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Leila's Yr 5 Pathology > Micro 9 - Mycobacterial disease > Flashcards

Micro 9 - Mycobacterial disease Flashcards

1
Q

2 broad groups of mycobacteria - phylogenetically and clinically

A

Clinically: mycobacterium TB and non tuberculous mycobacteria

Phylogenetically: slow growing + rapid growing

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2
Q

which subtype of mycobacterium is not grouped and why

A

M.leprae, not grouped because it cannot be grown

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3
Q

MTB complex consists of

A

Mycobacterium tB

Mycobacterium bovis

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4
Q

mycobacterium TB slow or fast growers?

A

slow grower

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5
Q

which group of mycobacteria = fast growers? (<7 days)

A

Mycobacterium abscessus complex

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6
Q

Name 3 slow growing NTM

A

Mycobacterium avium intracellulare/ MAC
Mycobacterium marinum
Mycobacterium ulcerous

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7
Q

structure and shape of mycobacteirum

A

non-motile rod shaped bacteria, structurally gram +Ve

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8
Q

mycobacteria stain used for SCREENING and one used for DIAGNOSIS

A

Screening: auramine
Diagnosis: Ziehl Neelsen

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9
Q

which NTM most commonly seen in immunocompromised/HIV pts?

A

MAI/MAC

Will affect immunocompetent w/o HIV if they have pre-existing bronchiectasis/cavities

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10
Q

SWIMMING pool granuloma

A

Mycobacterium marina

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11
Q

Which NTM results in huge chronic painless ulcers

A

Mycobacterium ulcerous

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12
Q

M. abscessus/chelonae/fortuitum

What type of mycobacteria are these? when are they seen?

A

Rapid growing NTM

Hospital setting/ tattoos - skin and soft tissue infections

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13
Q

treatment regimen for NTM (RiCES)

A

Rifampicin
Clarions/azitro
Ethambutol
+/- streptomycin/amikacin

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14
Q

2 main types of mycobacterium leprae

A

Paucibacilary tuberculoid

Multibacilary lepromatous

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15
Q

Features of paucibacillary tuberculoid

A

Few skin lesions + less joint infiltration

Robust T cell response

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16
Q

Features of multibacillary lepromatous

A

Abundance of bacili
Multiple skin lesions + joint inflammation
Poor T cell response

17
Q

A 23 year old HEALTHY male is aCLOSE CONTACT of a person with smear positive pulmonary TB, What is his lifetime risk of developing active TB?

A

10%

18
Q

3 most common forms of MTB?

A

Mycobacterium TB
Mycobacterium bovis
Mycobacterium Africanum

19
Q

Skin manifestation of TB?

A

Erythema nodosum

20
Q

what is Ghon focus?

A

granuloma in the lungs of pts with pulmonary TB

21
Q

What is post primary TB?

A

LATENT TB that is reactivated >5 years later

22
Q

“millet seeds” on CXR

A

Miliary TB

23
Q

WHICH LNs most commonly involved in extra pulmonary TB?

A

Cervical

24
Q

What is scrofula?

A

lymphadenitis, some children can get this in response o BCG

25
Q

ix for clinical suspicion of TB?

A

Sputum sample x3
Endobronchial Ultrasound transbronchial needle aspiration (EBUS TBNA)
CXR

26
Q

GOLD STANDARD test to diagnose TB

A

Culture on Lowenstein Jensen medium (stain with auramine/ZN) - takes 6 weeks

27
Q

what is the TST? which type of hypersensitivity reaction?

A

Purified protein derivative, delayed type hypersensitivity reaction

28
Q

what is the Ix of choice if the patient has had BCG in the past and is clinically suspicious of TB/

A

IGRA e.g. QUANTIFERON OR ELISPOT

29
Q

disadvantage of IGRAs

A

cannot differentiate between active and latent TB

30
Q

TREATMENT OF TB

A

RIPE
Rifampicin + Isoniazid for 6 months
Pyrazinamide + ethambutol for 2 months

31
Q

SEs of rifampicin

A

orange secretions
deranged LFTs
CYP450 INDUCER

32
Q

Isoniazid SEs

A

Peripheral neuropathy - give with pyridoxine

hepatotoxicity (Drug induced liver injury)

33
Q

ethambutol SEs

A

usual disturbance

34
Q

definition of multi drug resistant TB

A

Resistance to rifampicin + isoniazid

35
Q

definition of extremely drug resistant TB

A

RESISTANT TO Rifampicin + isoniazid + fluoroquinolone e.g. moxifloxacin > 1 injectable e.g. amikaxin

36
Q

mx of MDR/ EDR TB

A

4-5 drug regimen for 9-12 months

37
Q

diagnostic challenges of HIV and TB coinfection

A

smear microscopy + culture less sensitive
TST more likely to be negative
IGRAs less sensitive

Leila's Yr 5 Pathology (100 decks)

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