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IBI Test I > Gram Indeterminate Bacteria > Flashcards

Gram Indeterminate Bacteria Flashcards

1
Q

acid fast bacilli

A

mycobacterium tuberculosis

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2
Q

why is mycobacterium tuberculosis acid fast?

A

retains stain d/t high mycolic acid content in cells

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3
Q

virculence factors: mycobacterium tuberculosis

A

cord factor
activates macrophages
sulfatides

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4
Q

cord factor

A

serpintine cord appearance in virulent M. tuberculosis

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5
Q

what are the affects of macrophage activation by M. tuberculosis?

A

granuloma formation
release of TNF-a

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6
Q

sulfatides

A

surface glycolipids that inhibit phagolysosome fusion

enable survival and intracellular replication in macrophages

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7
Q

How is M. tuberculosis transmitted?

A

inhaled respiratory droplet

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8
Q

TB patients should be placed in ____________ for containment

A

negative pressure isolation

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9
Q

TB replicates in

A

macrophages

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10
Q

Activation of macrophages by TB induces __________ by cord factor

A

phagocytosis

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11
Q

TB survives due to failure of _________________ due to sulfatides

A

phagolysosome fusion

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12
Q

TB forms granulomas with ___________ necrosis

A

caseous

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13
Q

TB forms caseous granulomas composed of

A

activated macrophages and Th1 cells

**Langhan’s cells may also be seen

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14
Q

Granulomas form to

A

contain the bacterial infection

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15
Q

Risk factors for TB

A

immunocompromised, prisoners, immigrants, healthcare workers

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16
Q

Symptoms: TB

A

weight loss, fever, night sweats, cough, hemoptysis

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17
Q

Where is the Gohn complex seen in primary tuberculosis?

A

lower lung

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18
Q

Gohn focus

A

granulomatous focal lesion seen in TB

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19
Q

TB replicates in

A

alveolar macrophages

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20
Q

Primary TB may be eliminated but bacteria often survive in

A

large caseating granulomas

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21
Q

Gohn complex

A

Gohn focus + lymph node

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22
Q

Gohn complex is seen as ________ on CXR

A

focal lesion and hilar adenopathy

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23
Q

Primary TB: inhaled droplets of bacteria are phagocytosed by

A

alveolar macrophages

24
Q

Latent TB will present with a [positive/negative] PPD skin test

A

positive

25
Q

latent TB is contained in

A

granulomas with calcification

26
Q

Patients with latent TB are __________ and have ________ CXR

A

asymptomatic; unremarkable

27
Q

Secondary tuberculosis is seen in ___________ patients

A

immunocompromised

elderly, AIDS, steroid use, biologic drugs

28
Q

Secondary tuberculosis is due to

A

failure of granulomas to contain bacterial spread

29
Q

secondary TB is seen on CXR as

A

cavitary lesions in upper lung

30
Q

miliary TB

A

dissemination and seeding of TB causing little focuses resembling millet seed

31
Q

what is it called when TB spreads to vertebrae?

A

Potts disease

32
Q

milliary TB can cause

A

Potts, meningitis, pericarditis, mediastinitis, skin lesions, hepatic lesions

33
Q

laboratory tests TB

A

PCR, PPD skin test, IGRA

34
Q

PPD

A

purified protein derivative

35
Q

The TB PPD skin test tests for

A

prior exposure and cell mediated immunity

36
Q

immunocompromised patients can present with a _______ PPD skin test

A

false negative

37
Q

positive PPD skin test diameter for patients with no risk factors

A

> 15 mm

38
Q

positive PPD skin test diameter for patients with risk factors

A

> 10 mm

39
Q

positive PPD skin test diameter for immunocompromised patients or recent contact

A

> 5 mm

40
Q

positive PPD skin tests require a _____ to confirm

A

CXR

41
Q

IGRA

A

measures amount of IFN-gamma released by T cells when exposed to antigens

42
Q

IGRA tests for

A

prior exposure and cell mediated immunity

43
Q

IGRA is ________ over PPD

A

preferred

Bacille Calmmette Geurin vaccination can cause false positive

44
Q

Treatment for TB

A

RIPE

1st line: Rifampin, Isoniazid

45
Q

no cell wall

A

mycoplasma pneumoniae

46
Q

grown on eaton agar

A

mycoplasma pneumoniae

47
Q

cell wall contains cholesterol

A

mycoplasma pneumoniae

48
Q

transmission: mycoplasma pneumoniae

A

droplet

49
Q

occurs in young (<30) individuals living in close contact

A

mycoplasma pneumoniae

50
Q

CXR looks worse than patient presentation would suggest

A

mycoplasma pneumoniae

51
Q

symptoms: mycoplasma pneumoniae

A

slow onset: fever, headache, nonproductive cough

52
Q

CXR: mycoplasma pneumoniae

A

pathy/diffuse interstitial infiltrate
atypical pneumonia

53
Q

IgM antibodies agglutinate RBCs under cold temperature

A

mycoplasma pneumoniae

54
Q

causes hemolytic anemia

A

mycoplasma pneumoniae

55
Q

treatment: mycoplasma pneumoniae

A

macrolides, fluoroquinolone

56
Q

is penicillin effective against mycoplasma pneumoniae?

A

no, no cell wall

IBI Test I (18 decks)

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