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AANIYA PATH > Aani Micro: Resp/TB > Flashcards

Aani Micro: Resp/TB Flashcards

1
Q

Which is a common Co-pathology if you have TB?

A

HIV

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2
Q

What gram stain is TB?

A

Gram Positive Rods

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3
Q

What should you do if you find someone with TB?

A
  • Notify
  • Negative Pressure isolation
  • BCG (live attenuated M.Bovis)
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4
Q

What are the 3 main strains of TB Mycobacterium?

A

BAT
Bovis
Africanum
Tuberculosis

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5
Q

How long does fever last in TB?

A

approx 3 months

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6
Q

Which strain of MTB is resistant to Pyrazinamide?

A

M. Bovis

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7
Q

What are the drugs used to treat TB?

A 
RIPE
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
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8
Q

Side Effects of:

Ethambutol?

A

Optic neuritis + Visual disturbances (do ishihara test)

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9
Q

Side Effects of:

Rifampicin?

A

Orange secretions
Cytochrome P450 inducer
Hepatotoxicity

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10
Q

Side Effects of:

Isoniazid

A

Hepatotoxicity

Peripheral Neuropathy - give B6/Pyridoxine

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11
Q

Side Effects of:

Pyrazinamide

A

Gout

Hepatotoxicity

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12
Q

What is the classical pulmonary lesion in TB?

A

Caseating granulomas

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13
Q

Are the atypical mycobacteria strands fast or slow growing?

A

Slow growing (and not spread person to person)

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14
Q

What is a Ghon Focus?

A

A primary lesion usually subpleural caused by Mycobacterium bacilli (tuberculosis) developed in the lung of a nonimmune host (usually a child).

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15
Q

What is the RIPE treatment regime for TB?

A

RIPE for 2 months then I+R for 4 months

RI - 6mth
PE - 2 mth

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16
Q

What is the RIPE treatment regime for TB meningitis?

A

RIPE for 2 months then R+I for 8 months

10 months RI
2 month PE

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17
Q

How to treat latent TB?

A

Isoniazid 6 months

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18
Q

What is the second line treatment for TB?

A

Injectables: fluroquinolines

other injectables:
(capreomycin, kanamycin, amikacin), Quinolones (moxifloxacin), Cycloserine, Ethionamide/Protionamide, PAS, Linelozid, Clofazamine Resistances)

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19
Q

What is the name of the pleural surface lesion caused by TB?

A

Ghon Focus

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20
Q

Which TB is resistant to just 1 drug?

A

Mono

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21
Q

Resistant to R+ I

A

MDRTB

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22
Q

Resistant to R + I and injectables?

A

XMDRTB

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23
Q

Prophylaxis against TB ?

A

isoniazid alone

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24
Q

Where is the cavitation on the lung?

A

Upper lobe

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25
Q

What can you give to induce sputum for sputum sampling?

A

Hypertonic Saline

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26
Q

What are the Atypical Mycobacteria?

A

UMA

  • M. Ulcerans
  • M. Marinarum
  • M. Avium Intracellular Complex (MAC)
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27
Q

What vaccine is given for TB?

A

BCG:
Bacille Calmette Guerin

M.bovis attenuated strain

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28
Q

Which stains are used for TB sputum microscopy?

A
  • Ziehl Neelson and Auramine

- Will show Alcohol Acid Fast Bacilli

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29
Q

Is MTB slow or fast growing?

A

Slow

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30
Q

How do you diagnose TB meningitis?

A

CT

Lumbar Puncture

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31
Q

How do you treat TB meningitis?

A

Anti-Tb meds plus Steroids

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32
Q

Which types of TB is the BCG vaccine good/bad for?

A

Bad: Pulmonary TB
Good: TB meningitis, disseminated TB, TB leprosy

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33
Q

Which gene gives Rifampicin resistance?

A

RPO gene

34
Q

If you immune system is really weak, what is the worst presentation of TB you can get?

A

Milliary (widespread)

35
Q

What is it called when you have TB in the cervical lymph nodes?

A

Scrofula (glandular swelling)

36
Q

What is leprosy called?

A

hansen’s disease

37
Q

What causes leprosy?

A

Mycobacterium Leprae or Mycobacterium Lepromatosis

38
Q

What parts of the body does leprosy affect?

A

Skin
Nerves
Limbs
Eyes

39
Q

Management of leprosy?

A

Rifampicine
Dapsone
Clofazimine

remember wild west scene with rifle, deputy badge and cloth

40
Q

How does your risk of getting active TB from latent change if you have HIV?

A

No HIV? Latent will turn to active 5-10% in lifetime

HIV + Latent will turn to active 5-10% in year

41
Q

How is M.Marinarum spread?

