i. Miliary – lesions resembles grains of millet (bird seed)
ii. Occurs in less than 5% of cases; primarily immunocompromised patients
iii. Disseminates to various organs, especially kidneys, brain, spleen, and liver
iv. Usually fatal generalized infection

Answer 20

Secondary tuberculosis

Question 21

i. Interleukin-1 – mediator of fever

ii. Tumor necrosis factor (cathectin) – interferes with lipid metabolism (leads to weight loss)

Answer 21

Macrophages become more activated in secondary tuberculosis

Question 22

Ghon complex enlarges and tubercles rupture into airways and blood vessels – clinical tuberculosis (about 6% of cases)

i. Caseous material coughed up
ii. Major organ involvement

Answer 22

secondary tuberculosis or clinical tuberculosis

Question 23

i. Miliary – lesions resembles grains of millet (bird seed)
ii. Occurs in less than 5% of cases; primarily immunocompromised patients
iii. Disseminates to various organs, especially kidneys, brain, spleen, and liver
iv. Usually fatal generalized infection

Answer 23

Rapid failure of Cell Mediated Immunity may lead to disseminated miliary tuberculosis – rapidly progressive systemic disease and death (about 3% of cases)

secondary tuberculosis or clinical tuberculosis

Question 24

Miliary think fatal and think

Answer 24

secondary tuberculosis or clinical tuberculosis

Question 25

vaccine for

Answer 25

BCG (Bacillus Calmetter-Guerin) is prepared from attenuated bovine TB
bacterium. Is administered in many countries with high TB rate, but not used inUSA.

Question 26

Tuberculin Skin Test

Answer 26

PPD or Purified Protein Derivative (looking for previous immune response) Remember that previously vaccinated person will produce a false-positive

Question 27

Antimicrobic Resistance and Treatment of

Mycobacterium tuberculosis

Answer 27

(a) Due to high frequency of resistance, infections are treated with two- to four-drug regimen of antituberculosis and traditional antimicrobics: Isoniazid (INH),
Rifampin, Ethambutol, Streptomycin, etc.

(b) MDR-TB (Multiply Drug Resistant) – resistant to 2 or more TB drugs

(c) XDR-TB (Extremely Drug Resistant) – resistant to 2 or more plus
fluroquinolones and one second-line anti-TB drugs

Question 28

Mycobacteria other than ____ are collectively referred to as MOTT

Answer 28

M. tuberculosis

Question 29

unrelated to this block, but if you have a quick response for salmonella or many other microbes (12 hrs or less) think this…

Answer 29

Toxin