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RES Biweekly 3 > Fouty- Latent TB infections > Flashcards

Fouty- Latent TB infections Flashcards

(75 cards)

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1
Q
A

acid fast bacilli (mycobacteria)

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2
Q

Robert ____ developed Tuberculin in 1890

A

Koch

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3
Q

_____ testing of cows and pasteurization of milk eliminated bovine transmission of TB

A

tuberculin

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4
Q

precipitated protein fraction from a single strain of human tubercle bacillus; purified and potent; non-sensitizing

A

PPD test

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5
Q

high strength PPD increases _____ positive rate

A

false

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6
Q

main symptoms of active TB

A

coughing and night sweats

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7
Q

if patient has a reaction to PPD test, what does it mean

A

they have been exposed to tuberculosis before

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8
Q

Tools required for chemoprophylaxis of TB

A

skin test
chest x-ray
meds

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9
Q
A

unable to control initial infection

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10
Q
A

controlled infection to some degree

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11
Q

what factors of TB bacilli contribute to primary infection

A

amount and how strong (virulence)

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12
Q

____ indicates they have activated adaptive immune response and have T cells that will react to the proteins in PPD

A

+ PPD

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13
Q

travels to tissue and lymph nodes and dissemination
continued replication in non active monocytes
onset of cell-mediated immunity and delayed type hypersensitivity

A

MTB

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14
Q

location of primary calcified foci

A

lower lobes

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15
Q

location of re-infection tuberculosis

A

upper lobes

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16
Q

cavitary TB location

A

upper and lower lobes

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17
Q

______ occurs while CMI/DTH controls initial infection

A

dissemination

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18
Q

____disease progresses while primary foci is controlled

A

distal

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19
Q

infection
logarithmic growth
cell mediated immune response
primary complex controlled (dormant)
bacillemia

A

active TB

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20
Q

TB alive but controlled (through granulomas)

A

dormant

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21
Q

what can cause reactivation of TB in patient

A

medications for Crohn’s, HIV, cancer (suppresses immune system)

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22
Q

breakdown of _____ due to decreased immune response and cavitary pulmonary TB in upper lobes forms

A

granulomas

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23
Q
A

cavitary TB (reactivation)

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24
Q

most common reactivation spot for TB

A

RUL

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25
how to control TB
find infected patients and treat them and isolate them
26
HIV infected or at risk close contacts of newly diagnosed tuberculosis fibrotic lesions on CXR c/w old healed TB what is considered + PPD test
>/= 5mm induration
27
what is considered a + PPD test
>/= 10 mm induration
28
low risk groups what is considered a + PPD test
>/= 15 mm
29
_____ groups should not be skin tested
low risk groups
30
Does the skin test represent a true Tuberculosis Infection? Infected without clinical symptoms and with negative cultures
latent disease
31
What is the risk of progressing to Tuberculosis Disease? Infected with clinical symptoms with positive cultures
active disease
32
no treatment (low risk, <15 mm)
33
along with IBD and Rheumatoid arthritis; increase likelihood of what
increase likelihood that TB infection will become TB disease
34
2 things to consider when asking "does the skin test represent a true TB infection"
size of induration risk of exposure
35
treatment (high risk due to exposure; >5 mm)
36
treat (high risk of exposure; >5 and 10 mm) she's a recent converter
37
when is the risk of developing TB disease after infection with MTB the highest
within the first 2 years after infection
38
Highest TB outbreak ever reported in the world Prevalence was so high everyone was infected
Bethel, Alaska
39
____ decreased progression to TB disease
Isoniazid (INH)
40
goal when there is a +PPD test:
decrease risk of developing TB disease
41
treatment (came from high prevalence country and >10 mm)
42
_____ have the same rate of progression to TB disease as that of their native country for the first 5 years
immigrants
43
high-risk _____ treated with chemoprophylaxis if in US less than 5 years
immigrants
44
treat (exposure and >10mm; but low risk of developing TB disease)
45
after 5 years, the TB disease rate of immigrants is similar to TB infected US citizens which is what
within 2 years
46
age with an increased risk for INH-induced hepatitis
50-64
47
risk of INH-induced hepatitis increases with _____ therapy
longer
48
Immigrants from high-risk countries treated if in US less than ____ years.
5
49
Immigrants from high-risk countries in US greater than _____ years are only treated if another risk is present
5
50
treat or not
treat
51
A lot of _____ in patients with previous TB infection went on to develop active TB even though they were culture negative at time you screened them
scarring
52
calcified granuloma (Ghon focus)
53
granuloma + ipsilateral calcified lymph node
Ranke Complex
54
RUL (treat)
55
treat patient with _____ lesions to decrease progression to TB disease
fibrotic
56
1. no treatment 2. treat 3. treat
57
what to do if children have been exposed but PPD test is pending
treat until get results back
58
treat (regardless of BCG status)
59
Most non-infected people vaccinated with BCG are PPD ____
negative
60
attenuated but live strain of M.bovis used to prevent TB disease in developing countries
BCG vaccine
61
used in the US determines if person has been exposed to TB measures ____ release from sensitized T cells in patient's blood
IFNgamma (assay)
62
If the T cells have never seen TB antigens before they won’t release _____
IFNgamma
63
does a negative PPD or IFNgamma assay rule out TB
NO
64
goal of PPD and IFNgamma assay
to identify patients infected w/ mycobacterium tuberculosis
65
inhale it and itrs trouble from the beginning (active TB) initial infection replicates and replicates no granulomas, no control (no activation of adaptive immune response) happens in children and immunocompromised patients die 2 months later
primary disease
66
granulomas present but no active TB disease
latent TB infection
67
re-activation of TB due to immune system being repressed
TB disease
68
important test to determine if someone has TB
chest x-ray
69
don't test low risk individuals unless what
they are going into high-risk environment
70
if TB infected (+PPD or IFNgamma), make sure they do not have TB disease (active disease) by
asking about sx's CXR sputum
71
The worst thing you can do is treat a patient for TB Infection if they have _____
TB disease (active disease)
72
treat for TB infection
73
approved treatment regimens for TB infection
Isoniazid + Rifampin for 3 months
74
Don’t repeat ____ if they already have +PPD test
skin test
75
only do CXR if patient has what
symptoms

RES Biweekly 3 (11 decks)

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