Lecture 11 Tb Flashcards Preview

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Flashcards in Lecture 11 Tb Deck (23):
1

Tb patients slowly waste away, hence the name ______

consumption

2

tb has a thick ____ covering that prevents staining by usual gram stains. some time it stains weakly gram ___

lipid;
positive

3

why is Tb more resistant to antibiotics?

divides very slowly, most Abs kill dividing bacteria

4

____ was the first Ab discovered to kill Tb because it affects ribosomes.

streptomycin

5

____ acts on the Tb cell wall and induces nitric oxide that kills bacteria

Isoniazid (INH)

6

____ lesions are more infectious than just smear positive infections

cavitary

7

infection is most likely to produce disease in _____ and the ____

infants, elderly
(also 15-25 year olds)

8

most common presentation of primary infection? What part of the lung is it seen in?

asymptomatic;
typically lower lung (ie lower part of the middle lobe)

9

what is usually the only evidence of a primary Tb infection?

positive PPD

10

bacteremic tb is called _____. do most patients after primary infection progress to more symptoms, or do most become asymptomatic?

milliary tb;
most become asymptomatic-latent Tb

11

In 5-10% of patients with latent Tb, it will become active again. this is called ____ tb.

reactivation

12

where does reactivation tb typically present in the lung? Why? what are the usual symptoms?

upper lobes, due to higher O2 tension;
fever, night sweats, hemoptysis, weight loss (classic Tb symptoms)

13

____ lesions on CXR are common in patients with reactivation Tb

cavitary

14

extra-pulmonary tb in the cervical lymph nodes is called _____. Tb in the spine is called ____.

scrofula; pott's disease

15

The PPD is due to a _____ ____ immune response. It is measured based on ___ of the indurated skin

cell mediated;
diameter

16

false positive PPDs may be seen in patients with _____ or other mycobacterial infection. False negatives may occur in those with advanced ____, immunosuppresive therapy, or those with ____ ____

previous BCG vaccination;
HIV; active disease

17

2 other tests for latent infection:

do those with previous BCG vaccination react ?

T-spot; Quantiferon TB (measures release of IFN gamma);

nope

18

what is the gold standard for diagnosis of active disease?

culture; it takes 3-6 weeks

19

how many sputum smears for Acid Fast Bacteria are needed to diagnose or rule out Tb?

3 smears, over 8 hours apart

20

treatment of latent Tb:

Isoniazid (INH) for 9 months

21

toxicity of INH?
what to include to prevent side effects?

neuropathy, hepatotoxicity;

include vitamin B6 to prevent neuropathy

22

Standard care of treatment for active disease:
_____ for 2 months, check _____. then 4 months of _____

rifampin, isoniazid, pyrazinamide, ethambutol (RIPE);
sensitivity;
Rifampin, INH

23

____ is also effective in treating Tb.

fluorquinolones