Chapter 157 - Tuberculosis and Infections With Atypical Mycobacterium Flashcards
(47 cards)
Main cause of death of patients infected with HIV
Tb
TB is currently ranked ___ leading cause from an infectious agent,ranking higher than HIV/AIDS
9th
The highest burden of TB was in 5 countries
India Indonesia China Philippines Pakistan
In contrast to obligate pathogens, ___ do not cause disease by person to person spread
Facultative pathogens
2 most frequent forms of skin tuberculosis
Lupus vulgaris
Scrofuloderma
Most common cause of disseminated bacterial infection in patients with AIDS in the US
Mycobacterium kansasii
Incidence of TB in patients with AIDS is almost ____ than that in the general population
500 times
Local ID injection leads to delayed hypersensitivity reaction with macimum intensity by 48 hours
Tuberculin reaction aka Koch phenomenon
Tuberculin sensitivity is necessary for immunity.
True or False
False
For Quantiferon Tb GOLD test, (2) proteins are incubated for 16 to 24 hours and the amount of ___ produced by T cells are measured
ESAT-6 and CFP-10
IFN gamma
Histopath hallmark of TB
Tubercle - accumulation of epithelioid histiocytes with Langhans giant cells and caseation necrosis in the center
Only ___% of PCR positive patients respond to antiTB therapy
80%
TVC and localized forms of LV may be treated with ___
INH alone for up to 12 months
Extensively multidrug resistant TB is defined as
Resistance to at least Rifampicin + INH \+ Resistance to any fluoroquinolone \+ Resistance to second line anti Tb drugs (Capreomycin, Kanamycin, Amikacin)
First line drugs of AntiTb (4)
Rifampin/ Rifapentine/Rifabutin
Isoniazid
PZA
Ethambutol
Second line anti Tb drugs (9)
Amikacin/Kanamycin P-Aminosalicylic acid Capreomycin Cycloserine Ethionamide Gatifloxacin Levofloxacin Moxifloxacin Streptomycin
Introduced into tissue via minor wounds eg. Unpasteurized milk, tooth extraction, mucosal trauma.
Primary inoculation Tb/ Tb Chancre/ Tb Primary Complex
Ulcer with little or no tendency to heal with unilateral regional LN in a child arousing suspicion
Primary inoculation Tb/ Tb Chancre/ Tb Primary Complex
PPD of Primary inoculation Tb/ Tb Chancre/ Tb Primary Complex
‘-‘ —> ‘+’
Paucibacillary disorder caused by exogenous reinfection in previously sensitized individuals with high immunity
Tuberculosis verrucosa cutis aka Wart tuberculosis aka Prosecutor’s wart aka Lupus verrucosis
Histopath feature of tuberculosis verrucosa cutis
Pseudoepitheliomatous hyperplasia with marked hyperkeratosis, dense inflammatory infiltrate, and abscesses in the superficial dermis or within the pseudoepitheliomatous rete pegs
Typical tubercles are common in tuberculosis verrucosa cutis.
True or False
False, uncommon
Lupus vulgaris is an extremely chronic, progressive form of cutaneous Tb occurring in individuals with ___ immunity and a ___ degree of tuberculin sensitivity.
Moderate; high
On diascopy, LV shows
Apple jelly color