A

Fish tanks/swimming pools

42
Q

How is M.Ulcerans spread?

A

Insects/tropics

43
Q

How does MAC present in kids?

A

Pharyngitis/cervical adenitis

44
Q

How does M.Marinarum present?

A

Clusters of papules/plaques

45
Q

How does M.Ulcerans present?

A

painless nodules that slowly become ulcerations and hideous deformities

46
Q

Describe some extrapulmonary manifestations of TB?

A

Pott’s disease- TB of bones and joints e.g. spine/hand

Milliary TB- Lots of dots on CT & they’re more likely to have TB meningitis

47
Q

What are the clinical investigation findings of pulmonary TB?

A

Sputum tests + AAFB on ZH and Auramine
Upper lobe changes
Mediastinal lymph nodes
Caseating granulomas

48
Q

What are the features of the CURB 65 penumonia screen?

A 
Confusion
Urea >7mmol/
Resp rate > 30
BP <90  <60 
65 (more than 65 years old)
49
Q

How do you interpret the results of a CURB 65 screen?

A

1 point for each of the 5 areas.
2 points- admit
3+ point - severe

50
Q

CXR findings of bronchitis?

A

Normal

51
Q

Which organisms cause Bronchitis?

A

H.Influenza
Strep. Pneumoniae
M.Cataeehalis

52
Q

Describe how this organism would look under the microscope:

MTB

A

Gram + Rods

53
Q

Describe how this organism would look under the microscope:

Strep Pneumonia

A

Gram + Diplococci

54
Q

Describe how this organism would look under the microscope:

Staph Aureus

A

Gram + cocci (grape bunch clusters)

55
Q

Describe how this organism would look under the microscope:

H.Influenza

A

Gram -
Cocco-baccili

remember candy shop with the coccobacillus candy machine

56
Q

Describe how this organism would look under the microscope:

M. Catarrhalis

A

Gram -

Coccus

57
Q

Describe how this organism would look under the microscope:

Klebsiella Pneumonia

A

Gram - Rods

58
Q

Which organism gives rusty coloured sputum?

A

Strep Pneumoniae

59
Q

Which organism is associated with Post-Influenza infection + cavitation on CXR?

A

Staph Aureus

60
Q

Which people groups are at risk of getting Kelbsiella Pneumoniae?

A

Alcoholics

Elderly

61
Q

Which organism is associated with Birds?

A

Chlamydia Psittaci

62
Q

Which organism causes whooping cough?

A

Bordatella Pertussis

63
Q

Which groups are at risk of getting Legionella Pnemuophillia?

A

Smokers
Hotel
Pond
Water jobs

64
Q

What is the biochem of someone with Legionella?

A

Low Sodium

65
Q

What can you develop if you get infected with legionela?

A

Hepatitis

Legionairre’s disease –> organ failure

66
Q

If you have Batwing on CXR what organism could be be?

A

PCP Pneumocistic Jiroveci Penumonia

67
Q

If you have HIV which Resp tract infections are you most at risk of?

A

PCP
TB
Cryptococcus Neoformans

68
Q

If you have neutropaenia which RTI are you most at risk of?

A

Fungi (aspergillus spp.)

69
Q

If you have CF which RTI are you most at risk of?

A

Pseudomonas Auerginosa

Burkholderia Cepacia

70
Q

If you have BMT which RTI are you most at risk of?

A

Aspergilus

71
Q

If you have Splenectomy which RTI are you most at risk of?

A

H. Influenza
S. Pneumonia
N. Meningitidis

72
Q

If you see boat-shapes on silver stain, which organism is it likely to be?

A

Pneumocystis Pneumonia

73
Q

How to treat mild/mod CAP?

A

Amoxicillin or Macrolide if atypical

74
Q

How to treat severe CAP?

A

Co-amoxiclav + Clarithromycin

Cefuroxime if allergic to Pen

75
Q

Which atypical CAPs do you get?

A

Chlamydia

Mycloplasma

76
Q

How to treat atypical CAPs?

A

Macrolide or Tetracyclin

77
Q

How to treat MRSA?

A

Vancomycin

78
Q

What do cold agglutinins usually suggest?

A

Mycoplasma

79
Q

5 causes of typical Pneumonia?

A 
Meeran Says Sole Helps Kids
M.Catarrhalis
Staph Aureus
Strep Pneum
H Influenza
Klebsiella Pneumonia
80
Q

4 causes of Atypical Pneumonia?

A

My Lungs Can’t Cope

Chlamydia Pneumoniae
Chlamydia Psittaci
Legionella Pneumophilia
Mycoplasma Pneumonia

AANIYA PATH (35 decks)

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